[Mr David Crausby in the Chair] — Diabetes

Part of the debate – in Westminster Hall at 10:31 am on 9 January 2013.

Alert me about debates like this

Photo of Diane Abbott Diane Abbott Shadow Minister (Public Health) 10:31, 9 January 2013

I congratulate Mr Sanders on securing this debate. I am struggling with the aftermath of a new year flu, so I hope that my voice will hold out.

I should declare an interest: I have been diagnosed as a type 2 diabetic. As always, I follow humbly in the footsteps of my right hon. Friend Keith Vaz; I have spent 25 years doing that. I am grateful for the opportunity to speak on behalf of Her Majesty’s Opposition about diabetes, one of the leading health threats in the UK. As we have heard, there are 3.7 million people in this country living with the disease. As we have also heard, it is a particular issue for people of south Asian and African and Caribbean descent in our big cities. I am hopeful that one thing that will emerge from the changes to the NHS is more local targeting, both by clinical commissioning groups and in public health, of local issues and local demographics. We cannot engage with diabetes unless we also engage with local specifics in our cities and regions.

As we have heard, diabetes costs the NHS one tenth of its budget—more than £10 billion a year. We have heard in detail about foot care and amputations, but the general problem is that diabetes is a gateway condition to hypertension, stroke, kidney problems and amputations, leading to early death. I was struck by the figure given by my hon. Friend Nick Smith of 23 amputations in Blaenau Gwent. It makes one stop to think about the human reality of diabetes in communities.

The fact that diabetes is a gateway condition makes early diagnosis and engagement so important. It is important to be mindful of the new NHS architecture. It is not just a question of asking Ministers to do more; we must also take the debate to a local level, with CCGs and directors of public health, because healthy living issues will fall to directors of public health and local authorities, rather than Government, to deliver. We can also look to local authorities that have been innovative about healthy living issues by offering free swimming lessons and so on.

We have heard about the basic health service treatments and checks that people should have. The Minister will be aware that the Public Accounts Committee’s report was critical of the management of adult diabetic services in the NHS. The report said that every year, 24,000 people with diabetes die simply because their disease has not been effectively managed. That is not a satisfactory figure in the 21st century for one of the world’s leading economies. Although people now know what needs to be done for people with diabetes, the Public Accounts Committee found that progress in delivering the recommended standards of care and achieving treatment targets has been depressingly poor.

What is the Department’s response to the Public Accounts Committee’s report? What can the Minister tell us about improvements in policy and service in line with the Committee’s recommendations? Does the Department of Health have a plan for ensuring the effective implementation of the NHS health check programme after the NHS reorganisation in April?

I would also like to say a word about children and young people with diabetes. As many as one in four young people are diagnosed with type 1 diabetes. The UK has the highest number of children diagnosed with diabetes in Europe and, sadly, the lowest number of children attaining good diabetes control. Christine Cottrell, a diabetes nurse specialist from Warwick, told The Daily Telegraph last July:

“We are even getting children as young as seven with Type 2 diabetes”.

It is an important public health issue, and the prognosis is not good:

“These children end up having heart attacks, or losing a limb, or their sight, in their 30s and 40s.”

I know that it is difficult in a Westminster Hall debate to bring up issues that cut across Departments, but has the Minister had discussions with her colleagues in the Department for Education about what support could be offered to schoolchildren and young people to manage their diabetes effectively and prevent the development of early complications? What efforts are being made to ensure that both staff and pupils are aware of the nature of diabetic epileptic attacks, which can take place in schools, and the best way to assist sufferers in an emergency?

What steps are the Government taking to increase the number of people not previously diagnosed with diabetes who receive diabetes testing? What was said earlier about the role of pharmacists was an interesting suggestion. Do the Government have a plan in place to make the public aware of the symptoms of diabetes sufferers? Are there any plans for a nationwide public awareness campaign? On prevention, we know that the new NHS commissioning board will be mandated to prevent diabetes. I know that it is perhaps not reasonable to say that GPs do not perform things that are not targeted exactly as well as things that are, but is the Department considering introducing diabetes testing targets for GPs?

The Public Accounts Committee inquiry to which I referred earlier heard that out of 20 trusts that needed to improve their diabetes care, only three accepted the offered help. That is not reassuring. How can the Minister ensure that care through health providers meets the targets set by the Secretary of State? As clinical commissioning groups and directors of public health take over some of those responsibilities, what can the Department do to ensure that diabetes is on their agenda?

On some of the more general issues around diet and healthy eating, although diabetes management, foot care and preventing diabetes from becoming a gateway to even more serious conditions are important, the most important thing that we can do in medical and public health terms is consider diet and healthy eating and other prevention matters, particularly for young people. Most experts agree that the excessive consumption of sugar is a factor in both obesity and diabetes. Increasingly, people are saying that sugar is addictive.

Colleagues have mentioned some important things to engage with in terms of policy, such as minimum pricing for alcohol, about which the Government are consulting and which is supported by Opposition Members. We suggest looking at the sugar composition of some foods, particularly those targeted at children. Most parents want to do their best, and I hope that the advertising campaign launched by the Minister will shed some light on such issues for parents. However, how many parents know that Coco Pops are one third sugar? People joke about it, but although most parents would not sit their child down to breakfast and put a bar of chocolate in front of them, they will give them a bowl of Frosties or some children’s cereal, which can have a higher proportion of sugar than a bar of chocolate. Opposition Members are saying that we need to consider legislating to ensure that the proportion of sugar in some foods that are directly targeted at children can be brought down.

I am glad to advance Her Majesty’s Opposition’s position on diabetes. I congratulate the Government on what they have done up until now, but there is more to be done, both in locking in a concern for diabetes locally when clinical commissioning groups and directors of public health take up their new responsibilities and dealing with the broader issues of healthy eating and a healthy lifestyle and the preponderance of sugar in modern processed food.