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We have already mentioned the industrialisation of food production: the ready, microwaveable meal, fast-food production and the decline in home cooking and home food production, which is coupled with the inevitable but contrary rise in the purchase of cook books—regularly bought but invariably not used very much. Further to that, there is the habit, as alluded to in one intervention, of people not eating as families but engaging in activities known as foraging and snacking.
Then there is physical activity and the end of playing out, which used to be such a simple thing. Children would play out in the street in which they lived or in the neighbouring street, but in many cases that is now seen by neighbours as a social nuisance or a threat, and by parents as a personal hazard or social danger, so it does not happen a great deal. If we add to that the reduction in school sports, as extra-curricular activity is squeezed by the need to get good results, we have an increasingly inactive youth population.
Even things as praiseworthy as the Disability Discrimination Acts, which are intended to serve the needs of the disabled, have led to a plethora of lifts, so that able-bodied and overweight people need to go neither up nor down stairs. I am slightly amazed and appalled—the puritan in me is coming out—when I see people in this place who are clearly overweight but take a lift to go one floor down. I feel like commenting, but I restrain myself, and perhaps it is just as well. It does happen, however. We can add to that another social problem, which is the increase in social drinking, because drink, believe it or not, contains calories, and it gives society a huge additional headache.
Some individuals—we do notice them—counteract those factors by efforts of will: they jog in their lunchtime, although jogging along the banks of the River Thames has almost become in itself a social nuisance; and some go to gyms in the evening. But I do not think that anybody can be anything other than fatalistic about relying on heroic acts of individual will, and if we considered more mundane things such as the slimming industry and its value for money, we would arrive at some pretty grim conclusions.
Science offers some, albeit limited, hope. We will understand more about metabolic rates and the tendency of some people to put on weight and others to do so to a lesser extent, and we will get better at identifying risks and diagnosing the physiological and psychological factors in eating and overeating. However, at the end of the day, as the Minister suggested, the cultural changes are sizeable and we might genuinely question whether any Government have the tools to address them because, as we all know, the fundamental problem is that too much of the wrong food is eaten and too little physical activity is undertaken.
My analysis is that the population once stayed fit through what I call inertial factors, that it got fat through inertial factors—it was not a question of people deliberately deciding to behave differently—and that we can only really solve the problem through inertial factors. We can solve it only by creating a climate in which people stay thin—a non-obesogenic environment.
I welcome many of the initiatives, such as better nutritional advice for families, which, surely, has its place. We would be mistaken if we thought people naturally acquired that advice through osmosis; it needs to be taught, and sometimes taught in schools. I also
welcome the educational programmes and the recent more long-term thinking about school dinners and the disastrous effect—I observed this in the past as a teacher—that unguided choice in developing dietary preferences has had. I have seen children walk past salad bars and all sorts of healthy eating options only to go for the pizza and the chips, and the next day do exactly the same—and the day after that as well. However, I worry that if we concentrate too much on children’s eating habits and mishandle the issue, we may aggravate eating disorders among children and adolescents, and we want to do nothing of the sort.
I welcome, too, food labelling and simple—
Mr. Deputy Speaker (Sir Michael Lord): Order. I feel that the hon. Gentleman has had his allotted time.
Dr. Pugh: My apologies, Mr. Deputy Speaker; I was not sure whether we changed the Standing Order yesterday. I was not sure whether it had come into operation. May I just conclude by—
Mr. Deputy Speaker: No, no. I am afraid that the hon. Gentleman will have to resume his seat—sadly.
1.45 pm
Alistair Burt (North-East Bedfordshire) (Con): This is an interesting debate that contrasts several modern dilemmas. First, we must recognise that we in this country have the luxury of debating obesity. Most of us have the opportunity to travel around the world, and we go to many places where obesity is not an issue at all, so we should always remind ourselves that in the western, developed world, the subject of the debate might be termed a luxury.
Dawn Primarolo: The hon. Gentleman is looking at the whole question of obesity, but by way of information, India, for instance, has the two extremes in one nation: obesity and those who do not have enough. Regrettably, obesity is not just a European or north American challenge.
Alistair Burt: I take the Minister’s point, but India is a developing society and it counts itself as one. If we went to parts of Africa, we would not find that the issue was handled in the same way. I take the Minister’s point that obesity affects all nations that have reached a certain status, but, for us, it is a slight luxury to be dealt with.
We have the dilemma of being an information-based society—there is no shortage of information about health, diet and everything else—that takes no notice. It is not a class issue, but the problems are concentrated among the poorest. We have another dilemma whereby the Government do not want to lecture, or to finger-wag, as the Secretary of State said when he launched “Change4Life”, but they have to pick up the very substantial bill for a nation that neglects the issue of obesity. The debate is interesting because, as several contributors have said, there is a limit to what we can do about it. However, talking about the issue and raising it is what we do, and it is very important.
I shall concentrate on four points. First, I shall return to the international situation. More than 923 million—perhaps 1 billion—people in the world are hungry.
Every day 16,000 children die from hunger-related causes, and every year more than 20 million low-birth-weight babies are born in developing countries, where they risk dying in infancy or growing up with various diseases. If food was left on the side of the plate in Victorian times, the mother or father would pronounce to the child the maxim, “This is needed in some other part of the world. If you were living somewhere else, they would want it.” Well, we cannot all do that, and it does not quite translate in the same way, but it should be an issue in this country, and people should be reminded that, when compared with other places, the luxury of food in this country means that perhaps the imperative that we take what we want, but eat what we take, actually matters. There is no harm in introducing that point to the debate.
Secondly, on the Government’s role in the provision of information, there is no shortage of information about what obesity means and what we might be able to do about it. Obesity is a contributory risk factor in many chronic diseases: heart disease, stroke, some cancers, type 2 diabetes and so many other things. Obesity and lack of physical activity are risk factors in several major cancers, and, in addition, obese people are more likely to suffer from a number of psychological problems, such as low self-image, lack of confidence, social stigma, reduced mobility and an overall poorer quality of life. Despite all those documented risks, the prevalence of obesity in England more than trebled between 1980 and 2002, which is an extraordinary increase in such a short time. It went from 6 per cent. to 22 per cent. in men, and from 8 per cent. to 23 per cent. in women. The increased prevalence can also be seen in children aged two to 10. Between 1995 and 2003, levels of obesity among children rose from 9.9 per cent. to 13.7 per cent., and the combined overweight and obese levels rose from 22.7 per cent. to 27.7 per cent.
In my area of Bedfordshire, it is estimated that approximately one quarter of the adult population—some 83,000 people—are obese. An additional 40 per cent. of men and 30 per cent. of women there are overweight; perhaps 128,000 people there are at an increased health risk. If trends continue, by 2010 94,000 adults in Bedfordshire will be obese. That is an extraordinary number. The sheer number of obese and overweight people from my area would fill Wembley stadium to bursting point. The national costs of obesity are huge. The Health Committee has estimated them at between £3.5 billion and £4 billion a year; if the overweight are included, the figure rises to between £6.6 billion and £7.4 billion a year. Between 1998 and 2004, there was a seventeenfold increase in the drugs used to treat obesity.
We know the figures, but the lack of interest is remarkable. The Library put together an excellent debate pack. I was struck by Department of Health survey statistics that revealed that just 11.5 per cent. of those with children who are overweight or obese recognise the fact. Only 38 per cent. of adults know that obesity could lead to heart disease, and only 6 per cent. of adults recognise the links between cancer and being obese or overweight.
I suspect that there is a frustration on both sides of the House that so little is done about the information, despite all our efforts and the fact that it is well known. I praise the efforts of the local authorities in Bedfordshire and the primary care trust in setting the appropriate
targets and in aiming for weight reduction, particularly among children. By 2020, their target is to reduce the proportion of obese and overweight children to the levels of the year 2000. They recognise that, sadly, there is only so much to be done with adults, but that as much as possible must be done with children.
There is a limit to the responsibility of the Government and local government. The provision of information is one aspect of their responsibility and the promotion of active and healthy lifestyles is another. The completion of various cycle ways has made a lot of difference in Bedfordshire. Furthermore, we have schools that are devoted to fitness and healthy food and GPs have joined in the PCT’s targets.
I should like to refer to two or three particular things that might make a difference. First, we should emphasise fitness rather than only attacking weight. The hon. Member for Southport (Dr. Pugh) was coming to this point, before his remarks concluded; I sense the direction in which he was going, and perhaps I complete the point that he was going to make. Sadly, due to the nation’s obsession with celebrity and how people look, attacking weight is leading to its own problems, as youngsters get caught up with eating disorders and the like. I was struck by a couple of comments in the Library briefing. At a recent British Dietetic Association conference, Claire Mellors, a dietician, said that:
“a real fear of obesity is an emerging and worrying trend...From my clinical experience I would say that as healthy living messages have become more prevalent, there has been a corresponding rise in referrals for children with disordered eating”.
Andrew Hill, a medical psychologist at the university of Leeds, has said:
“It is vital that children develop an understanding of why exercise is important. There are risks of inactivity that they do need to know about. But why does it always have to be hung on a peg of obesity? They should grow up enjoying activity, not doing it because it makes them thin.”
We have to be careful in balancing the messages and making sure that they get out.
Secondly, we have to be prepared to speak out firmly. I noted the point made by the Secretary of State in introducing Change4Life—that it was not about finger wagging and lecturing. However, on some occasions we are entitled to do that. We are all picking up the bill for obesity, and in some cases people can do something about their condition themselves. We must not move completely away from a sense that the issue is about personal responsibility, as well as about providing opportunities for food, exercise, dieting and everything else. If we continue to produce excuses for everybody and say that it is not their fault, but all a cultural thing, we will not get to the necessary stage at which people accept their personal responsibility and do something about it.
When Jamie Oliver came to give evidence to the House, he was more direct. He said that the issue was not about class or poverty because people had material goods coming out of their ears. The problem was that people had forgotten how to cook and could no longer be bothered to cook. He was very direct and critical, and said things that politicians should say equally clearly. I tell the Minister that she is entitled to wag her finger and tell people that they could do better.
Dr. Pugh: I totally accept the hon. Gentleman’s point about individual responsibility, but commercial responsibility is also involved. Many of the food companies that are keen on labelling have retail outlets in which the only things people wanting a bag of crisps or bar of chocolate can buy are a grab bag or a very large bar. The companies know that; it is a sales strategy.
Alistair Burt: That is a fair point. Looking at the commercial practices of companies can lead to difficult issues. On the one hand, they sell goods that people like and enjoy and, in small measure, are good for us—“A little of what you fancy does you good,” “Moderation in all things,” and so on. Yet when such things are taken to extremes, they cause the very problems that we are speaking about. In addition to the commercial responsibility, there is also the responsibility of individuals, not only when they buy for themselves, but when they buy for others. I want to encourage the Minister: occasionally, a bit of finger wagging may not be a bad thing.
The encouragement of cookery at school level is important, as the Minister knows because I have told her in the House about the kids’ cookery school that I have visited. It tries to provide opportunities for youngsters, particularly in poorer areas, to learn more about practical, basic cooking, which can make such a difference to diet and budget. I encourage her to do more on that issue.
My last point about finger wagging and lecturing relates to the fashion industry. As a bloke, I am not attracted to size-zero women. The determination to drive women to a particular size because of the notion that that will somehow make them more attractive to blokes and the world at large is misplaced. We love women of all different shapes and sizes. We love them not because of how they look or are dressed, but because of who they are—their spirit, style, humour and everything about them. We do not need an industry to force women into a box. The fashion fascistas should be lectured on every possible occasion by those who say, “Don’t do it for us, because we’re not interested.”
Finally, I turn to the issue of sport and fitness. I belong to Biggleswade athletic club and I commend all those who work and provide coaching in youth and sporting organisations. I am also president of the sea cadets in Biggleswade and I know that all youth organisations do so much to encourage physical activity, not only for its own sake but for a sense of the fitness and discipline that go with it. As new houses make the populations of areas such as mine larger, having in place a decent leisure strategy for the growing numbers of people becomes essential. They will need to use facilities that are often undervalued and overrun.
I pay particular tribute to Phil Dean, who died last week. He was the motivator behind the recent success of the Biggleswade swimming club and a remarkable man whose very nature, spirit and style said much about the area he came from and his personal determination to see youngsters have the chance to be fit and have opportunities for swimming and fitness in my area. He was a giant of a bloke and will be sadly missed by his family and all those who knew him. However, there are many Phil Deans who work hard as youth coaches and motivators, and we need to encourage them all. We need to help volunteering, including in sport, and encourage our youngsters to be fit, rather than just to lose weight.
In that way, we will make some progress towards the goals that the Government and all in the House have rightly set.
1.59 pm
Mr. David Amess (Southend, West) (Con): I listened carefully to the Minister of State, and I suppose that there was very little that I, or indeed anyone in the House, could disagree with. However, I am disappointed by the degree of seriousness that the Government attach to the subject.
Those of us who become Members of Parliament do not, presumably, come here just to time-serve but to try to achieve something. For instance, when I was proud to pilot through the House the Warm Homes and Energy Conservation Act 2000, which tasked the Government with eliminating fuel poverty, I thought: “Fantastic! Everyone is going to be warm in their homes and fuel poverty will be eliminated.” I then found out—although there has been no publicity for this—that the Government took the definition of “eradicate” in the Act to a court of law, where its terms have been overturned despite our discussions and arguments in Committee.
Throughout my time as a member of the Select Committee on Health, the finest report that we produced followed our inquiry into obesity. Of course, I would say that, because it was my idea to have the inquiry. We worked as a team under our excellent then-Chairman, David Hinchliffe, together with the current Secretary of State for Culture, Media and Sport, who was then a member of the Committee, and my hon. Friend the Member for West Chelmsford (Mr. Burns), who was one of the leading lights in our inquiries. The reality is that the Health Committee triggered the national and international debate on obesity.
I say that I am disappointed with the Government’s response so far because, as a Conservative, I am not into gesture politics. I said to my colleagues at the time that, as a nation, we need to be serious about obesity. Perhaps we are not serious and we want to fatten everyone up—if so, we are succeeding. As my hon. Friend the Member for North-East Bedfordshire (Alistair Burt) said, the excellent briefing from the Library shows that of the OECD countries, Britain is second to America in the extent of obesity, and rapidly catching up. It is costing this nation £3.7 billion a year to treat people with ailments caused by obesity.
Following its superb inquiry, the Health Committee produced a report, and I want the Minister to tell the House precisely how many of its recommendations the Government have implemented. When I participated in our questioning of the then Minister for Public Health, Melanie Johnson, her responses suggested that the Government were not going to do anything terribly tangible. I said:
“I am thinking about advertising, labelling calories on bottles of alcohol.”
Yes, there are calories in alcohol; I saw the Minister nodding when that was mentioned earlier. I went on:
“Is the Government really saying that it is an individual’s responsibility and no to legislation?”
“We are not saying either of those things. What we are saying is that there needs to be a balance”.
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