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NHS: Diabetes

Volume 793: debated on Tuesday 9 October 2018


Asked by

To ask Her Majesty’s Government what steps they are taking to ensure that the National Health Service receives adequate funding to provide treatment to those with type 2 diabetes and to manage their increased risk of developing cancer.

My Lords, it is for local organisations to commission services to meet the healthcare needs of their populations, taking account of local and national priorities, including for diabetes and cancer. Funding has been made available through to 2020-21, and we expect it to be spent in line with the priorities set out in NHS England’s mandate, including for diabetes.

My Lords, I repeat my previous declaration of interest. Since diabetes has doubled in 20 years, making it the fastest growing modern health crisis, should not one Minister be put in charge and report annually to Parliament, coupled with a new fund to support greater adoption of new technologies? The Prime Minister proudly wore her flash monitoring device at the Mansion House; regrettably, the device is available on the NHS in only 63% of areas—others have to pay about £100 a month for the device. The hold-up of universal access is not with the clinicians but with the clinical commissioning groups. Will the Secretary of State take a personal interest in the development of this problem?

I thank the noble and learned Lord for that question. In particular he raised the issue of flash monitoring units. As the noble and learned Lord is aware, they are a very useful tool in the management and control of the problems people have with diabetes. Many CCGs perform very well, but some do not provide this service. They are being encouraged to do so.

My Lords, as the grandmother of six extremely greedy grandchildren, I know how difficult it sometimes is to get children to eat healthily, but surely it is best if no weight is gained in the first place. What advice is being given to young children and those who look after them about what is good healthy food and bad food?

My Lords, my noble friend makes a very valid point. One in three children are now overweight or obese by the time they leave primary school. Early intervention is very important whether we are talking about cancer or about diabetes. At the moment, we are reviewing how to encourage children to be more active and are consulting on proposals to limit further the advertising of unhealthy food to children, to change the way unhealthy products are sold, to improve the information provided in restaurants and to ban the sale of energy drinks to children.

My Lords, does the Minister recognise that some people suffer from forms of cancers that do not allow them to eat orally so they have to be intubated and the food with which they are intubated very often causes type 2 diabetes? Could more research not be done into forms of nourishment for people suffering from cancer who cannot eat orally?

My Lords, the noble Baroness makes a very good point. Diabetes UK has reported that if you have diabetes you can be more at risk of developing certain types of cancer, while some cancer treatments can affect diabetes and make it harder to control. In partnership with Macmillan, Diabetes UK has produced an information booklet for anyone who has been diagnosed with cancer and is living with diabetes. I am glad the noble Baroness raised this point and I will ensure that my noble friend the Minister is aware of it.

My Lords, does the Minister accept that funding for the kind of structured educational programmes that are necessary to support people with diabetes is actually threatened by the reductions in provision for public health, and that a survey by GPonline showed that 30% of practices are reducing provision for weight management courses? Is this not counterproductive to a strategy that should be based on prevention?

My Lords, I agree with the noble Lord when he mentions prevention. He is right that, as I said earlier, early intervention prevents further problems later on in life. I should also add that we are spending another £5 million that will produce a number of specialist nurses in around 70 different hospitals throughout the country. As the noble Lord will also be aware, we have rolled out the national diabetes treatment and care programme, a countrywide programme that is the only one in the world.

My Lords, is this not a case where people in this country must take responsibility for their own health? The huge majority of type 2 diabetes cases, though not all, are caused by eating the wrong food, eating too much food, drinking too much and not taking exercise. Surely we must send out the message that each individual must take responsibility for him or herself.

My Lords, my noble friend makes a very good point. This is why I go back to the childhood obesity plan and reiterate that we have to intervene early to stop this problem gathering apace and introducing more people in the population suffering from diabetes. The plan is to educate children and their families on how they should eat. We have to look at what children are eating and discourage them from eating things that are harmful to them.

My Lords, the evidence coming from the DevOS study in Singapore shows that the incidence of gestational diabetes—diabetes during pregnancy—is about twice as common as is generally recognised in maternity units across the world. Can the Government do something better about screening for diabetes during pregnancy? That is a clear and important point. It may not be cancer but other diseases that follow later on as a result of that in the children.

I speak from family experience of gestational diabetes: my wife had gestational diabetes with our third child, and I might add that all three children’s blood sugar was in double figures when they were born. She had diabetes then and she is also being screened on a regular basis by the local practice—the sugar level in her blood is being measured on a regular basis. I take on board what the noble Lord says; he makes a very good point.