Combating Obesity

Topical Debate – in the House of Commons at 1:24 pm on 13 November 2008.

Alert me about debates like this

Photo of Dawn Primarolo Dawn Primarolo Minister of State (Department of Health) (Public Health) 1:24, 13 November 2008

I beg to move,

That this House
has considered the matter of combating obesity.

It was almost a year ago today that the Foresight programme report served notice of the grave threat posed to health by obesity. That group of eminent scientists claimed that modern society had created an obesogenic environment, which, without radical action, would result in nine in 10 adults and two thirds of all children being overweight or obese by 2050. The prognosis is truly frightening. Within a generation, three in five cases of type 2 diabetes and a fifth of all heart disease cases will be caused by obesity, and for the first time in centuries we face the terrible spectre of some children living shorter lives than their parents unless we reverse current trends.

Yet the prescription, on paper at least, is simple: we all need to eat a little less and exercise a little more; we will then, hopefully, live a little longer. In practice, though, the challenge is rather more difficult. People live hectic lives. Time is at a premium, and so often, exercise or healthy food can be edged out by family commitments, work, a lack of good leisure facilities or a lack of shops that sell fresh food in the area. Fundamentally, making the big lifestyle changes is a question of access, opportunity and will. Those are the issues that we must address emphatically if we want to turn the tide on obesity. The Government have already taken important steps: for example, we have allocated £65 million to NHS primary care trusts to help them to identify, monitor and support obese patients. We have updated the child health promotion programme and expanded the new family nurse partnership programme. In partnership with the children's plan introduced by the Secretary of State for Children, Schools and Families, that will help to support the health and well-being of children and young people.

Working with Ofcom, we have placed new restrictions on the broadcast advertising of unhealthy foods to children, and are continuing to work with industry on the healthy food code to reduce salt and fat content in manufactured foods. But—and it is a big but—changing behaviour is not something that we can do from the Department of Health, Whitehall or this House. We need a lifestyle revolution driven not from above but from below, and embracing all aspects of a person's life. That means that everyone—schools, councils, local businesses, charities and community groups—must play a role in helping people to make space for the little things that can make a big difference.


Dawn Primarolo acknowledges the hectic pace of life here, the time pressures which make it hard for people to incorporate exercise into their lives and the lack of good leisure facilities, but these fine words are not matched with the necessary actions. Lifestyle changes are a question of 'access' and 'opportunity', she says, and yet the steady erosion of public sports centres and swimming pools continues unabated. a)The Government has failed to provide any statutory protection for leisure facilities and has allowed council after council to stand up and say "it is not their job" to provide them. This means that centres can be closed and sold off without any consultation or warning whatsoever: eg Harlow residents lost their only public pool last September (2007) b)Even where a replacement leisure centre is planned, there is no regulation at all on how long that time gap can be: eg Matlock, in Derbyshire, lost its only sports centre in 2007; Derbyshire Dales District Council didn't want to spend money repairing Sherwood Hall and yet the new CALC (Central Area Leisure Centre) is unlikely to be open before 2011. Matlock's only pool was also closed this year, but public pressure has induced DDDC to go ahead with repairs: the pool should re-open next March 2009, eight months after its closure in July 2008 c)In many places the closure of a public facility has been followed by the opening of a private one, which, by definition, aims for an atmosphere of exclusiveness. d)The national governing bodies, like Sport England, are actively pursuing a "fewer but better" policy which directly contradicts their...

Submitted by sally wainman Continue reading

Photo of Philip Hollobone Philip Hollobone Conservative, Kettering

The right hon. Lady is making an extremely good point about lifestyle choices and the link with being unhealthy. Does she agree that it is time for the Government and other bodies to once again encourage family meal times, as opposed to the increasing snack culture in which so many young people and adults participate? That is contributing to an unhealthy lifestyle.

Photo of Dawn Primarolo Dawn Primarolo Minister of State (Department of Health) (Public Health)

The hon. Gentleman makes an important point. I know that he follows the issue closely. In debate, we have to consider how we engender changes in lifestyle, because we cannot force families or individuals to make those changes. We must consider what sort of partnerships we need to create and sustain to deliver that. I want to go on to give some examples, because he makes an important point. As I am sure he will agree, those changes include taking part in important campaigns such as the "5 a day" campaign, kicking a ball around with the children, ditching the car on the school run, and sharing family meal times, as he said.

Photo of David Taylor David Taylor Labour, North West Leicestershire

Will my right hon. Friend turn, at some point, to the influence of commercialisation on food choices? Testing shows that even very young children are influenced by brands. Although young children know what is good for them, they are more likely to be influenced by familiarity, taste, and the visibility of the product in the environment in which they live than by other considerations. How can we reasonably tackle that while remaining relatively liberal, in terms of advertising?

Photo of Dawn Primarolo Dawn Primarolo Minister of State (Department of Health) (Public Health)

I am grateful for my hon. Friend's instruction, and I shall come on to give an example of the way in which the Government's leadership role, by providing the framework for action and creating the opportunities and infrastructures for healthy living in our communities, can address those problems. When I do so, and if he does not think that I have answered his question, I shall be happy to give way again.

Photo of Dawn Primarolo Dawn Primarolo Minister of State (Department of Health) (Public Health)

I am happy to give way to the hon. Gentleman, but then I should like to make progress.

Photo of Shailesh Vara Shailesh Vara Shadow Deputy Leader of the House of Commons

The Minister is indeed generous, and is making some powerful points. She spoke about the need to encourage a change in lifestyle, but does she accept that we must ensure that when young people leave school they know how to cook? One of the greatest failings at the moment stems from the fact that people buy pre-cooked food because they do not know how to cook. Changing that would not only be cheaper but healthier.

Photo of Dawn Primarolo Dawn Primarolo Minister of State (Department of Health) (Public Health)

I certainly agree, and each intervention has touched on the fact that there is not one, simple solution to the problem; it is about what we eat, where we eat, how the food is prepared, what our knowledge is, opportunities to exercise, the way we arrange our lives, and about making choices. The role of government is to create partnerships, offer choices, and provide information, then support individuals as they seek to make those choices. That is our strategy, and it means anything from improving parks to building more cycle routes; cookery classes in school; encouraging children to do more sport; and working with employers and retailers to make it easier and more practical for people to take more exercise and eat more healthily. What the Government are being told is that people understand what the choices are and want the opportunity to act on what they know, and that is what we have to provide.

As we step back from the foresight report, we must give due prominence to local ideas and local actions—families, individuals and communities taking action. Ultimately, that means we must make sure that what is happening on the ground—in the family, in the parks and in shopping centres—contributes to a healthy lifestyle.

Photo of Kerry McCarthy Kerry McCarthy PPS (Rt Hon Douglas Alexander, Secretary of State), Department for International Development

I thank my right hon. Friend for her generosity in giving way. She will be aware of initiatives in Bristol such as the "Thank you for not driving" campaign, which aims to tackle the school run, and the healthy schools initiative. The other day, I presented an award to St Anne's infants school, which has received a healthy schools certificate. Does she agree that children have a role to play as ambassadors to try to encourage their parents to adopt a healthier lifestyle?

Photo of Dawn Primarolo Dawn Primarolo Minister of State (Department of Health) (Public Health)

I certainly agree with my hon. Friend. As a constituency neighbour of hers, I know that Bristol is a cycling city: it is undertaking the "active Bristol" programme and considering how it can improve its parks, provide family-centred facilities and safe corridors for family activities, so that children can undertake that exercise. It is a small step, if the House will forgive the pun, and it also enables children to set an example to their parents.

Of course it is about money, and the Government have invested in such programmes, but it is also about creating a movement. At the centre of what we are doing is the Change4Life movement, which is a huge coalition for better health that brings together many different initiatives under one banner. Returning to the point that my hon. Friend David Taylor made, before I received notice of this debate I was supposed to be in Newcastle for the first Change4Life partnership with local convenience stores, which will help to break a simple barrier to good health: the fact, that in some parts of the country, local shops simply do not stock fresh fruit and veg. The project is about making that easier, by supporting retailers and working with them. The first step is the launch of 12 development stores, which will be provided with funding, so that they can offer such opportunities. By May next year, it is hoped that there will be 120 such stores across the north-east. Assuming that the scheme is successful, it will be rolled out across the country. We have every reason to believe that it will be successful, because similar projects have worked in Scotland.

This is not just one issue—we have to look at wider considerations and say which organisations and agencies must come together to develop and support a wide range of initiatives at community level. What is happening in the north-east is mirrored across England. The coalition is impressive, and 12,000 grassroots organisations are involved in Change4Life, working with leading charities and big high-street names such as Asda, Tesco, Kellogg's and PepsiCo. It is about breakfast clubs, sponsoring sport and making sure that people can make those changes to their lifestyle. Fittingly, a year on from the foresight report, this week we have announced the nine areas chosen to become "healthy towns", receiving a share of £30 million to pioneer approaches that will enhance choices for their local communities and their ability to live a healthy life. Manchester has seen the launch of the Points4Life loyalty card, which rewards people with free activities or healthy food when they visit the gym or take exercise. Tower Hamlets is running a scheme to persuade shops and restaurants on the main road to the Olympic park to push healthier options. In Tewkesbury, people are developing an urban garden programme which will help residents to keep fit, rebuild green space in the wake of last year's floods, and make sure that they have access to such opportunities.

We must celebrate and encourage that diversity of approach, because obesity is not confined to one social group or area, and we know it is exacerbated by poverty. That also means getting the message across that Change4Life is for everyone: children, busy parents, health professionals, and even hon. Members and, dare I say, Ministers of State. We all need to get involved because we can all benefit. In challenging economic times, when family budgets are under pressure, we must spell out the message that healthy eating does not have to be expensive. In fact, as Mr. Vara said, healthy home-cooked food is often considerably cheaper than a takeaway burger or pizza.

This is not about interfering in people's lives, or about creating a nanny state, but we are not prepared to neglect the issues that face us, or hide behind vague notions of nudging people to better health. Quite simply, the cost of inaction and neglect is too great. It is the human cost of 9,000 premature deaths a year because of obesity. It is the increasing economic damage from the causes of rising chronic disease, and it is the cost to our society, rising to £50 billion a year within two generations, if we do not tackle the problem. In the face of those dangers, we need concrete action, not platitudes. Our obesity strategy is a comprehensive, proactive agenda for change, delivered for communities, by local communities, in local communities. I am confident that that will help our nation to shed the pounds, and give us all the chance to lead healthier and more enjoyable lives.

Photo of John Pugh John Pugh Shadow Minister (Treasury) 1:38, 13 November 2008

I am heartened by the Minister's speech and her conclusions, not least because they were similar to those I arrived at, possibly with more detail attached to them.

The problem is known—we have increased levels of obesity; more overweight children; higher risks of cancer, heart disease, diabetes, infertility and early death—and, a bit like the credit crunch, it is worldwide. Most industrial nations, although they vary a little, depending on climate, demography and the national diet, suffer from that problem, and it appears to be concentrated among the urban poor.

The causes are almost universally understood, too, but they are numerous: the mechanisation of labour in the home and in the workplace, which is good and irreversible but has consequences; the availability of cheap, personal transport door-to-door, whether it is to school—the infamous school run—or to work; and the attractions—we should not deny them—of sedentary pursuits, because the computer offers a lot, the TV always did, and the TV with the remote control takes away the necessity of even getting up to change the channel.

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—

Photo of Michael Lord Michael Lord Deputy Speaker (Second Deputy Chairman of Ways and Means)

Order. I feel that the hon. Gentleman has had his allotted time.

Photo of John Pugh John Pugh Shadow Minister (Treasury)

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—

Photo of Michael Lord Michael Lord Deputy Speaker (Second Deputy Chairman of Ways and Means)

No, no. I am afraid that the hon. Gentleman will have to resume his seat—sadly.

Photo of Alistair Burt Alistair Burt Opposition Whip (Commons), Deputy Chair, Conservative Party 1:45, 13 November 2008

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.

Photo of Dawn Primarolo Dawn Primarolo Minister of State (Department of Health) (Public Health)

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.

Photo of Alistair Burt Alistair Burt Opposition Whip (Commons), Deputy Chair, Conservative Party

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. 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.

Photo of John Pugh John Pugh Shadow Minister (Treasury)

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.

Photo of Alistair Burt Alistair Burt Opposition Whip (Commons), Deputy Chair, Conservative Party

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.

Photo of Sir David Amess Sir David Amess Conservative, Southend West 1:59, 13 November 2008

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 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 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?"

Miss Johnson replied:

"We are not saying either of those things. What we are saying is that there needs to be a balance".

Later, I said to her:

"You have told the Chairman that obesity is at the top of the agenda in terms of public health."

So where do we stand now? The Government have recently made two announcements, which, as ever, caught the headlines. The first concerned tackling childhood obesity. We had a great opportunity to do that when our report was published four years ago. Much as I applaud the fact that the four supermarkets are going to work together to tackle childhood obesity, I want to hear a little more from the Minister to convince me that this is not gesture politics and that there will be a sustained follow-up to that announcement. Then we had the healthy towns initiative. Will the Minister explain how those towns were chosen? Were they invited to bid? Do I need to tell off my own town of Southend for failing to put in a bid? It is a great idea, but are these pilot schemes, and how will the Minister decide whether they have been a success?

We drew a number of conclusions in our report, saying finally:

"While we have tried wherever possible to take the food industry at its word, and seen it as 'part of the solution', we recommend that the Government reviews the situation in three years"— it was published in 2004, so we were recommending that it be reviewed last year—

"and then decides if more direct regulation is required."

On one of the Committee's trips, we went to America, where we met people from all the big names in the food and drink industry. McDonald's, Nestlé, Coca Cola—you name it, we met them. To a woman and to a man, they were in total denial that the responsibility was theirs. All they wanted to emphasise was physical activity. I do not want any of my colleagues to boo from a sedentary position, but I am an unashamed enthusiast for the Olympic games. The Minister for the Olympics is reported to have said at a dinner earlier this week that if we had known then what we know now, perhaps we would not have bid for them, but I am delighted that we are going to have them, because there will be a sustained focus on physical activity. We debated the legacy a couple of weeks ago. I hope that the physical activity will not end with the closing ceremony and that people will continue to run, jump, swim, dance and all the rest of it. That is splendid.

We do not die if we do not take physical exercise, but we do if we do not drink and eat. The nature of the human beast is that we are all sinners. We all like to drink and we all like food. We like our taste buds to be triggered in some way or other. The key is to get the food and drink industry to take seriously the fat, salt and sugar content of the things that we eat and drink. In trying to get the supermarkets to agree on what we recommended in terms of traffic light labelling, we have ended with a shambles. It is no good having two systems—we are all very busy, and when we go round the supermarket the additives have to be clearly identified. I go back to what I said to Melanie Johnson during the inquiry.

We now have a Labour Government who say that they do not want to have a nanny state nor do they want to tell people what to do. However, a general review has not worked—I am not even convinced that that is happening—and having targets has not worked. We need action and leadership from the Government. I want them to assure me that obesity is at the top of their health agenda, because I am not convinced that it is. There are no quick fixes, but what we have are all the gestures that the Government participate in, seemingly every six months or in a year.

When the Select Committee visited a town in Europe, however, we saw a fantastic project—no motor vehicles were allowed in the town, and everyone was riding a bike. I suppose that it was a little bit like Cambridge. Since the publication of our report, I see no evidence that the Government have set any sustained target for wider involvement of the public. We had the BBC's "Fat Nation" for a while, but we seem to be going in and out of the process of involvement.

I applaud the latest two initiatives, but I want tangible leadership from the Government. If they had accepted every one of the Health Committee's recommendations, the Minister of State would be able to stand at the Dispatch Box and say, "We are actually treating this problem seriously and we are determined to defeat obesity."

Photo of Andrew Pelling Andrew Pelling Independent, Croydon Central 2:10, 13 November 2008

It is important to give every opportunity to people to take responsibility for their own health, but we must also be cognisant of the important issue of stigma. It is very much the Government's approach to ensure that no stigma is applied to the obese in initiatives to combat obesity. It is important that we recognise that many people suffer from obesity for reasons of genetics or metabolism rather than greed. It is not acceptable for us to take the approach of bullying the school fatty, or for society to hold a view that implies that obesity means slowness of gait, or of wit or mind. Recently, I was the subject of criticism by the Sri Lankan Government because I took an interest in the peace process in that benighted isle. They made many criticisms of me, but one—that I was fat—may well have some truth. That is a sign that accusations concerning size are a matter of stigma, attack and derision.

More seriously, I would like to speak from personal experience about the important dovetailing of the issues of obesity and mental ill health. I went through a period of mental ill health that coincided with significant changes in weight between 72 kg and 104 kg, which is a range of 44 per cent. I had an illness, followed by purposeful use of antidepressants to improve on my lowered weight, but we must recognise that antidepressants have an unintended effect on the weight of many of those taking them, which can have a significant effect on their willingness to continue to take them. One of the most significant reasons for non-compliance in the taking of important antidepressants is unintended weight loss.

The Government have been supportive in their provision of additional resources for mental ill health, and in my locality, we benefit greatly from the South London and Maudsley trust, which is an excellent, world-beating provider in the area of mental health. Nevertheless, there is a lack of sufficient resources to provide the counselling, advice and therapy for those with mental ill health, and for those who might need such support in the context of deciding not to continue with their medication because of concerns about the side effects of antidepressant use.

I would like to mention briefly the way in which combating obesity links to diabetes. My local primary care trust in Croydon has undertaken important initiatives in that area, but I still believe that additional steps could be taken to identify a number of different causes and symptoms of diabetes. It is a particular curse for the large south Asian community in my constituency, and it is most appropriate that we are debating this issue just ahead of world diabetes day.

Another important link between this subject and ill health is eating disorders, which have already been referred to by other Members. They particularly affect young ladies, who can be oppressed by social and peer pressures. I was impressed by the work done by the Greater London authority. Dee Doocey, who is a Liberal Democrat Member of the London Assembly, and Boris Johnson have considered the matter, and asked whether funding should continue for London fashion week when there is such an obsession with size-zero models. Such models put pressure on many young girls and young ladies to believe that they are fat or obese when that can hardly be the case. It is fair to say that I have some doubts about my ability to be a judge in the "Miss Croydon Advertiser" contest that will be taking place this evening at House of Fraser in Croydon, but the good news about that contest is that it is about the style, poise, intelligence and attitude of real people. I know who the finalists are, and they are between sizes eight and 12. It is good to see that people recognise that there is beauty to be found in young people of all sizes, and in all of us.

I would like to touch briefly on the comments made by Mr. Amess about the important role of food companies, particularly as there is a great temptation in times of great economic stringency for people to buy cheaply, but wrongly—to buy food that might not be nourishing, but which is more likely to add to their obesity. Despite the rather ill-judged reputation that one company in Croydon has, I am pleased to say that Nestlé UK takes a responsible attitude by ensuring that it sells good food to its customers. It is a very good Croydon company.

We often make fun of ourselves and the Government by mocking the cross-cutting approach taken across Departments to deal with important social issues. It is ambitious of the Government to pursue proper co-ordination among Departments and between different public sector bodies. It is therefore important to see how the annual report will bear out matters next year in its measurement of providing the most effective co-ordination between Departments, and the extent to which it has been possible to inculcate an absorption policy in local authorities and local schools.

A number of Members have mentioned the importance of sports. An area of cross-cutting governmental co-ordination I find of interest is the extent to which the Building Schools for the Future programme has taken cognisance of the danger of trying to secure capital receipts and therefore compromising the provision of school playing fields. I am a former chairman of education, and it is fair to say that I have sold playing fields myself, so I plead guilty to that, but I hope that the Government are resisting that temptation.

It is also important to have joined-up government in the areas of social services and sports provision. I would like to highlight the good practice, which I am sure is being pursued elsewhere, that was taken up as an initiative by Croydon council before the Government took a more national approach. The council saw that there were significant savings to be made in social services care for senior citizens by providing free swimming. Free swimming, at little extra cost, means that many of our senior citizens enjoy a better quality of life, through more active minds and bodies. I congratulate Councillor Steve Hollands on Croydon council on making that policy judgment.

It will be interesting to note in next year's annual report the extent to which there has been an early trend towards a fall in obesity levels. Perhaps we can also hope for some early savings and a reduction on pressures on the NHS budget as the result of Government initiatives.

Photo of Howard Stoate Howard Stoate Labour, Dartford 2:20, 13 November 2008

Not only the scale of the problem—Alistair Burt set out the statistics well—but the speed and trajectory at which it is becoming a major disaster for Britain and the wider world are shocking. My friend Dr. David Haslam of the National Obesity Forum spoke of a time bomb; he said that there is no obesity time bomb because it has already exploded and that we are now suffering its aftermath. We are dealing with the effects of a disaster.

We have already heard about the effects of obesity, including the huge increase in diabetes. An obese person has approximately 30 times the risk of diabetes compared with somebody of normal weight. As we all know, diabetes can significantly shorten life; it causes heart disease, strokes and vascular problems, not to mention the damage to eyes, nerves and kidneys. It is a multi-system disorder, which can cause significant problems. Type 2 diabetes is almost exclusively related to obesity. It is unusual to find somebody who is not obese with type 2 diabetes—the link is that great.

We have also heard about the link between obesity and cancer. Several cancers are directly related to obesity, as are heart disease and degenerative diseases such as arthritis. Obesity shortens life and causes misery. It has been estimated that obesity can knock nine years off life. I do not exaggerate when I say that, if the trend continues, a generation of young people will pre-decease their parents. That would be the first time in the civilised world that a generation had pre-deceased its parents through non-war-related effects. The position is that serious.

We have heard about the reasons for the increase in obesity. We eat far more refined food, which, almost by definition, is more calorie-dense than non-refined food. For example, a bag of crisps has a far higher calorie density than a pile of mashed potato. People experience more problems because they eat more processed food.

One of the big debates about obesity is whether calorie intake, lack of exercise or a combination of both causes it. The obvious answer is that it is a combination of both. However, a misleading statement that we often hear from several quarters is that people are not eating more than they did. People say that because they completely ignore food that is eaten outside the home.

Photo of Mike Penning Mike Penning Shadow Minister (Health)

The hon. Gentleman is right to say that we must examine calories and exercise, but we must also consider salt and fat, which do not necessarily fall into calorie content, but are just as dangerous and cause obesity.

Photo of Howard Stoate Howard Stoate Labour, Dartford

The hon. Gentleman is right about fat. Salt in itself does not cause obesity—it can cause other problems, such as high blood pressure, and it has a significantly damaging effect on health. Fat is the main problem because it is the most calorie-dense food. It has approximately nine calories per gram, whereas carbohydrate and protein have approximately four to five calories per gram. Fat is, therefore, almost twice as calorie-dense as carbohydrate and protein. Anything people can do to switch from fat to carbohydrate will reduce their calorie intake. It is difficult to determine the scale of the problem in terms of what people are eating simply because it is hard to measure what people eat outside the home. Many surveys ask what food people have eaten and bought in the supermarket, but that ignores the bag of crisps, the bag of sweets and so on.

Although we have labelling on foods bought in a supermarket, there is no such requirement for food in a restaurant. Many restaurants simply do not give information about the calories in their foods. When I tackled McDonald's about the matter, it said that the information was available if one looked for it and that it was also on the website. However, people queuing to buy a Big Mac are not simultaneously checking the website to find out the number of calories it contains.

Some fast-food outlets and restaurants provide such information, but it is not uniformly available. If one goes out for a curry, one has no idea how much fat, salt and sugar and how many calories it contains. It is therefore almost impossible to measure calorie intake because the information for reaching a conclusion is unavailable.

Photo of John Pugh John Pugh Shadow Minister (Treasury)

When I was a lad, school dinners were not under-caloried, if I may put it like that. There were no tuck shops in those days, but children ate an awful lot of sweets, and did not seem to get obese, which inclines me to the view that lack of activity rather than calorie intake is the principal cause of obesity.

Photo of Howard Stoate Howard Stoate Labour, Dartford

I hate to disagree with the hon. Gentleman, but he is wrong. People eat more calories—they can afford more food than they could in the past. There was a tuck shop at my school, but I could not often afford to buy anything from it. Food, like alcohol, has become relatively cheaper over the years and that means that it is more available.

However, it is interesting and paradoxical that obesity in this country is a disease of poverty. People who are poor are far more likely to be obese simply because poorer people tend to buy more energy-dense foods, which are cheaper—people can fill their children up for less money. The children are thus more likely to become obese.


I am afraid Mr Stoate that is wrong. When I was at school over 50 years or so there was no obesity amongst children and this was in the immediate post war period when we were all fairly poor. We did eat very stodgy and fattening foods like suet puddings, bread and jam and fish and chips. The big difference was that we all walked to school or got the bus and we had PT and games periods several times a week. It was unthinkable...

Submitted by Michael Dow Continue reading

Photo of Alistair Burt Alistair Burt Opposition Whip (Commons), Deputy Chair, Conservative Party

I am grateful to the hon. Gentleman, who has been generous in giving way. I confess to running a tuck shop when I was at school—it was part of the prefects' duties. Before he moves from calories, will he explain why he believes that when we have a lot of information about calories—people can find out about calorific content and the risks of food if they want—people ignore it? Statistics from the Department of Health and other sources show that. Why does he believe that so many people ignore the information and blithely go on in their own way?

Photo of Howard Stoate Howard Stoate Labour, Dartford

That is an interesting question, which I can answer. The Select Committee on Health, of which I am now a member, is undertaking an inquiry into health inequalities. Last week, Jamie Oliver came to talk to us about that very issue. I take issue with Mr. Amess, who said that there were two labelling schemes—there are three. One is guideline daily amounts without traffic lights, one is GDA with traffic lights and the other is traffic lights. There are three competing schemes. I told Jamie Oliver at the Health Committee sitting last week that I did not understand the GDA system, and he said that he did not, either. I then asked, "If I'm a mother with three young children and I pick up a packet of something in the supermarket, which says, 'This packet contains 13 per cent. of the GDA for this particular nutrient', what does it mean?" He said that he did not know. This morning, I tackled the Food Standards Agency about the matter, and it could not give me the answer.

We must have a far more robust mechanism whereby people can receive information quickly. We have the eight-second rule in politics: if we put a letter through someone's letter box, we have eight seconds to convey our message. That is the time it takes to pick up the letter off the floor, take it to the bin and throw it away. That is what happens to political leaflets. People probably have less time than that in the supermarket. If they are busy and trying to buy food for their kids, they pick up a bag of whatever, and think, "Yes, oven chips—in the basket." We must forget the idea that someone can digest a range of nutritional information such as GDA percentages per 100 grams, per half a pack and so on, at the same time as doing the weekly shop with two children in tow. It cannot be done. People do not deliberately avoid or misunderstand the labelling—it is simply opaque and obscure. I have been a doctor for a long time and I do not understand it, so I cannot assume that anybody else does. That is why, frankly, the current voluntary system that food manufacturers and vendors are operating is not working. Voluntary systems did not work with smoking, and in the end we had to legislate. Voluntary systems are not working with food labelling, and we will probably have to legislate on that, too. I ask the Minister to consider that carefully in her response.

I know that time is pressing and I do not want to detain the House for too long, but we have to take robust action. We need far more robust action on advertising and on point-of-sale labelling and information, so that people have a much better idea of what they are eating and understand exactly what is in it. We must work with the food production industry to ensure that the salt, fat and sugar levels in food are lower wherever possible and to encourage it to transfer from saturated to non-saturated fats. All those things can be done, I hope not by forcing the industry, but by persuading it to do them on its own initiative.

We also need to do more for people in their communities. Many people come to see me as a GP. I am very pleased that we are now measuring body mass index as part of our quality and outcomes framework, so that we at least have records of it. In addition, the Prime Minister's welcome announcement on vascular screening this year means that we are not only weighing a far broader section of the population, but measuring blood pressure and cholesterol levels far more.

However, it is one thing to identify people with a problem—raised cholesterol, body mass index or whatever it might be—but another to sort it out. I make a plea to the Minister for far more support in general practice, so that when we pick up someone with a problem, we have the resources to address it, instead of just saying, "Get a diet sheet from the nurse" or "Take tablets." I do not want to go down that road. I want to ensure that we have enough information and community resources to refer people to an appropriate service where needed, whether it is a slimming club, a dietician or whatever. It is common to see obese children now, but it is much more difficult for GPs to send them down an appropriate avenue to deal with that obesity.

Obesity is a serious issue and I am pleased that the House has found time today for this debate. If we do not keep returning to the issue, it might slip off the agenda, and that would be a disaster for us all. I am therefore very pleased indeed that the Government have called this debate and that hon. Members have joined in. I am impressed by hon. Members' information and knowledge about obesity. In other words, everyone is aware of the issue; tackling it is the problem.

We probably all agree in our hearts that obesity is down to a combination of diet and exercise. Obviously we can disagree about the exact contribution that each makes, but it would quite wrong to assume that one is more to blame than the other. Both are responsible. As a society, we ignore the problem not just at our peril, but at the peril of our children and grandchildren, because if we do not sort it out, it does not bear thinking about.

Photo of Mike Penning Mike Penning Shadow Minister (Health) 2:31, 13 November 2008

It is a pleasure to respond to this debate on behalf of Her Majesty's Opposition. This debate is important, but it is difficult to call it topical on a day when BT has announced 10,000 job losses and at a time when 2,000 jobs a day are being lost in the British economy. Even the Minister was surprised to find herself here this afternoon responding to a debate that she did not know was going to be called.

On the serious issue of obesity, however, many figures have been cited but probably the most worrying is the one from 2006, which is that one third of all children then were classed as technically obese. That means, on the Government's own statistics, that unless we all do something, 60 per cent. of the British population will be obese by 2050. That is why this is such an important debate.

The Minister said in her opening remarks that we are not talking about a social group, the working class or anything like that; we are talking about a major issue that affects people across the board. As many hon. Members have said, obesity dramatically affects the lower socio-economic groups in our society—I will come to that—but it dramatically affects certain ethnic groups, too. As we become a more diverse population, some ethnic groups, particularly certain Asian groups, suffer disproportionately from obesity and the medical problems associated with it. I am aware that the Bengali community is particularly worried about type 2 diabetes, which is affecting it so much and which seems to be becoming a genetic problem.

There were reports in the press this morning that having fat in certain parts of the body affects a person's likelihood of contracting cancer. One report said that having "love handles"—that is, fat in the abdomen area, round the body more generally—makes a person more likely to get cancer. I am worried by such research and the way that it is reported in the press. As other hon. Members have said, the issue should not be about a stigma, but about helping people to live healthier lives. We are all different shapes and sizes, so we should not worry people by saying that if they have the odd extra pound around their abdomen they are more likely to get cancer; rather, we should address the issue of obesity.

I pay tribute to hon. Members who have talked about the push by the fashion industry and others for size zero, and about those who say that only sizes eight and 10 are acceptable. That is abhorrent, and we should treat it with the contempt that it deserves. I only wish that my daughters would do so. They are absolutely paranoid about their weight—even though they are very sporty, they worry a great deal about what they eat. That worries me as a father, and I am sure that other parents in the House are similarly worried.

In August, my hon. Friend Mr. Lansley, the shadow Health Secretary, said that the Conservative party's proposals for a response to the problem will deal with the industry. It cannot be right that legislation alone is the answer; there must be a partnership between the community, businesses and Government. I was conscious that the Minister did not refer to food labelling. I hope that she has time to do so towards the end of the debate. I know that it is difficult for her to talk about that, because legislating is difficult.

Photo of Mike Penning Mike Penning Shadow Minister (Health)

The Minister is indicating that it is not a problem, so perhaps she will explain later why she did not mention it once in her 10-minute speech, even though it is one of the most controversial food issues at the moment.

As I understand it, one reason why the Health Committee report recommendation on traffic lights was not implemented—it is also why the Conservative party is not saying that it should be implemented—is that under European law it cannot be implemented. That is the issue that is at stake. Unless our European partners agree that traffic lights are the way forward, we cannot introduce them.

Photo of Howard Stoate Howard Stoate Labour, Dartford

I asked the Food Standards Agency about that this morning. It told me that European law was not an obstacle and that, in fact, the current recommendations from Europe made it perfectly possible to have a traffic light system if we choose to do so.

Photo of Mike Penning Mike Penning Shadow Minister (Health)

I look forward to looking at the Health Committee's evidence. I had the honour of being a member of that Committee. I too had meetings with officials of the FSA recently, but they indicated to me that European law was a concern. If there is a concern, we need to go for the best possible option. I agree that the guideline daily allowance system is not perfect, but at least it means that information for people who are willing to look for it is on the front rather than the back of packs. Perhaps a voluntary traffic light code would be the way forward.

I should like to comment on some of the excellent comments that have been made in the debate. I believe that my hon. Friend Mr. Hollobone referred in an intervention to the fact that it would be much better if fewer of our constituents drove their pupils to school. I agree with him. There were some excellent community-based ideas, such as walking buses and so on. When I ask my constituents why they drive their children to school, they say, "Fear." They do not feel that it is safe to let their youngsters walk to school any more, either with a friend or with another parent. We must address that. People in all parties are worried about that, and rightly so.

Before Dr. Pugh was cut short—I am sure that he will learn from that crisis—he was absolutely right to say that interaction with youth is very important. I am conscious of the fact that, as my hon. Friend Alistair Burt said, when school facilities are not being used, when schools are closed in the evenings, clubs and other sporting people should have the opportunity to use them.

Photo of David Davies David Davies Conservative, Monmouth

I apologise for my earlier absence—I was at a sitting of the Home Affairs Committee. Does my hon. Friend agree with comments made by the Under-Secretary of State for Culture, Media and Sport, Mr. Sutcliffe, who has indicated his support for encouraging more boxing in schools, as a sport that can do a great deal to tackle obesity?

Photo of Mike Penning Mike Penning Shadow Minister (Health)

I declare an interest as someone who boxed for some 30 years. I cannot think of a better way of keeping fit than boxing, and it should be brought back into schools. It is about the fitness regime, not the bouts. If the calories are going in, one can certainly burn them off with a decent boxing trainer. Parents should not fear allowing their children to participate in amateur boxing—the protection these days is very good.

On some of the other points made by my hon. Friend the Member for North-East Bedfordshire, personal responsibility is crucial to any Government proposals to move the issue forward. We cannot be a nanny state—an issue that the Select Committee has considered previously—because the public will reject it and look the other way. At the same time, we need to protect. I am concerned about the poorest groups in the community using more and more ready-made meals, which are getting cheaper and cheaper in our supermarkets but, because of the salt, fat and sugar contents, are the most damaging to our constituents.

My hon. Friend Mr. Amess referred to his time on the Select Committee. I had the honour of serving on it after the report he mentioned was published—prior to the 2005 election. I agree that it was one of the greatest reports, although the report on smoking was also remarkable for its cross-party basis and for the legislation that it prompted, perhaps in a way that the House and country might never have believed could happen. It showed how we could protect so many people in our communities.

In my remaining time, let me say that it is not possible for any Government simply to drive legislation through. Any action we take has to be cross-departmental and based on joined-up thinking with businesses, schools and parents. I hope that this morning Jamie Oliver did not use some of the colourful language he often uses in his TV programmes. He and other chefs have undoubtedly driven forward the whole concept of cooking. My own daughters now cook on a regular basis, which I would never have dreamed of a few years ago. The debate needs to continue. It is shame that the Government have not adopted more recommendations from the 2004 Health Committee report. I look forward to hearing from the Minister how many of those recommendations we can hope to see introduced in the future.

Photo of Dawn Primarolo Dawn Primarolo Minister of State (Department of Health) (Public Health) 2:41, 13 November 2008

With the leave of the House, I would like to respond to the issues raised in this interesting and well-informed debate. Let me start with Dr. Pugh, whose comments were echoed by a number of Members, including the hon. Members for Croydon, Central (Mr. Pelling) and for North-East Bedfordshire (Alistair Burt).

Crucial points were made about balance, and it is important that none of us implies that there is a single answer to the problem; it is far more complex than that. The hon. Member for Southport highlighted the importance of activity, food labelling, cooking healthy food, planning, urban design, advertising, reformulation of foods, using pester power to generate pressure for healthy foods, calories on menus, portion sizes and so forth—all matters of great importance that we are taking forward. The hon. Gentleman also raised the issue of self-image; the way in which we conduct the debate is crucial for us all—whether it be the Government, non-governmental organisations, local authorities, health service bodies, local communities or whatever. The hon. Member for North-East Bedfordshire touched on that, as did the hon. Member for Croydon, Central.

The information we convey about maintaining a healthy weight and a healthy lifestyle must not just be about what we eat or how much exercise we take. Nor is it just about making people in our society so obsessed with their diet that they do not eat enough; we have seen the difficulties people get into with eating disorders. As the Minister responsible for public health over the last year and a half, I have sought to be careful with the language that I use and to stress the importance of a healthy lifestyle and living healthier and longer lives rather than going for a one-size-fits-all solution. I endorse all the points that Members have raised in the debate.

The contribution of the hon. Member for North-East Bedfordshire was helpfully divided into four parts. He made international comparisons, which were absolutely valid, and he spoke about the luxury of food and eating what is necessary. The Government can play a role, as highlighted in the Select Committee report, in the matter of portion size, as it takes us into labelling, how much we are eating and what our food contains.

The hon. Gentleman spoke of the need for reliable information. We are bombarded with reports and research from all over the world, but what people need is reliable, simple, accurate information, and that is what Change4Life seeks to provide. The hon. Gentleman also perceived a lack of interest. The results of surveys suggest that while people consider obesity to be an important problem, they do not feel that it applies to them. Therein lies the real issue: it is always someone else's problem. Even the parents of obese children do not recognise it.

The way in which we are conducting the debate on this subject allows us to polarise the issue. We think of it as applying to the person who weighs 50 stone, 20 stone or 30 stone, but once our body mass index rises above 25, we should all be wary of the health implications. We need to ensure that the information is there, that it is accessible and that people perceive it as relevant rather than accusatory or polarising, or paving the way for unintended consequences. The hon. Member for Croydon, Central made the connection with mental health.

Following the Health Committee's excellent report, the Government acted on all its recommendations. We gave funds to primary care trusts to enable them to produce the necessary information, we updated the child health promotion programmes, we put more funds into the family-nurse partnership, and we changed the national child measurement programme so that parents can be informed of their children's weight and height and told whether the statistics fall within a healthy range. We worked with Ofcom to change the advertising rules, particularly those applying to children.

The Food Standards Agency has worked relentlessly on reformulations of foods. It has worked relentlessly on salt and sugar, and huge steps have been made, but more needs to be done. The question that I would put to the food industry is, "If some changes can be made by some manufacturers, why cannot all the changes be made by all the manufacturers?" My hon. Friend Dr. Stoate asked that question as well.

A great deal of work is being done to build on those successes. Following the Health Committee's report, we commissioned the Foresight report. We asked scientists to look critically at all the elements that were contributing to a substantial public health challenge. Mr. Amess felt that he did not have all the information that he ought to have in connection with the Health Committee's report. I should be happy to send the details to him, and I hope he is now satisfied that the Government acted on its recommendations.

As for the healthy towns initiative, perhaps the hon. Gentleman should have a conversation with his local council. There were 160-odd expressions of interest in the initiative. Councils had to make specific proposals related to what their communities said they needed, and a selection process finally reduced the number to nine. Those nine councils will be monitored, and the measures that are found to work will form the basis of programmes for the future and funding to help all the councils implement their plans.

That brings me to the point made by the hon. Member for Croydon, Central. This is about partnership across Government. It is about what can be done by the Department for Culture, Media and Sport, by the Department for Children, Schools and Families, by the Department for Transport and by the Department for Communities and Local Government. Of course it is about the Department of Health, but it is also about the Department for Work and Pensions and what we can do with employers to ensure that there are healthy workplaces. We must work with the Food Standards Agency and local authorities through local area agreements and make this issue a high priority. I look forward to that annual report and I hope that Members will welcome the progress that we are making.

I fear that we will need to return to the points raised by my hon. Friend the Member for Dartford on food labelling. The Government have been clear that the best and swiftest agreements to achieve with the industry are those of a voluntary nature, but we have made it clear that if progress cannot be made, we will consider other methods. He is right in terms of comparing ourselves with other countries; there is a great deal of information on food labelling and the traffic light system is very clear, but there is still not one system. That is why the FSA is undertaking research to settle once and for all the best, simplest and most straightforward information that needs to be available on food. It will be based on the traffic light system and will ensure that one of the building blocks—but only one—is in place as the Government work with local government, communities, the health service, NGOs and community activists in partnership to deal with the biggest public health challenge that has faced this country in a very long time.

Question put and agreed to.


That this House has considered the matter of combating obesity.