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5 pm
Mr. David Evennett (Bexleyheath and Crayford) (Con): I am pleased to follow my neighbour, the hon. Member for Dartford (Dr. Stoate). Although I do not often agree with him, he made several important points today. However, I was disappointed that he had not listened to the speech of my hon. Friend the Member for Westbury (Dr. Murrison), who said that he wanted to ring-fence funds and that there should be a Cabinet Minister to deal with public health. Both are policies that we should consider for the future, with—I hope—increasing support from Labour Members.
I am pleased to be able to speak in this debate. Health debates tend to be about hospitals, primary care, cuts and so forth, rather than about public health.
The Parliamentary Under-Secretary of State for Health (Mr. Ivan Lewis): Cuts!
Mr. Evennett: I am sorry that the Minister finds everything so amusing, but I am afraid that cuts are being made in primary care trusts. It is a problem that we are experiencing in Bexley. But we must not go down that path; today we are discussing public health, not primary care trusts.
Preventive health care, health education and making healthy choices are important issues. For my constituents, they are vital issues. I was disappointed by the Minister of State’s speech, because I have a good deal of time for her—unfortunately, she is not in the Chamber at the moment—but today she was combative, aggressive and very party-political. I do not think that that helps when we are discussing an issue such as this. The hon. Member for Kingston upon Hull, North (Ms Johnson) was also party-political when commenting on the Liberal Democrats, but I shall not go down that path either.
We ought to be working together to establish how we can improve public health. To listen to the Minister, one would think that there were no problems for the public health of our country, but I cannot agree that that is the case. The issues that I want briefly to discuss are smoking, alcohol, obesity and healthy eating. In my part of south-east London, problems are increasing in respect of all those issues.
I fundamentally opposed the extension of licensing hours to allow more drinking time. My neighbour, the hon. Member for Dartford, said that everything in Dartford was fine, but in our borough the extension has increased binge drinking and the consequences of antisocial behaviour. I was appalled to learn that about one in 26 NHS bed days could be ascribed to alcohol-related diseases, and that 40 per cent. of accident and emergency admissions were alcohol related. Those are real problems in today’s society. The increase in the rate of deaths from alcoholism among women and in the number of women drinking to excess is worrying. We should be thinking about how we can stop binge drinking and the increase in alcohol abuse. The Government made a mistake in increasing licensing hours and opening times, and the figures that we are seeing are cause for concern.
In my patch, I have been involved with Welling Alcohol Service Provision, or WASP, a voluntary organisation based in Welling. Working on the ancient principle that
actions speak louder than words, a small group of former alcoholics arranged a meeting and subsequently set up an organisation at a drop-in centre—a pop-in service that would be available 365 days a year for ex-alcoholics who needed a place to meet and socialise. They are doing a wonderful job and I pay tribute to them. Regrettably, funding is a problem. The Government should consider making more funding available for such organisations so that they can do good work in the community to help people who have problems overcoming their alcoholism.
The second aspect that concerns me greatly is the problem of obesity and healthy eating issues. I was appalled to see that in my borough, Bexley, 11 per cent. of children are obese when they enter primary school, according to the children and young people’s plan for our borough for 2006-09. That is an extremely worrying trend. I welcome the efforts by Sainsbury to improve food labelling, the efforts by Jamie Oliver to encourage healthy eating and so on, but that is not enough to improve the health of our young people. Too many of them are still going for fast food and still eating all the wrong things, which will have long-term consequences for their health.
Education is of course the key—education at home, with the family, and education at school. More publicity and more media attention are vital, or we are storing up public health problems for the future. I am not convinced that the Government have got it right. They cannot do it alone. As I tried to suggest to the Minister in an intervention, it is no good her saying that the Government are doing this or that. There must be a broader-brush approach, with all of us involved, including voluntary and community organisations and parents groups. The Government should take the lead, but that is not enough. It is a matter that we should discuss constructively across the Chamber. That is why I was a little disappointed with the brush-off that I got from the Minister, which was party political.
The Government have taken positive steps—on smoking, for example. I voted for the smoking ban. I think it is a good thing— [Interruption.] I am sorry that my hon. Friend the Member for Beverley and Holderness (Mr. Stuart) does not agree. I have never smoked and I am worried about the youngsters in my borough who smoke. They are ruining their lives and potentially causing damage for the future. We are grateful that the House had the opportunity to vote as it did, and we look forward to the summer, when the ban will be introduced and people will no longer be subjected to passive smoking.
I am concerned by the lack of physical activity among our young people. The Olympics will be a tremendous opportunity, which we welcome, although there are other associated issues, such as the problems that we will have in Bexley as a result of paying for the Olympics, and whether the facilities will be completed on time. However, the principle is good and we should be extolling the virtues of sport and physical activity.
According to the Office for National Statistics time use survey in 2005, the three main activities of people in Britain were sleeping, working in their main job, and watching TV and videos or listening to music. Although all those are important, one would like to think that, if we aim to encourage people to pursue a
healthier lifestyle and if public health is at the top of our agenda, people would also engage in physical activity and sport.
The percentage of time spent on sport and outdoor activities has fallen during the Government’s time in office, from 15 per cent. in 2000 to only 10 per cent. in 2005. If we are serious about improving public health, the Government must get people to do more physical activity, especially youngsters, so that their lifestyle includes sport and recreation.
This has been a very good debate, albeit that it has been too partisan for those of us who believe that public health is a bigger issue than one for party political knockabout. Education has to be the key target to change people’s lifestyles and ensure that they learn about the consequences of their actions. The Government can do much, but it is limited.
Finance is always the key, so what my hon. Friend the Member for Westbury said about ring-fencing needs to be looked at again. I know that primary care trusts in south London are raiding the budgets of the public health sector to meet their shortfalls. In the long term, the consequences will be disastrous. If we had ring-fencing, it would help to keep the public health sector afloat. I hope that the Minister will agree to look again at the proposition made from the Opposition Benches.
We need a more co-ordinated approach under local directors of public health, with the local authorities and PCTs working much more closely together. It is a joined-up approach that we need if we are to tackle this growing problem. There is a great opportunity, and I hope that the Government will take that on board.
5.11 pm
Mr. Bob Blizzard (Waveney) (Lab): It is a pleasure to follow the hon. Member for Bexleyheath and Crayford (Mr. Evennett). Many years ago, I spent 10 years teaching in his constituency. When I go back now, I can see that people there are much healthier today than they were back then.
We know that throughout history the greatest advances in human health have occurred not because of doctors, hospitals or even medicines, but because of improvements in public health, including clean drinking water, improved sanitation, better shelter and housing, enabling people in countries such as this to keep warm, and proper nutrition. There was a point in the second half of the 20th century in this country at which, with poverty falling and all the factors that I have just mentioned moving in the right direction, along with the onset of medicines for the epidemic diseases and increasing longevity, we looked forward to a time when we would have almost perfect health. Something else was happening at that time, however. With that increasing prosperity and consequent lifestyle changes, we were getting fatter. We are still getting fatter, and our children are getting fatter than ever. It is on that problem—obesity—that I wish to focus today.
In 1976, in a consultation document on public health produced by the then Department of Health and Social Security, obesity was barely mentioned. It was
considered a minor risk factor for coronary heart disease. By 2004, however, the Wanless report, “Securing good health for the whole population”, said that obesity
“has the potential to be of equal importance to smoking as a determinant of future health.”
Since then, we have seen even greater changes regarding obesity. The key facts are that obesity reduces life expectancy by an average of nine years and is responsible for 9,000 premature deaths a year. The prevalence of obesity has trebled since the 1980s. Some 22 per cent. of men and 23.5 per cent. of women are now obese, and well over half all adults are either overweight or obese; that is 24 million people.
Overweightness and obesity are also increasing among children. Almost 28 per cent. of children under 11 are overweight or obese, and 14 per cent. are obese. If we do not do anything about that, the number of affected children will continue to rise, and they will have a shorter life expectancy than their parents. If current trends continue, at least one third of adults, one fifth of boys and one third of girls will be obese by 2020.
I declare two interests in this debate. First, my wife works in public health for the Great Yarmouth and Waveney primary care trust. Secondly, a few years ago, I lost a lot of weight. I therefore feel that I can speak with some personal authority this evening, not because of the former—my wife’s job—but because of the latter. Some hon. Members will remember how I used to heave myself around the place, and one of our friends in the Press Gallery once wrote in a diary column that when I stood up I looked as if I had just eaten somebody for breakfast. I do not know how heavy I was back then, because bathroom scales stop at 20 stone—I was probably closer to 21 than 20 stone.
By 2001, after I had got myself re-elected, I had had enough—I was fed up of spilling food at mealtimes on my tie, fed up of the difficulty of threading my way through crowded receptions. People have asked me how I lost the weight. The lesson is very simple. First, one should eat less. Secondly, one should think about what one eats, avoid fat and sugar—if one does not want to be fat, one should not eat fat, or not a lot of it—and try not to eat between meals. People have said to me, “Why don’t you write a book called, ‘The Politician’s Diet’. It might sell a few copies among the others.” It is no good going on a diet: if one does, when one comes off it, the weight goes back on. The point is to change one’s approach to food.
Mr. Charles Walker (Broxbourne) (Con): As someone who has lost 2Â1/2 stone over the past three months, I know that the hon. Gentleman is right. One must change one’s life; a diet is useless. One must change one’s whole outlook and one’s relationship with food.
Mr. Blizzard: I congratulate the hon. Gentleman on his achievement. It is nice to know that we agree on that anyway.
I wonder what the reaction of other people has been to the hon. Gentleman’s weight loss. People did not come up to me and say, “Well done. Great.” They gave me a funny look and said, “Are you all right?” They thought I was ill with a wasting disease or something.
Everyone wants to lose weight, but when somebody does, people think that the person is ill. It is strange. I have shown that I was not ill, and I am not ill now. I am so much more active, and I hope that the hon. Gentleman feels the same. I am fitter, and I do not have the tiredness and aches and pains that I used to have. I have been able to pursue my hobby of walking up mountains and managed to reach the highest peak in north Africa. In the summer, I finally achieved my goal of getting to a 20,000 ft peak in the Andes. I put the picture of myself standing on Mount Toubkal on my last election address to show my electorate that I was fit and not dying.
People talk about exercise, but I just walk. I always walk up escalators. If we want to see the problem in the country, we need only look at the people who stand on escalators when they could walk up them, or who use lifts instead of stairs. Exercise is good, but I am told that to burn off a cheeseburger, fries and a shake one must walk 9 miles. I was lucky: I had someone who helped me to focus on my aim to lose weight; not everyone is that lucky.
Today, I want to focus on the food that we eat. We need to change the food that we eat and the amount that we eat. The food industry and retailers have a huge role to play. They are not doing enough, and I question the commitment of some of them to helping us solve the obesity problem. Why do I say that? Every year, for many years, I have gone along to Tesco’s computers for schools presentations. Last year, it occurred to me that collecting computers for schools tokens was an incentive to buy more food, so I suggested to Tesco that perhaps it should build in an additional incentive by giving extra vouchers if people bought fruit and vegetables. I also put the idea to the Minister of State, Department of Health, my hon. Friend the Member for Don Valley (Caroline Flint) in a parliamentary question.
There was a little publicity, and Tesco’s initial response was that it did not believe in straitjacketing its customers, which was not very helpful. When I eventually received Sir Terry Leahy’s response in a letter, it was full of what I call healthy food-speak waffle; it did not say anything at all. Tesco refused to take up that sensible and reasonable idea. In the meantime, I received a letter from Sainsbury’s saying that it operated precisely such a scheme for its sports equipment vouchers. I therefore congratulate Sainsbury’s, and say, “Shame on Tesco” in that respect.
I began to suspect whether some companies were serious about tackling obesity. My suspicions have increased since the recent debacle over food labelling. It is important to be able to see the label on food. I used to look at the percentage of fat per 100 g. That helped me, but the information is not prominent; it is in small print and not easy to follow. I was delighted when the Food Standards Agency brought out the traffic light system. It sends a simple, clear and strong message because it gives fat, sugar and salt the red light, and we need to do that if we are to change what we eat, which we must do. One can go into small convenience stores on the way home in the evening and find that all they have are things such as crisps and Munchies. There is no fresh food. The people in them say, “That’s what our customers want,” but customers will react to the red traffic lights and want different things.
On the same day as the traffic light system was launched, the Food and Drink Federation launched its guideline daily amounts. It is a recipe for confusion. Sadly, I think that it was deliberately planned by certain food companies and food retailers as an attempt to undermine the Food Standards Agency scheme. The GDA boxes require quite a high level of intelligence to understand. Having been a teacher, I have a good idea of what can generally be understood and it takes very good mental arithmetic to keep a tally of all the percentages of fat, salt and sugar. It probably needs a calculator and one would have to write it down in a book. That will not achieve anything. In addition, there are different guideline daily amounts for men and women and different types of people.
When people from the Food and Drink Federation came to the House, they made a slick and hard-selling presentation. They held up a bottle of ketchup and said that the problem with the red traffic light system is that it is all based on percentage per 100 g, but people never put 100 g of ketchup on their food, so it is rubbish. But people do eventually eat 100 g of ketchup; it does not matter whether they put it on all at once or over a week. That is where the federation is wrong. It brought its range of produce along with it. We need to change that produce. If people see red traffic lights and change what they ask for, customers will give food manufacturers a different message and we will end up with better food in our shops.
5.22 pm
Mr. Charles Walker (Broxbourne) (Con): Thank you, Madam Deputy Speaker, for calling me to wrap up the Back-Bench contributions in this extremely good debate. I have very much enjoyed sitting through it.
The press lobby called me amiable and chubby. I cannot do much about being amiable, but I decided to do something about being chubby. I went on a diet and now hope that I can keep the weight off. However, I shall not bore the House with my eating habits. I want to stay within the boundaries of a public health debate. If I do not, Madam Deputy Speaker, I am sure that you will rule me out of order. I want to link my comments to the cuts in the Hertfordshire health economy. The £50 million savings that we are being asked to make over the next two years will have a fundamental impact on public health provision across the county and in my constituency.
We cannot fail to mention per head funding. In Hertfordshire it is £900 per head; in the constituency of the Secretary of State for Health it is £1,300 per head, and in parts of Scotland it can be as high as £1,800 per head. There may be very good reasons for those discrepancies, and this is not the place to argue the pros and cons. However, at a time when our acute services and public health services are being cut, the discrepancies are causing my constituents and the residents of Hertfordshire a great deal of concern.
Mike Penning: I am grateful to my hon. Friend, who has a short allowance of time, for giving way. Those cuts in local primary care in Hertfordshire are devastating. A recent letter leaked to me from the PCT indicated that £1 million of extra savings had to be made locally in primary care, which means that district nurses are going to be made redundant, as well as the acute nurses whom we will lose.
Mr. Walker: My hon. Friend makes a good point.
A paper published this month, entitled “The future of health visiting in Bedfordshire and Hertfordshire”, by the Bedfordshire and Hertfordshire Local Medical Committee Ltd quotes a report by Amicus, which is a fantastic union, as I am a member of it. The Amicus “Who cares?” campaign reported that the number of whole-time equivalent health visitor jobs slumped to a 12-year low for England in 2005. That seems to conflict with the Minister’s comment in her opening speech that they were at an all-time high.
The report was written jointly with health visitors. It went on:
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