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Obesity (Young People)

2 pm

Mr. Nigel Evans (Ribble Valley) (Con): I am delighted to have the opportunity to raise a subject that is of interest to people inside and outside the House.

The problem of obesity is spiralling out of control in the United Kingdom, although it is not unique to this country and affects others too, notably the United States of America. Already, 8.5 per cent. of six-year-olds and 15 per cent. of 15-year-olds are classed as obese. It is estimated that the cost to the economy of obesity is around £7.5 billion and that obesity reduces life expectancy by nine years. The BBC has reported that more than 30,000 deaths a year in England alone are caused by obesity. We know too that obesity leads to other health-related problems, including arthritis, heart disease and diabetes. In addition, there is the risk that certain cancers, such as prostate cancer, are more difficult to diagnose in those with obesity.

It is in young people, however, that the problems have increased at an alarming rate. Since 1982, the number of obese children has doubled. If present trends continue, half of all children in the United Kingdom could be termed obese by 2020. We need to take action now, before it is too late for our children. There is an acknowledged problem, so action is needed now. When I talk about obesity, I am not referring to a genetic condition termed Prader-Willi syndrome, which I believe was the subject of a BBC 2 documentary last night.

What is being done to help young people not to become obese? The "Choosing Health" White Paper is a welcome step in the right direction. The Prime Minister notes in the foreword:

That is okay as far as it goes, but the Government should ensure that young people receive the information that they need to make the correct choices. If people are not doing enough exercise and are not maintaining their health with the information that the Government provide—the figures that I have quoted prove that people are not—much more must be done to give information to young people. I mentioned the cost of £7.5 billion, which is a huge drain on the economy, never mind the fact that the quality of life for young people with obesity will be dramatically altered.

Obesity is on everyone's radar screen. I welcome the Health Committee's report on obesity from last year and I am delighted that hon. Members who serve on that Committee are here this afternoon. On 9 February, between 8.15 am and 10 o'clock, the hon. Member for Dartford (Dr. Stoate), who is also here, will hold a mini conference to discuss the White Paper.

I read with interest the Hansard report on the hon. Gentleman's debate on the same subject in January 2003, which I am sure he remembers well. The then Under-Secretary of State for Health, the hon. Member for Tottenham (Mr. Lammy), said:

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He continued:

Two years on from that debate, why has so little been done on obesity? Talk is clearly cheap, but we now need action to ensure that the problem is properly tackled.

Physically active people have a 20 to 30 per cent. reduced risk of premature death and a reduced risk of contracting major chronic diseases such as coronary heart disease, stroke, diabetes and cancer of up to 50 per cent. It is estimated that more than one in 200 people in the UK are diabetic and that the figure is dramatically increasing. It is clear how important it is not to be obese or overweight and to take physical exercise.

Some 30 per cent. of boys and 40 per cent. of girls are not meeting the recommended one hour a day of physical activity for children. It is in school that that should become second nature, as part of their way of life. The number of obese children has tripled in the past 20 years. Physical education is a compulsory part of the national curriculum up to key stage 4—or 16 to the rest of us. In 2001, the Labour party manifesto stated:

We now know that that target has been missed. According to the Department for Culture, Media and Sport, sport and physical activity among five to 16-year-olds has actually declined since 1999. According to teachers, children are lucky to get two 45-minute sessions a week. Given the time that it takes to get to the gym, change and have a shower afterwards, we are talking about nothing like 45 minutes, and children would be lucky to get two sessions of half an hour, which adds up to one hour a week.

Recently, I spoke to Heinrich Ungerer, a PE instructor from County Hall gym. He said that young people should exercise at least three times a week, spacing their exercise sessions out within the week so that their bodies had time to repair. He believes that many young people rely on their metabolic rate to hide the fact that they simply do not do enough exercise. It is my view, therefore, that physical activity provision in schools should be increased so that youngsters get exercise at least three times a week—Monday, Wednesday and Friday—and for at least an hour each time, not including the time that it takes for them to change and shower.

I am of the considered belief that, in the past, physical activity, or PE, was always seen as an add-on—it was something that we had to do, but if we could not do it, we would not be too bothered. Furthermore, some of the equipment in schools, certainly in my day, was not up to the job. Physical education in schools should, however, be as important as maths, reading and writing, and I hope that the Minister will confirm that she, too, believes that it is as important as some of the other subjects in the curriculum.

We also need to make it exciting for young people to go to the gym. I referred to the facilities in schools in my day, but we know that state-of-the-art equipment is now available in the best gyms in the country. I do not see why our youngsters should suffer, and I hope that the
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Minister can give us some good news about ensuring that all schools can now start to re-equip their gyms with state-of-the-art equipment so that youngsters will be encouraged to use them.

Clearly, a one-hour session will not be enough for students to stay fit, and there are initiatives to help children who are being failed by the education system. I can point to things that are being done in my constituency, and I suspect that all hon. Members could do the same in theirs. For instance, I am president of the Clitheroe Wolves football club, which is led by George Hibbert, and I pay great tribute to him. Every Saturday, he has up to 400 boys and girls of all ages out training in Clitheroe. They play football regularly, and they play in teams too. That is superb. Clearly, with 400 youngsters, he does not do that all on his own; he has a number of other dedicated volunteers to help him, and I pay tribute to them. I saw them working last summer in Clitheroe, and it was fantastic to see so many youngsters out enjoying themselves. Clearly, the scheme is outside the education system.

I have also been in touch with Farouk Hussain; he, too, is a volunteer, and he works with other volunteers to run the Clitheroe cricket club for youngsters. He says that, on Thursdays, well over 100 youngsters regularly take part in exercising through cricket. He also has 35 youngsters who coach themselves and other youngsters; that is not only helping them to keep fit, but teaching them leadership. I congratulate him and his volunteers.

In Wales, people over 60 are entitled to free swimming, and some youngsters are also eligible. A constituent asked why that provision could not be extended throughout the country, and the Minister responded that it was not possible for the Government to provide such schemes. However, swimming is one of the healthiest forms of exercise that we can do, and I hope that the Government will look again at the issue. I hope that they will look at what is happening in Wales and at why we cannot extend that throughout the country.

I also congratulate those involved in sporting events such as the London mini marathon, which has been going on since 1986. Teams can enter from all the London boroughs, and there are also 10 county teams and home county teams from Scotland, Wales and Northern Ireland. Many of us will be familiar with other mini marathons that take place throughout the country, encouraging youngsters to get fit, undergo training and participate in and enjoy running in the marathon.

Professional football clubs must also be congratulated on the work that they do with youngsters. Blackburn Rovers is just outside my constituency. The club runs a number of programmes designed to tackle obesity and promote healthy eating. The students study what a player eats in a day, comparing a player's diet with what they eat, and consider questions such as, "why should you eat healthily?" The club also gets the children to monitor their physical fitness by running up   to 100 m and then monitoring their heartbeat. Programmes are designed specifically to meet the different needs, ages and academic abilities of the pupils. They also consider other important health issues such as the dangers of alcohol. A number of other professional football clubs participate in such schemes, and we should encourage the spread of such schemes throughout the country to all football clubs.
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It is also important that there is provision for physical activity in the workplace. I asked BAE Systems, which is based in Samlesbury in my constituency, what sort of facilities were provided and found that there was a sports and social association—a gym at the factory with up to 500 members, about 20 per cent of the work force. But the company also encourages youngsters into its grounds to participate in sport in the summer. More such initiatives should be encouraged.

In the workplace, there is a tax of 20 per cent on "free" memberships of gyms at work as a benefit in kind. I know that the Prime Minister is looking at taxation as a way of incentivising people to take out gym membership. Indeed, we should be looking at ways of ensuring that we at least do not penalise companies when they offer free gym membership to their workers. So I hope that when the Chancellor of the Exchequer speaks in just over a couple of months' time he will be able to give some good news in this regard.

I have discussed physical activity. Now I shall speak about food education. Education in what we eat could go some way to stem the problems of obesity. Food education is loosely mentioned in some of the subjects covered at school, such as science subjects. When young children are taught about keeping their teeth clean, they are told which foods can be harmful to their teeth. I have learned of schools that have personal, social and health education that includes some teaching on healthy eating, but there is little direction and there are few examples of firm education on how to lead a healthy lifestyle. Including that in the national curriculum would benefit youngsters and the whole country. Most adults and children do not meet the dietary recommendations of five pieces of fruit and vegetables a day.

I welcome an initiative mentioned in one of today's newspapers, led by the hon. Member for Croydon, Central (Geraint Davies), who is campaigning and trying to enforce nutritional standards for school meals. Under his private Member's Bill, nutritional information would be displayed on school menus and vending machines on school premises would be regulated. Any increase in the amount of information that we can give to young people about what they eat must be welcomed.

I have been contacted several times about the food that is provided in vending machines in schools. I welcome initiatives by the Dairy Council and the Food Standards Agency, such as the healthy drinks vending study in 12 secondary schools across England and Wales. The pilot, managed by the Health Education Trust, examined the likely demand for healthy alternatives to carbonated drinks. For 24 weeks vending machines containing healthy drinks such as milk, water and fruit juice operated alongside more traditional machines. I read that the scheme was a great success. It gave youngsters choice and around 70,000 drinks were purchased from the machines, the most popular being semi-skimmed milk, milkshakes, mineral water and pure juices. With schemes like this, we can make a direct impact on young people's lives. Although this was a pilot and a leaflet was produced and distributed to 9,000 schools, it is no promise that things will change in schools without direction. We need clear commitments from the Government to ensure that drinks like these get into school vending machines.
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Fast food is always the butt of everyone's criticisms when it comes to talking about obesity. The Health Committee had meetings with McDonald's, among others, concerning obesity. A recent article in the Financial Times highlights these anti-fast food sentiments and I believe that Brussels has given the food industry a year to stop advertising its fast food in the way that it does and to improve product labelling or face legislation from a European level.

I went to McDonald's when it had one of its open days at the top of Victoria street. I was pleased to see that it is beginning to recognise that there is a problem, and that it wants to give its customers a varied choice. It has introduced items like fruit segments, which it never had before. Super-size meals have been junked out of the window, and salads have now started to feature on the menu. It also makes skimmed milk available to customers. I welcome its initiatives, such as partnerships with the four home-nation football governing bodies, which will create 10,000 community coaches across the United Kingdom between 2002 and 2006. McDonald's calculates that those partnerships have led to children aged seven to 16 across the country receiving an extra 800,000 hours of coaching. McDonald's seems to recognise its social responsibility: it provides food, giving more choice to youngsters, but it is also doing something about exercise, which is absolutely right.

There has been a similar movement to promote a healthier lifestyle by Coca-Cola, another company berated from time to time for its products. The company has a four-point strategy for supporting healthier diets and active lifestyles, including initiatives such as offering greater product choice, more low-sugar and diet drinks, greater promotion of Diet Coke, the expansion of responsible sales and marketing practices, such as commercial-free zones in schools, and the encouragement of communities to take part in a range of grass-roots sports, including the schools football cup, which a number of youngsters participate in. As hon. Members will know, I have my own retail convenience store, and what I hear about the sale of Diet Coke now being greater than the sale of ordinary Coca-Cola is certainly reflected in my business. I welcome the company's decision not to brand its vending machines, which will offer a full choice, especially of the lower-sugar and diet products. I understand that it has just introduced a smaller size of Diet Coke can as well.

I hope that the Minister can give us some good news following today's debate—one of many that we have held in the House on this subject. Will she look carefully at ensuring that the level of activity for children in schools will be increased, that activity will be treated as seriously as other subjects on the school curriculum, and that sports facilities generally will be improved and made more available to children, particularly in summer? I cannot stand the fact that when the schools close in summer, the sports facilities alongside them close as well. We have mentioned that time and again in the House over the past few years. The excuse, or maybe a legitimate reason, is that they are afraid to open up, let us say, the soccer fields or the tennis courts because they cannot get insurance. The facilities would have to be insured, and people would have to be paid to monitor the youngsters. I hope that the Minister will look at making facilities within schools available during school holidays, and in the evenings. I know that a lot is done
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with community school sports facilities—we have one in Longbridge, in my constituency—and we must ensure that they are also fully supported.

On the nutritional side, more information must be given to youngsters, both in the classroom and in the dining room, regarding the nutritional value of what they are eating and the long-term effects if they do not correct their diet and balance their lifestyle with healthy exercise. That is vital. Fruit, for instance, is a cheap and economical food these days, and in many supermarkets is cheaper than some of the other foods that youngsters buy. Fruit is filling and hugely good for them. We need to give that information to youngsters so that they can make intelligent choices. Unless we do so, we are storing up much greater problems for ourselves in the future.

2.19 pm

Dr. Howard Stoate (Dartford) (Lab): I am pleased to be called in a debate of enormous importance not just to the House but to everyone in the country. I am pleased, too, that the hon. Member for Ribble Valley (Mr. Evans) has secured an opportunity for the House to look in hard detail at an extremely worrying and important issue.

I am particularly pleased to take part as I understand I am the only practising GP left in the House. I chair a number of Back-Bench all-party groups—the all-party group on obesity, the all-party group on primary care and public health, the all-party group on pharmacy and the all-party group on men's health—all of which have taken an active interest in the problem of obesity. I co-authored, with my research assistant Bryan Jones, a report published just over a year ago by the Fabian Society called "All's Well That Starts Well". That came up with some controversial views that were well received and debated by people outside—in the media and across the country—and again contributed to the debate.

I am pleased to be president of Team Darenth, a cycling club in my constituency. The club is one of the largest and most successful in south-east England. It teaches young people how to ride their bikes safely and how to use cycling as a sport and hobby—indeed, as a learning experience for life. Many young people are benefiting from that club and the person running it, Michael Humphries, has put great efforts into making it a success.

Along with other hon. Members, I have on many occasions referred to a time bomb of obesity. I must be slightly out of date as my friend and colleague Dr. David Haslam, chair of the National Obesity Forum, says that the time bomb of obesity has already gone off and what we are now waiting for is the time bomb of diabetes and heart disease that will follow it. That is what we are facing. The hon. Member for Ribble Valley has already alluded to obesity leading to significant increases in diabetes and heart disease. What he did not mention is that someone with a body mass index of 30 and above faces anything up to 30 times the risk of getting diabetes at some time during their life.

When I was a medical student, type 2 diabetes was considered to be a disease of middle and old age—indeed, it was called maturity onset diabetes. It is now called type 2 diabetes partly because we are seeing it
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happening in much younger people. It is wrong to call it a disease of maturity and middle age, as it can now happen in the teenage years, or even before.

It should be a worrying pointer for us all to be seeing significant numbers of children coming through diabetic and endocrine clinics in our hospitals, suffering from diabetes. Those children face a hugely increased risk of heart disease, early death, blindness, loss or amputation of limbs. The complications of diabetes are pretty unpleasant and the longer one has it, the more complications arise. Therefore, a person who gets diabetes in their teens has an extremely high chance of complications as they get older. That wrecks not only their own lives, but the lives of their families. As the hon. Gentleman has mentioned, it causes a huge drain on resources for the entire health service and the wider community.

I do not need to rehearse the statistics that the hon. Gentleman mentioned, but he is right that the number of obese children has trebled in the past 20 years. That should give us all pause for thought. Another worrying statistic is that, in a typical week, one in five children eat no fruit at all, according to the national diet and nutrition survey in 2000. Nine out of 10 children taking packed lunches to school have lunches that contain far too much fat, salt and sugar. Therefore, we face a massive problem.

It is not right to say that the Government have not taken the matter seriously. As the hon. Gentleman said, I secured a debate about this important issue a couple of years ago. I am extremely gratified by the huge amount of work that the Government have done, particularly the Minister who is on the Front Bench today. In publishing the recent White Paper on public health, she has made an enormous contribution to this topic. It would be wrong to score party political points by saying the Government have not taken it seriously, when clearly they have.

I know that the Minister will go through the arrangements the Government have put in place in more detail, but I want to recap a few of them to give hon. Members an idea of the range of topics that the Government are addressing. For example, we are trying to ensure that children have equal access to healthy living, a main area of action outlined in the White Paper. Meanwhile, the Sure Start programme, which is already helping children with healthy living, will develop new child development projects, including volunteers visiting families who are under stress and who need extra support.

That is very helpful, as is some of the action that is targeted at schools such as the national healthy schools programme, which is encouraging schools to foster better health. The provision of free fruit and vegetables to all children aged four to six has been enormously popular in my constituency. When I visit schools in my area, particularly primary schools, many children are extremely pleased to get their free fruit every morning in school. I find that extremely helpful. They are teaching their own parents to buy and eat fruit. That has also been important.

The Government are working hard on revising school meals to improve their nutritional content. There is more support for cycling to school and for promoting sport in schools. At least 400 sports specialist schools are
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to be established over the next few years and the food in schools programme, a joint venture between the Department of Health and the Department for Education and Skills, will help to ensure that children have access to healthy choices of food in schools. The programme will develop a range of nutrition-related activities and projects in schools to add value to some of the other things that they are doing.

Another cornerstone of the White Paper is the promotion of joint action by local authorities and business voluntary groups to tackle local health inequalities and other issues. People are to be encouraged to become more active through cycling and walking initiatives and will have easier access to sports facilities. By 2006, local authorities are forecast to have built more than 7,000 miles of new cycle tracks and cycle lanes.

Consumers are to be helped to choose healthier meals by a colour-coded system of food labelling and will have more guidance on portion sizes, while the Government, working with the food industry, aim to reduce levels of salt, added sugars and fat.

Mr. Simon Burns (West Chelmsford) (Con): In what is known as the traffic light system of labelling—the hon. Gentleman has a medical background, which may help—what colour would the label be for an avocado pear? On the one hand it is a fruit that we are encouraged to eat; on the other hand, if eaten regularly, it could cause one to become quite fat.

Dr. Stoate : There are several responses to that question, but most of the deprived children in my community are not worrying too much about avocado pears. We need to concentrate more on the staple foods and diets that they will be eating.

Mr. Burns : Answer the question.

Dr. Stoate : The answer is that there will always be difficult areas at the margins, and we must make a sensible and grown-up decision about certain foodstuffs that do not easily fall into a category. The hon. Gentleman is right. There will be some foods at the margins that will be difficult to classify, but that does not undermine the point of the scheme, which is to give people simpler, more straightforward and more helpful advice, particularly those who have to feed large families on relatively fixed incomes.

Mr. Burns : May I try again? If the aim is to have better, simpler, comprehensive labelling, so that consumers know what they are buying, is not it unhelpful that three different supermarket chains are working on their own labelling systems, which are all at variance with one another and will simply cause more confusion?

Dr. Stoate : I entirely agree with the hon. Gentleman. It is nonsense for different companies to work on completely contradictory schemes. I hope that the Minister will be able to explain how the Government will work with the different food retailers to make sure that they produce a harmonised scheme that is simple and easy to understand. I agree with the hon.
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Gentleman that it is easy to pick holes in such initiatives, but their point is to make life much simpler and more straightforward for those who are struggling.

Seventy per cent. of young families admit that they do not have enough information to ensure that their children are fed healthily. That is a worrying statistic,   and I am pleased that the Government are looking at it and are trying to improve it. Although there will be difficulties and problems in achieving that improvement, we must help the 70 per cent. of families who are struggling to feed their children because of a lack of appropriate knowledge.

Mr. Evans : The hon. Gentleman is a doctor, and it is good to have a doctor in the House on these occasions, but surely the whole point of giving youngsters and parents information is so that, when they are deciding what to eat, they can choose a balanced diet. Eating the same foods is not a balanced diet. Sometimes they can have chocolate or chips, but not at every meal, not three times a day.

Dr. Stoate : That is entirely the point; it is exactly what we must concentrate on. No one is saying, "Chocolate is always bad. Coca-Cola is always bad". Of course they are not. What is bad is the proportion of the diet that those foods make up. People should be free to eat what they want, but if they have the information to make choices that balance their diet and can choose from a wide range of available foods, which I am pleased to say most shops now stock, that will improve nutrition. Therefore, it is a question not of banning foods or making them difficult to get, but of making sure that people have the right information to make balanced choices for themselves.

I want to scotch the idea that we are producing a nanny state—that is precisely what we are not doing. The Government are ensuring that people are properly educated in order to make choices for themselves. At the moment, when anyone raises the issue of obesity in the House, the newspapers jump on it and make it look as though the Government are telling people how to live their lives, which is exactly what we are not doing. I am pleased to be able to make that point.

As I have said, there is an awful lot going on. In 2007, the Government will launch a new health initiative, health direct, which will be an online service and phone helpline that will allow people access to all sorts of information to improve their health. The Government have done a lot, but I am not complacent and we are not yet reversing the trend. Although they are on the right track, it is not working yet because we are still seeing an increase in obesity in children. The problem is getting worse, not better, so much more must be done.

The extraordinary thing about nutrition is that children are not born with a particular taste in food. They are not born wanting burgers, chips and cola; that is learned behaviour. We must tackle the problem at the point where children learn that behaviour. The situation is a bit like that of smoking. Once someone has become a smoker, they are a smoker. If we can prevent them from taking up smoking, it will have a great effect on their health chances.

The same thing applies to young children. Something happens at a very young age to many children that turns them on to a diet that is far too high in saturated fat,
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sugar and salt. If we can get a handle on that early formation of their dietary preferences, we can make an effective difference. Hopefully, they will then grow up with a taste for less unhealthy foods, healthier options, more fruit and vegetables and less saturated fat.

We need to concentrate far more on food education, which has become increasingly marginalised in schools during the past 20 years. I understand that there is increasing pressure on the curriculum for all sorts of core subjects, which must be tackled. Often, however, schools lack specialist equipment, kitchen space and appropriately trained teachers, which is one of the biggest problems. That has led to the statistic I cited earlier: 70 per cent. of parents do not know how to feed their children effectively. They did not learn how to do that at school, so it is hardly surprising that they are unable to pass the relevant information on to their children.

We should make food education a compulsory part of primary and secondary education. Unless children are brought up with a good understanding of what constitutes a healthy diet and how to make such choices, there is little chance of them getting it right. As we know, there is a statutory obligation for primary schools to offer food technology lessons, but that does not apply to secondary schools. The Government recommend that schools offer students the opportunity to study food technology. However, 10 per cent. of schools offer nothing at all and many give students only a limited introduction to the subject.

At the moment, the food technology syllabus comes under the heading of design and technology, which means that students are far more likely to spend time designing the biscuit packaging than understanding what the biscuit contains and whether it is good for them. Obviously, altering the curriculum will have significant cost implications. For a start, schools will need extra grants to invest in kitchens and equipment. Teachers will need help to get the necessary training. There would be a cost implication, but we have a duty to consider that to see where Government, local authorities and local education authorities can help to put things right.

Mr. Evans : One of the statistics that I used showed that obesity costs the NHS about £7.5 billion. We are talking about shifting the money from when the problem exists to before it exists. I suspect that a percentage of the money used to tackle the problems of obesity after it has happened could be used to prevent it, which would mean that we saved more money than we spent.

Dr. Stoate : I happen to agree with that constructive comment. We could do that if we recognised the opportunity cost of transferring some resources into prevention. The hon. Gentleman is right. Such initiatives can be brought to bear to improve the position.

There is an initiative in my constituency called "Don't Sit, Get Fit", which is an excellent example of what can be achieved in schools and the community. It has given scores of children in Dartford and Gravesham the
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opportunity for the first time to take part in regular out-of-school exercise and to learn about healthy eating. Its latest initiative, a healthy living calendar, involved 12 primary schools in Dartford and Gravesham each contributing a healthy recipe. That is a valuable resource. Last week, I met children who were involved. They were extremely energised and enthused by it and were learning a lot from it.

The other area of the school curriculum that is vital is physical education. The Government's White Paper, "Schools—achieving success", gave a commitment that all children will be entitled to two hours of physical education a week. I accept the point that the hon. Gentleman made. Two hours does not always necessarily translate into two hours of actual activity, as there are issues at each end of the lesson. However, at least it goes a long way towards putting that right.

To back up that commitment, the Government have already spent more than £1 billion on the development of school sport. It is hoped that, by 2006, 75 per cent. of all pupils will be participating in physical activity and sport each week. That is encouraging.

The Government are also encouraging schools to develop stronger links with the community and sports clubs to encourage kids to continue their interests outside school. One in five year 2 to 11 students in sports partnership schools now participate in clubs with links to their schools. Again, that is spreading out into the wider community, which is the sort of thing that we need to do.

If we focus on schools as the main driver, the benefits can spill out into the wider community. The cycle club that I mentioned is based in school premises, which the school has made available to the club to use at weekends. To answer the point that the hon. Gentleman made about school facilities not being open outside school hours, they often are. Team Darenth is able to use the school at weekends and has free access to the school grounds, the playing fields and all the things that are needed to ensure that the kids have access to off-road safe cycling and facilities. It can be done. It is just a question of the initiative needed to get it going and the will to drive it along.

I would like trained specialist coaches, particularly from some of our prestigious sports clubs, to go into schools. I know that some already do that, and I think that that could be widened. I would like school sports facilities to be made more accessible to other members of the community, so that the benefits from the school spill out into the community and the community comes into the school to use its sports facilities and other equipment. That can foster closer links and hopefully forge greater partnerships.

Another area that we need to consider is transport to school. Currently, only one in 11 primary school children travel to school unaccompanied, compared with one in five a decade ago. The number of children being driven to school has increased enormously over the past 20 years. We need to do something to reduce the dependence on car transport and to encourage more kids to walk and cycle to school regularly. That is essential to get them into the habit of taking daily exercise. It is not only exercise at school that is important, but the exercise that they get while going to school and the other things that that will achieve. The
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Government have made £50 million available to help schools and local authorities to draw up measures to reduce car dependency. Again, that is a successful start. It obviously needs to go further, but it is an important beginning.

Another problem is access to fresh food. In the UK today, we buy 80 per cent. of our food in the main national supermarket chains. Those supermarkets are designed and located to cater for the affluent car-owning majority. If one does not have a car—one in five of us does not—access to supermarkets, which are often in edge-of-town locations, is severely reduced. The Government are now revising planning guidance to prevent any edge-of-town spread. However, in my constituency, many of the supermarkets are based on the edge of communities and are quite difficult to get to if one does not have access to private transport.

A young mother with two children in a pushchair, trying to carry home the weekly shop on a bus, would know what I mean. It is extremely difficult. Many of them have to resort to taxis, which they can ill afford, or else they have to shop in more expensive shops that offer a narrower range of foodstuffs. That issue needs to be tackled if we are to reverse the trend.

Mr. Burns : How?

Dr. Stoate : Quite often, the shops in the middle of towns not only offer a more restricted range of food but are more expensive. They do not offer the choice that supermarkets do.

I will give the hon. Member for West Chelmsford (Mr. Burns) an example. A basket of healthier food is significantly more expensive than a basket of unhealthy food. A survey was carried out a while ago in a London suburb that showed that a basket of healthy food is 41 per cent. more expensive than the equivalent basket of less healthy food. That obviously puts a huge strain on the budget of families with limited incomes. It means that they are much more likely to choose foods that are less healthy for their children purely on the ground of economics. We need to look hard at that to ensure that healthy, fresh produce is priced in a way that makes it accessible to members of society with less disposable income.

Quite a lot of work has been done on street markets. Many street markets, which often offer a wide range of affordable food, are being squeezed by some of the large out-of-town developments that tend to have a negative impact on many market towns. The number of market stalls reduces as supermarkets gain a greater market share. That puts more pressure on costs and can drive them up beyond what many people can afford.

Mr. Paul Burstow (Sutton and Cheam) (LD): I take the hon. Gentleman's point about the changes in Government planning guidance that will move supermarkets increasingly from the edges to the centres of towns. How, precisely, will that change help those markets?

Dr. Stoate : One of points that I wanted to make was that we need incentive schemes. There are still many difficult estates that are, effectively, food deserts. Often, there are no shops in those inner-city areas, or the shops
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that are available offer narrow choice and foodstuffs that are not necessarily appealing to people, or do not have a sufficient range.

I should like the Government to look hard at the idea of a fresh food audit for some of our difficult towns and cities, which would discover what fresh foods were available there. If areas fell below a Government standard for the fresh food that should be available, serious consideration should be given to tax breaks or subsidies to ensure that those foodstuffs were available to people who could not get access to out of town shopping centres.

I know that my suggestion is a bit controversial and I do not expect the Government to promise such a bold step at once. However, I want them to take a hard look at ways of improving the availability of foods in areas where people have low incomes and poor access to transport, and find it extremely difficult to get healthy food for their families. If we could get that right, it would make a huge difference to nutrition and to the massive burden of obesity that we all face. It will affect the whole country sooner or later. If we do not tackle the problem now, we shall all face the consequences in years to come.

2.41 pm

Mr. David Amess (Southend, West) (Con): I congratulate my hon. Friend the Member for Ribble Valley (Mr. Evans) on securing the debate. Seldom have I heard him speak with such passion and enthusiasm. He was entirely right to choose the subject of obesity in young people. I was initially concerned when he seemed to concentrate most of his remarks on physical activity, but he more than redressed the balance in the latter part of his speech. I think that the emphasis, in dealing with this problem, should come from the fact that we would not die if we did not engage in physical activity but would die if we did not eat and drink.

Four hon. Members are present for the debate, and all are or have been members of the Health Committee. I consider our report on obesity to be the most profound of any that we have produced since I became a member of the Committee. I do not want to pre-empt remarks that I hope to make on 10 February when the Minister will respond to our report. I simply want to say that the Health Committee report has led the way on the subject of tackling obesity.

After the Obesity Awareness and Solutions Trust came to see me at my surgery and shared with me a significant number of problems that rather large ladies face, I attended a meeting of the Committee in which we considered our future programme. In complete naivety I suggested the subject of obesity and all members of the Committee agreed. Now our report is of national and international importance.

When I asked the producer of the BBC's "Fat Nation" programme, "You do know, don't you, all about the Health Committee report and the fact that we started this?", I was reassured when she said that she will run the programme for two years and that she is not into gesture politics. I am sure that all hon. Members have been sent videos in connection with ITV's Britain on the move campaign. I am told that those running it are not into gesture politics either. They will continue with the campaign for a considerable time.
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No politician or Government should be engaging in gesture politics on this subject. It cannot be cured by photo opportunities of politicians on bikes, or taking part in marathons, or with young people. If the country is serious about dealing with obesity—and it is not yet—doing so will take at least two decades. That is why it is so important that the Government listen to the Obesity Awareness and Solutions Trust strategy for dealing with obesity. I am sure that the House of Commons is sick to death of listening to all the statistics about how many people are obese and how many ailments one can contract as a result of obesity. The House does not need any more proof that obesity is a serious subject. We need some action and leadership; we do not need gesture politics. That is why I look forward to the Government's response on 10 February to our Select Committee report.

Southend does not intend to wait for the Government to act; we intend to lead the way with initiatives. The Minister of State has been in correspondence with me about a frontier-leading production by Sally Lawrence. I can sense that a general election is on the way, as everybody is mentioning local initiatives so I am not going to step away from that. My constituent Sally Lawrence, from Outloud Productions recently came to see me at a surgery with a great idea to promote healthy eating among young people. Her production, "An Unhealthy Invasion", is an innovative approach to promoting healthy eating. The Minister's letter arrived today with her views on the initiative. In the production, the characters, Healthy Kid, Vitamin Girl, High Energy and Protein Dog join forces to rid the world of Gargoyle the Greedy and end his oppressive reign of obesity. The production's use of comic book-style characters is an excellent way to tap into the mindset of young children and teach them about the problems of obesity.

My hon. Friend the Member for Ribble Valley has concentrated on young people. Those of us who have children observe daily how young people live their lives. I have five young children. We have a black labrador dog, which requires a great deal of exercise. If I were to ask my children, "Would one of you kindly take the dog for a walk?", one or two expletives would be let out, and eventually one of them would go to the front door, open it and let the dog out of the house. The idea that young people are overwhelmingly and regularly into physical exercise in the sense that my hon. Friend has mentioned, is absolutely ridiculous. I can say that with all the experience of my children, who are attending school.

Young people live in a completely different style to that of hon. Members present. I walk a lot; young people do not. Those of us with children often run a taxi service. If they want to be dropped off at a party or see their friends, they do not walk half a mile, they say to mum and dad, "Can you give me a lift?" Mobile phones, the internet: all that technology has meant that young people, as they go about their daily lives, do not participate in as much physical activity as they used to.

I hope that in 2012 we will have the Olympic games in London. I totally support that. If we are successful, it will provide a big boost for physical activity among young people. However, we cannot wait until 2012; we cannot wait until the announcement this year; we have to do something now. My hon. Friend the Member for
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West Chelmsford (Mr. Burns) referred to the traffic light system. During the Health Committee's inquiry into obesity, we visited America and had talks with McDonald's and Coca-Cola. We were all appalled at what we witnessed. We found those companies in a state of denial. They did not want to talk about the amount of sugar, salt and fat in their products. They were much keener to talk about the emphasis that they wanted to place on physical exercise. I feel strongly that our battle is with the food manufacturers.

In the last parliamentary Session, I raised with the then Under-Secretary of State, the hon. Member for Enfield, Southgate (Mr. Twigg), the issue of healthy eating in schools. In America, we saw healthy schools and unhealthy schools. We saw some schools where one could get snacks at any time. At other schools, there was a ban on access to those snacks. The Government cannot step away from the issue. If schools in the United Kingdom say, "We cannot do away with vending machines because it would adversely affect our income", the Government must address the matter.

Mr. Burns : Am I right in thinking that my hon. Friend was a strong supporter of Baroness Thatcher when she introduced the local management of schools, which gave to governing bodies and head teachers the powers to run our schools? As my hon. Friend is nodding, I assume that he did support it. Surely it is up to governors and head teachers to take decisions on vending machines and not for the Government to interfere and lay down the law.

Mr. Amess : My hon. Friend has guessed the next point that I was going to make. It is entirely a matter for the governing bodies of those schools to determine priorities and to ensure that healthy eating and tackling obesity are at the top of the agenda. As far as the Government are concerned, guidance is advisable. I cannot see any reason why the Government should not let it be known that they hope that the governing bodies of our schools take the initiative on the issue. I am delighted to say that some schools in my constituency, for example St. Christopher's school, have taken the initiative on vending machines. At Belfairs high school, which I visited last Friday, healthy eating options are available immediately for young people.

Recommendation 19 of paragraph 222 of the Government's response to the Health Committee's report says:

I could not care less what the recommendation is. I want something to happen. I hate the expression "a traffic light system", but I hope that, in the next two decades, the food manufacturers will let it be easily recognisable where the healthy foods are in a supermarket. It is not the case that those of us who do supermarket shopping get hold of each product, look at its contents and say, "Well, this has got so much salt and so much fat." If we did that, we would never get our shopping done. However, it is possible to have a range of products in a supermarket that are either healthy or not so healthy,
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whether we call them red, green or tangerine. A number of famous supermarkets are bringing out healthy lines of products, but I think that a colour system is desirable.

Mr. Burns : Can my hon. Friend tell me how he would categorise an avocado pear?

Mr. Amess : My hon. Friend already gave notice of that question. I will write to him on the issue after I have discussed it with the people who supply avocados.

I am delighted to say that Southend-on-Sea borough council has a successful walking buses initiative. I hope that other local authorities will copy that. In Southend, in March, there will be a launch—I hope that it will   attract some national interest—involving opinion formers and celebrities addressing the issue of obesity. It will not just be a photo opportunity for the great and the good to turn up, mouth a few words and then forget about it because they have done their bit. We need to be    obsessive about this issue. Giving people the information—that is Government-speak: this is not the nanny state—will not be easy. If the Health Committee report, which I know all members of the Committee are proud of, is to deliver what we want eventually to see, we must create a climate in which it becomes second nature to eat and drink healthy products—with just as nice a taste as non-diet products—and in which people undertake as much physical activity as possible. This is the most serious and the biggest of all challenges that our health service faces today. I congratulate my hon. Friend the Member for Ribble Valley on giving us the opportunity to debate it.

2.56 pm

Mr. Paul Burstow (Sutton and Cheam) (LD): I congratulate the hon. Member for Ribble Valley (Mr.   Evans) on securing the debate. It is a useful opportunity to review progress and to pose some questions to the Government. The hon. Member for Southend, West (Mr. Amess) talked about the need to be obsessive. I concur that he is obsessive about this issue—and rightly so. A litany of statistics has been set out during the debate. Like him, I do not propose to trot out many more, but they are compelling evidence of the need to take the issue seriously and for this to be a matter of consistent and clear focus for public policy. They also make a compelling case for us as individuals to take stock of our own lives and the lives of those for whom we have caring responsibilities.

I take the point that was made by the hon. Member for Dartford (Dr. Stoate) that perhaps the obesity time bomb went off and we almost did not notice it. We are now feeling the aftershock and that in turn will lead to some huge health consequences. The Health Committee paid a visit to the United States as part of its inquiry into obesity. One of the points that was made when we visited the parks department in New York—the point was made time and again and it has been echoed in today's debate—was that children as young as four or five were now being diagnosed with type 2 diabetes. Cases among children of that age have been diagnosed in this country. The consequences for those young people's lives—lives that will be brought to an end far sooner than they should be, and that will be blighted by disability, blindness and many other things—mean that it behoves us all to make this an issue that involves not just debate, but action.
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I was particularly struck by research that my hon. Friend the Member for Harrogate and Knaresborough (Mr. Willis) undertook. He considered the views of heads of PE departments. Activity is undoubtedly part of the equation. The issue is about how we readjust the energy-in, energy-out equation so that we get ourselves into a virtuous circle rather the vicious weight-gain spiral that we are in now. In the survey, he considered what was going on in schools and found that just one in 10 heads of PE believe the average pupil in secondary school to be in good health and to have good fitness levels. Some 65 per cent. of those same heads of PE said that they felt that the health of those in their charge, in their schools, had deteriorated during the past five years.

That statistic bears out many of the findings of Sport England and other organisations, and of the chief medical officer, who found that levels of activity had gone down over the past decade or so. It is therefore not surprising that when the National Audit Office considered obesity, it came up with the shocking cost figures that the Health Committee has, in turn, looked at and updated. In 1998, the Committee found that the direct costs to the national health service would be £480 million and the indirect costs £2.1 billion—a combined cost of £2.58 billion to the economy. It estimated that the cost would rise to £3.6 billion by 2010. The Committee recalculated those costings and found that the cost of obesity alone was £3.7 billion—and that is the cost now, not by 2010. So the very conservative figures that the NAO came up with are already found to be wanting. The challenge is found to be greater. When "overweight" is added to the equation, the total cost rises to £7.4 billion a year, as we have heard. We need to be doing more to promote physical activity as part of the equation to reduce those risk factors.

I was struck by the contribution of the hon. Member for Southend, West regarding the parental angst of taxiing one's children from one place to another. The evidence from the University College London study into physical activity is very persuasive. It is not just the physical activity within the curriculum that matters. More calories were burned by walking to and from school than during the two hours of weekly PE lessons. It is not surprising, if most of that time is taken up with getting to the gym and getting changed, then having the exercise before getting changed and going away from the gym, that that two hours does not have the impact that is needed. Clearly, there is a lot that has to be done across government outside the Department of Health, in planning and highways policies, to make our environment beyond the school safer, so that people feel more willing to walk to school with their children, and more content for children to walk to school. That has to be a focus.

The Olympics in 2012 are all about excellence in sport. The key to cracking this problem is about encouraging everyone to participate in physical activity. We must not lose sight of that when we make decisions about the way in which the curriculum is structured and funding for sport is orientated, so that we do not underfund everyone taking part at the expense of ensuring that we have the excellence as well.

Nutrition has been mentioned. I feel very strongly that we need to see every school developing a nutrition policy in consultation with parents and children. That would be a powerful tool for change within schools. It
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would make possible critical discussion of the merits and demerits of, for example, tuck shops and vending machines, and what should be in those vending machines. That could be a useful way of moving things forward at a local level without undermining the autonomy of school governing bodies.

There is an area, however, where the Government have the right to step in: nutrition standards for school meals. One of the areas that I was particularly disappointed with in the public health White Paper, "Choosing Health: making health choices easier", was the Government's approach to nutrition standards. The Health Committee recommended that the English standards should be abandoned and we should adopt the Scottish standards. The Government are committed to a leisurely three-year review of this. They are only committed to considering it. They are not minded, at this point, to make such an important change, which could have a real impact on the quality of the food served in our schools.

It is worth picking up on what we have done to under-educate people about food. The hon. Member for Dartford mentioned that there is less education now, and there are no requirements in secondary schools. It is not surprising, therefore, that in 1983 the average time spent preparing a meal was about an hour. Today, that has gone down to 13 minutes. It is amazing that it takes that long to unwrap the packaging of a fast food meal and shove it in the microwave, but clearly it does. My belief is that we need to have a curriculum that equips everyone with the basics to shop for, and prepare, a meal—not a curriculum that turns out the food technologists of the future.

Mr. Evans : The hon. Gentleman has reached a very important point. Does he not also believe that newspapers have a role to play in giving this information to parents and youngsters? Indeed, in today's Metro, in Metro Health, it talks about breakfast being the most important meal of the day. It goes through about 10 options, saying that having nothing is the worst thing you can do, and porridge is the best. Would the hon. Gentleman recommend that newspapers play a more active role in disseminating information for parents and youngsters?

Mr. Burstow : The hon. Gentleman is absolutely right that newspapers can play a powerful part in educating and informing parents, not least because it was found in a survey that one in four children regularly eat sweets and crisps for breakfast, not porridge, which is the more desirable foodstuff.

The other point that I should like to pick up briefly is reformulation. It is important not only that we focus on salt, but that sugar and fat are rapidly addressed. Food labelling has a part to play in driving the reformulation agenda. We need to move beyond a voluntary approach to labelling towards something mandatory, not least because of the confusion that could arise if a multiplicity of labelling schemes emerged throughout the country. Surely the Government should give a clear lead and a framework within which labelling schemes can be operated.
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Hon. Members have rightly highlighted the challenges that obesity poses to the country and the costs, human, personal and to the economy as a whole, that it imposes. I hope that the Minister will say—or at least indicate when she will be able to say—at what point she believes the sum total of Government policies that bear down on the problem will reach a tipping point and the obesity trends will begin to reverse. If the Government are willing to set targets for others, we need to be clear what their own targets are, so that we can see whether Government policy really is making a difference and, ultimately, saving lives.

3.6 pm

Mr. Simon Burns (West Chelmsford) (Con): I warmly congratulate my hon. Friend the Member for Ribble Valley (Mr. Evans) on securing this important debate. We have heard in the speeches so far, from my hon. Friend the Member for Southend, West (Mr. Amess), the hon. Member for Dartford (Dr. Stoate) and the Opposition Liberal Democrat spokesman, the importance that is attached to the problem of obesity.

In many walks of life, we are thought to be about five to 10 years behind the United States and constantly playing catch-up. However, obesity is not something on which we want to catch up with the US, where the problem is far more significant than it is here. Sadly, however, that is not to minimise the extent of the problem in this country.

In the past decade or so we have, regrettably, been playing catch-up. The statistics, as hon. Members have mentioned, are daunting. About one in 20 boys and one    in 15 girls—or 5.5 per cent. and 7.2 per cent. respectively—aged between two and 15 were obese in 2002, according to the international classification. Overall, more than one in five boys and more than one in four girls were either overweight or obese. Projecting those figures forward 15 years and assuming steady growth suggests that around one third of adults will be obese by 2020. However, if the rapid acceleration in childhood obesity in the past decade is taken into account, the predicted prevalence of obesity among children in 2020 will be in excess of 50 per cent., which is a staggering and extremely worrying statistic.

In the majority of European countries, the prevalence of obesity has increased by between 10 and 40 per cent. in the past 10 years, but in England the rate has more than doubled. Levels of walking and cycling have fallen drastically in recent decades, while the number of cars has doubled. That shows the extent of the decrease in the amount of exercise taken.

Added to those statistics is the equally worrying research carried out by London Metropolitan university, which shows that between 1989 and 1998 the average waistband of a two-year-old girl increased by 5 per cent. and that that of a two-year-old boy increased by 4 per cent. An increase in waist size is the most serious problem for health, because it increases vulnerability to heart disease and type 2 diabetes. The waistline of a two-year-old girl increased during that decade by 2.5 cm, or 5.2 per cent., and her body mass index increased by 1.7   per cent. The waistline of a two-year-old boy increased by 2 cm, or 4.1 per cent., and his body mass index increased by 1.8 per cent. If one takes the average waistline figures alone, there was an increase of 2.9 per cent. over the decade, which is staggeringly and deeply disturbing.
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The question that we must ask ourselves is where we go from here to ameliorate the problem. As many hon. Members have said, the answer is a combination of two things: a healthy, balanced diet and proper exercise. At this time of the year, one often sees people making new year's resolutions to join a gym and start losing weight, but by the end of January, all their good intentions have gone by the wayside. That is not the way to solve the problem; it is a short-term gimmick, which will not succeed.

Instead, we must ensure that there is better education, not only for children in the school system, although that is important, but for parents. There is a lost generation in this country—a generation of couch potatoes who have been all too quick to jump in their cars and to choose a sedentary lifestyle. They are now superimposing that lifestyle on their children, and we are reaping the harvest of that failure. Therefore, we must use the education system to teach young people about the differences between quality food and poor food, between fresh food and processed food. We must also educate them about cooking and about the need to eat fruit and vegetables, of which, to be fair to the Minister, the Government have made great play. Their work in that respect is to be commended, and it is part of an educational programme that we should all welcome. We must educate children about the importance of such issues, in the hope that they will then be able to educate their parents, who are, in many ways, members of a lost generation. In that way, they, too, will be able to pick up on the benefits of a healthy, balanced diet.

We must also ensure that people do not eat a disproportionate amount of certain foodstuffs. To my mind, there is nothing wrong with a Big Mac or a KFC once in a while, but when everything is with chips—three times a day, seven days a week—and everything is fast food, rather than part of a balanced diet that includes fresh fruit and vegetables, one has problems.

Similarly, we must ensure that there is provision for proper exercise in our schools. We must ensure that there is more school sport, by which I mean not only sports lessons, but physical exercise during playtime in the playgrounds. We must ensure that children understand that it is important to walk up or down escalators, rather than just standing there letting the machinery do the work for them.

It is also important for children to be able to walk to school, although I accept that there is a serious problem as regards their cycling there, and I suspect that the Minister will agree with me. There has been a dramatic decrease in recent years in the number of school children who cycle or walk to school, and for the first time in our history, fewer than 50 per cent. of children cycle to school. That is because the competing traffic makes many roads too dangerous for them to do so, and parents are unwilling to let them. In certain areas, particularly in the winter, many parents are not happy to let their young children walk to school unescorted in what could be the hours of darkness. All of that has increased the numbers of parents getting into their cars and taking their children to and from school. I am not sure what the answer to that problem is, because it is a difficult issue. However, that does not excuse us from examining it. There are many other aspects to the matter. Before the Government proceed, I urge them to
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consider that although they may perceive some advertising of certain foodstuffs as poor and unhelpful, advertising can also be used positively, to get positive messages across.

It will seem odd if the Government decide to ban television advertising of foodstuffs for part of the day or before a certain watershed, but not to pursue a ban in other areas of advertising, where there are so many food advertisements. I think that the proposal is unworkable per se, but I urge the Government against a knee-jerk reaction of rushing ahead without considering the whole issue and its implications.

The key message is a balanced, healthy diet and more exercise, but it is necessary to educate young people, children and parents, so that we can begin to make an impact and try to reverse a deeply worrying trend that is already having a significant and adverse impact on the health of the nation and individuals.

3.16 pm

The Parliamentary Under-Secretary of State for Health (Miss Melanie Johnson) : I respond with pleasure to this important debate, and join other hon. Members in congratulating the hon. Member for Ribble Valley (Mr. Evans) on raising the issue of obesity in young people. Much public attention has been devoted to the matter in the past few years by influential bodies and the press. That concern is not misplaced, as we all agree.

There is emerging evidence of the effect of obesity on children's long-term health, including UK researchers' frightening prediction that the increase in obesity threatens to reverse the gains in longevity made in the past 100 years and in some cases could result in parents outliving their children; that is a terrifying thought.

It is well recognised that overweight and obesity increase the risk of coronary heart disease and some cancers, as hon. Members have said. They can also increase the risk of diabetes and hypertension, as my hon. Friend the Member for Dartford (Dr. Stoate) said, and conditions such as osteoarthritis. All those factors led the National Audit Office to highlight the fact that obesity is responsible for more than 9,000 premature deaths each year in England. That is not many compared with the number of deaths from smoking, but it is still a large number of deaths and a major problem.

I agree that the problem being stored up for young people is of particular concern to us, as it presents an opportunity to get things right, and those people have the longest lifespan ahead of them. As hon. Members have pointed out, obesity results in significant costs to the NHS and the wider economy where it can result in lost days at work and other costs.

I am grateful to hon. Members on both sides of the Chamber for their support and enthusiasm in this matter—particularly my hon. Friend's remarks about the White Paper and the action proposed in it. I think every hon. Member knows that the Government recognise the impact of obesity, and that tackling it is at the heart of many of our priorities. There is considerable cross-government action to deal with the prevention, management and treatment of obesity, as we have set out in what I am grateful to see is a much-quoted White Paper.

Increased consumption of food and drinks that are high in fat, sugar and salt may contribute to increasing rates of obesity and other health problems. Few children
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eat the recommended five portions a day of fruit and vegetables, and four in 10 boys and six in 10 girls do not take the recommended hour a day of physical activity.

In response to the remarks of the hon. Member for West Chelmsford (Mr. Burns), England is not the only country to have experienced a rapid increase in the prevalence of obesity, although rates differ between countries and I entirely accept that we do not want to catch up with the US in this regard. Virtually all population surveys have shown an increase in the past two decades. Several countries, including the US and Denmark, are taking steps to deal with the issue.

Hon. Members asked how we judge ourselves and how we know whether we have made progress. They are legitimate questions. We believe that we will have delivered if we move the balance of the national diet in England towards that recommended by experts and by 2010 halt the year-on-year rise in obesity among children under 11 within our broader strategy to tackle obesity in the population as a whole. That is part of our 2004 target. It is the way in which we measure our success, although there are many other indicators too.

I am grateful for hon. Members' examples and points. I shall not be able to respond to all of them in detail. There was a veritable forest of good questions and positive points.

I am grateful to the hon. Member for Ribble Valley for agreeing that we cannot make people healthy. That is our starting point which, as my hon. Friend the Member for Dartford said, is far from the nanny state. There is a role for a nanny, as it were, in a child's life. Parents mostly fulfil that role, but the state also has responsibilities, as do schools and other organisations, for the well-being of young children. Again, that is uncontroversial.

Our principles are informed choice—much has been said about the importance of giving people more information; personalisation—allowing people to make choices that are tailored to the reality of their lives; and working together. The Government must not only work with individuals; key partnerships are needed to help to deliver these principles. A number of hon. Members have mentioned the important role played by schools and sports clubs. There is huge scope for partnerships to work here in the right way.

As a Department we cannot tackle things on our own. We are working with a range of partners—national, regional and local. Action on nutrition includes investment in the five-a-day programme mentioned by some hon. Members, an excellent programme that is leading to changes in eating behaviour at home as well as at school.

As hon. Members have cited their own constituencies, I may as well revert to form and do so too. I visited the Green Lanes primary school in my own patch a little while ago and saw children taking part in the school fruit and veg scheme. I was amazed to see even raw mangetouts being consumed with enthusiasm. I am sure that many parents would have been surprised by that. We must also challenge parental assumptions about what children will and will not eat. The children were
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gobbling the mangetouts down as if there were no tomorrow; most parents would not have put money on that.

Mr. Burns : The Minister is talking about children gobbling down food. Does she remember the Minister for Sport and Tourism endorsing the Cadbury's wrapper campaign, in which children had to buy X thousand bars of Cadbury's chocolate to get a piece of sporting equipment for their schools? If a subsequent campaign were proposed, would the Minister be happy with the Department for Culture, Media and Sport endorsing it, as it did the last campaign?

Mr. Deputy Speaker : Order. Before I call the Minister, perhaps I should get in on the act and declare that I am a life member of Blaydon rugby football club.

Miss Johnson : We are following your lead on these matters now, Mr. Deputy Speaker. Clearly anything like that will be tackled by the Government, as a cross-government issue, and will be in line with our suggestions in the White Paper.

Mr. Burns : That was not my question.

Miss Johnson : I was amazed that the hon. Gentleman did not ask about avocados and DCMS policy on avocados.

Mr. Burns : Will the Minister give way again?

Miss Johnson : No; I would like to make a little progress.

Mr. Burns : The Minister has not answered my intervention.

Miss Johnson : I will give way one more time.

Mr. Burns : I should be grateful if the Minister would answer the question: would she expect the Government to endorse another wrapper campaign in the way that the Minister for Sport and Tourism endorsed the last one?

Miss Johnson : It is clear that the White Paper policy would not necessarily advocate such support in future. I am sure that we would not expect to see such developments in future. As hon. Members have outlined, we want the Office of Communications to take action about advertising food to children. I myself was commenting on the EU proposals for action last week. We are clear that some food promotions aimed at children, such as toy offers, are extremely unhelpful, as they put pressure on parents and encourage children to try certain foodstuffs or demand more of them.

It is for all those reasons that we are investing in schemes such as the school fruit and vegetable programme, and working with the food industry to reduce fat, sugar and salt. I agree with the hon. Member for Sutton and Cheam (Mr. Burstow) that we should be tackling all three substances. The progress that we are starting to make on salt will be replicated, as will the methods of working, when dealing with fat and sugar.
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We are determined that unhealthy foodstuffs should not be promoted to children by adverts that are clearly aimed at them, during children's programmes or otherwise.

I have already mentioned that we have a public service agreement target. We want to see more action at a local level, and a number of Members have talked about the importance of that. I am delighted by the admission by the hon. Member for Ribble Valley that he is a member of the Clitheroe Wolves. We will not comment about wolves here, but it is clear that a lot of clubs, such as Blackburn Rovers football club, have good programmes for helping young people to think through diet and exercise issues, often building self-esteem as well. Such work is enormously valuable and provides leadership in the community. It is difficult to find the kind of leadership that has quite that standing with young people.

Mr. Evans : I am grateful for the Minister's comments, and pay tribute to everybody who volunteers in the wider community to give our youngsters opportunities to participate in sport outside school. Will she now give a commitment to increase the number of hours for which youngsters can participate in sport in school?

Miss Johnson : We have made it plain that we expect to see a large investment in school sport. One billion pounds is going into facilities and improvements. Many programmes are designed to increase the number of hours in which children get physical activity each day. There will be a supportive environment through the healthy schools programme, and people have talked about active travel programmes. We are also considering some of what the chief medical officer has set out, including ensuring that children get the
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recommended amount of physical activity a day. It is also important to look beyond sport. Sport is important and I entirely endorse its important role, but we must build physical activity into everyday life for children and parents. We should push for people to walk or cycle to school regularly, as they are the kinds of activity that help keep weight down and lead to more cardiovascular activity.

We are committed to nutritional standards, and to a nutrition-based approach to school meals. Because schools have a lot of freedom, governors can now take action themselves. The school fruit and vegetable scheme has taught us that schools often wait for some other incentive to come along, and introducing that programme then means that they can decide to take action on other issues, such as the food that children bring to school, the wider availability of fruit and vegetables, the availability of water and what the vending machines contain. All those questions are already for the schools to decide, and although they can do a great deal, we will support them and give them more direction, looking at the way that school meals can be used in the school environment and ensuring that healthy schools are developed across the board. It is important to recognise that walking and cycling to school are ways that that can happen.

On the question of the fresh food audits raised by my hon. Friend the Member for Dartford, the local authorities and primary care trusts have been working together in Barnsley, Knowsley and other places. They have identified some of the "food desert" issues, and addressed them through food co-ops.

Mr. Deputy Speaker : Order. I am afraid time is up. We have to get on with the other debate, as there is likely to be a Division in the House later.
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25 Jan 2005 : Column 55WH

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