Obesity: Covid-19 — [Philip Davies in the Chair]

Part of the debate – in Westminster Hall at 10:37 am on 10th November 2020.

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Photo of Alex Norris Alex Norris Shadow Minister (Health and Social Care) 10:37 am, 10th November 2020

It is a pleasure to serve under your chairmanship, Mr Davies. I congratulate Jim Shannon on introducing the debate and on the tone he set in doing so. The disparities between our nation and similar nations show that something different is going on in the UK, and that should, we hope, act as a call to action for all of us in seeking to do something about it.

The hon. Gentleman’s references to income and ethnicity equalities were important and well made. He was a little bashful in talking about the financial impact, but it is worth recalling that obesity is terrible for the individual and for the collective in its impact on our health service and economy. We have not only a moral but a vested interest in this.

Colleagues made excellent contributions. Dr Davies picked on the disparities in the impact of covid and outcomes for obese people, and in raising them the Prime Minister did a public service. The hon. Member for Strangford also mentioned social justice issues—a theme that Andrew Selous developed with characteristic force. We will all take away the statistic on processed food as it brought into sharp relief the difference between the UK and other countries. That should act as a wake-up call, and I hope this will be a kick-off for parliamentary debates on it.

I was glad that Wera Hobhouse referenced eating disorders. When we discuss obesity I prefer to refer to a range of healthy weight interventions. The obesity strategy might be better as a healthy weight strategy because it is only part of the picture. The hon. Lady made important points about how the different disorders are linked.

The phrase that I underlined from the speech of Jo Gideon was that the public mood has changed in recent months. It has, and we must take this opportunity, but a delicate balance must be struck. You, Mr Davies, have spoken publicly about the need not to moralise, and you and I have had that conversation in the context of gambling. People switch off if we wag our finger and say that they should be as virtuous as we are. We do not, however, do our people a service if we are blind to the challenges that our environments and our lifestyles are creating for us. We must find the balance between not wagging our fingers and being assertive enough to say when things are not working and are not right. The time when the public mood is changing is a good moment to do so.

I liked the emphasis that Caroline Nokes gave to wellbeing. I do not think that is too new age for us to latch on to. It would be a really good outcome of the covid settlement, as people have made this extraordinary national sacrifice, to have public services, an economy and a general environment that points towards wellbeing for all of us. We should all be interested in that.

In my community, in 1920, poverty manifested itself in malnutrition. We have all seen the pictures of rake-thin children. In 2020, it is the opposite. A third of our children leave school overweight or living with obesity. In the adult population, two thirds of us are above a healthy weight and half of those are living with obesity. That is a challenge of exceptional scale. It is a population-level public health challenge. That behoves us to act. We know that obesity is a risk factor for heart disease, type 2 diabetes, some cancers and covid-19, as hon. Members have said. This is a good moment to tackle a national crisis.

My party has had interest in this matter for some time. Members may recall that our former deputy leader, Tom Watson, who is no longer of this parish, took on this issue personally during the last Parliament. His journey was incredible and I know people have taken great interest in it. He is a great ambassador.

We are glad to see the obesity strategy. I am happy to say publicly, as I have said in the media, that we support the Government in their efforts. We want to see the strategy actually implemented, so we do not get bogged down in consultations for ever and things do not actually happen. Rather than pushing the Minister on the substance of the strategy, I will push her on making it happen. There are arguments to broaden it out to a healthy-weight strategy and bring in greater emphasis on mental health, but at the moment I will take what we have.

Yesterday, the Minister replied to my written parliamentary question on this issue. It is clear that there is no new money for this and it is within the public envelope. I will talk about public health cuts shortly. The reality is that there have been diminished resources for this over the past few years. The impact of covid-19 on public finances means that resources are likely to diminish further. We should question whether we are geared up to meet such a significant challenge.

One reason why it is expensive and hard to tackle obesity centres on the complexity of the issue. It is about not just food, but childhood experiences, education, income and mental health, as well as poverty, in which I have a direct interest as the representative of one of the poorest communities in the country. We know that in communities such as mine, children are twice as likely to be obese as children who live in better-off places. Those children are no different. It is not because our burgers are any bigger or our sugary drinks any more sugary in Nottingham. There is nothing in the waters. Those environmental factors in our community push children and young people towards obesity. It is fine and right to talk about personal choice, but we have to understand that there are structural, social and economic inequalities in our country that close down choices, limit opportunities and push very difficult life outcomes on to our young people.

This is a challenge for the Government. This Administration and previous Governments in the past decade have not taken a long view on this—an investment view, rather than a finances view. Short-term decision making will cause greater problems. Public health cuts are a shining example of that. The migration of public health to local authorities is a good thing and one of the few aspects of the Health and Social Care Act 2012 that is likely to remain much longer. However, cuts to local authorities have meant a diminution or repurposing of those services.

I know from three years of leading in Nottingham on our public health grant that once we have paid for drug and alcohol services and sexual health services, which are demand-led services, there is not a lot left for smoking cessation, which really works, or for early life-course interventions, which are spectacularly effective. Unhealthy weight barely gets a look in. Across the country, we have seen the complete loss of any supported cooking programmes or those sorts of things that pull down the myth that cooking and eating healthily is hard or time-consuming.

That is thing that frustrates me. If I could get one message across to my neighbours, it would be that with a little bit of planning, it could be cheaper for them to eat healthily and it could be better for them, too. We have lost that, because we have lost the support through the public health grant. Covid makes everything harder because all of our local authorities—I am talking about England specifically; I apologise to Scottish colleagues—are looking at their finances. The “don’t worry, we’ll meet all your covid expenses” promise will not be honoured—that is clear by now—so there will be in-year cuts, and they will come from the places that they came from in the past, because they cannot come from children’s or adult’s social care, but from things that are seen as discretionary That is bad for individuals and our communities, and it is dreadful for all of us collectively because it will create much greater expense further down the line.

I will reference briefly free school meals. When I wrote this speech at the weekend, events had not moved on. Again, that was a prime example of understanding the cost but not the value of something really significant. Research by the Nuffield Foundation found that the provision of free school meals leads to a fall in obesity rates. I have gone public on this: I have no more interest than you, Mr Davies, in moving to a point where the Government feed children routinely. However, we need to understand that it is partly a good thing. When we have children at school, it is good because we educate them, but we can do many other good things around health and exercise, and we should not miss those opportunities.

Before I finish I want to make a quick point about Public Health England. I still think it is a very odd thing—one of the oddest things that has happened in an exceptionally odd year—that during this pandemic the Secretary of State for Health and Social Care would want to abolish Public Health England. It is an important ring-holder body for our obesity efforts as a country. I understand the disease and infection control points, but the Secretary of State wants his organisation, so he will have it. To an extent, I will not contest that space but, for the remaining functions of Public Health England, which are vital whether it is around obesity, smoking or drugs and alcohol, I really hope the Minister will give us a sense of what the plan is. I have asked parliamentary questions, so I know the consultation is coming soon, but we do not have long if it is to be up and running by April. I hope we have a soft landing. I will commit publicly to making no political capital out of it. We will all be relieved and will move on and never mention it again. That would be in all of our interests.

The hon. Member for South West Bedfordshire said the real theme to take away from this is a combined national effort. I really like that. We can find a high level of political consensus on this really easily. As the hon. Member for Stoke-on-Trent Central said, there is a public interest. Industry is falling over itself at the moment to tell us about the good things that it is doing. That is great. We should welcome that and encourage it. If we come together, resource it properly and see the long-term benefits of it, we can make a significant difference. It will make the country much healthier, more robust in many ways, and we will all be better for it.