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Diabetes — [Mr Laurence Robertson in the Chair]

Part of the debate – in Westminster Hall at 10:35 am on 9th January 2019.

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Photo of Sharon Hodgson Sharon Hodgson Shadow Minister (Public Health) 10:35 am, 9th January 2019

It is a pleasure to serve under your chairmanship this morning, Mr Robertson.

I thank Sir John Hayes for securing this important debate, especially after the excesses of Christmas—in which I am sure we all indulged, which is relevant to the topic we are discussing—and for his characteristically informative, entertaining and articulate opening speech. I also thank all right hon. and hon. Members who have taken part: my right hon. Friend Mr Howarth, Andrew Selous, who is co-chair of all-party parliamentary group on obesity and does excellent work in this area and the hon. Members for Rochford and Southend East (James Duddridge) and for Linlithgow and East Falkirk (Martyn Day). They made excellent contributions.

As we have heard—I will repeat these facts because they are worth saying again—there are currently 4.6 million people living with diabetes. Over the last 20 years, the number of people diagnosed has more than doubled. Every day, around 700 people—one person every two minutes—are diagnosed with diabetes, which is really quite shocking. Diabetes UK estimates that if nothing changes, more than 5 million people will have diabetes in the UK by 2025. That is why this debate is so important, and I am pleased to be here to discuss treatment, remission and prevention.

I start with treatment and care. Once a patient has been diagnosed, it is crucial that they get the right treatment and care for them. Technology can play a role in that, particularly for people with type 1 diabetes. New technologies mean that patients can be treated and monitored, which can help to reduce diabetes-related complications in the long term. However, access to those technologies is subject to a postcode lottery, as are many other things. I have heard of huge variation of availability and use across the country. I was pleased to see the Government commit to making life-changing flash glucose monitors available for patients with type 1 diabetes by April 2019. Will the Minster please also ensure that basic technologies, such as test strips and meters, are available to all patients who clinically need them across the country? We cannot just say that everyone with type 2 diabetes would clinically need them—although I have bought myself one and they are good for monitoring—but if people need them clinically, they should be available, not subject to a postcode lottery.

Such technology can be redundant if patients do not know how to use it, or do not know enough about their condition and how to manage it. That is why educational courses, such as the one that the hon. Member for Rochford and Southend East said he attended after his diagnosis, should be widely available, to give patients the knowledge, skills, support and independence to look after their own health. I was pleased to see that get a mention in the long-term plan earlier this week. Can the Minister please elaborate on when he expects the

“structured education and digital self-management tools” to be expanded?

It is crucial that patients know about their diabetes and the health risks associated with it. According to Diabetes UK, there are over 160 lower-limb amputations every week in England that are a direct result of diabetes. As someone with type 2 diabetes, I find that really scary. Four out of five of those cases could have been prevented. Local foot care teams help to prevent thousands of amputations each year, but diabetes-related amputation is now at an all-time high. Does the Minister have any strategy to reverse that trend?

Finally on treatment and care, one in six people currently occupying a hospital bed has diabetes; at some sites it is as many as one in four. The majority of patients with diabetes are admitted for treatment of a different condition, but while in hospital their diabetes should not be in ignored. When diabetes is not adequately cared for in hospitals, harm can result from the in-patient stay. Acute or long-term conditions can develop further, adding further costs to the NHS and complications for the patients.

The long-term plan includes a welcome commitment to introducing diabetes in-patient specialist nursing teams to improve recovery and to reduce lengths of stay and readmission rates. Will the Minister indicate when he expects that to begin? Will he also assure us that those teams will be available in all hospitals across the country?

On remission, as we have heard, my hon. Friend Tom Watson has been very vocal about his own transformation—it has been huge—and the remission of his diabetes owing to exercise and changes in his diet. He has done a fantastic job, as we have all acknowledged, and I wish him all the best. Diet changes, when I stick to them, have also helped me in my management of my diabetes. When I have totally cut out sugar and reduced all carbs, as the hon. Member for Rochford and Southend East said helped him, it has made a massive difference. While there is currently no evidence that diabetes can be completely cured, even by changes to diet and lifestyle—I am told that once someone is diabetic they always will be—people can take steps to control, reduce or even reverse symptoms of diabetes, and to put their diabetes into remission.

As we heard from the hon. Member for Linlithgow and East Falkirk, research and trials by Professor Roy Taylor of Newcastle University—I am very proud that a north-east university is leading the way on this—has found that a low-calorie diet of 800 calories a day, which is low but manageable, can actually reverse diabetes, which was recently listed by MadeAtUni as one of the UK’s 100 best breakthroughs in health. It is certainly an area that needs to be explored further. However, not everyone can make those changes on their own, and patients must have access to medical support and dietary advice if they wish to try. The NHS has confirmed that it will pilot diabetes remission services in England and Scotland. Some places are already rolling out the service informally. For example, I know that some GPs in Tyneside are piloting this model. Will the Minister please tell us when expects those pilots to begin?

On prevention, 12.3 million people are now at an increased risk of developing type 2 diabetes. Of course, not all of those will go on to develop diabetes, but such a high number of people at risk is deeply concerning. Type 2 diabetes has several risk factors, but as the hon. Member for South West Bedfordshire highlighted, being overweight or obese accounts for as much as 80% to 85% of someone’s overall risk of developing the condition.

Almost two in every three people in the UK is either overweight or obese. I am obviously one of the two at the moment. I strive and hope to be like the hon. Member for Rochford and Southend East, who said he is now the one of out of those three. I congratulate him on that. I am back on a diet and cutting out sugar and carbs again and trying my best. However, if it was easy, nobody would be overweight. It is hard, and Christmas is not the best time to try to diet. This is why the nudge theories introduced by Public Health England are very welcome, along with proper traffic light food labelling and the “Eatwell plate”, for example.

However, we have to acknowledge that our society has become increasingly obesogenic and sedentary, and we have to address that as soon as possible, starting with the next generation in particular. In that regard, the Government launched the second childhood obesity plan last year, which will hopefully help to tackle this problem if they implement all the policies within it and do not only consult on them. Clear calorie labelling and introducing a 9 pm watershed for adverts for food and drink that are high in fat, salt and sugar are two steps that the Opposition would introduce if in Government, to help to reduce the high level of obesity in this country.

However, it is not all about diet, as Baroness Tanni Grey-Thompson is always telling me, but about exercise, too. Inactive children become inactive adults, which increases their risk of long-term conditions. According to ukactive, only 50% of seven-year-olds meet recommended physical activity guidelines. We therefore need to make sure that children have the space and resources to participate in sports, activities and play, which will benefit them in a whole host of ways, not just their health.

Nor should we forget the over-55s—or anybody, actually. According to ukactive, a total of £80.5 million could be achieved in NHS and healthcare savings on diabetes if one third of inactive over-55s were supported to be active over the next 10 years. The Secretary of State says that prevention is better than cure, and I think that that figure alone shows that it is.

The long-term plan committed

“to fund a doubling of the NHS Diabetes Prevention Programme over the next five years, including a new digital option to widen patient choice and target inequality.”

That must target people from black, Asian and minority ethnic groups, who are six times more likely to develop type 2 diabetes. We must ensure that any prevention programme reaches those communities as a matter of urgency.

To conclude, people with diabetes are sadly at greater risk of serious but largely preventable complications. For example, they are twice as likely to have a heart attack or a stroke. For those of us here who suffer from diabetes, that is a sobering fact. We must ensure that their diabetes is properly managed and cared for, so as to avoid those serious complications. What the Government do next as part of the long-term plan will be beneficial to those with diabetes, and I know that patients, campaigners and all of us here will keep a close eye on developments.