Thursday 24 October 2019
[Graham Stringer in the Chair]
Plastic Food and Drink Packaging
I beg to move,
That this House has considered the Sixteenth Report of the Environment, Food and Rural Affairs Committee, Session 2017-19, Plastic food and drink packaging, HC 2080.
It is a pleasure to serve under your chairmanship, Mr Stringer. It is also a pleasure to see the new Minister in her place and the shadow Minister, the hon. Member for Ipswich (Sandy Martin), here as well.
Plastic waste has been at the forefront of public interest for the last few years. There is, quite rightly, outrage about the impact of plastic pollution on the natural environment and about the amounts of recyclable waste exported, only to pollute other countries. The Environment, Food and Rural Affairs Committee set out to examine whether enough is being done to reduce the use of plastic and properly manage waste in the food and drink sector.
It is worth reflecting on the fact that plastic is everywhere for a reason. For food and drink, it is lightweight and flexible, and it ensures high standards of hygiene. We should also remember that when plastic is used properly, it can help us to prevent food waste, which is a big contributor to carbon emissions. We do not want to increase the amount of food that is wasted.
Plastic’s durability is both a blessing and a curse. The properties that make it useful for food preservation also mean that it lingers in our seas for decades. We need to manage our waste better. More materials need to be captured for recycling. The Committee was supportive of the Government’s proposal to introduce consistency in recycling collections and simpler labelling for consumers. We would like to see that across the whole country.
Unfortunately, it is not particularly clear how much of our plastic waste is actually recycled. The Government often cite a 46% recycling rate for plastic packaging. However, businesses that produce fewer than 50 tonnes of packaging per year do not have to report on how much they place on the market or recycle, so there is a gap in the figures. We think that threshold should be lowered to 1 tonne of packaging. I ask the Minister to consider that.
On top of that, 60% of what is classed as “recycled” is actually exported abroad. Members will have seen media reports that our plastic exports can end up in countries where they are landfilled or burned instead, which can really affect villagers and others in those countries. We must recycle our own waste. We do not currently know how much plastic waste is recycled—it is likely to be less than 46%—and, if we cannot measure recycling, we cannot know whether policy changes are having the right effect. It is vital that we get the right figures.
The introduction of a deposit return scheme was another focus of our inquiry. We heard convincing evidence that a DRS would boost recycling of plastic bottles. I am convinced that if plastic bottles are to be recycled, that must be done through a reverse-vending machine so that the same bottle can be made again from that plastic. Hon. Members may ask: why am I saying that? It is because most recycled plastic is not used to make the same item again; we get a much lower-quality waste plastic. We need to ensure that the label, the top and all those things are recyclable so that we can make another bottle out of the bottle that went through the reverse-vending machine.
We have also heard concerns from local authorities that taking that valuable material away from kerbside collection would undermine the viability of their wider recycling efforts. We therefore recommend that the Government monitor carefully the financial impact on local authorities of introducing a deposit return scheme.
In Northern Ireland, we already have kerbside collections—indeed, we have moved on marvellously with recycling materials. It is incredible what a household can do when it commits to recycling. Has the Chair of the Select Committee had an opportunity to look at any of the other regions—Northern Ireland, for instance—where kerbside collection is already in place and working well?
We did not look at the situation in Northern Ireland, although I understand that that is a good method of collection. In England, we found that because there are so many authorities with so many different contracts, there are totally different methods for what is recycled where. To put on my local government hat from many years ago, local government likes its own views and ways of dealing with things. However, in this case, we need to know how to recycle properly.
The hon. Gentleman makes the point that Northern Ireland is naturally a more compact, smaller community. Recycling works quite well in Wales, where again there are fewer authorities, which can come together better. Given its size and the number of its authorities, England is more difficult. Somehow or other, the Government must send down an edict to local authorities to pull them together. Some local authorities will have long-term contracts that will take a while to get out of, but the Government must pull them together, because what we recycle and how we do it here in London is totally different from what we do on the farm back in Somerset, for instance.
During our inquiry, witnesses regularly made the point that kerbside collections and all the legislation can be in place, but if the general public do not take part, stiff penalties in some shape or form are required to force them to. Otherwise, we will have a major problem—more so than now.
I agree, but before we bring in stiff penalties we must ensure that there is a similar system all over the country. Otherwise, people can quite rightly say, “We didn’t know what we had to do.” The hon. Gentleman is right in his assumption, but let us get the system right. That is clear. There is the old adage, “You can lead a horse to water but you can’t make him drink.” We must keep going with people to make sure they are more concerned. They are concerned about plastic and recycling and want this all to happen, but we must make sure that some of those who are not quite so keen will take part in future. We need a system with a penalty, but let us get the system similar first—perhaps a carrot before the stick.
I have spent quite a bit of time working with schools in my constituency, and Commercial Primary School and Carnock Primary School are leading the field on the green agenda and sustainable development. In the last few weeks, we have also seen one of the first plastic-free hotels in Dunfermline.
There is great enthusiasm at grassroots level for recycling and how we dispose of plastic waste and waste in general, but the point, which I think the report covers, is: how do we get that linkage between local authorities, central Government and policy to ensure that we are working with communities and people, with everyone buying into the concept of looking at our environment in general and seeing how we can improve it?
The hon. Gentleman is exactly right. We must ensure that we explain what we are doing and what it will achieve, and that the public buy into it. I had one of my local schools come in the other day from Axminster, and they said, “What can we do for the environment?” I said, “Why don’t we work to get a water fountain in the middle of Axminster, so that you can refill your bottles rather than buying new plastic ones?”
Schools and others are buying into all this, and students go home and say to their parents, “Why haven’t you recycled this? What have you done?” There is nothing like children being critical of their parents. This is all good stuff, and I think it will work, but we need to work together to make things similar across the country—I keep repeating that, because otherwise people do not actually know what to do.
Our plastic food and drink packaging inquiry also looked at the alternative materials being used instead of plastics. Some were conventional materials, such as paper, and others were more novel, such as compostable plastics. It is easy to think that the solution is to ban plastics, particularly single-use plastics, but, as always, the truth is more complicated. We need to think about what replaces those plastics, and whether they are actually better for the environment.
The society we live in now is in danger of just doing things that make us all feel better—it is right that we do those things, but they must actually be better for the environment and not worse. We need to look at that very carefully. For example, replacing plastic with heavier paper or glass could increase the carbon emissions associated with transporting those products. Compostable plastics are becoming more common, and hon. Members will have noted that here on the estate we have switched towards compostable packaging in our catering facilities. They have probably seen it.
The downside of compostables is that they require a separate waste stream so that they can be industrially composted. They need to reach 60° before they actually compost, and if we are not careful they can end up contaminating recycling, if there are non-compostable plastics as well. They work well at a pop festival or an event where they can all be collected, but when they are mixed, it can be a problem. We found throughout the inquiry that there is a real lack of consumer understanding of waste infrastructure. On this point, we have recommended supporting compostables for “closed loop” environments such as here in Parliament, where we can better control how they are disposed of. That is essential.
The Government and industry have focused on recycling and replacing plastic packaging, but less emphasis has been placed on reducing plastics in the first place. Yet, as we know from health issues, prevention is often better than cure. We therefore looked at how to reduce the amount of single-use plastics that we use. I ask the question, “Do we always need to wrap our carrots and potatoes?” We do not. Other vegetables such as cucumbers perhaps need to be wrapped in plastic so that they last longer. We need to be thoughtful about all these things.
Consumers are increasingly interested in reusable and refillable packaging. We have already seen the shift from disposable bottles and coffee cups towards refillable drinks containers, and that is very good news. Some retailers are experimenting with refillable packaging for food too, which would mean taking our own containers when we go shopping, just as most of us now take reusable carrier bags. We must also ensure that they are clean and that retailers are able to put food in them with confidence. Some vegetables, as I said, will keep longer if wrapped in plastic, but others can be sold loose.
However, refillable packaging is a bit trickier, because it will require a huge shift in the way we shop and consume. People want to use less plastic, but they also like to maintain their lifestyle, so it is a question of getting this exactly right. We like the freedom of a disposable, on-the-go culture, and we do not all have time to remember to wash and bring our containers when we go to a supermarket. On top of that, there are questions about how many times a container would need to be reused before it becomes environmentally better than single-use packaging. We have therefore called for the Government and the Waste and Resources Action Programme to take a closer look at refillable packaging systems and find out what actually works.
As my hon. Friend will know, the food and drinks manufacturing sector is the largest manufacturing sector in our country. It is very innovative, it is a big employer and exporter, and it clearly has a major role to play in the reduction of the use of plastics. Does he agree that it is important that the Government work with the industry to look for solutions, rather than trying to impose solutions on it, as those might not actually work?
I thank my hon. Friend for that intervention. He does a great deal of work with the food and drink sector, and he is right. It is a question not only of working with the food and drink sector in this country, but of imports. As we change things—as we start to put taxes on plastic, and so on—we must ensure that our businesses here are not affected more than businesses that make the goods that we import. That is very important, and I am certain that the Minister has taken a great deal of notice of what my hon. Friend has said.
We need to take the industry with us, because they are the ones who will create the packaging in the first place and will then need to have a method of disposal through the retail system; they will need to work with retailers and consumers to ensure that we get it right.
To conclude, we in Parliament need to lead by example, by removing all single-use packaging from our catering facilities. Will the Minister work with House authorities to help us achieve a plastic-free Parliament?
I thank the Chair of the Select Committee for giving way. Will he join me in congratulating Surfers Against Sewage for all the work it has done on a plastic-free Parliament? We have been doing it through the all-party parliamentary group on ocean conservation. As he says, there is some way to go—that is why I brought my own cup today rather than using the compostable ones, just in case they are not composted—but the organisation has done a good job in trying to get the parliamentary estate to change its ways.
I thank the hon. Lady for her intervention; she is an excellent member of the Select Committee and I know she has also done a great deal of work on food waste. This is important. We have all worked together with the authorities here to deliver a much better system, but we must ensure that we carry on to conclude it. That is why I ask whether the Minister will work with House authorities to help us to achieve a completely plastic-free Parliament. We have made a lot of progress, but we need to finalise it.
We also need consistency in recycling collections and simpler labelling for consumers—not just putting a green dot on things, because a green dot means nothing; it just means that somewhere along the line, something might have been recycled. It does not mean that that particular item is recyclable. When does the Minister expect new systems to be introduced—knowing her, it will be immediately—and will she commit to ensuring that businesses that produce 1 tonne of packaging per year report on how much packaging they place on the market? That is important, because a lot of plastic is coming through that is not being measured.
Finally, the most important message of our report is that reduction of plastic in the first place is the best way to prevent plastic pollution. Will the Minister work closely with the industry to ensure that we stop the use of unnecessary plastics in the first place?
I commend my hon. Friend the hon. Member for Tiverton and Honiton (Neil Parish)—Tiverton is obviously first—for securing the debate and for all he does with his Select Committee. This is such an urgent issue, and the report is timely. It contains some helpful work and recommendations, and I hope that the Government take seriously and implement them all. It is urgent that we cut plastic pollution.
I declare an interest: I am the Member for west Cornwall and the Isles of Scilly, in the most beautiful constituency—that is undisputed.
I will not comment on Tiverton and Honiton again. I say that my constituency is the most beautiful because, apart from a short section that neighbours the constituencies of my hon. Friends the Members for Camborne and Redruth (George Eustice) and for Truro and Falmouth (Sarah Newton), we are entirely surrounded by the sea. However, although ours is a beautiful, unspoiled part of the world where every Member—as well as most of the country—gladly chooses to holiday during the summer, the truth is that we do see plastic pollution.
My researcher loves going to Scilly; he is going there for Christmas. He was showing me in the office just now that it is 12 °C in Scilly and the sun is shining. He was rather wishing, given the weather today, that he was there. Beautiful as Bristol is, I might have to agree with the hon. Gentleman.
I can, but the clouds sometimes obscure it.
On the Isles of Scilly, where it is 12 °C and warm and beautiful, there is no hiding the fact that plastic pollution is taking its toll. I am the parliamentary species champion for the Manx shearwater, a ground-nesting bird that was in significant decline. We have been able to turn that decline around on the Isles of Scilly because we have been able to get some of those islands—they are both inhabited and uninhabited—completely clear of plastic pollution and rats. As a result, the birds are now thriving, and last year they were the fastest recovering species at risk in the UK. They nest only in two parts of the British Isles. That is an example of the immediate benefit of getting on top of this problem for wildlife.
I was shocked by something that I learned when I went on a visit to Nancledra school, which was holding an eco-fair. People took shovelfuls of sand—anyone who looked at it would have assumed that it was just ordinary sand from the beach, as it was—and poured it into water. As they did so, the plastic came to the top. Anyone who has not done that experiment should do so when they—or their member of staff—go on holiday to Cornwall. If we pour sand that looks perfectly ordinary into a bucket of water, we will find it startling how much plastic is in that water. That plastic harms our marine life, so we really must get on top of it. We will never get on top of all the minute plastic pieces that are in the sand but, as my hon. Friend the Member for Tiverton and Honiton says, we can certainly stop contributing to that.
In my constituency and around the country, as we heard from the hon. Member for Dunfermline and West Fife (Douglas Chapman), who is from way up north—I have not been here long enough to learn all the pronunciations—there is a huge amount of effort and will from people on the ground. Right across the Cornwall coastline, organisations continue to undertake regular beach cleans, and they are now moving inland because of all the plastic caught up in bushes and hedgerows. We will see less and less plastic there, but mainly because people are working so hard to clear it up.
Every year, I run an outdoor adventure camp, and I have done for 20-odd years. This year, we decided that we would be plastic free. I cannot tell hon. Members how difficult it was to run a camp for 100 young people and not bring on to the site unnecessary plastic packaging. Schools tell me exactly the same. Mounts Bay Academy in Penzance held a huge event to celebrate its plastic-free status, but staff kept telling me that they could not get suppliers to stop sending into the school stuff that was wrapped unnecessarily in single-use plastic. We need to address that, and I hope that the Government will do so as a result of this report.
There are a couple of things I want to commend. Penzance was the first town to become plastic free. Surfers Against Sewage was started in Cornwall 20 or 30 years ago, campaigning to clean up our beaches. We were pumping raw sewage into our beaches, but we have been able to address that and now we have blue flag beaches that are the most beautiful in the country. SAS staff have now rightly turned their attention to plastic, and they have done amazing work. They have been into Parliament—I am sure that most Members will have met them already—to make the case for bottle deposit schemes and legislation from the Government to change things. SAS also supports the industry to move away from unnecessary plastics.
Despite all that effort, herein lies the problem: there is still no let-up in the use of unnecessary plastic packaging. Supermarkets continue to use it for no good reason. If there is a good reason, I would be delighted if someone—perhaps the Minister—could correct me. I am an old-fashioned person of faith, and I believe that we are provided with what we need. Fruit and veg are provided with their own natural wrappers and protections. Why do our supermarkets choose to shrink-wrap cucumbers—or swedes or turnips, depending on the part of the country—and other fruit and veg? It is completely unnecessary, and it amazes me that we continue to do that.
There is a counter-argument for some of this packaging, particularly when it comes to cucumbers. The hon. Gentleman will find people who say that if we are trying to address food waste, such packaging is the way to keep cucumbers fresh. However, the Select Committee had a really interesting session with people who are developing alternatives, and the seaweed-based alternatives in particular were absolutely fascinating. Perhaps that is the route to go down.
I completely accept that. Cutting down on food miles and getting better at using food when it is available, and from close to where it is supplied, might be part of the solution to food waste. I agree with the hon. Lady, however, and I will come to the alternatives in a moment.
I am most intrigued by the hon. Gentleman’s comment, and what he said was true. Those of us who come from the countryside probably expect our potatoes to have a bit of soil with them, and maybe a wee distortion or a growth on either side. That does not really bother us. However, the housewife does not see things as we who live in the countryside see them. The housewife sees things as products and, with respect, she probably has no idea where they come from or what they are like; they just have to look good. As far as the supermarkets are concerned, products must look good; as we all know, that may not make them good.
I will not criticise my own Government, but I learned home economics in school, which taught me what cauliflowers and so on look like when picked from the ground. There is a joke around in Cornwall about children thinking that bottles of milk are literally collected from nests, rather than that milk comes from cows. However, the point has been properly made that we need to get to a place where people understand—or have the opportunity to learn, if they choose to—how food is produced, and how they can use it in a much more natural way. I will not say much more on that.
I come back to the intervention about shrink-wrapped cucumber. I accept the points that have been made, and that we can use alternatives to keep cucumbers fresh, but we cannot use the same argument for tinned vegetables. Baked beans, which are already wrapped in tins, are wrapped again in plastic. I cannot see the need for that. Some producers find that cardboard is a useful alternative. I think that the supermarkets and food packagers need to be leaned on by the Government to get rid of unnecessary single-use plastic. I do not think that there is any excuse for using it. I do not want to pick on Mr Kipling, who was a favourite of mine when I was younger, but he likes to wrap his cakes and biscuits in far too many wrappers. It would be great for people to take action about the lack of movement, not only from the Government but from some of the companies that continue to use unnecessary plastic.
The hon. Member for Dunfermline and West Fife—I am sorry; I am really not familiar with his constituency—made a good point about the enthusiasm of local people. There is enormous enthusiasm and determination among the people I meet to cut plastic where possible, so I have three, or possibly four, simple asks.
First, what I hear from people is that when they buy biodegradable or compostable products, they want to know what that actually means. If we buy biodegradable nappies, as I did, how long does a nappy sit in our compost heap before it disappears? I put the nappies in my compost heap—and then I had to put them in the bin about four years later. We need to be really clear with people and have a proper legal definition of what biodegradable actually means. How long should we expect something to take to rot down? What is compostable?
That is what we found in the inquiry. Compostable plastic has to reach 60°C; it has to be industrially composted. That will work, but not in someone’s garden. That is why the material has to be collected separately. Somehow or other that has to be explained to the public, because at the moment they are rather confused about the whole matter.
I agree, and I intended to refer to the report picking up on that point, so I thank my hon. Friend for the intervention. First, therefore, let us get that issue properly sorted out and the information communicated clearly, so that we have practical measures to deal with items described as compostable and biodegradable.
We need to support the innovation of alternatives. A number of organisations have come into this place in the last year or two, as we have talked more and more about alternatives to plastics, and demonstrated what they have produced—we heard about seaweed earlier. We need to find a way whereby Government can really encourage that research and development.
I refer back to what the Chairman of the Select Committee, the hon. Member for Tiverton and Honiton (Neil Parish), said: we have to get the system right. But supermarkets, of course, are sometimes governed by public health in what they should do, so it is a multi-agency decision on all of this. There needs to be a partnership, as the hon. Member for St Ives (Derek Thomas) has said, to try to relieve the difficulty that we have with plastic, but this is a multi-agency situation.
I agree, and I welcome that intervention. It is true that there will be some single-use plastic that we cannot avoid. If we go into a hospital, we will find items that are wrapped for what are obviously good reasons. I will name-check now if I am permitted to, Mr Stringer. There is a large outlet—retailer—in my constituency called Thornes. It sells a lot of fruit and veg and all sorts of other items. It decided, very early after the Government launched their 25-year environment strategy in January 2018, that it would not use single-use plastic, and it has moved away from it, including for its fruit and veg. That outlet certainly compares in size to a small supermarket, so if it can do it, it must be possible for supermarkets to take greater measures than they already do. But I accept that we need real leadership from Government, and urgently.
I have two or three more asks. We need legislation—I hope that we will do this through the Environment Bill—to ban unnecessary single-use plastic. That is the only way we will get businesses to really respond and urgently develop the alternatives. We also need legislation to ensure that all remaining plastic that is necessary—my hon. Friend the Member for Tiverton and Honiton was right to say that there is necessary plastic—can be recycled. We still purchase plastics and products that cannot be recycled, and that just needs to come to an end.
It would be remiss of me not to commend some of the supermarkets for what they are doing. In my constituency, in the constituency of my hon. Friend the Member for Upper Bann (David Simpson) and, I suspect, in everyone’s constituency, the large supermarket chains, come Friday and Saturday night, have a system whereby if a product, such as fresh fruit or veg, is coming near its end of life, they disperse the produce among community groups. As I said, that is done in my constituency, and it works exceptionally well. It does away with the loss of the product and someone gets the benefit of it. Supermarkets are chastised, but sometimes they do a lot of good things.
I am not here to beat up the supermarkets, and if I have done so, I apologise. I welcome the intervention, and the hon. Gentleman is right: in Cornwall, we have an excellent project—it is very early in the embryonic stage—called Hive, which is doing just what he describes. Already this year, it has taken 8 tonnes of food from the local supermarket, turned it into nutritious meals and distributed it to families who need it.
There is some really good work, and supermarkets are playing an important part in that. Obviously, it saves them a lot of money as well, because they then do not have the costs of having to dispose of the products. All I am saying is that much more can be done across supermarkets and retailers. If there are people, as there are in Cornwall, who are determined to reduce their use of single-use plastic in particular, they must be allowed to do that. They must be able to buy items and products that are not unnecessarily wrapped.
I want to draw the House’ s attention, before I conclude, to one fantastic piece of technology that has been developed in the UK, supported by Government funding. Called the HERU—home energy resource unit—it is the solution when we just cannot get rid of or cannot stop altogether the use of plastics and other items in our house. This appliance can at the moment be purchased and go alongside our home—outside—and every piece of rubbish from our home, such as nappies, coffee cups and plastic packaging, can be dropped into it. The rubbish is incinerated, which deals with the 60° issue, and then that generates energy for our home. At the moment, it is a brand-new product and an expensive appliance to purchase, but it would be great, as Government move forward on the issue of decarbonising our nation and addressing the question of how we get rid of waste sustainably, to look at an innovation such as the HERU to see how that can be used to support homes and communities and even to help councils to get on top of the challenge that they have.
I shall return to the Isles of Scilly, as it were, once more. They collect very little in the way of council tax from their residents: just over 2,000 people live there. They spend hundreds of thousands of pounds every year moving rubbish from the Isles of Scilly to the mainland and wherever it goes from there. A piece of technology such as the HERU could be the solution for the Isles of Scilly in seriously reducing their carbon footprint, but also their costs, so it would be great if the Minister could continue to work with me and with our right hon. Friend the Chancellor of the Exchequer to see how we can support the Isles of Scilly to use such innovation to address many of their challenges.
Thank you, Mr Stringer: you have been very patient.
It is a pleasure to serve under your chairmanship, Mr Stringer, and a great pleasure to follow my hon. Friend the Member for St Ives (Derek Thomas), whose constituency includes the Scilly Isles.
Plastic packaging and its impacts on the environment, for many of us and certainly in my case, burst into our consciousness when Sir David Attenborough put a spotlight on the impacts that our activities are having beneath the waves. Perhaps it is because my hon. Friend and I both represent coastal constituencies that that really hit home. I probably do not have quite as much coast around my constituency as he does, but I do have in my area the extremely sunny Selsey, the Witterings, which also has blue flag beaches, Bracklesham Bay, Chichester harbour itself, which is an area of outstanding natural beauty, and Bosham. This issue really matters to people in my constituency, because the coast really matters—for many reasons, ranging from tourism to fishing.
Those programmes about plastic really did cut through. So much so that some surveys have even suggested—get this—that the British public care more about plastic pollution than Brexit. Obviously, being in this place, we find that incredibly hard to believe, but apparently 82% of people are now trying to reduce the amount of plastic packaging that they throw away, and I know from meeting people across my constituency that they feel the same. Everyone wants to do the right thing. I am always struck by the fact that the British people are very good at trying to do the right thing, but often we confuse them with mixed messages. The education that we give is not sufficient. The situation is so difficult because we have introduced systems that are non-standardised and are incredibly difficult for people to follow.
The recent report from the Environment, Food and Rural Affairs Committee, chaired by my hon. Friend the Member for Tiverton and Honiton (Neil Parish), whom I thank for securing this debate, highlights the huge amount of work ahead of us if we are truly to get to grips with this issue. I fully agree with many of the recommendations in the report. It was a very thorough report, on which the Chair and the other members of the Select Committee are to be congratulated.
On consistency across the UK and trying to have a more joined-up approach, in Scotland, we are about to launch the deposit return scheme. As the hon. Member for Strangford (Jim Shannon) has said, there are good examples from across the country, which we can evaluate and spread wider, to share that benefit across the UK.
The hon. Gentleman is right. We have an opportunity to standardise a new scheme—well, an old scheme that has been brought back—that we are not introducing. I hope the Minister takes note that we should be working together to ensure we have standardised schemes.
We need to get to grips with the current situation. As my hon. Friend the Member for St Ives mentioned, the report rightly emphasises the current inadequacy in the monitoring of plastic usage. That impacts our ability to accurately calculate our usage. Some surveys suggest that we are putting about 2.2 million tonnes of plastic packaging into the UK market each year, but we need to do more to know exactly how much we are using.
Our priority must be to use less plastic. There is a whole host of solutions to help us achieve that. We have seen fantastic results from the 5p plastic bag, which led to a significant reduction, with 15.6 million fewer bags used since 2015. There is scope to extend that to other forms of packaging and products where suitable alternatives exist.
We all know that immediate changes can be made. The thing that bugs me is crisps: every packet I buy is half empty. Introducing regulation around packaging, so that it is designed around product size, instead of making things look bigger, would be a good start. Many shops and some supermarkets are going further.
As my friend, the hon. Member for Dunfermline and West Fife (Douglas Chapman), mentioned, some of the schemes run in Scotland have been done in Northern Ireland, too. The plastic bag charge has been incredibly successful in Northern Ireland, to such an extent that the use of plastic bags has reduced to about 20% or 25%—a massive reduction. It has been successful because people want it to be successful, because children tell their parents that they must do it and because that money goes back into society and can help environmental projects. We should be pushing more on that.
I completely agree. As well as being influenced by children, consumer behaviour can take some time to change. I remember coming home from this place late at night and I would never have plastic bags with me to go shopping—I am sure many of us have done the same—but I have solved that problem by buying one of these little fold-up bags, so at least I always have that. We also have reusable plastic bottles. I have lost mine again today. I do not know how many I have lost. I am sure my impact on the environment in lost water bottles is greater than what I have saved, so now I have taken to reusing this plastic bottle. I think I am not supposed to refill it, but I do anyway.
There are plenty of opportunities for us to move towards being plastic-free. Everywhere we go, we see more and more plastic. Once we become conscious of it, that is it, we see it everywhere. Some supermarkets are moving to packaging-free aisles and even the funny-shaped potatoes, which my friend, the hon. Member for Strangford (Jim Shannon), referred to—I have seen them with a little bit of soil on them, but I am sure that is just for authenticity.
Last year, I opened Stansted Park farm shop, in my constituency. The whole business has an environmentally friendly ethos. Most of their produce is loose. It has drastically reduced all plastic use. There is a future model in package-free and refill shops, similar to the old-fashioned way. My grandmother used to have glass jars for everything. We used to take them to the shops and they would be refilled from huge sacks. I can see the hon. Member for Strangford nodding, because he remembers the same. We are obviously around the same age.
E-commerce could play an important role in this area by delivering food in reusable boxes on a subscription or bespoke order model. We need to do something about e-commerce. I do not know if you have noticed this, Mr Stringer, but when I order my stuff, it comes in several different deliveries, with several different delivery drivers coming to my house two or three times a day. Maybe I am just a prolific shopper, but they could deliver them by a more transport-friendly mechanism. Moving to online shopping does not necessarily mean it is environmentally friendly, so we need to encourage those businesses, as well.
The humble cucumber has been mentioned a few times. Apparently, wrapped, they have a shelf-life of 15 days when chilled, but only nine days when unwrapped. That is true. They go all soft when they are unwrapped, and they are inedible. Removing plastics in some cases can increase other forms of waste. I do not think there is much market for an end-of-life cucumber. Other forms of waste and emissions are released when we consider the entire carbon budget of products. We need to get this right.
I am still driving a diesel car. Why? Because I followed the advice and bought a diesel car. Now, of course, I cannot get rid of it. The market share of diesel cars went from something like 14% to 65%. Everybody followed the advice and then we realised the advice was wrong. We must get the advice right. There are many alternatives, as the hon. Member for Bristol East (Kerry McCarthy) suggested, such as seaweeds and potato starch wrapping. That innovation will come the more the Government incentivise innovation.
Most of us have the ambition to use less single-use plastic. Many people now use alternatives. I try to use less in my day-to-day life. I mentioned my water bottle. I also gave up plastic for Lent. It was a nightmare. It was incredibly different and I had to change my whole life for six weeks. I chose an easier option this time, because it was so difficult to give up plastic for six weeks. We need to make this easy. We are consumers and we simply will not do it, if it is incredibly difficult and everybody must carry around glass jars and things that do not fit into everyday life.
The hon. Lady referred to consumer behaviour. As I was saying to the hon. Member for Dunfermline and West Fife, the greatest scourge of this modern age is probably takeaways. I am in the takeaways regularly, but I am talking about the materials they use to wrap the product in. I am old enough—I do not think the hon. Lady is, despite what she says—to remember fish and chips wrapped in newspaper, and they tasted great. This system does not allow that to happen. Some of the takeaway companies have come up with some ideas for reducing the products they use. I think the Chairman is looking at me—I think this is an important point. If we want to do something specific and great, we should look at methods to reduce takeaway packaging. That would make a magnificent change to the disposables market.
I completely agree. There were some mentions of takeaways in the report. We could also not have as many takeaways. That is another thing that has changed in the last 20 to 30 years: we eat a lot more takeaway food. It is not very good for us, so there are many reasons, not only environmental, to cut out takeaway food to some degree, and to use more locally sourced products and to cook ourselves. My hon. Friend the Member for St Ives mentioned home economics. I cannot say that my home economics classes were very successful. When I brought my rock cakes home, my father said he now understood where the name came from and I have not made a cake since.
It was harsh, but, unfortunately, it was true.
Making it easy for people to use less is the first thing. Recycling has a major role to play. We have all said that we need to standardise recycling. Between my home in London and my home in Petworth what and how I can recycle is completely different. When I go back to my parents in Knowsley, their system is not only different, but the opposite of what I do at home in Petworth, so I am always putting things in the wrong bin. Even things such as colours could be made so much easier. We have allowed every council to design it. I think that is driven by the design of the equipment at their local recycling centre, what it can do, and how it manages bottle tops and various bits of plastic. That has driven the standards, just by what local authorities have invested in for their recycling facilities.
As part of the endeavours to increase recycling rates, the Government have proposed a new tax system to ensure that at least 30% of packaging is made from recycled material, and I fully support that direction of travel. However, I also think that the Committee’s recommendation to have a more modulated tax system might be more effective in incentivising the use of a greater percentage of recycled material.
We have talked about the deposit return scheme. When I was reading about it, I remember thinking, yet again, “That sounds almost exactly like what used to happen many years ago.” I remember the Alpine lemonade man coming round when I was a child. The bottles then were glass. We used to collect them; in fact, it was the only way we made any pocket money. In fact, for today’s children, there would be a financial incentive for them to collect all of this plastic if they could make some money out of it.
There is not a single school that any of us go into in which we are not asked about insects that are no longer around, which we never even knew existed. Children today are so well educated on the environment; indeed, they are already forcing a generational change. We have a beach school at Chidham, run by one of my schools, and I will ask the staff if they have done the sand experiment for our area. We also have forest schools. I go to schools in Southbourne, Sidlesham, Harting, Loxwood and Rake, and they all have eco-warriors and eco-councils. The questions I get asked in schools are the hardest questions I get; I can talk about Brexit all day long, but with some of these environmental questions, the children have studied to a much greater degree than we ever did. In fact, we did not do any of that in school and now we are struggling to catch up. The children really have a fantastic approach and I am pretty sure that if they were incentivised with cash, they would make sure that they collected everything for deposit return schemes, because it would be a good way of topping up their pocket money.
The 1st Chichester Brownies unit in Christchurch wrote to me recently to ask me to support its plastic promise, which of course I have agreed to do. It aims to raise awareness of plastic pollution and to reduce our reliance on single-use plastics. So those children are not only telling their parents what to do but telling their MPs what to do, which is very welcome. In the letter I received, it was obvious that the Brownies were very excited by the deposit return scheme; they really welcomed it and I can see them going round in their uniforms to pick up all the plastic, and making some cash in the meantime. Probably, that cash will go to good causes, because that is another thing that children get involved in.
I will conclude by emphasising the importance of international co-operation in tackling this issue. Currently, of the estimated 8 million tonnes of plastics that enter the oceans each year, the US, the UK and Europe collectively contribute about 2%. Therefore, the Government’s investment of over £60 million to help the Commonwealth nations improve their waste management is vital and is the right approach. We have to show leadership and there is much we can do to help other countries. That would also make a massive impact. I hope that we can continue our domestic journey of self-improvement in this area, and I believe the best way to instil change abroad is to lead by example at home. I also look forward to seeing the technology and innovation that will rise to this challenge, to make sure that we free our world from plastic pollution.
As always, Mr Stringer, it is a pleasure to serve under your chairmanship.
I, too, welcome the Minister to her place. I am cautiously optimistic—maybe even optimistic—that she has the ability to deliver improvements on environmental issues for this Government, and that is not a first: I believe it.
I congratulate the hon. Member for Tiverton and Honiton (Neil Parish) on securing this particular debate. I agree with the hon. Member and I share his concerns on the gap figures, our export figures and the systems of collection. I think that we are all on the same pilgrimage on this matter. As a point of information for him, a water fountain will be installed in my constituency by Scottish Water on 31 October. I might be going to another destination that day—maybe even one from the Prime Minister—but I hope that I can manage to get back to my constituency. It is exactly the same thing as the hon. Member for Chichester (Gillian Keegan) mentioned—people will be able to fill their bottle of water in the street, as was normal further back than she can go. Fountains were common in every town and city.
Regarding the other interventions, in particular that by the hon. Member for St Ives (Derek Thomas), I am extremely intrigued to hear about the schools the and initiatives that are happening; I will come on to that issue later on.
The hon. Member for Chichester was absolutely right about the 5p charge on plastic bags. That initiative has been a success and the easiest way to witness that success is to consider the lack of plastic bags lying about the streets. Before, there were so many that it was a pitiful and disgraceful sight. We could see them around every supermarket; indeed, flung about everywhere we went. So I am impressed by the hon. Lady’s little bag and I might purchase one myself soon.
The plastic waste and the crippling cost of it to our planet, with debris that lasts forever, simply has to cease. If we want to change the world, we should get busy in our own little corner of it; I have believed that for a very long time and we should all do that.
At this point, I must declare a non-financial interest. I am a member of CGI, the community green initiative, in Falkirk, and of the Communities along the Carron Association, or CATCA. I am also trying to establish youth climate ambassadors in Falkirk schools, and an all-party parliamentary group on youth action and climate change, to make children’s voices heard in this Parliament, the devolved Administrations, local authorities and possibly even—with a bit of good luck—at COP 20 next year in Glasgow.
The Committee’s report highlights that it is important to engage with young people about recycling, because they often educate their parents, and we must be mindful of that.
I am just looking at a document on the sustainable development goals: No. 4 is on education and No. 13 is on climate change. No. 4 says that all learners should
“acquire the knowledge and skills needed to promote sustainable development”.
In Scotland, that fits very well, for example, with the curriculum for excellence, whereby all schools encourage their pupils to be responsible citizens. So, regarding my hon. Friend’s proposed all-party group to support young people in their efforts, he can put me down to be No. 1 on the list. I am sure that some other Members will also be happy to join him in his efforts.
I thank my hon. Friend for that intervention. I agree with him; in fact, it has already been very encouraging to see the number of Members who have requested to join the APPG. We must engage with future decision makers, who will come from all pairts, not just from middle-class backgrounds, and with children who have got little voice. The point of the APPG is to bring that out. I have met the director of education in Falkirk. He will try to get all the local schools to participate and try to identify children who normally do not have a voice, and to bring them forward to participate.
Even going round various schools, such as St Bernadette’s primary school in Falkirk, I have been astonished by seven and eight-year-olds, with their in-depth knowledge of what is happening, and what they knew about palm oil and the devastation it causes to the Amazon, the lungs of the world. They are aware of what is going on and Greta Thunberg must be praised for her efforts on this issue; she has brought it into our living rooms.
All of us know of the very successful environmental leaders and community litter clean-up organisations in our constituencies. There are many such examples of volunteers across Falkirk, the rest of Scotland and indeed the world. I believe that a world conversion is taking place in how we treat this planet and how we lead our lives. That behavioural change is happening, and not before time, because we just do not have time on our side.
What impact do the real ultimate decision-makers have on our daily lives, to reduce waste? Well, I will have to get a wee bit political here, Minister, because the austerity measures of successive Tory Governments have held local authorities back and restrained them from delivering improved recycling services in England. Spending on the environment has been cut by 20% and half of English local authorities are planning further cuts to services.
I will quote the evidence from St Helens Council to the Housing, Communities and Local Government Committee:
“When faced with a desperately strained social care system…trying to look after elderly people…and increasing numbers of children being taken into care, issues such as recycling rates cannot possibly be considered a priority.”
That statement should worry everyone here and I hope that the Minister will address that concern when she sums up today. Taxes are the price that we all pay for a civilised society. Austerity affects the poorest in society for the mistakes of the richest. Local authorities should not be forced into making those choices.
Standardising and simplifying the collection of material for recycling has been identified as being key to improving kerbside recycling rates. There is an opportunity to nudge us all into better habits. We are at a pivotal moment in time and we need to start ridding the planet of the filth we are creating. Two or three Members have referred to our collections systems. I have met professionals, partners and stakeholders, whether that is here in Parliament, at conferences or at the Environmental Audit Committee. All agree that a new waste collection system needs to be designed. We certainly would not want to start from here with the system we have.
The conclusions of the Committee’s report highlight inconsistency in collections. It is impossible for consumers to understand the on-pack recycling labelling scheme. We heard that the binfrastructure should be harmonised. A traffic light, colour-coded system was suggested, where the colour symbol on a bottle or paper cup could be matched to the appropriate colour-matching bin lid. That nudge would take the confusion and dilemma out of thinking, “Which bin do I put this product in?”
As manufacturers move to make packaging simpler and easier to recycle, colour coding could be added to all packaging to simply tell people which bin disposable items go in. For example, I have to look at the bottom of this plastic cup to see where it should go. Imagine a harmonised colour-coded bin system at airports, bus stations, train stations, football and rugby grounds and venues across the country. Will the Minister tell the Chamber whether that suggestion has been discussed at any level in Parliament?
The SNP Government in Scotland are leading by example. We take the environment very seriously in Scotland. We aim to make Scotland a zero-waste society with a circular economy, and we have ambitious targets in place to make that vision a reality. The Scottish Government are committed to minimising the population’s demand on primary resources and maximising the reuse, recycling and recovery of resources, rather than treating them as waste. There are ambitious targets in place for reducing waste and increasing recycling. For example, by 2025, we want to reduce total waste arising in Scotland by 15% against 2011 levels, to reduce food waste by 33% against 2013 levels and to recycle 70% of the remaining waste, sending no more than 5% of the remaining waste to landfill. Those are ambitious targets, but furthermore, we aim to match the EU ambition for all plastic packaging to be economically recyclable or reusable by 2030.
For information, the Scottish Government have banned personal hygiene products containing plastic microbeads and have launched a consultation on a ban on plastic-stemmed cotton buds. We are keen to follow best practice and improve standards. Scotland’s people expect that, and the recent EU plastics directive will be adopted imminently, leading to the banning of plastic straws, stirrers and other throwaway items.
The Scottish Government support the EU Commission’s vision that all plastic packaging should be easily recycled or reusable by 2030. We are a founder member of the plastics pact. Scotland is also the first part of the UK to commit to introducing a deposit return scheme for drinks containers, and we aim to have that up and running within the next two years. The purpose of that scheme is to increase the quantity of target materials captured for recycling and improve the quality of material captured. That will allow for high-value recycling, and, most importantly, build and encourage wider behavioural changes in the use of materials to deliver the maximum economic and social benefit to Scotland.
Order. May I ask the hon. Gentleman to bring his speech to a conclusion within the next couple of minutes so that there is equal time for the Labour spokesperson and the Minister? I have divided the time from the start of his speech to the end of the debate approximately into three. I would be grateful if he began to bring his speech to a close.
That is lucky, because my voice is beginning to give way anyway. There is real concern that Brexit poses a real threat to environmental standards in the UK, with DEFRA being singled out as the least-prepared Department for the UK’s departure from the EU. The best way for us to achieve our environmental ambitions is to ensure that Scotland’s devolved powers continue to be respected.
It is a pleasure to serve under your chairmanship, Mr Stringer.
I was delighted to read this report, and I congratulate the hon. Member for Tiverton and Honiton (Neil Parish) and his Select Committee on its production. It is wide-ranging, insightful, accessible, level-headed and challenging —all in just 41 pages of actual text. I actually enjoyed reading it; I apologise to any Members who might think I need to get out more. I fully support the emphasis that the report puts on using deposit return schemes to increase the quality and value of recycling, and I thank the hon. Gentleman for emphasising that today.
I hear what the hon. Member for Strangford (Jim Shannon) is saying about the importance of working co-operatively with councils. That needs to come in before the strategy is created, as well as during the operation of any waste strategy. I agree with the Chair of the Select Committee about ensuring that a convenient and effective regime is in place for people to use before we start to impose any penalties on people for not using it. I agree with the hon. Member for Dunfermline and West Fife (Douglas Chapman) about the necessity for education and public information, to ensure that people know how the regime is meant to work.
The hon. Member for Carlisle (John Stevenson) said that he did not want us to impose things on people. Of course we need to work with industry and retailers, but we also need regulation to prevent bad practice from crowding out and undercutting good practice.
My office and I ran a survey of small businesses in my constituency, and we discovered that many small business people are keen to support that work. They would be interested to read the report, although perhaps not quite as interested as my hon. Friend. Their issue, however, was that they wanted leadership from central Government. It is wonderful to see the level of agreement among the different parties represented in the Chamber today, but does he agree that what is needed is that leadership?
I absolutely agree. Far too much of the discourse about waste and the environment has been couched in terms that sound as though they are intended to make people feel guilty. We do not need to make people feel guilty; we need to put in place the regimes that enable them to do the right thing. I very much welcome the comments of my hon. Friend the Member for Bristol East (Kerry McCarthy) about the importance of Parliament’s setting a good example. That can extend to us as Members of Parliament—not only here in Parliament, but in our constituencies.
The hon. Member for St Ives (Derek Thomas) spoke about the unspoilt countryside in Cornwall, which I have enjoyed, like almost everyone else in this country. The important issue of plastic litter is clearly one of the public drivers in the debate about waste, and that is one of the good reasons why deposit return schemes are effective. In Germany, more than 98% of applicable packaging is recycled through deposit return schemes. As the hon. Member for Chichester (Gillian Keegan) pointed out, we could have people scouring the countryside, picking things up and ensuring they were not left lying around.
There was some discussion about local foods. The day before yesterday, I was rather distressed to see a response from DEFRA about Brexit, saying that we will need to rely more on local food and mentioning our ability to change over to root vegetables. I would support that, but they referred to cabbages and leeks as root vegetables; given that, I am not sure quite how much guidance we will get from DEFRA about what we should be eating. I absolutely agree about the need to get away from wholly unnecessary packaging and I am sure—well, I hope—that any strategy that the Government bring in will help to address that.
I also agree with the hon. Member for Chichester that people want to do the right thing. I had experience of that in Suffolk when we introduced a three-bin doorstep collection system, and there was an enormously high level of compliance. If we do the right thing, we will get people to comply with the regime.
The past year has been a bit of a roller-coaster ride for waste, and I feel we are on one of the high-speed sections at the moment—I very much hope that the wheels do not come off. A year ago, I was asked to take on the role of shadow Minister for waste and recycling. Within weeks, the Government published their strategy document “Our Waste, Our Resources”. Arising from that have been several extensive consultations, and several petitions and debates have arisen as the general public have made us all aware of the seriousness with which they take the issue.
Running in parallel with all that, the EFRA Committee committed to an in-depth examination of many of the trickier issues, of which the report is the result. Now, of course, we have the new Environment Bill, part 3 of which, on waste and resources, covers many but not all of the issues raised in the report. I say “covers”, but not necessarily “resolves”. I am certain that the work that went into the report and the evidence collected by the Committee were very valuable in informing the new Bill, but there are clearly concerns in the report, which I share, that are not yet resolved in the Environment Bill.
The report is extremely timely as it can inform any amendments that Members might wish to make to the Environment Bill; I am sure that there will be some. I will mention a few of the main themes, and ask the Minister for her reaction. First, and most importantly, the report is not complimentary about the Government’s lack of focus on waste reduction as the first priority. The industry tells us that there has been a significant reduction in the weight of some packaging, but that does not necessarily translate into a reduction in the environmental impact; if a turtle suffocates on a plastic bag, it makes little difference whether that plastic bag weighs one gram or two grams. Substituting plastic for card may well reduce the weight of the packaging but not its carbon footprint.
Between 2000 and 2010, there was a revolution in the recycling of waste in this country, driven largely by the landfill tax. During that revolution, household recycling rose by 235%. The landfill tax was a weight-based system. It was straightforward to understand and simple to administer, but recycling has plateaued for the past 10 years and it is time to move on to new, more effective ways of dealing with the problem. The highest priority has to be reducing the amount of waste that we generate, not just its weight. I ask the Minister whether the Government recognise the need to move away from weight as the prime factor in waste targets, and whether carbon impact might not be a better measure.
Secondly, I concur with the findings of the report, which, while clearly recognising the carbon footprint of plastic packaging and the potential environmental impact of plastic waste that is not properly disposed of, points out the danger of demonising plastic and letting other materials off the hook. As the report says, we urgently need more information about the overall life-cycle impacts of various packaging solutions, and the figures quoted in various parts of the report—and the inconsistencies between some of them—clearly demonstrate that we cannot rely solely on data from the industries involved to inform policy decisions.
There needs to be a far more effective independent research and data regime for waste and resource use. More significant investment in the area is likely to save huge amounts in developing our waste policies in the future. I challenge the Minister to tell us whether the Government intend radically to increase the resources available to the Waste and Resources Action Programme as a matter of urgency, and what other research and development investments in waste management the Government are contemplating.
Thirdly, the report rightly highlights the laxity of the current reporting regime for producers, with the threshold for reporting on packaging set far too high. I would be interested to hear whether the Minister believes that the statutory duty to comply with whatever waste regimes are introduced through the new Environment Bill should apply to all—or almost all—producers, or whether, once more, a substantial number of businesses will simply escape the system.
Fourthly, the report examines in some depth the problems associated with compostable plastics. The desirable disposal methods for compostable plastics and for recyclable plastics are completely different, and it is essential that they should be kept separate. Yet there is very little recognition of that in the Environment Bill, so I would be interested to hear from the Minister whether she will be guided by the report in amending the relevant sections of the Environment Bill when the time comes.
Finally, an issue that is touched on in the report, and has been mentioned by the Chair of the Select Committee, but is not, I believe, given sufficient emphasis, is the lack of recycling facilities in the United Kingdom, and the tragic impact on our oceans caused by the export of waste to countries that were clearly not equipped to deal with it in a sustainable way. That issue has, however, been extensively covered in a previous report this year from the Environmental Audit Committee, so I understand why the EFRA Committee would not want to repeat those findings.
There is plenty more that I could say about this excellent report, but most of it has been said by others already, so I will take my seat and listen with interest to what the Minister has to say.
Thank you, Mr Stringer; it is a pleasure to serve under you today. I will endeavour to leave a minute for my hon. Friend the Member for Tiverton and Honiton (Neil Parish), whom I must thank for introducing the debate and for all the work of his Committee. I was previously a member of the esteemed EFRA Committee, and I know what excellent work it does and how important this inquiry was in informing what is, as we can tell from today’s debate, an engaging and really important subject. As constituency MPs, plastic packaging is a subject that so many people come to us about, so the information was—and is—really useful. The Government will publish their formal response shortly.
Clearly, plastic from packaging is a really serious issue. It makes a huge contribution to the overwhelming amount of plastic in the world around us. Some really excellent points have been raised today, as they were in the inquiry, but I wish to assure hon. Members that progress is being made—hopefully I will make that clear in what I will say—and leadership is being shown on the issue.
First and foremost, we have set out our ambitious 25-year environment plan to eliminate all avoidable plastic waste within the lifetime of the plan. For the most problematic plastics, we are going faster. In the resources and waste strategy for England, which was published last December, we committed to working towards all plastic packaging placed on the market being recyclable, reusable or compostable by 2025.
We have already made good strides. We banned microbeads in cosmetic and care products. I thank the hon. Member for Falkirk (John Mc Nally), who was very involved in that campaign, as was I on the Environmental Audit Committee. Of course, waste and recycling is a devolved matter in Scotland, but we worked together on that. We will also ban plastic stirrers, cotton buds and straws by 2020.
I will mention four areas of overhauling the waste system. We have had four major consultations on that. People say, “Why do you keep consulting?” but we have to have the data before we know what the right steps to take are. We have consulted on the consistency of recycling collections, which has been mentioned by so many Members. That consultation had a phenomenal response, and we intend to introduce consistent collections in 2023, subject to further consultation. That will be in the Environment Bill, with further consultation, and is a firm commitment.
That is a good point. Members touched on funding. We will give increased powers to local authorities, fully funded through the producer responsibility scheme, which I will go on to talk about. They should not fear; they are going to be a key part of this. As so many Members have referred to, achieving this alignment is critical to the future of the plastics world. That is all being listened to and consulted on, and there will be further consultation in the environmental improvement part of the Environment Bill.
The Government also carried out a consultation on producer responsibility, which will be a radical reform for producers of packaging. It will put the onus entirely back on them to be responsible for what happens to their product, how much recyclable material it contains, where it will go at the end of its life and all that.
On a point of clarification, I understand that the EU is currently reviewing both the extended producer responsibility rules and the essential requirements in the packaging waste directive. How does that fit with the reviews that we are carrying out here if we are to leave the EU?
I urge the hon. Lady to look at the detail of the producer responsibility scheme and the consultation. We will develop our own bespoke system. This is all being done in conjunction with businesses, and there is a great deal of support for it.
A point was raised about the thresholds for reporting the amount of packaging waste. Some consultation has been done on that and feedback has been provided, and I assure my hon. Friend the Member for Tiverton and Honiton that information will be available in the near future. Similarly, we want consistent labelling on packaging so that consumers know what to recycle, in order to reduce the confusion that everyone keeps talking about regarding what is and is not recyclable. Another consultation is being carried out on that to gather yet more data.
We have also consulted on the deposit return scheme—one of those critical subjects that everyone seems to contact us about. The details of that scheme will come forward in the Environment Bill, with a view to introducing what we hope will be the best system in 2023. There will be a further, final consultation on that in the second part of the Bill to make sure we get it right. As I am sure Members are all aware, there is so much to this: what are we going to include? Will it be glass? Will it be plastic? What does the industry want, so that the scheme is usable by them when they gather all the material? It is not quite as straightforward as people think, but it is definitely coming forward.
I just wanted to address the point, which I think was made by the hon. Gentleman, about local authorities no longer being required to collect DRS material. Obviously, their new systems of collection will be funded through the producer responsibility scheme, so I hope that puts Members’ minds at rest.
Her Majesty’s Treasury has also consulted on a plastic packaging tax on the production and import of plastic packaging, to encourage the use of more recycled content. DEFRA’s proposals will work to increase the quality and quantity of the supply of recycled material; the plastic packaging tax will work in parallel, meaning that the amount of recycled material has to be incorporated into products. If producers do not reach the right level, which is purportedly going to be 30%, they will pay a tax.
I will now move on to the Environment Bill.
I will take as much time as I need, but I thank the Minister for her comments. My hon. Friend the Member for Falkirk (John Mc Nally) mentioned the EU directive on single-use plastics, which is a policy that the Scottish Government support. Beyond 31 October, what does the Minister anticipate will be the view of the UK on keeping pace with environmental policy across the rest of Europe? Obviously, we will still be trading with other member states, and in this case the directive is a force for good. The Minister has talked about bringing in something as an alternative to the directive, so what would that look like?
We have committed to maintaining our environmental standards, and will always keep a weather eye on what is going on in Europe. We will be moving on in our own way, but it is crucial to maintain very high standards in all these areas and we have committed to do so in the waste strategy, the Environment Bill and the 25-year environment plan.
I hear Members say, “It is all very well having all these consultations, but how do you bring them into practice?” As I have mentioned, we will make these measures a reality through the Environment Bill. All the measures I have mentioned—deposit returns, producer responsibility and consistent gathering—will come forward in that Bill, which will be quite radical in getting rid of the “take, make, use, throw away” world that we live in and introducing a much more circular economy. To respond to the point made by the shadow Minister, the hon. Member for Ipswich (Sandy Martin), many of those measures will, of course, result in less waste being produced in the first place.
Much has been said about consumer confusion, and my hon. Friend the Member for Tiverton and Honiton and the shadow Minister mentioned biodegradable plastics in particular, which I hope will be addressed as part of dealing with the labelling issue. It is an area in which data is so important—what is biodegradable? What do things break down into? What do they produce in the soil, and what runs off into the water? All those questions need to be carefully researched. As a consequence, the Government published a call for evidence in July 2019 to help consider the development of the standards and the certification that might be given to biodegradable and compostable plastics. That call for evidence has only just closed, on 14 October, and its findings will be published in due course.
I was very interested in the point about nappies made by my hon. Friend the Member for St Ives (Derek Thomas)—I used washable nappies for my first child, and it nearly killed me because it was such hard work. We will need to address the issue of proper biodegradable nappies in the future. I also wanted to mention the 5p charge, which demonstrated how bringing in such a measure can cause a paradigm shift, making the whole of society change how it acts.
My hon. Friend the Member for Tiverton and Honiton mentioned his water fountains, and I commend him on those; they are a great idea for his local area. He may want to contact Water UK, which advises on introducing water fountains in public and the refillable bottle scheme in cafes and shops. The shadow Minister and I share our bottles in common, and I was one of the people who worked on the plastic-free Parliament initiative—lots of Members did that, across all parties—and on giving up plastics for Lent, which was very hard. Those are great initiatives, and they are moving forward.
I also commend the UK Plastics Pact, the first initiative of its kind in any European country, which is run by the Waste & Resources Action Programme and supported by 80 Members. It contains key issues and objectives for 2025, including the elimination of problematic or unnecessary single-use packaging through design and innovation; for 100% of plastics packaging to be reusable, recyclable and re-compostable; for 70% of plastics packaging to be recycled and composted; and for there to be an average of 30% recycled content across all plastics packaging. Its endeavours are excellent. I know that Scotland was an early member of that group, and it has got a lot of support from businesses including Waitrose, Morrisons and Tesco. Many of those companies are trialling loose and unpacked vegetables. I still use my Somerset wicker basket, which I try to mention in any debate I can possibly get it into, rather than plastic bags. I have run a one-woman campaign on this all my life; we should all have a wicker basket, which also help to take in carbon through growing the willow for the baskets.
A lot of funding and effort is going into research and development and into innovation, which are absolutely key to reducing our plastic use, as has rightly been said by the shadow Minister and many other Members. Already, £20 million has gone into a plastics research and innovation fund, £20 million into a plastics and waste innovation fund, and £60 million into the smart sustainable plastic packaging challenge. A lot is going on in this space, and I commend and welcome it.
This is a complex area, but I assure Members that I feel we are making progress. If Members join in with the Environment Bill, we will get some measures through that will change our lives.
I thank all Members for participating; there has been much cross-party support today. We all want to reduce the amount of plastics we use, to recycle more and to make sure that the Government take action.
I welcome the Minister’s enthusiasm in her new role, and I also thank the shadow Minister, the hon. Member for Ipswich (Sandy Martin), for actually reading the report—perhaps we should recommend it to all Members of Parliament. I thank my hon. Friends the Members for St Ives (Derek Thomas) and for Chichester (Gillian Keegan) for speaking, and the two members of the Select Committee who are present for their support.
Motion lapsed (Standing Order No. 10(6)).
Diabetes: Tailored Prevention Messaging
[Ms Karen Buck in the Chair]
I beg to move,
That this House has considered tailored prevention messaging for diabetes.
It is a pleasure to serve under your chairmanship, Ms Buck. It is good to see a group of MPs here who have made the effort and taken the time to come to a Thursday afternoon debate. I am pleased to see the Minister in her place. As she knows, I am particularly fond of her as a Minister and look forward to her response. I have given her a copy of my speech, so we can perhaps get some helpful answers. I thank her in advance for that. I am also pleased to see the shadow Minister, the hon. Member for Washington and Sunderland West (Mrs Hodgson), who is always here, and other right hon. and hon. Members who regularly come to diabetes debates.
I am particularly glad to see the right hon. Member for Leicester East (Keith Vaz), who chairs the all-party parliamentary group for diabetes, of which I am the vice-chair. We have many things in common. Not only are we both type 2 diabetic—I make that clear at the beginning—but we are faithful fans of Leicester City football club. We have followed it for years, and it is third in the premier league. Tomorrow night, as I understand, it plays Southampton away, where I hope Brendan Rodgers will do the best for us again.
We are here to discuss diabetes. I have been a type 2 diabetic for 12 to 14 years or thereabouts. I was a big fat pudding, to tell the truth—I was 17 stone and getting bigger. I enjoyed my Chinese and my two bottles of Coke five nights a week. I was probably diabetic for at least 12 months before I knew I was. When I look back, I can see the symptoms, but I never knew then what the symptoms were—I was not even sure what a diabetic was. When the doctor told me that I was a diabetic, he said that there were two things to know. They always tell people the good news and the bad news, so I said, “Give us the good news first.” He said, “The good news is that you can sort this out. The bad news is that you’re a diabetic.”
I went on diet control and stayed on it for four years. When I talked to my doctor again, he told me that the disease would get progressively worse. Even after four years of diet control and dropping down to 13 stone—about the weight I am now, although I am a wee bit lighter at the moment, because of not being that well for the last couple of months—I went on to metformin tablets. A few years later, they were no longer working, so he increased the dosage. He also said, as doctors often do, “You might have a wee bit of bother with your blood pressure. You don’t really need a blood pressure tablet, but take one just in case.” I said, “Well, if that’s the way it is, that’s the way it is”, but he said, “By the way, when you take it, you can’t stop it”, so it was not just about blood pressure.
I say all that because diabetes is about more than just sugar level control. It affects the arteries, blood, kidneys, circulation, eyesight and many other parts of the body. If people do not control it and do not look after it, it is a disease that will take them out of this world. That is the fact of diabetes.
I congratulate my hon. Friend on securing the debate. He is an assiduous attender; he attends so much that I think the Speaker of the House said on one occasion that he thought my hon. Friend actually slept in the Chamber. He is alluding to his personal circumstances, but I and other hon. Members have raised the issue of juveniles and underage individuals who have an obesity problem that, over time, begins the process of type 2 diabetes. Although we need to tackle the problems in adulthood that he is raising, we also need to tackle them among children.
My hon. Friend is absolutely right. The figures that he and I have indicate that almost 100,000 people over the age of 17 live with diabetes in Northern Ireland, out of a population of over-17s of 1.6 million. We know it is more than that and that there are a lot of diabetics under 17, so he is right to bring that up. Northern Ireland has more children who are type 1 diabetic in comparison with the population than anywhere else in the United Kingdom.
I congratulate my hon. Friend on securing the debate. He referred to having been a big fat pudding; well, I probably am, but we will not go there. Importantly, we have young children in schools who need insulin, but there is a difficulty with teachers and classroom assistants giving it to them. What more can we do about that? How can we encourage the education people to do it?
I know the Minister will reply to that, because that is one of the questions that I had hoped to get an answer on.
On the Monday before last, we had a diabetes event in the House. Before I came over, some of my constituents said, “Will you go along to this event about diabetes? It is really important, because some great things are being done in some parts of England and we would like to know about them.” When I got there, the people were most helpful and informed me that Northern Ireland has one of the better type 1 diabetes schemes, which is reaching out to 70% of people. As we often do in Northern Ireland, in this case we have a scheme in place that is almost voluntary. We have an un-functioning Assembly, which is disappointing, but we have a system whereby that scheme is working. Some of the things that we are doing, we are doing quite well.
There are 4.7 million people living with diabetes across the UK, each of whom should be treated as an individual. In Northern Ireland, we have 100,000 people with diabetes in that 17-plus bracket, but obviously it is more than that when it is all added up. Every day across the United Kingdom of Great Britain and Northern Ireland, 700 people are diagnosed with diabetes; that is one person every two minutes.
I had a good friend—he is not in this world any more, but that is not because of diabetes—who was a type 1 diabetic. He ate whatever he wanted and I always said to him, “You cannot eat all those things.” He said, “Oh, I can. All I do is take an extra shot of insulin.” I said, “That’s not how it works!” I do not know how many times I told him that. My three hon. Friends—my hon. Friends the Members for East Londonderry (Mr Campbell), for South Antrim (Paul Girvan) and for Upper Bann (David Simpson)—will know who it is, so I will not mention his name. He was very flippant about the control of his diabetes, but it seemed to work for him. I could never get my head around the idea that an extra shot of insulin seemed to cure the problem.
I thank my hon. Friend for bringing this important debate to the Chamber. My wife is a type 1 diabetic who is insulin-dependent. She has already—she is a bit younger than me—lost a kidney, because of lack of control, which can cause problems. That needs to be identified: control is vital, and it is important for people to monitor regularly. New technology is available that can actually give readings constantly, as people go. It is important that people start to use the available technology, so they do not have to take more insulin than they need, but can take it only when it is needed.
Like my hon. Friend, my wife is younger than me. It must be a Northern Ireland DUP MP thing—we look for younger wives to keep us young. I am not sure if that is right or wrong, or if it is politically correct to say that, but my wife is nine years younger than me. She understands the issue of me and diabetes.
Some 10% of people with diabetes have type 1 and 90% have type 2. I will refer to both throughout my speech, and I encourage hon. Members to do the same and to acknowledge the different factors at play with each. We can manage type 2 with medication, provided we control what we eat and what we put in our bodies. Of those living with diabetes, we have the broadest cross-section of society. The condition affects all genders, ages, ethnicities and financial situations. However, too often I see that policy makers and clinicians fall into the trap of treating people with type 1 or type 2 diabetes as homogenous groups that will respond to the same approach and message, but they respond in different ways.
During this debate I want to focus on four things: the primary prevention of type 2 diabetes; the need to offer different messaging to ensure that the support is appropriate for each individual living with diabetes; the necessity of preventing the complications of all forms of diabetes; and innovations in technology—there is marvellous technology —and patient pathways that can improve outcomes for people living both type 1 and type 2 diabetes. I wish that I had known 12 months before I was diagnosed that the way I was living—the lifestyle, the stress—was putting me at risk. We all need a bit of stress; it is good and keeps us sharp, but high stress levels with the wrong eating and living habits is harmful. I do not drink fizzy lemonade any more because it was one of the things pushing me over the edge. That was probably why I lost most of the weight fairly quickly.
Let us talk about prevention. Today more than 12 million people are at increased risk of type 2 diabetes across the UK. More than half of all cases of type 2 diabetes could be prevented or delayed. If I had known a year before my diagnosis, I could have stopped the downward trend in my health, but I did not know, and I wish that I had done. Many in this House offer leadership on type 2 diabetes prevention; the right hon. Member for Leicester East is certainly one of them. England is a world leader on this front, having recently committed to doubling its national diabetes prevention programme.
I was pleased to attend a roundtable discussion last summer, chaired by the hon. Member for Enfield, Southgate (Bambos Charalambous), at which we considered the link between obesity and diabetes and the importance of tailored messaging for the different subsets of the population. During the discussion I met the inimitable Professor Valabhji, the national clinical director for obesity and diabetes at NHS England, whose leadership in this space should be celebrated. I put that on the record because his knowledge and help for those around him, and his research into and development of how we deal with diabetes, are incredible.
For people with type 2 diabetes, there is the additional aspiration of achieving remission. I echo colleagues’ congratulations to the deputy leader of the Labour party, the hon. Member for West Bromwich East (Tom Watson). We watched him almost shrink. One day I stopped him and said, “Tom, is everything all right?” He was losing so much weight, but it was his choice to diet as he did. He is an inspiration for many people because of what he has done, and I commend him for it. The concept of remission can be alienating, however, because it is not possible for every person with type 2 diabetes.
Central to the effectiveness of all types of support for the individual and the wider population is the messaging used, which is what this debate is about. Tailored messaging should be developed for the sub-groups most at risk of type 2 diabetes. For example, those in the most deprived areas of the country are nearly 50% more likely to be obese and have type 2 diabetes than those in the most affluent areas: there is type 2 diabetes in areas where people do not have the same standard of living.
Obesity is responsible for around 85% of someone’s risk of developing type 2 diabetes. Additionally, south Asians are six times more likely to develop type 2 diabetes than Europeans are. It is a well-known cliché that men are not so open or proactive—I can say this is true—about their health needs, and men are 26% more likely than women to develop type 2 diabetes. I am willing to speculate, as one who fell into that category, that that is in part due to messaging not being in a format that reaches men. I did not know what it was, did not know what it meant, did not know what the symptoms were, but it was happening.
We need to focus some of the messaging on the importance of prevention and the risk of type 2 diabetes for men. Will the Minister commit to ensuring that all messaging to support those with type 1 and type 2 diabetes, as well as for type 2 diabetes prevention, is tailored to the relevant sections of our society?
I have to manage my diabetes every day. I take my tablets in the morning and at night. I am careful about what I eat. By and large, I manage it. I check my sugar levels every morning. The doctor tells me to check and I do it every day so that I know where I am. I am a creature of habit; I do it all the time so that I know exactly where I am. Some days it is out of kilter, probably because I transgressed and had a cream bun when I knew it was the wrong thing to have. None the less, we do such things.
On self-management, the average person with diabetes will spend just three hours a year with a healthcare professional. That means that they will spend most of their time managing the condition themselves and will need appropriate education. The right hon. Member for Leicester East chairs the all-party parliamentary group on diabetes. He organised a seminar where we looked at healthcare professionals and how people manage their own condition and therefore need appropriate education. The current delivery of structured education does not reflect the varying needs of each individual living with diabetes. We are all different.
The best efforts of healthcare professionals and those who provide education often focus on perfect self-management or no self-management at all. In reality, the daily struggle of living with a long-term condition means that every marginal improvement should be seen as a true achievement. We have to manage it and encourage ourselves as we move forward. We have to make sure that by moving a step forward we can then move forward again. There has been an admirable drive to increase the uptake of education, but education alone will not help an individual manage the ups and downs of living with the condition. They need the tools and confidence, as well as the education, necessary to manage their condition.
When I speak to people in my constituency who live with diabetes, they often highlight the feeling of isolation. I am sure we can all agree today that there is a need to provide each of those individuals with the support they need to take away the isolation. Being a diabetic can be lonely if someone does not know how to manage it. They might think they are doing the right thing when they are not. Issues have been highlighted to me about the delivery and format of education programmes. Digital solutions and coaching services should be explored. The Minister referred to that in a conversation that we had prior to this debate. I look forward to her response. We always get something positive from her, and we will certainly get something positive today.
Will the Minister commit to ensuring that the delivery, format and content of structured education programmes is improved through the use of digital solutions, and that national guidelines are adapted to accommodate that? Health apps could also be used to refine and augment diabetes training programmes by enabling clinicians to learn from patients about what motivates them and therefore what support to provide.
I want to congratulate the hon. Member for Wolverhampton South West (Eleanor Smith) on her leadership on how health apps can be used to improve care and patient self-management. Many MPs in this House are diabetic or have an interest in diabetes. That is why we are here today. We are either diabetic or interested in the matter and here to make a contribution. I commend and thank right hon. and hon. Members for their commitment.
Will the Minister commit to undertaking an extensive public engagement and education programme, using digital platforms where appropriate, to showcase effective and evidence-based health apps and encourage their wider usage? Support needs to be tailored to individuals’ particular needs, in recognition that no single solution works in self-management for everyone. Everybody’s needs are different. I was the first diabetic in my family. When the doctor diagnosed me as a diabetic he asked me about my mum and dad and my wife’s mum and dad, and whether there was anybody in my family tree with the condition, but there was no one there. Unfortunately, my condition was caused by my diet and my lifestyle, so I created the problem. It was not hereditary, but it is how we deal with such things and tailor our responses that matters.
I have recently been convinced that health coaches—the Minister will comment on this—can play a key role in this space. Coaches can bring a distinct non-clinical skillset that poses questions for patients to help them devise the solutions that work for them, to help build their self-confidence and self-motivation—in stark contrast to the more prescriptive approach taken in clinical settings. Coaching needs to be clearly defined, and the full range of support that coaches can provide to support tailored prevention messaging needs to be identified. I look to the Minister’s response, because I believe it will have some positivity in relation to what we seek and what will happen.
It has been brought to my attention that the health service may ultimately need to decide whether to adopt a population-based approach to support improved outcomes across the entire population, or a more targeted approach aimed at those facing the greatest barriers to effective self-management. Will the Minister ensure that the health system explores the full range of ways in which health coaches can support people living with long-term health conditions, as well as carers and family members, through the development of an NHS definition of health coaching? Does she agree with me—and I hope with others in the House—that the UK has an opportunity to be an exemplar in the use of health coaches? It is an excellent opportunity and I hope that through the Minister we can make those changes.
I want finally to discuss the potential of innovations and technology in addressing issues related to self-management. That is what I do—I self-manage my diabetes. A flexible approach to the provision of structured education is vital to support self-management. Once equipped with the information and skills necessary to self-manage, people must have access to, and choice from, a range of proven technologies to help them manage their condition in everyday life. There has been a big investment in technology recently in the NHS.
We welcome the Government’s commitment to the extra spend on health, which we talk about regularly. All us in the House are particularly appreciative of the Government commitment. People with type 2 diabetes are now provided with glucose monitors; my hon. Friend the Member for South Antrim (Paul Girvan) referred to those in an intervention. However, people are offered little education on how to use them appropriately. There may be something more that we can do about that. It is good to have the technology, and to be taking steps forward, but it is also good for people to understand how to use it appropriately for management.
The level of investment in innovative hardware for people with type 1 diabetes is substantial and should be commended. However, individuals can be left lost if timely support is not available to help them to interpret and utilise those tools as a means of preventing complications. Many people with type 1 diabetes choose not to access the technologies now available to them. Why is that? I do not know the reason, but it is a question we must ask. I believe that it is partly because of a lack of individual awareness. In the case of my diabetes, that would be right. It could, potentially, be linked to a lack of information. If information is not being provided, I should hope that something could be done about that.
Later in the month an event is being held in Parliament, chaired by the right hon. Member for Knowsley (Sir George Howarth). The event, held in partnership with the type 1 diabetes charity JDRF, is to do with the development of a new report on access to technology for people with type 1 diabetes, “Pathway to Choice”. I look forward to reading the report when it is published, and I know the Minister will be keen to read it.
All of us with an interest in diabetes—and that is why Members are here for the debate—will be interested to read it. Can the Minister inform colleagues here today what measure will be introduced to ensure that all people living with either type 1 or type 2 diabetes can access the latest proven technologies that are right for their situation?
The hon. Gentleman has highlighted two important themes: self-management and knowing how to go about it properly; and the more recent theme of the potential of technology to achieve good control. He knows I am keen on both. However, does he accept that artificial intelligence can never replace the human element of having someone to talk to, who can give good, accurate information about how to deal with the condition?
The right hon. Gentleman is absolutely right. Artificial intelligence is beneficial: it can help where it can help. However, it is better for people to have the chance to talk to someone who can instruct them. I think probably we all want to talk to someone face to face, so we can understand the issues better.
An event that I attended here—with the hon. Member for Heywood and Middleton (Liz McInnes), I think—was about diabetes and also bariatric surgery. It may have been in the Thames Pavilion. I mention it because sometimes bariatric surgery may be the only way to reduce weight and enable someone to get to the other side, to address the issue of diabetes. That, as the right hon. Member for Knowsley said in his intervention, is something that people need to talk about. It needs to be discussed so they know what the options are. It is not for everyone, but it is for some people. A number of my constituents over the years have had that surgery and it has always been successful. It has reduced their weight in such a way as to control their diabetes. They are fortunate. Not everyone would have been able to have that surgical operation, but bariatric surgery is important.
To conclude, there is no one solution to diabetes prevention or management. Sometimes, no matter how well informed we are, diabetes can present new and potentially insurmountable challenges. I have some recommendations for the Minister. Primary prevention of type 2 diabetes should take a broad population approach, while ensuring that there is a range of programmes, including digital ones, so that no groups are excluded. There should be someone to speak to—access to someone to converse with who can advise and take things forward. Messaging should be varied and regularly re-evaluated, to ensure that there is engagement from those subsets of the population at the highest risk of type 2 diabetes. We cannot ignore the issue of obesity and diabetes. That was referred to at business questions and will probably be referred to during Health questions on Tuesday.
Finally, a holistic approach should be taken to diabetes care both to ensure value for the individual and to maximise the benefits to the NHS. When we are dealing with the NHS we must look at the money we have to spend, and how to spend it better. Prevention and early diagnosis are among the ways to do that, and the area of type 1 diabetes technology is important. Over the years I have had a number of constituents under the age of 10 who had early-onset type 1 diabetes. I can picture some of their faces, as I speak. They will always have to manage their diabetes. Mine came about through bad diet and bad management, but for some people it is hereditary. I ask the Minister to ensure that the Department for Health and Social Care will continue to focus on the important issue of messaging, in relation to diabetes.
It is a pleasure to serve under your chairwomanship, Ms Buck. I am grateful to the hon. Member for Strangford (Jim Shannon) for bringing this important debate to the Chamber today and for his comprehensive introduction to the subject, which included his own personal experience. I speak in my capacity as co-secretary of the all-party parliamentary group for diabetes, and I recognise the hon. Gentleman’s active role as vice-chair of the group.
My interest in diabetes comes from my background as an NHS clinical scientist, as well as the major health issues presented to our communities by the prevalence of diabetes. My constituency has a higher than average incidence of diabetes—8.5% of the population compared with 6.7% overall in England—so I am always interested in what steps can be taken to improve control of the condition and what preventive measures can be taken to lessen the risk of type 2 diabetes developing.
I want to draw attention to the difference between type 1 and type 2 diabetes, and I sometimes think it would be helpful if we considered them to be two completely separate and distinct diseases. I stress that while being overweight or obese is a major risk factor in type 2 diabetes, type 1 is caused by the body not being able to produce enough insulin and is an autoimmune disease. Although diet and exercise have a role to play in type 1 diabetes management, they cannot reverse the disease or eliminate the need for insulin. It is important to stress that, because of the number of times I have stood in this Chamber and listened to MPs saying, “If only people would lose weight their diabetes would be cured.” It is misleading, and it is unfair to people who are unfortunate enough to suffer from type 1 diabetes.
I am grateful that my hon. Friend made that point. She knows that I, too, insist that we deal with them as two separate diseases. There are consequences to the myth that everyone’s diabetes is lifestyle-related. In some cases children are bullied at school for having an autoimmune condition that they have no control over. Yet people believe they have caused it themselves.
My right hon. Friend is absolutely right. There is an unfortunate blame culture and children can be quite cruel to each other at times; we, as adults, must be careful about the language that we use about diabetes. If I achieve one thing in this place, I would like to get people to understand the difference between type 1 and type 2 diabetes—then I would feel as though I had achieved something.
Despite the growing public pressures associated with both type 1 and type 2 diabetes, a person living with diabetes only spends, on average, three hours a year with a clinician. People with diabetes are often put under a great deal of stress, because of the challenges and complexity in managing the condition and the multiple day-to-day decisions they have to make. In order to allow them to develop the necessary skills to manage their own condition, further support is required—including, but by no means limited to, weight management support.
This debate is very timely and follows a meeting we held in parliament in June of this year, which was attended by the hon. Member for Strangford and my right hon. Friend the Member for Knowsley (Sir George Howarth), among other MPs. The meeting was about realising the potential of health coaches in diabetes care, which the hon. Member for Strangford has already mentioned, and it was supported by Roche Diabetes Care—although of course I have to say that other diagnostic companies are available.
The meeting heard from health coaches about how they support participants in a lifestyle management programme, using their professional expertise as qualified nutritionists to support people to better manage their weight.
Does the hon. Lady agree that sometimes GPs do not give the right advice to patients? Perhaps a patient who presents with a bad infection is put on antibiotics, which can have an impact on their absorption of insulin, and as a result they can go into a hypo or take a low. That can cause major problems unless they have someone who knows them well, who can watch the signs and knows how to deal with them. Some GPs do not relay that information to patients when prescribing.
The hon. Gentleman makes a very important point, which I will come to later in my speech, about the need for all health professionals to be aware of diabetes and the complications that can arise, particularly in the situation he describes, where a GP may prescribe something without asking how it will impact on other conditions. The hon. Gentleman highlights the need for more and better training for health professionals around the whole condition of diabetes.
The meeting held in Parliament in June had three main themes. The first theme was relieving workforce pressures in diabetes care by providing non-clinical advice where there are gaps in clinical capacity, which refers back to the point that the average diabetic does not spend a lot of time every year with a clinician. The second theme—it is very pertinent to this debate—was about helping people to find their own tailored solutions to immediate health challenges such as weight management, as well as changing the way they think about their situation. The third theme, which the hon. Member for Strangford mentioned, was digital solutions to deliver 24/7 services to users. The health coaches explained to us how, through apps and other devices, users can message them at any time of day or night. The health coaches will get back to the individual, talk to them and help to address the issue.
Health coaching should be seen as a complement to clinical work and not as a tangent to it. It does not necessarily have to be done by discrete health coaches and could be incorporated into the day-to-day work of NHS staff; that relates to the point made by the hon. Member for South Antrim (Paul Girvan) on GP coaching. It should be incorporated into the day-to-day practice of all staff who work with people with diabetes. That is a point that NHS England and Health Education England should be considering.
Some would say that coaching on lifestyle and weight management is a role that should be fulfilled by the diabetes specialist nurse. I am interested to hear the Minister’s comments on the decline in the numbers of those who perform that very important specialist role. The National Diabetes Inpatient Audit reported that more than a quarter of hospital sites do not have a dedicated in-patient specialist nurse—there is a real gap that we need to examine. The specialist nurse is recognised by most diabetics as their go-to person, so it is quite shocking to hear that they are no longer available in a quarter of our hospitals.
I agree with the basic premise of the hon. Member for Strangford on tailored solutions and prevention messaging for diabetes. I hope the Government will follow the issue up, as well as ensuring that provision is equitable and that variations in uptake are addressed.
Of course, underpinning the whole issue is the need for better public health funding. It is no coincidence that just yesterday in this very Chamber in a debate on the declining numbers of health visitors, I quoted the figures for the national reduction in public health funding and the local reduction in my own borough of Rochdale. Nationally, there has been a reduction of £531 million on public health spending. In my local borough, there has been a cumulative reduction of £8 million over the last four years.
We cannot provide important services on an ever-decreasing budget. It was short-sighted of the Government to try to cut costs by reducing public health funding, and the chickens are now coming home to roost on this ill-thought-out decision. Given the emphasis on prevention in the NHS long-term plan, I will be interested to hear what the Minister has to say about how the cuts to public health funding will be reversed, and how quickly.
Finally, I understand that a National Audit Office report on health inequalities will come out at midnight tonight. I suspect that that report will lay bare the health impacts of cuts to public health services. I will certainly read it with great interest, and I hope the Minister will too.
It is a pleasure and honour to serve under your chairmanship, Ms Buck—for the first time, I think. I thank the hon. Member for Strangford (Jim Shannon) for securing this debate, not only as vice-chair of the all-party parliamentary group on diabetes, but as a fellow Fox—a supporter of Leicester City Football Club. As we heard from the hon. Member for South Antrim (Paul Girvan), he is also probably one of the most assiduous Members of this House.
I am pleased to see the Minister in her place and congratulate her on her appointment. I hope she will last longer than the last three diabetes Ministers—I am not one of those who wants a general election tomorrow, and we would like to see her build herself into her portfolio. I hope she will last as long as the shadow Minister, who has been there a while and so has been through many Ministers. We hope they will be able to share information. Let us keep the Minister in her place for some time—until the election, of course.
I declare my interest as a type 2 diabetic and chair of the all-party parliamentary group on diabetes. I have a family history: my mother, Merlyn, and my maternal grandmother both had diabetes, which gave me a 4% higher than average chance of getting diabetes. Added to my south Asian heritage, that makes me six times more likely than my European counterparts to be someone who would get type 2.
We have heard some amazing statistics. We should all just sit down, as if we were sitting in the Supreme Court, and say, “We agree with the hon. Member for Strangford,” because we agree with practically everything that he and my hon. Friend the Member for Heywood and Middleton (Liz McInnes) have said. However, it would not, of course, be the nature of Parliament if we all just agreed with the speech of the person before us, so I will plough on; I apologise if I repeat some of the things already mentioned.
As we know, every two minutes someone is diagnosed with diabetes. In my own city of Leicester, a higher than average number of people have diabetes—8.9% compared with 6.4% nationally—and that is expected to rise to 12% of the city’s population by 2025. That is due to the higher proportion of black and minority ethnic residents compared with the UK national average—BAME communities are genetically more likely to get diabetes.
In the time that I have spent as a type 2 diabetic, which is about 10 years, and as the chair of the APPG, I have come to the conclusion that there are five pillars of diabetes care, and I want to talk briefly about each one. The first is putting consumers first: we must put diabetics at the heart of diabetes care. There are meetings, seminars and events—a whole industry around diabetes care. We need new technology, experts and so forth, but we must never forget that it is the consumers—the diabetics—who should be put at the forefront of the debate on diabetes. Sometimes we forget the user: the people at the end of the process.
As we have heard, we need better technology. Members of the APPG and I visited the Abbott site in Witney in July 2019. I was first invited to go there by the former Prime Minister, in whose former constituency Abbott is based, because we wanted to look at the company that produced flash glucose monitoring devices, which have transformed the lives of so many people with type 1 diabetes. We went there because there are shortages of the equipment. In the past, one could go on the website and take one’s own device. There has been a shortage since the Government very kindly decided that everyone with type 1 diabetes would be able to get a machine on World Diabetes Day last year, so we went to talk to the chief executive about it. I know the company is working hard to ensure that the situation is reversed—I suppose we win the lottery by being able to provide the machines, but then we find that we do not have enough machines. I hope that this is going to improve.
I would like to show you my fingers, Ms Buck, so you can see the holes from my twice-daily finger pricking—I am surprised that I have any blood left. I use my GlucoRX device in the morning and am shocked at the reading in the evening, but I just carry on. I would love to have a flash glucose monitoring device—I cannot get it on prescription, because it would probably bankrupt the NHS if all type 2 diabetics received it, but it is a very important device.
My hon. Friend the Member for Heywood and Middleton, who is an assiduous member of the APPG, reminds us of the importance of diabetes specialist nurses such as Debbie Hicks in Enfield and Jill Hill, who have both given evidence to the APPG at one of our meetings. They have an incredible amount of knowledge. To go back to what the hon. Member for South Antrim said, we know that doctors are gods—they have a better reputation than MPs, anyway. Who wants to listen to an MP when they can listen to their local GP? However, they do not have the time. From our constituents, we all know that doctors are unable to see all their patients and spend sufficient time with them talking about diabetes. The point that has been made about diabetes specialist nurses is very important: we need to ensure that we have more of them.
The second pillar of diabetes care, after the need to put consumers first, is awareness. We all know that diabetes is a ticking timebomb. There are 4.6 million people with diabetes in the country, but an additional 1.1 million people, which is equivalent to the entire population of Birmingham—imagine the whole of Birmingham suddenly getting diabetes overnight—are undiagnosed. We therefore need to support awareness campaigns, which have been led very much by the private sector but supported by the Government, because that is the best way to tell whether people have type 2 diabetes and whether they can change their lifestyle.
We have heard from the former Chinese-meal eating, lemonade and fizzy drink-drinking hon. Member for Strangford how he changed his lifestyle. If only he had been told before, he might have changed it earlier. I remember that when my mother had type 2 diabetes, I had just been appointed Minister for Europe by Tony Blair and had no time to look after my mother. I was flying around Europe trying to enlarge the European Union by bringing in Poland and Hungary—as we are about to leave the European Union, I will not start another debate about that. The fact is that I did not spend enough time with my mum, which is a source of great guilt for me personally—finding out about diabetes, how she got it, what she was doing about it, and why she was still eating chocolate when she was a type 1 diabetic. Looking back at it, it seems amazing. It is important that we diagnose earlier, because then we can take our medication.
The right hon. Gentleman is absolutely right, and I thank him for putting forward his own personal story. The Government have taken some steps in the right direction on the sugar tax. Does he think we should be looking at things such as a soft drinks levy; trying obesity reduction through sugar in schools, in food and in the standards that are put forward; addressing the issue of takeaway food and restaurants, where the level of sugar in meals is incredibly high; introducing a 9 pm watershed for junk food advertising; banning multibuy offers; and providing clearer labelling? Those six things would be a step in the right direction.
I say yes to the hon. Gentleman on all those points—I agree with them all. I will come to the sugar tax later, but I can take a chunk out of my speech by saying that I agree with all those six points. His shopping list is fine with me, and I will happily copy it.
However, campaigns are extremely important. Very soon, we will have World Diabetes Day. Diabetes UK writes to everyone, asking them to turn buildings in their constituency blue. That is in just 26 days’ time. As chair of the APPG, I have written to mayors across the country, asking them to turn their landmark buildings blue. I ask the Minister to turn the Department of Health and Social Care blue on the outside—it may well be blue on the inside—on World Diabetes Day. I say to the hon. Member for Strangford that he should turn the Castle Ward or the statue of St Patrick blue in his constituency to raise awareness. Of course, one day we will have a statue to the hon. Gentleman himself in Strangford, next to the one of Jamie Vardy, and we will turn them both blue.
We in the all-party parliamentary group, of which we have so many members here—one could call them the usual suspects, but I call them the all-stars—meet every month. We produce reports, one of the most important of which is on mental health and diabetes, something that diabetics are simply not aware of when they get diabetes. I certainly was not aware of it. Support for mental health and wellbeing is critically important to people who have type 2 diabetes. It is an ongoing thing; people do not know why they have depression or why their lifestyle has changed, but it is to do with diabetes. I pay tribute to Diabetes UK, to Chris Askew, and to Nycolle Diniz for the work she does for the APPG.
It is not only specialist nurses who can help us, but other professionals, such as pharmacists. Everyone knows that pharmacies and pharmacists have great expertise in diabetes. My mum—I go back to talking about my mum—could spend more time with her pharmacist in Evington in Leicester talking about her condition than she ever did with her doctor. Maybe the Government should run the awareness campaigns through the pharmacies. That would mean reducing the money going to the doctors a little, and they will quaff around and complain—but if we fund pharmacies to do the testing, we will save so much money in the end. Pharmacists such as our APPG ambassador, Jimmy Desai in Ilford, have done an amazing job. Let us empower them to do things.
The third pillar is prevention, which we have all talked about, and reversal if possible. The hon. Member for Strangford has changed in terms of his weight; we have heard from people such as Dr David Unwin, another of our ambassadors at the all-party parliamentary group, that around 60% of cases of type 2 diabetes can be delayed or prevented by making those lifestyle changes and having a healthy, balanced diet.
At the Health Hub in Doha, which I recommend the Minister visits—although obviously not if there is a crucial vote, as the Government will need her here; I am happy to pair with her and we can go together—if a doctor says, “You are borderline diabetic,” they do not give the patient tablets. Rather, they say, “Here is a prescription to go to the gym downstairs. Start doing your gym work, and don’t see me again until you get your lifestyle sorted out,” because lifestyle makes a great deal of difference. Some of us have our watches connected to our phones—I do not know whether my right hon. Friend the Member for Knowsley (Sir George Howarth) does—so we know about our steps. I very rarely hit 10,000, but at least there is a willingness to try to do more exercise, and walking round the Palace is a way to make sure we do that.
As we have heard, obesity is a killer. Obesity-related conditions cost the NHS—cost the Minister—£6.1 billion a year. I adopt as my own the shopping list of the hon. Member for Strangford: the six things he has asked for, from the watershed to multiple offers in supermarkets. We should all do that and say, “Let’s do it.” The private sector has done its bit. Kellogg’s has put traffic light labelling on most of its cereal packs sold in the United Kingdom since 2018—well done to it!
On food and how manufacturers can help, does the right hon. Gentleman agree that much of the focus is on sugar, and little is on carbs, which normally convert to sugar in the body? With the Dose Adjustment For Normal Eating—DAFNE—programme, instead of counting sugar, people count carbs. It is really only for type 1 diabetics, but it helps them administer their insulin according to the carbs they have eaten during the day.
I will. I hope that was not related to my mentioning George Osborne. We want to thank him for introducing the sugar tax, which has made a huge difference. Sugar in soft drinks has gone down by 28.8%, which is a huge achievement.
We have all praised the great Jonathan Valabhji, but I also want to mention the work of Partha Kar, who only this morning set right the statement by Mr Paul Hollywood on “The Great British Bake Off”, who said that one of the dishes looked like “diabetes on a plate”. I am sure he meant it as a joke, but for type 1s it was a real surprise that someone should speak like that. We desperately need structured education. We have all talked about the three hours of care, but there are 8,757 other hours.
In a few days’ time, we will be launching in Leicester the diabetes log book by the Leicester physician Dr Domine McConnell. I hope the Minister will spare some time to come and read it and perhaps launch it with us. It will give patients a better understanding of how they can record and monitor information. They can keep it with them and take all their readings wherever they go. Far too often, when I visit my GP I cannot remember my last HbA1c reading, and I need to make sure that is done. I realise that it can be done on a phone, but not everyone is able to do that.
My last plug for Leicester before I end is about the pilot that has been put together by the chair of the clinical commissioning group, Dr Azhar Farooqui, and Sue Lock, its retiring chief executive. It allows, on a Thursday, all diabetics to go to the Merlyn Vaz Health and Social Care Centre in Leicester. It is a very important initiative. People can have their feet looked at, their eyes looked at, their blood tested, their lifestyle dealt with—all the things they need to do, on one morning in one place. The opportunity to put that together makes a great difference.
In my GP surgery, and I think across the whole of Northern Ireland, GPs have classes for diabetics. They bring them in and do all those things: they do their feet, check their blood, check their eyes, talk about their health and check them over physically. They send those tests away, and they are brought back to make sure they are clear. Things are often done in other parts of the United Kingdom of Great Britain and Northern Ireland that could be used as examples here. The right hon. Gentleman is talking about what is happening in Leicester, and it is good to hear that, but we are very fortunate to have that in my clinic and other clinics across Northern Ireland, where we get those checks twice a year.
Well, I will go on longer, then—excellent! That makes me feel much better.
I hope the Minister will come and visit the Merlyn Vaz Health and Social Care Centre. People like me and the hon. Member for Strangford have to go to eight different professionals to have our diabetes checked. In one visit on one morning in Leicester, people can have it all done, from the top of their head to their feet and everything in between—they can get it all tested.
I will end with an anecdote; I was going to end, Ms Buck, because the House has heard enough from me. I recently saw a film—the hon. Member for Strangford will like this, because it was about the Beatles, and people of our general age will remember them—called “Yesterday”, directed by Danny Boyle. It was about how the internet went down on a particular day, and references to the Beatles disappeared, so nobody knew about them. Nobody knew their songs or who they were. When they typed in “Beatles”, they just got a beetle on the screen.
There is a scene in that film when somebody turns to another person and says, “I’m going outside to have a cigarette.” The person says, “What’s a cigarette?” because the cigarette had disappeared from the internet along with the Beatles. No one could remember it. When we introduced the smoking ban, it had a profound effect on cancer issues. We want to ensure that diabetes is reversed for type 2s and that we are able to manage and help those with type 1. We start that with a war on sugar and changing the way we live. Working together, I think the House can achieve that.
I am grateful to the hon. Member for Strangford (Jim Shannon) for securing this debate and for his personal account of his experience. He covered diet, control and tablets in his general summary of the issue. He highlighted the importance of prevention, the correlation between poverty and lifestyle, the importance of messaging to different sections of our society and the value of digital solutions.
We also heard from the hon. Member for Heywood and Middleton (Liz McInnes), who also has direct experience of the issue. She emphasised the importance of the difference between types 1 and 2. Most of my comments will be about type 2. The right hon. Member for Leicester East (Keith Vaz), a very knowledgeable Member, covered a range of points. It is impossible to disagree with anything I have heard today. I thoroughly enjoyed the presentations.
I am not diabetic, but when I phoned my office to tell my office manager that I had a debate about diabetes today, she thought I said that I had diabetes. She said, “I’m not surprised, with your lifestyle and diet.” There may be some lessons there that we all need to take away. We need to look at our diets, in particular.
We have heard about the scale of the problem in Northern Ireland and England, and I have to say that the Scottish situation is not dissimilar. In 2016, more than 257,000 people were living with a diagnosis of type 2 diabetes across Scotland, and every year 17,000 people are diagnosed with it. It is estimated that about 10% of cases of type 2 diabetes remain undiagnosed. Diabetes Scotland estimates that more than 500,000 people in Scotland are at high risk of developing type 2 diabetes. The NHS spends about 9% of its total health expenditure treating type 2 diabetes.
It is estimated that more than one in 16 people across the UK has diabetes, whether diagnosed or undiagnosed. Around 80% of diabetes complications are preventable, so just think how much we could save the NHS by tackling the problem, as well as the benefits that could be brought to people’s lifestyles. We should not short-change ourselves by cutting back on the diabetes spend—it is a spend-to-save area. Many of those complications are preventable or can at least be significantly delayed through early detection, good care and access to appropriate self-management tools and resources.
Being overweight is the most significant risk factor for the development of type 2 diabetes. Diabetes can be prevented with targeted weight management interventions that provide individuals with the support, skills and resources to improve their health and delay the onset of type 2 diabetes. As we have heard, recent studies have shown that it is possible to reverse a recent diagnosis of type 2 diabetes through intensive weight management programmes, which would enable the individual to achieve remission.
As obesity and lifestyle are such significant factors, what we do with our young people is critical. The SNP Scottish Government have a plan to halve childhood obesity by 2030, and that sits at the heart of the diet and healthy weight delivery plan. The Scottish Government’s commitment to legislate on the restriction of point-of-purchase junk food promotions will be a major help. I hope that we will see action from the UK Government on advertising, particularly on TV and in the media, because that would make a big difference. In 2019-20, the Scottish Government invested an additional £1.7 million in weight management services for children and young people. Targeted messages are a key component of the Scottish Government’s diabetes prevention, detection and intervention framework.
The Scottish Government’s framework “A Healthier Future: Framework for the Prevention, Early Detection and Early Intervention of type 2 Diabetes” was published in 2018—the Library briefing contains links to it, so hon. Members can see the full details. The framework is supported by £42 million until 2023, and it was produced in collaboration with the prevention sub-committee of the Scottish Diabetes Group, which comprises informed specialists in diabetes, dietetics, maternal health, public health, primary care and obesity.
Wider support should be available for all individuals who have been identified as at risk. Health and social care professionals should signpost individuals to the support groups that are available to them. A Local Information System for Scotland, or ALISS, is a programme funded by the Scottish Government and delivered by the Health and Social Care Alliance Scotland. The objectives are to increase the availability of health and wellbeing information for people living with long-term conditions, disabled people and unpaid carers, and to support people, communities, professionals and organisations who have information to share. The sharing of information is critical. The Scottish Government also published the diabetes improvement plan in 2014, with prevention as its No. 1 priority.
It is important to get the right messages to people, and methods of communication must also be considered. Modern-day flexibility and the use of mobile phones in everyday life means that they are an ideal tool to support people with diabetes, whose conditions needs constant management. Additionally, they can provide effective methods of support to patients in rural and remote locations where access to healthcare providers is limited. However, we must be careful when adopting such practices because there are drawbacks, such as the digital divide. Mobile phone use is lower among some groups, such as the elderly, the poorest and people with disabilities, so face-to-face contact remains a vital communication tool.
It is a pleasure to serve under your chairmanship, Ms Buck. In my long tenure as shadow Minister for Public Health, it has been a pleasure to speak in many debates with the hon. Member for Strangford (Jim Shannon), on all sorts of health issues. I congratulate him on securing this debate and on his excellent speech. I know that diabetes is an important issue to him and I thank him for speaking so honestly about his own journey with diabetes. In the past, I have spoken about my own journey, but I do not plan to dwell on that too much today.
I thank other hon. Members for their excellent contributions: my hon. Friend the Member for Heywood and Middleton (Liz McInnes), my right hon. Friend the Member for Leicester East (Keith Vaz) and the SNP spokesperson, the hon. Member for Linlithgow and East Falkirk (Martyn Day). Although there are not many of us in attendance, we have heard some excellent contributions and the debate has been full, detailed and excellent. I also thank charities such as Diabetes UK for the work that they do, both to support people with diabetes and to prevent diabetes.
Like the Secretary of State and, I am sure, the Minister, we all believe that prevention is better than cure. We all say that, and I honestly think that we all believe it. As hon. Members have said, however, the Government repeat that mantra but have cut public health funding to the tune of £700 million since 2013. Those cuts have had a serious impact on the nation’s health, but they have hit those in low-income areas the most, as we have heard. That is particularly concerning, given that children and adults living in deprived areas are substantially more likely to be obese, and obesity is a risk factor for diabetes—particularly type 2 diabetes, as my hon. Friend the Member for Heywood and Middleton made clear.
According to NHS Digital, one quarter of people living with type 2 diabetes in England are from the most deprived fifth of society, compared with 15% from the least deprived. We have had that knowledge for a long time, so it really is time that the Government used the knowledge and took action to tackle both the obesity and the diabetes epidemic, both of which disproportionately affect those in the most deprived areas.
Opposition Members have been clear that there is no silver bullet to fix the issue. However, we support the proposal to introduce a 9 pm watershed on the advertising of food that is high in fat, salt and sugar. We also support a restriction on the sale of energy drinks to under-16s and clearer labelling on food and drink—that would help us all. Those are all policies on which the Government have consulted, but we have yet to see anything from the Government setting out whether they will be implemented. Can the Minister update us on the consultations when she responds?
I congratulate the hon. Lady on her contribution and her comments. I was sitting here thinking about families and diabetes. In a family of four or five, there may be one diabetic member of the household. I believe that the whole family—mum and dad, brothers and sisters; whoever it may be—need to give consideration to the person with diabetes to ensure that their battle with diabetes is one that the whole family fights together. That is difficult to do, but it is important that families realise that they have a job to do.
I am not sure whether there is a hereditary aspect to it, but I am aware that sometimes there can be a number of people with diabetes in the same family. I am the only one I know of in my family with the condition, but then again I do not know my father’s side. My mam always says that I take after my dad with regard to my size, so perhaps there is a link and I am just not aware of it. The eating habits of members of a family can be very similar. If eating habits have led someone to get diabetes, the condition could have affected others in the same family, so the hon. Gentleman makes a valid point.
The evidence shows that the policies proposed by the Government, if they are fully and quickly implemented, could help us to make real progress towards reducing childhood obesity by 2030. Will the Minister tell us what the delay is? Instead of just window-dressing with the childhood obesity plan chapters 1 and 2 and the former chief medical officer’s special report on childhood obesity, which we had in the past couple of weeks, the Government must now take bold action and implement all the policies in the reports. The time for reports and consultations is over. We all know what needs to be done, and now we need urgent action.
According to NHS England, managing the growing incidence of diabetes in England is set to become one of the major clinical challenges of the 21st century, as we have heard expressed clearly in this debate. Estimates suggest that the number of people with diabetes is expected to rise to 4.2 million by 2030, affecting almost 9% of the population, with all the associated costs.
More than half of all cases of type 2 diabetes could be prevented or delayed. The hon. Member for Strangford and my right hon. Friend the Member for Leicester East both spoke about that in detail. By reducing the number of people who are overweight or obese, we can reduce the number of people who develop type 2 diabetes and live with the life-changing complications that are associated with it. Like the hon. Gentleman, I wish I had known much sooner the irreversible damage that I was doing to myself. I have done a detailed blog post about it, which is available online, if anyone is interested in my thoughts—I will go into them no further in this debate. Steps that the Government take today will benefit people greatly tomorrow, so will the Minister please outline the Government’s plans to prevent further incidence of diabetes?
There is no one-size-fits-all approach to diabetes, which is why targeted messaging and support is so important, alongside societal and environmental changes to tackle obesity, as I have mentioned. Interventions such as NHS health checks, weight management programmes and the NHS diabetes prevention programme should therefore be offered and taken up more often in order to identify risk and to prevent diabetes. Many people who are eligible for the NHS health checks are not invited to them or do not attend.
What will the Government do to encourage people to attend their NHS health check and to ensure that everyone who is eligible is definitely invited for a check? About 1 million people live with undiagnosed type 2 diabetes, and one in three people already have diabetes complications by the time they are diagnosed with type 2 diabetes, so that service could be invaluable in preventing further incidence of diabetes and of the complications that sufferers experience.
Those who have diabetes know that it is possible to put type 2 diabetes into remission through substantial weight loss. As the hon. Member for Strangford mentioned, my hon. Friend the Member for West Bromwich East (Tom Watson) has been incredibly vocal about his very visible journey. He has been an inspiration to many. We need to make sure that when people go into diabetes remission, they continue to get support, access to diabetes monitoring and, where necessary, care, because, as I was told, “You are never cured.” Even if someone with diabetes is in remission through diet, they will still forever be a diabetic—we have broken our bodies, basically.
People who wish to go into remission must have continued support. There is still a need for more research to understand the long-term impact of remission on reducing complications, but for now the future in that regard looks positive. This debate has been excellent, and it has demonstrated that there are clearly steps that the Government can and should take to prevent diabetes. I hope that the Minister will take them on board. I look forward to her response.
In closing, I thank and congratulate—on behalf of all us who are living with diabetes—Professor Ian Shanks, the inventor of the blood glucose monitor some 40 years ago. I was so pleased to hear the news overnight that he is to be paid a small award. I say “small” because, although it is £2 million, I understand that most of it will be eaten up by the legal costs of a 13-year battle. He might not be a rich man after he has paid all his legal bills, but he will be rich in terms of gratitude for the millions of lives he has saved, and no doubt improved, with his invention.
It is a pleasure to serve under your chairmanship, Ms Buck.
I congratulate the hon. Member for Strangford (Jim Shannon) on securing this important debate, on its tone and on how informative it has been. It is a powerful indicator of how a debate in this place can help to educate and spread information. As the hon. Member for Heywood and Middleton (Liz McInnes) said, types 1 and 2 are distinctly different conditions. It is important for us to note that so that when people talk about diabetes, they do not talk about it in the round as one condition, but nuance it. That goes to the heart of what the hon. Gentleman was asking for—information to be tailored to the patient and every individual, so that people receive the information appropriate for them.
I thank the hon. Member for Strangford and all Members who sit on the all-party parliamentary group for diabetes for their fantastic work. It is one of the most dynamic APPGs in this place. In particular, I thank the right hon. Member for Leicester East (Keith Vaz), who chairs it. I am afraid that I do not share his and the hon. Member for Strangford’s love for Leicester City, but as a regular visitor to Welford Road, I know his city and I like the tiger in it. I will leave it there.
More than 3 million people in England have been diagnosed with diabetes and, as the hon. Member for Washington and Sunderland West (Mrs Hodgson) said, an estimated further 1 million remain undiagnosed. Public Health England estimates that 5 million people are at high risk of developing type 2 diabetes, and that number rises each year. Like everyone in this room, and probably everyone in the country, I know someone with diabetes. My mum is in remission—she has lost a lot of weight and she exercises, but she is in her 80s, which shows that no matter people’s age, they can take steps to help them live healthily, even with a condition.
The hon. Member for South Antrim (Paul Girvan) spoke about his wife, and the importance of people looking after themselves during their journey with diabetes, so that they know they are as in control of their condition as they can be. As we have heard from several Members, diabetes has other effects on the body, and it is important that people with the condition look after their eyes, their kidneys and, in particular, their feet. That presents challenges for people attending multiple different clinics for multiple different things.
I will also mention Professor Jonathan Valabhji, the national clinical director for diabetes and obesity. I look forward to working with Jonathan, who strikes me as a truly inspirational person in this area. Only last week, he told me not to be too hard on the situation, and that we have come a long way over the decades. We no longer see the same number of amputations or complications. There has been improvement in the treatment, and it is important to recognise that clinicians have done an awful lot.
Preventing type 2 diabetes and promoting the best possible care for all people is a key priority. I am proud to say that NHS England, NHS Improvement, Public Health England and Diabetes UK have had great success with the first diabetes prevention programme to be delivered at scale nationwide.
With a new Minister, we get a new broom and, therefore, a fresh pair of eyes. The collection of data is a key issue. We have tabled parliamentary questions to Ministers and asked, for example, how many diabetic nurses there are in the country or how many doctors have a specialism in diabetes. Those facts are available in Scotland, but not in England. Will the Minister make it a priority, as a result of this debate, if nothing else, to get more of that data? With good data, we can plan better.
Further to the points made by my right hon. Friend the Member for Leicester East (Keith Vaz), I tried to get information about waiting times in clinics and hospitals for various kinds of appointments related to diabetes out of the Minister’s Department, but I was unable to. When she looks at my right hon. Friend’s list, will she look at mine too?
I truly will. That brings me to the hon. Member for Heywood and Middleton, who wrote to me about the meeting she mentioned. I have written back to say I would really appreciate the chance to meet her to discuss the various challenges. Having already had an obesity roundtable and a Green Paper roundtable, I know there is an awful lot of overlap in these areas. I feel we could work on that. If she will forgive me, I will get back to answering the hon. Member for Strangford.
Over 2018 and 2019, the diabetes prevention programme achieved full national roll-out, making England the first country in the world to achieve full geographic coverage, which is a great achievement. There is strong international evidence demonstrating how behavioural interventions that support people to maintain a healthy weight and be more active can significantly reduce their risk of developing the condition in the first place, which I think the hon. Member for Washington and Sunderland West referred to. The programme identifies those at high risk and refers them on to behaviour change programmes, which, as we know, is very much more likely to lead to positive results than sending someone away and telling them, “Get on with it yourself.”
The NHS long-term plan commits to doubling the capacity of the diabetes prevention programme to up to 200,000 people per year by 2023-24 to address the higher than expected demand and specifically to target inequalities. Furthermore, NHS England and NHS Improvement have enabled digital routes to access the programme, which will support individuals of working age in particular. As the hon. Member for Strangford pointed out, it is important that people can get information where it is most accessible. Those digital routes went live across nearly half the country in August 2019, and full digital coverage is expected in the next year.
The hon. Members for East Londonderry (Mr Campbell) and for Upper Bann (David Simpson) spoke about children. That is where the prevention Green Paper, “Advancing our health: prevention in the 2020s”, targeted support, tailored lifestyle advice and personalised care using new technologies will all have an effect. I take on board the point that there have been a lot of consultations and so on in this area. We received an awful lot of responses to the Green Paper and we are considering them, but I will make announcements shortly, particularly on ending the sale of energy drinks, on promotions and on one or two of the other areas the hon. Member for Strangford mentioned, so watch this space. I have been in position for only 12 weeks, but this whole area is of huge importance to the nation’s health. I hope that, if we can target children and young people through their lifetime, we can stop problems later on.
I am very encouraged—I think we all are—by the Minister’s response on that point. When she brings recommendations and legislation forward, I think she will find that Members across the House will be very supportive of them. I am greatly encouraged by what she says.
I thank the hon. Gentleman. I hope Members noticed that yesterday we launched the National Academy for Social Prescribing. I think Members across the House understand that people do not always need a tablet when they go to the doctor. The hon. Gentleman spoke about the importance of mental health support, referral to exercise classes and various other things for people with diabetes. I was lucky enough to go to Charlton Athletic yesterday and see some brilliant things being put into practice in the community, where the messaging was much better received. Twenty-six per cent less men feel able to go and talk to their doctor, so perhaps we can give them the message at their football club, their rugby club or just their workplace. That applies to women too, now they have much busier lives and many more of them work. Targeting people appropriately so we can get messages to them in the right places about how they can look after themselves better has to be the right way to go.
A dedicated Type 2 Diabetes Prevention Week campaign was launched in 2018. The campaign aims to raise awareness among healthcare staff in primary care about the causes, complications and groups at risk of type 2 diabetes, which I think was mentioned, and the services available to manage patient health. Following the success of the last two years, the campaign will be rolled out again in 2020.
The hon. Member for Strangford mentioned the importance of ensuring that messaging to support those with diabetes is tailored to relevant sectors of society. In June 2018, Language Matters was launched to encourage positive interactions with people living with diabetes, to ensure tailored messaging to relevant sectors of society and to expand routes into the prevention programme. It is a little like health checks: people have to know about it, and know how to use it, in order to access it.
In 2017-18, and again in 2018-19, an additional £5 million per year was made available for diabetes specialist nurses. There is a need to beef up support in that area. Diabetes UK, which I have already met—I happen to be lucky enough to have known its chief executive for some time, and it was at the obesity roundtable, as was Cancer Research UK—does a fantastic job in helping to spread that message and to provide information. Another message that has come out is “think pharmacy first” to empower pharmacists. The 11,500 pharmacists on our high streets are a resource that is just waiting to be used, and I hope the new pharmacy contract will be the start of that relationship.
We will do more in the future to support those with type 2 diabetes. There are a range of apps in the NHS app store to further overcome many of the issues people currently face with traditional, face-to-face structured education. NHS England and NHS Improvement are developing online self-management support tools called Healthy Living for people with type 2 diabetes. Many in the Chamber will be familiar with DAFNE and DESMOND—dose adjustment for normal eating, and diabetes education and self-management for ongoing and newly diagnosed—as well as other programmes for those living with diabetes.
Healthy Living will consist of a structured education course with additional content focused on maintaining a healthy lifestyle, including content on weight management, alcohol reduction and cognitive behavioural therapy for diabetes-related distress. Once the course has been developed, NHSE hopes to commence its roll-out from January 2020. It will have universal availability, it will be free to users and local commissioners, and it is intended as an online resource to supplement other quality assured digital coaching programmes that can be commissioned in local health economies. However, it will be in addition to face-to-face support, because everyone has a preferred method of getting information.
As the right hon. Member for Leicester East said, the risk of developing type 2 diabetes is higher in black, Asian and minority ethnic communities. I am pleased to say that NHS England and NHS Improvement are working with the Cultural Intelligence Hub to deliver an insight project to support future communications and improve engagement with those communities. The aim is to support an increase in available places on the NHS diabetes prevention programme and the take-up of those places; to raise awareness of type 2 diabetes, its risk factors and complications, and ways to prevent it; and to promote messages.
NHS England and NHS Improvement have invested £39 million in each year of transformation funding. That funding is key to improving structured education, reducing variation and helping with foot care for diabetic foot disease.
I agree that new technology is key to the management of diabetes. I hope the shortage in the supply of flash monitors will be overcome shortly, but what fantastic news it is that so many people, including many of our colleagues in this place, now have access to those monitors. I know how much difference they can make to people’s lives, and that is only to be welcomed.
I thank the hon. Member for Strangford for highlighting this issue. I look forward to meeting the all-party parliamentary group and working further with it on these messages. I hope I have demonstrated that we are working hard so people can receive the treatment and support they need to live longer but enjoy quality of life.
I thank the right hon Members for Leicester East (Keith Vaz) and for Knowsley (Sir George Howarth); the hon. Members for Heywood and Middleton (Liz McInnes) and for Linlithgow and East Falkirk (Martyn Day); the shadow Minister, the hon. Member for Washington and Sunderland West (Mrs Hodgson); and my hon. Friends the Members for East Londonderry (Mr Campbell), for Upper Bann (David Simpson) and for South Antrim (Paul Girvan). Most of all, I thank the Minister. We are all greatly encouraged by what she said and look forward to working with her to deliver a good, effective, positive and evidential diabetes strategy that can make lives better. All of us here are committed to that. Let’s do it together.
Question put and agreed to.
That this House has considered tailored prevention messaging for diabetes.