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Volume 809: debated on Tuesday 5 January 2021


Asked by

To ask Her Majesty’s Government what assessment they made of the report by the All-Party Parliamentary Group on Obesity The Future of Obesity Services, published on 25 November 2020.

My Lords, we welcome the ongoing work and support of the All-Party Parliamentary Group on Obesity and its report The Future of Obesity Services, which continues to make a valuable contribution to the debate. We published Tackling Obesity: Empowering Adults and Children to Live Healthier Lives last July, which demonstrates an overarching campaign to reduce obesity, takes forward actions from previous chapters of the childhood obesity plan and sets out measures to get the nation fit and healthy.

I thank the Minister for his reply, but he will know that we have had several obesity strategies before. What steps are the Government taking to ensure that this latest strategy is implemented in full without delay? Can he provide an update on the timelines for implementation? One of the main concerns of our witnesses was that the full range of services should be provided everywhere in the country, with easier access at any stage of the pathway. Will the Government take this on board?

I thank the noble Baroness very much for the recommendations of her report. Implementation is key. We have 13 workstreams, which is too much for me to go through in detail, but yesterday evening I tweeted a full list of each of them for her interest. Her point about implementation on the front line is extremely well made. I reassure her that the NHS plan makes it very clear that front-line services should provide obesity support in all the right cases.

My Lords, the report quite rightly encourages the Government to continue their promotion of better health and to develop an obesity prevention strategy. Twenty years ago, food was moved largely out of the Ministry of Agriculture into the Department of Health. Obesity is a question of our relationship to food. Could I encourage the Minister, in the light of changes to the way we do agriculture, to focus also on health and how, locally, the relationship between health, agriculture and the provision of food can actually be deepened?

The noble Baroness puts her point extremely well indeed. Undoubtedly, there is a movement in the country as a whole to relate more closely the production of food in this country and the way in which healthy eating relies on good, locally produced food, and I take on board her points entirely. We very much take obesity more seriously as a result of Covid. That has given our plans a huge amount of energy, and the sponsorship of the Prime Minister has been very vocal.

My Lords, would my noble friend agree that serious mental illness—SMI—must be a significant factor in the commissioning of and referrals within obesity services if those currently experiencing obesity and mental illness are to get the service, support and help they need?

My Lords, not everyone who is obese has mental illness, but some people who are obese do have mental illness. That is why we announced measures on weight management in Tackling Obesity: Empowering Adults and Children to Live Healthier Lives, which makes clear proposals for how those who have obesity as part of their mental illness challenge can be supported and provided for.

My Lords, I obviously welcome the report from the APPG, but I feel that we have heard it before and that its problem is in its implementation. I would like to make the point that a lot of our emphasis on the prevention of obesity is about stopping the promotion of unhealthy foods, whereas we do very little to promote healthy foods and to make a healthy diet affordable. Children from the poorest households are, at the moment, the most likely to suffer from obesity, but they are also suffering from food poverty. Healthy food is currently twice as expensive per calorie as unhealthy food, so just having a policy of restricting access to unhealthy foods can actually risk pushing people more into hunger and making them end up eating cheaper food. So, in order to address the inequalities in obesity levels, it is vital that restrictions in promotions of unhealthy food must be balanced by an increase of healthy foods, plus a really good public health campaign that encourages people to eat more healthily and tells them how.

The noble Baroness makes her point very fulsomely. We are doing a huge amount on advertising, promotions, front-of-pack nutritional labelling, out-of-home calorie labelling, alcohol calorie labelling and a whole range of stuff. The noble Baroness may well shake her head, but the truth is that this Government are doing more than any previous Government in this matter.

My Lords, I declare an interest as a member of the all-party parliamentary group involved with the report. We recommended that the Government should build on their Better Health campaign with a public information campaign. Picking up on the last point of the noble Baroness, Lady Boycott, and on the Minister’s remark that he had tweeted about the 13 streams, is not the basic problem that the public are not aware that we are trying to run a campaign and that we need a clear relaunch? This is the opportune moment to do it, when we have such problems with Covid.

The noble Lord rightly alluded to the Better Health campaign, and I remind him that we did relaunch it yesterday. That went extremely well and got a lot of coverage. But there is only so much that government advertising can do; I do not think that we can advertise our way out of this problem. It is up to individuals to make their own decisions, it is up to GPs to give the support that people need and it is up to us as a society to accept that the health of the nation is important to its resilience and to its long-term health. Until those decisions are made, we struggle to make progress in this area.

My Lords, what works in rural Cornwall may not work in metropolitan Camden. Could the Minister tell the House whether there is a plan to require local integrated care systems to develop a local obesity prevention and treatment strategy for their population, strengthening existing services and sharing good practice across the national network?

Yes, I am glad to be able to reassure the noble Baroness that ICSs will be instructed to take obesity as part of one of their primary framework objectives. In fact, that is a very good example of how ICSs will make a big impact on complex issues such as obesity and how that impact will be felt in far-flung communities such as those in Cornwall.

My Lords, there is much to commend in the Government’s obesity strategy, but the restrictions on broadcast advertising are completely wrong-headed and based on no evidence whatever. In fact, I think that the Government’s own impact assessment says that it would reduce calorific intake by 1.7 calories—the calorie value of a Tic Tac. If the Government are determined to pursue this wrong-headed strategy, could the Minister assure me that they will not impose further restrictions on broadcast advertising until they level up and impose the same restrictions on online advertising?

My Lords, I can give my noble friend no such assurance. The decrease in sugar in soft drinks, as he knows full well, between 2015 and 2019, was 43.7%, and the increase in soft drink sales during that time was 14.9%. With six out of 10 adults and more than one in three children between the ages of 10 and 11 technically obese, clearly more needs to be done.

My Lords, I think that the noble Baroness, Lady Boycott, is quite correct, and I did appreciate the Minister’s last answer to his noble colleague. But perhaps the Government need to consider healthy food where they can actually influence this, such as in hospitals, schools and care homes, and reinstate standards for healthy foods in those places.

Yes, I entirely agree with the noble Baroness. There are parts of the Government’s estate where more could and should be done in order to promote healthy foods. I pay tribute to the work of Prue Leith, who has done a lot to champion healthy food in hospitals. Progress has been made; I visited Southampton hospital with her earlier last year and saw her bringing healthy food direct to the patients, and the use of trolleys in order to ensure that warm food is delivered and that food does not have to come out of a plastic bag. More can be done, but I reassure the noble Baroness that we are working hard at it.

The Sikh community has for some years run lectures and health checks in gurdwaras to reduce the calorie-rich diet of those from rural communities to one more suitable for the more sedentary occupations in the UK. Would the Minister agree that, with a little support from the Government, our places of worship can be of real help in reducing an above-average incidence of obesity and associated health risks in those from the subcontinent?

The noble Lord makes an incredibly important point, and he makes it very delicately. I am extremely grateful to him for bringing this to the Chamber. It is true that many people from rural communities in the subcontinent bring with them eating habits that are simply not appropriate for modern life. We have seen that in Covid, where some of the most challenging incidences of Covid ITU have been in communities with a high level of people from the subcontinent, whose eating habits have, frankly, left them in no good state to fight this horrible disease. Tackling that issue is extremely complex, and I am extremely grateful to the Sikh community for setting this good example.