Skip to main content

Health Incentives Scheme

Volume 701: debated on Friday 22 October 2021

Mr Speaker, with permission, I would like to give a statement on our mission to help people live healthier lives. The covid-19 pandemic has exposed so many vulnerabilities in our nation’s health and highlighted stark inequalities that we must work hard to put right. As a Government, we want to do everything in our power to tackle these disparities and to help people live in better health for longer.

We know that regular physical activity and a healthy diet are strongly linked to a higher life expectancy and a lower incidence of many chronic conditions. However, two thirds of adults in England are currently living with excess weight or obesity, and obesity-related illnesses cost the NHS £6 billion a year. Not only this, but obesity is more prevalent among the most deprived areas, so a vital part of our mission to level up across the nation must be to level up the nation’s health, and give everyone the tools and support they need to make a positive change to their daily lives.

Earlier this year, we announced £100 million of funding to help those living with obesity move towards a healthier weight, and this month we have launched our Office for Health Improvement and Disparities, which has a relentless focus on prevention and tackling health disparities across the UK. Obesity policies cannot just be about sticks; we must also reward healthy behaviours. Today, I would like to update the House on the next step in our plans—our new health incentives scheme. The evidence shows that incentives can have an important role in improving rates of physical activity and encouraging healthier eating. For example, in Singapore, its national steps challenge has shown promising results, so we have been looking at what we can do here at home to encourage people to take the little steps that can make a difference and also to pursue a more personalised and data-driven approach to public health.

In England from next year, we will be piloting a new scheme to help people make positive changes to their diet, called Fit Miles. The six-month pilot will see users wearing wrist-worn devices to generate personalised health recommendations, such as boosting their step count, eating more fruit and vegetables, and lowering the size of portions. Users can collect points for making these healthy changes that will unlock rewards, which could include vouchers, discounts and gifts cards. We will be making £3 million of Government funding available for these rewards, and we will be releasing more information on the location of the pilot and how residents can take part in due course.

The app will be available to all adults within our pilot area, but will have a particular focus on those who are not physically active and have poor diets, as well as traditionally under-served groups—for example, those in areas of high deprivation. I would like to reassure hon. Members that the app will have the strongest standards of privacy and security, and we will make sure personal information is always kept safe. This groundbreaking new pilot offers a brilliant opportunity to explore how best to inspire people to make positive changes to their daily lives, and it is a fantastic example of how Government, business and the third sector can work together to make a difference.

I would like to thank HeadUp Systems for providing its international expertise in data science and health technology, and Sir Keith Mills, who has been advising the Government on how we can best make use of these incentives. We have been able to bring to bear his vast experience of working on reward programmes such as Airmiles and Nectar points, and I would like to thank him for his invaluable support.

There is no greater gift than the gift of good health, and we are determined to make sure that people across the country can live in better health for longer. If we get this right, it will be good for our NHS, good for our economy and good for our society. This is a mission that the whole House can get behind, and today’s important announcement is a great step forward for all of us. I commend this statement to the House.

I am grateful to the Minister for advance sight of her statement.

We on the Opposition Benches have campaigned for many years against this Government’s short-sighted cuts to public health funding. A reduction in spending of a quarter in this area has led to growing obesity in our population, loss of smoking cessation services, a ticking time bomb of poor sexual health, and over-burdened drugs and alcohol services. Of course, any savings made by those cuts has been hoovered up by the impact on the rest of the health service.

Obesity is at crisis level in this country. Two thirds of adults are above a healthy weight; half are obese. One in three children leaves primary school overweight, and one in five is obese. We know that leads to reduced healthy life expectancy, poorer mental health, and worsened outcomes at school and work.

We are not going to argue against measures that attempt to help our public improve their health, but like the obesity strategy that precedes it, this latest pilot is tinkering around the edges. Of course eating better and getting more exercise is important for all of us, but the Government once again fail to adequately address a central point.

Tackling obesity is about tackling poverty. People in the poorest communities are twice as likely to be obese as those in the best off. Poverty limits someone’s food choices, their exercise choices and their time. Why does that not feature at the heart of the Government’s plans to tackle this scourge?

Let us be very clear: whatever this pilot achieves, and whatever the obesity strategy achieves, it will all get knocked into a cocked hat by the £20-a-week cut to universal credit, which will push millions of people on to cheaper, less healthy alternatives. That will happen to adults and to our children. Add that to the broader cost of living crisis and these plans really do look small beer.

At the very least, it is vital that this programme is targeted at those communities that will benefit the most from it, because those cuts to public health have been targeted disproportionately at the poorest communities. Will the Minister make a commitment today that those invited to join this pilot will come from those communities? Will she also commit that this scheme and the obesity strategy are to be followed with a restoration of moneys cut from the public health grant?

We will only tackle obesity once we start tackling poverty. This scheme offers the tantalising prospect of vouchers, merchandise, discounts and even gift cards. I think most people would settle for a Government who do not make them poorer, an economy that allows them a decent job on decent terms and conditions, and decent housing. Frankly, until we get that, this is just tinkering around the edges.

I thank the hon. Gentleman for his comments. We have a common purpose: on both sides of the House, we are determined to tackle obesity. The measures that the Government have already taken—we have allocated £100 million to tackle obesity—show that we are serious about this. That is a huge amount of money. It is important to realise that lots of different measures have already been put in place. This is not tinkering at the edges at all.

We began tackling the issue of obesity a number of years ago with the soft drinks levy. I was delighted that the money raised from that went to school sports. We then tackled inappropriate advertising and promotions, out-of-home calorie labelling and front-of-pack nutrition labelling. We have the weight management programme and numerous other activities. It is important that we look at the population measures that are in place, but now we are also looking, with this new pilot, at individual responsibility—personal responsibility. I am really encouraged by this new approach to tackling obesity.

The hon. Gentleman mentioned other public health issues. Once again, this Government are determined not only to halve childhood obesity by 2030, but to make our nation smoke-free by 2030. We are really committed to tackling the public health issues that, as he quite rightly says, are affecting some of the most deprived parts of our country. The fact that we have launched the new Office for Health Improvement and Disparities shows exactly where our commitment lies, and I will continue to fight for this cause as we move forward.

To address the hon. Gentleman’s question about who we will choose for the pilot, we are going to make sure that we choose the right area so that it can really make a difference. That is so important when we are spending public money.

When we came back from recess, I was hoping to ask the Minister one question this week, so to be able to ask her three questions in two days is an unexpected thrill. I am grateful to her for her statement, and I welcome what she says. No Government can stand by when there is a 10-year difference in life expectancy between the richest and poorest 10% in our society. These measures are important and will make a difference. But could I ask her about something even more worrying than adult obesity? On childhood obesity, we are still the second fattest country in Europe. Has she had any discussions with the Department for Education about one of the root causes of that, which is that for several decades we have not guaranteed daily sport and exercise to every child in every state school?

My right hon. Friend will be aware that, as the previous chair of the all-party group on obesity, this issue has been close to my heart for many years. Over my years as a Member of Parliament I have been delighted to join some of my local schools and run the daily mile. It is inspiring to do that as an MP and I encourage anyone who has not done it to do so. The kids get so excited by it, and I see the difference it makes to them. More specifically, I am yet to have a meeting with the Department for Education, but it is high on my agenda. Tackling child obesity is a No.1 priority for me, and it has been for a number of years.

Like my hon. Friend the Member for Nottingham North (Alex Norris), I cannot oppose what the Minister tells us here today, but it is frankly on a very small scale. The point made by the former Health Secretary, the right hon. Member for South West Surrey (Jeremy Hunt), is fundamental. We need a recommitment to getting sports back in our schools for our children and young people. In particular, we have never been good at engaging girls and young women to stay in sporting activity, and that is now something of an emergency. Can the Minister give us more than her personal example and say what the Government will do to make that happen?

I am here today to talk about this pilot and how it will be taken forward, which is exciting news. This will be across the population to ensure that a mixture of people take part: different ages, males and females. That is so important. Some of the information from that will help us to look at policies in the future. There are good programmes to engage young women in sports. When female football teams or tennis players do very well that encourages even more people to take up sports—not just women but across the board. Such successes will help to tackle obesity in a soft way.

I thank the Minister and welcome her news about this important pilot. Eating disorders can be devastating for so many families. On behalf of those families, can my hon. Friend confirm that the focus of this scheme is not weight loss, but encouraging people to adopt a healthier lifestyle?

My hon. Friend is exactly right. This is not stigmatising anybody. It is not about weight loss; it is about healthy choices and empowering individuals.

In welcoming today’s announcement, may I concur with my right hon. Friend the Chairman of the Health and Social Care Committee about the importance of ensuring that we start as early as possible in tackling obesity? In doing so, may I encourage the Minister to continue to support, through her Department, the funding of the primary PE and sport premium, which is worth around £320 million a year, as well to consider the core recommendation of a report by the Association for Physical Education, for which I chaired a taskforce, which looked at how we can ensure that PE is at the heart of school life and that every child leaves primary school able to swim and has PE as a habit for life, so that we tackle this as early as possible?

I thank my hon. Friend for his question and his work on the taskforce. This is something I believe in and have been working on across my Department and the Department for Education, too.

I very much welcome this scheme. Does my hon. Friend agree that it is about not stigmatising obesity, but helping people to adopt a healthier lifestyle, and that part of that should be a seismic shift away from ultra-processed food, which is high fat, high salt and highly addictive?

I completely agree. A lot of the measures that have been put in place on the population side have resulted in reformulation by many manufacturers. That is so important. The soft drinks levy is a prime example. Just introducing that levy meant that so many manufacturers changed their formulation. Putting calories on menus and the traffic light system on the front of packaging once again encourages and pushes manufacturers quite hard to reformulate, and that will address the issues that my hon. Friend mentions.

A few years ago the Food Foundation pointed out that healthier food is often cheaper in Europe than unhealthier food; perhaps we could look at that. The young people of Jamie Oliver’s foundation, Bite Back 2030, have identified that healthier options in schools are often more expensive and do not meet the proper standards, so will the Minister have a look at this issue?

Yes, that point has been raised with me, so I am aware of it. I am looking into it and will update my hon. Friend on the outcome of my investigations.

Eight months ago, I did very little exercise and had done very little running since school, but three weekends ago I ran the London marathon—[Hon. Members: “Hear, hear.”] Thank you. I raised more than £37,000 for my local charities in North Norfolk. Does my hon. Friend agree not only that is this a wonderful initiative that puts healthy eating at front and centre of one’s physical health, but that there are also untold benefits for mental health, as I have found in doing this job and running the London marathon?

I congratulate my hon. Friend on his great achievement, not just on running the marathon, but on raising so much money; that is amazing. He is quite right that feeling good about ourselves and getting exercise really does help our mental health.

I do not know why, but I feel overwhelmed to declare an interest in this particular topic. Does the Minister agree that it is often community organisations that provide the best outputs? Organisations such as Beeches Martial Arts and the Cofton Park Runners do so much to promote healthier living and exercise choices across the Northfield constituency. There might even be a role for local Members of Parliament to take part too.

Of course, I would always encourage local Members of Parliament to take part in and enjoy every activity in their constituencies. Just yesterday, I was having discussions with people from the public health arena, who talked about the importance of community-based activities, which are often run by charities and volunteers, and what a huge impact they can have on people’s lives, including on activity levels and weight management.

Does my hon. Friend agree that this a fantastic new initiative and pilot, and that it is perhaps the forerunner to making everybody aware that the best way to protect the national health service is for us to have the healthiest lives possible and to make the healthiest choices possible, so that we have a national health service that is protected and that does not continue to be a national repair service?

My hon. Friend is exactly right. Obesity costs the NHS at least £6 billion. However, it is not just about the cost to the NHS, but the cost to individuals as well. People who are obese are more likely to have diabetes, cardiac disease and cancers, so this affects their lives. If we get it right for the NHS, we are getting it right for individuals as well.

To pick up that exact point about diabetes, obesity is inextricably linked to type 2 diabetes, which can lead to damage to people’s feet, eyes and kidneys. What is even more concerning is that it is easily reversible with a healthy lifestyle. If this pilot is a success, will the Minister consider targeting it particularly at those who suffer with type 2 diabetes?

My hon. Friend has a lot of knowledge as a former GP.

The pilot will tell us so much. It will be fascinating and I am sure that there will be lots of learning points that we can take forward into different disease areas such as type 2 diabetes.

It is always good to have a Minister at the Dispatch Box making a statement. However, precedent says that on a private Members’ Bill day, statements are put on only if they are extremely urgent. It seems to me that this is about something for next year. There are 17 Bills to be debated today. Why was it urgent to have this statement in private Members’ time rather than Government time?

Obesity is a top priority for the Government and covid-19 has shown us the necessity of levelling up disparities in health. We know how important it is to update the House first and to allow it a chance to have its say, so I wanted to update it as soon as possible on this important issue.

I offer my belated congratulations to my hon. Friend on her appointment to her role. In her statement, she mentioned Singapore’s national steps challenge, which has shown how to give small incentives to improve people’s lives. Will she confirm that her Department will draw on the best practice from around the world as it develops and pilots the scheme?

We have looked at schemes from around the world. Actually, if we get this right, we will be world-leading on this issue, although probably behind Singapore—I will give it some credit for being there first. We have looked at different schemes globally and we feel that this pulls together what has been tried in different areas, as well as having some uniqueness about it, which I am looking forward to developing as the pilot moves forward.

I welcome the news that the scheme will be developed in partnership with businesses and the third sector—the private sector and charities—with that dream team of public, private and volunteers. Will the Minister confirm that her Department will look at outcomes and measuring them and will take robust anti-fraud measures to verify that users of the scheme who gain access to the rewards will have genuinely improved their behaviour?

I reassure my hon. Friend that many checks and balances will be put into the app and the scheme to make sure that they are used appropriately and effectively and that we get some good outcomes from them.

Can my hon. Friend reassure the House that we will look at best value for money with the scheme to ensure that we are saving money for the NHS? The last thing that any of us want to do is spend more money and not get financial rewards to protect our NHS and ensure that we have healthier lifestyles for everyone.

My hon. Friend makes a very good point. We are investing some money in the new pilot and we are confident that it will give us some outcomes that we can work on to take measures forward. If we can save a fraction of the £6 billion, it will be still be a huge saving for people’s health, but, obviously, we want to make sure that this is about saving money and saving lives.

I am tempted to ask the Minister whether bobbing in this place might count towards the app’s incentives. I know that all Members will appreciate my hon. Friend’s courtesy in making a statement to the House rather than this being announced in a press conference later in the day. As well as the national steps challenge, the Singapore Government launched its Healthy 365 app around a year ago. Will the Minister be looking both at Governments around the world and at businesses and public sector organisations in the United Kingdom that already operate app-based fitness incentives to make sure that we learn from the best and avoid replicating others’ mistakes?

My hon. Friend makes a very good point. Yes, we know that there is a lot of experience out there and we want to pull everything together to make sure that we have an effective pilot and know how we move forward from that to help people to get healthy, get fit and enjoy good lives.

Sometimes the risk of such schemes is that they become a little bit siloed. We have heard, in contributions from other Members, talk about co-operation. Can my hon. Friend reassure me that any insights will be used to inform the response across Government, and that she will ensure that we take a collaborative approach to ensure a long-term gain, not a short-term success?

I reassure my hon. Friend that we want to ensure that this is a long-term success. It is a pilot, so we cannot pre-determine the outcome. However, tackling obesity and the disparities that come with it are a No. 1 priority for the Prime Minister, and that goes across all Government Departments.

Three weeks ago, I joined my hon. Friend the Member for North Norfolk (Duncan Baker) and other hon. Members in running the London marathon. Modesty precludes me from saying which of us finished fastest. Does my hon. Friend agree that running, particularly the daily mile, is great exercise? Will she join me in congratulating everyone involved in King’s Lynn park run, which has just celebrated its 100,000th finisher?

I am delighted to congratulate King’s Lynn park run on its achievements, as well as park runs across the whole country. I am not a great runner—I am more of a sprinter—so I tend to avoid them, but I know the enjoyment that can be achieved by going along and improving one’s fitness, as well as the sense of community they bring with them.

As somebody who is carrying a Westminster stone, I could definitely do with losing a few pounds myself. More than three decades ago, I was more than six stone heavier than I am today. I lost that weight without the need for airmiles and Nectar points. Does my hon. Friend agree that the most important factors in good health are personal discipline and personal responsibility?

I completely agree with my hon. Friend, who obviously has great motivation. We want to help everybody to have great motivation. If we can do that through an app, we will be able to find out what really helps people to make such changes to their lives.

I, too, welcome the pilot, which I hope will help to tackle growing obesity. As the Chair of the Health Committee commented, obesity often starts in schools—I think one in five schoolchildren are obese by the time they leave year 6—so would it not be a good idea to extend the pilot to schools? I know how excited children are when they wear gadgets. That might help them to start to work towards a healthy lifestyle.

My hon. Friend makes a very good point. Kids are excited by new technology, but the pilot will be for people aged 18 and over. I take on board her suggestion and perhaps we can look at other ways to encourage kids to use technology to improve their outcomes.

I welcome this announcement. We cannot, unfortunately, all have the iron will of my hon. Friend the Member for Thirsk and Malton (Kevin Hollinrake), but study after study shows that gamification really does drive positive behaviour. Can my hon. Friend confirm that this is just one part of the Government’s strategy and that we are also looking at changing physical infrastructure to improve cycling and walking access?

My hon. Friend makes a very good point. We cannot do this with one action alone. To me, it is very much cross-departmental. Whether it is through planning legislation or encouraging people to be more active, there are lots of different ways we can tackle obesity and the health disparities it brings with it.

I am sorry to strike a discordant note, but with regard to the Minister’s justification for this measure may I remind her that it is not the role of life to support the NHS; it is the role of the NHS to support life? Many despair of an obsessive cult within the Department of Health and Social Care for nudging. Can the Minister advise me on how this proposal is different from a social credit system that is adopted in other countries?

We want to have a whole range of measures to tackle obesity. The important thing is that we know how much obesity costs the NHS—£6 billion is a huge amount. That money could provide for a lot of more operations. There are a lot of other ways to stop people becoming obese, or to help them to lose weight and become more active. That is better for the NHS and saves money for the NHS, but it also helps people’s lives as well.

As the Prime Minister pointed out at the Conservative party conference, life expectancy in Blackpool is 15 years lower than it is in some areas just a few miles away. This scheme will help to reduce those disparities. Does the Minister agree that Blackpool would be the ideal location for this pilot scheme?

I am not going to give a one-word answer on this occasion, but obviously the location will be chosen carefully and will be announced in due course.

The importance of engagement with the pilot survey has already been mentioned. Sedgefield, like most of our constituencies, has various demographics, but I am thinking of certain neighbourhoods in particular. The all-party parliamentary group for “left behind” neighbourhoods, which I chair, found that some areas do not have the capacity even to become engaged in programmes such as this. May I encourage the Minister to include people in “left behind” neighbourhoods in the survey? We have organisations such as Junction 7 in Newton Aycliffe, and if schools are likely to be involved, I have some fantastic ambassadors at Ferryhill.

Obviously we will be looking at ways in which we can engage people, and ensure that they are fully aware of the pilot and have ready access to it.