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Category: Speeches

  • Richard Fuller – 2021 Speech on the Obesity Strategy

    Richard Fuller – 2021 Speech on the Obesity Strategy

    The speech made by Richard Fuller, the Conservative MP for North East Bedfordshire, in the House of Commons on 27 May 2021.

    I congratulate my hon. Friend the Member for South West Bedfordshire (Andrew Selous) on securing this debate, and I welcome my hon. Friend the Minister to her place. It is clear with the breathless endorsements from the Opposition that the Government, if they wish, can fully get their way with these proposals, but I worry.

    I worry that an opportunity for a determined and modern policy based on empowering individuals has instead been replaced with a rather tired, top-down, bureaucratic approach. I worry that the Department of Health and Social Care algorithm has resulted not in an intelligent group of products, but a confusing and ill-targeted group of products, as my hon. Friend the Member for Buckingham (Greg Smith) said.

    I worry that the policy is literally treating adults like children, particularly with its full-scale transfer of the nutrient profile model. Worse, I worry that the policy targets those who are poor, ethnic minorities and the elderly, who are most likely to be obese or overweight, and it connotes with it a rather condescending attitude that the Government know best for those particular groups of people.

    I worry that the evidentiary base is flimsy. The Minister mentioned the sugar tax, and the sugar tax may have been successful, but that is not what is in this policy. In fact, the policy being proposed is very different from the sugar tax. I worry that success is not defined or measured. Essentially, the policy remains a matter of hope, as my right hon. Friend the Member for Forest of Dean (Mr Harper) pointed out.

    I worry about the haste of implementation, adding new efforts and responsibilities on businesses just as they are recovering from the impact of lockdowns. In particular, I worry about the impact on Jordans in my constituency and the farmers who are supporting that business. I worry that the Department has chosen to silence the power of businesses and the power of their brands, rather than enhance them in the efforts they wish to undertake.

    I worry that the policy is blunt where it could be smart. For example, it prefers an outright ban to using technologies in advertising online that would help achieve the Government’s goals. I worry about the unintended consequences for people with eating disorders. I worry about timing. Many people are already anxious about their health post covid, and these measures will do nothing to avert those anxieties.

    I worry about the social credit system of points that Sir Keith Mills may come up with in his review, with all of its potential ramifications. I worry where all this may lead—potentially we will have an NHS app. As we walk down the street and pass a restaurant or a bar, it will beep to tell us, “Please input what you have eaten.” Perhaps we will reach there one day. In fact, we are already there. Those apps are already under trial by the NHS.

  • Robbie Moore – 2021 Speech on the Obesity Strategy

    Robbie Moore – 2021 Speech on the Obesity Strategy

    The speech made by Robbie Moore, the Conservative MP for Keighley, in the House of Commons on 27 May 2021.

    The challenge of obesity has of course been magnified by the last year’s events, and the evidence is clear, as ever, about the importance of having a healthy lifestyle and eating well. I welcome the national food strategy’s putting a better food system at the heart of the covid-19 recovery. It is worrying that one in three children who leave primary school is overweight and one in five is obese. It is crucial to rethink the food that young people are being given, and the right education is the key to the answer.

    I recently met and had a great discussion with Ruth Hall, a constituent in Addingham and a former home economics teacher, about ensuring that people know how to prepare healthy food. She showed me her old lessons plans, which included guidance on making nutritious meals at an affordable price. The people she taught over her 36 years as a teacher were given the right skills to cook, and I am sure their children are better informed about healthier eating.

    I worry that home economics as a subject for all at an early age in our schools is now lost, and I fear that a generation have now missed out on acquiring these skills, which I believe is a key reason for the worrying statistics I have mentioned. It is therefore vital for the Government to act to make sure that young people are equipped with the adequate training on and knowledge of nutrition and how to cook a decent meal—a decent, wholesome meal.

    There is a much wider discussion to be had about where people’s food comes from. I regularly speak to farmers and those working in the food production sector, who are frustrated by the lack of knowledge about that nationally in the wider population. It needs to be at the heart of our good food strategy. The Government’s intentions to change how food is advertised, displayed and promoted in shops will undoubtedly create purchase behavioural change, but I am yet to be totally reassured of the absolute benefits that will have.

    As my hon. Friend the Member for Warrington South (Andy Carter) and the Minister have said, there is no silver bullet. However, of course, in this place we cannot ignore the fact that this issue disproportionately affects those in deprived communities. Currently, children in those communities are twice as likely to be obese than those in less deprived areas. That must be addressed. I am pleased that the Government have pledged to halve childhood obesity and close that gap by 2030, but our approach cannot just be Government-centred; communities must be key, active players, and parents must take more responsibility for what they feed their children and the consequences of that. Of course, that loops back to education.

    I know that the NHS long-term plan has ring-fenced £4.5 billion to help local GPs, pharmacists and others deal with issues such as obesity, but I am sure that home economics, food nutrition, and teaching children and parents how to cook good, wholesome food will be a great start.

  • Andrew Lewer – 2021 Speech on the Obesity Strategy

    Andrew Lewer – 2021 Speech on the Obesity Strategy

    The speech made by Andrew Lewer, the Conservative MP for Northampton South, in the House of Commons on 27 May 2021.

    With more than half the adults in this country classed as overweight, which has well-known associated health impacts on society and the NHS, I understand why the Government want to tackle this issue. Much of the strategy on public health education is not objectionable, unlike the proposals about the advertising of two-for-ones and where shops can display their wares, which I believe fall foul of the core Conservative principles, which are the reason I am in politics, of promoting freedom and the liberty of our citizens.

    There is much evidence that suggests that such proposals will not work anyway and will be heavy-handed. That is why these ideas, thankfully, never came to fruition in two former Prime Ministers’ Administrations. The legislation will essentially nationalise the content of food advertising, which will be chosen by the Department of Health and Social Care in Whitehall. It is redolent of EU regulations about whether Jaffa Cakes are biscuits or cakes and Harold Wilson’s selective employment tax; instead we should trust citizens to make decisions for themselves and concentrate on education so that those choices are informed.

    The proposed advertising ban on high-fat, salt and sugar products before 9 pm on TV and online in its entirety will not only catch those foods that we commonly think of as junk, but target foods such as ready-made sandwiches, butter and jam. Speciality businesses such as wedding cake shops or artisan producers of sausages will not be able to promote their products on the primary advertising mediums of the 21st century. We are a party that claims to stand behind business, but the financial impact across the food, advertising and broadcasting industries, in stifling entrepreneurship and competition, will be enormous. All these proposals, by the Government’s own admission, will reduce children’s calorie intake only by an unnoteworthy amount. Research from Mondelez International states that restricting promotions will lead to an average daily reduction of only 8 calories for adults.

    An obesity strategy as a concept and one that empowers my constituents in Northampton South is fine, but proposals towards a nanny, banny state, which are contrary to years of the Prime Minister’s own writings and to core Conservative principles, are not at all fine. They exemplify the politician’s syllogism from the 1988 edition of “Yes Prime Minister”: “We have a problem. Something must be done. Well, here’s something, so let’s do that.”

  • Olivia Blake – 2021 Speech on the Obesity Strategy

    Olivia Blake – 2021 Speech on the Obesity Strategy

    The speech made by Olivia Blake, the Labour MP for Sheffield Hallam, in the House of Commons on 27 May 2021.

    Like almost everyone speaking in the debate today, I support measures to ensure that people have a healthy relationship with the food that they eat. However, healthy eating habits cannot simply be measured on weighing scales or counted in calories. Today, we are facing a mental health crisis, one element of which is the rising epidemic of eating disorders, including obesity.

    I fear that our strategy falls well short of the social and mental health support needed to help people manage a healthy relationship with food. I am talking about those who have any conditions relating to weight management, whether that is diabetes or heart disease, or an eating disorder. I hope that the new funding for services will see those approaches supported.

    While I am fully supportive of interventions such as restrictions on advertising and work to improve the diet of the nation, I remain very concerned about certain aspects of the strategy. Before the pandemic, hospital admissions were increasing, especially among teenagers. In 2019-20, we saw a sharp 32% increase on the previous year to more than 21,000 cases, nearly 5,000 of which were children. In addition to hospital admissions between February 2020 and January 2021, the eating disorder charity Beat reported a massive 173% surge in demand for its services. During that time, we saw no corresponding rise in the levels of funding going to eating disorder services. I have sat with eating disorder specialists who have told me that the money that is available often fails to get to the frontline. One doctor I spoke to said that his service was originally designed for 60 children, but now serves 280, with inadequate funding for those places.

    I know that NHS trusts are also struggling with non-specialist in-patient services for children. The rising demand means that they just do not have the expertise available to treat in-patients with eating disorders properly, with many waiting for urgent beds for children in crisis in any specialist unit anywhere in the country. We still see a situation in adult services where there are no waiting time targets for support for eating disorders.

    I am highlighting this dire situation because one measure of the Government’s obesity strategy involves calorie labelling on menus. Among those who will be reading those menus will be people with eating disorders. There is a wealth of research that shows that calorie labelling can exacerbate unhealthy relationships with food and can be a predictor of the onset of eating disorders. In trying to fix one problem, there is a real danger that Ministers will make another far worse, the costs of which are not trivial. Eating disorders have the highest mortality rate of any mental health problem, and people who suffer from them are at increased risk of suicide and self-harm. While it is true that half of those with eating disorders recover, 20% remain in a chronic condition.

    We should look at obesity in the round. Balanced nutritious meals, promoting healthy diets such as Mediterranean diets, and healthy levels of exercise are far more important ways of maintaining a healthy weight. I urge the Government to rethink and revisit that aspect of the plan, come up with a solution that balances the needs of all. If we really want to promote healthy eating habits, calories on menus are not necessarily the way to do it for the whole population and risk making a very bad situation even worse for those suffering from or at risk of developing eating disorders. I say this as someone with type 2 diabetes. I have lost weight in order to manage my diabetes. There is a real issue with anxiety around calories and weighing out food. More needs to be done to recognise these anxieties and mental health issues.

  • Jonathan Lord – 2021 Speech on the Obesity Strategy

    Jonathan Lord – 2021 Speech on the Obesity Strategy

    The speech made by Jonathan Lord, the Conservative MP for Woking, in the House of Commons on 27 May 2021.

    While I welcome many aspects of the Government’s obesity strategy, today I want to argue against the Government’s outlined proposals to restrict TV and online advertising for high- fat, high-sugar and high-salt foods.

    These proposals are blunt tools that will have little or no impact on obesity. The Government assess that both the TV watershed ban and the full online ban will lead to just a 4.5 daily calorie reduction among overweight children. That is completely inconsequential compared with initiatives such as The Daily Mile or Couch to 5K, which have the potential to increase calorific expenditure by about 100 calories a day, or targeted, community-based approaches, such as the Health, Exercise, Nutrition for the Really Young—HENRY—programme in Leeds or the Three Area Project in Wakefield. Those two programmes are based on a holistic approach. They address education, activity levels and food inequality, and have had measurable success.

    Commentators might argue that the proposed bans do not matter, but they have large adverse impacts on broadcasters, online news media, advertising and production companies, food and drink companies, retailers and the hospitality sector. Advertisers have made it clear that this ad spend and investment will not be rerouted back through other channels but could leave the UK market altogether. The bans will reduce the advertising revenue that media reinvest in programming and content. They will prevent food and retail companies and the hospitality trade from communicating with their customers. They will impact jobs and remove most incentives food manufacturers have to invest in healthier alternatives in this market, because the alternatives themselves may still fall within scope.

    The Quebec ban on advertising to children, introduced as long ago as 1980—incidentally, for reasons other than to tackle obesity—had no effect on childhood obesity rates in that province, compared with other provinces. Indeed, the prevalence of being overweight or obese among children in Quebec grew by 140% during the first 15 full years of the advertising ban—a faster increase than elsewhere in Canada, where those restrictions did not exist.

    The UK’s advertising restrictions, currently in place across broadcast and non-broadcast advertising, including online advertising, are already among the strictest in the world. They restrict the exposure of HFSS advertising to children under 16. Although TV restrictions have been in place since 2008 and have reduced child exposure to HFSS on TV by around 70%, this has made no measurable impact on obesity rates. These current plans are disproportionate and not evidence-based; they are not targeted at the problem that the Government say needs to be addressed, which is to protect children. Indeed, they are sweeping and comprehensive, requiring new laws and a new regulatory structure.

    I urge the Government to liaise much better with industry. The Committee on Advertising Practice, the advertising code body, has put to Ministers an alternative proposal to this online ad ban, which is targeted, workable, effective and enforceable. So, let us do that. Let us engage rather than have these damaging and over-the-top regulatory proposals.

  • Dan Carden – 2021 Speech on the Obesity Strategy

    Dan Carden – 2021 Speech on the Obesity Strategy

    The speech made by Dan Carden, the Labour MP for Liverpool Walton, in the House of Commons on 27 May 2021.

    It is a pleasure to speak in this debate, which is covering a wide range of issues. At its heart, it is about trying to support a healthier British public, which I think the whole House genuinely cares about.

    My reason for speaking in the debate relates to alcohol labelling; I am sure that the Minister remembers our recent Adjournment debate. We are in the incredible situation where a product such as non-alcoholic beer or wine may provide its calorie content, nutritional information and a lot more, but an alcoholic product need contain only three pieces of information by law: the allergens, the percentage of alcohol by volume and the amount of liquid in the container. That is quite a bizarre situation for us to be in, so I am pleased to hear that the Minister is pushing ahead with the consultation on alcohol labelling. There has been some confusion in recent weeks and months. Just a few weeks ago, we heard that the Government had ditched plans to force pubs to list calories as part of a drive to tackle obesity. That came from Downing Street. I hope that, given what the Minister said, the consultation will be kicking off some time soon.

    I want to push the Minister once more on the need for a national alcohol strategy. We had the highest rate of deaths from alcohol on record this year. Alcohol-specific deaths are at an all-time high at a moment when drug and alcohol services are underfunded and mental health services are overstretched.

    If this is all about supporting a healthier nation—we have the obesity strategy, Dame Carol Black’s review of drugs, a consultation on alcohol labelling, a review of the Gambling Act 2005, and a promised addiction strategy from 2019—I suggest to the Minister that that work needs to be pulled together. The issues that we have touched on in this debate, including mental health and poverty, which are drivers of addiction, really need to be focused on in the months and years ahead.

  • Mark Harper – 2021 Speech on the Obesity Strategy

    Mark Harper – 2021 Speech on the Obesity Strategy

    The speech made by Mark Harper, the Conservative MP for Forest of Dean, in the House of Commons on 27 May 2021.

    As I said in my interventions on the Minister, I very much support the Government’s objective. A situation in which 36% of adults in England are overweight and 28% are obese is not good, and there are many health consequences of it, but my view is that, fundamentally, we need, first, to enable people to understand whether they are overweight or obese. That might sound like a foolish thing to say, but there is some evidence that people do not recognise whether they or those around them are overweight or obese, and are not very good at working that out.

    Secondly, we need to make people understand the health consequences of being overweight or obese. The Minister talked about incentives. The real incentive that people should have is that they want to be healthier. Unless individuals themselves want to be healthier and move towards a healthy weight, it seems to me that we will not get very far.

    Frankly, getting to a healthy weight means having a healthy diet. It does not mean going on a diet and then going back to unhealthy eating; it means changing diet permanently. In many cases, it means making not dramatic changes but small changes that people stick to, such as reducing portion sizes. It is about reducing treats and things we like, not getting rid of them. When I eat, I like all the bad things, but I have become better as I have got older—I have needed to—and now I am a bit more controlled about how many times I have them. I watch the size of my portions, because as I have got older, I have had to watch what I eat.

    It seems to me that it is about diet, not about individual foods. As my hon. Friend the Member for Buckingham (Greg Smith) said, demonising individual foods is not a very successful strategy. There are plenty of things that I like that would individually be very unhealthy, but I just do not eat them very often. That is where we need to get to: people need to understand what a healthy weight is, understand the health consequences and want to get there themselves.

    I have a couple of questions for the Minister. She spoke about the evidence for out-of-home labelling. The impact assessment is a rather weighty document of 76 pages, but one of the things that I learned as a Minister is that it is worth plodding through such documents. There is lots of useful information in it, but I did not find any compelling evidence that introducing out-of-home calorie labelling would have any significant impact on the quantity of calories that people consume. Given the concerns that the hon. Member for Bath (Wera Hobhouse) and the charity Beat have rightly set out about those with eating disorders, the case for its successful impact is not very compelling. There is quite a lot of concern that it will not be helpful, so I think the Government ought to think again about their approach.

    I also have a question about the soft drinks industry levy. The levy has been successful in reducing the amount of sugar consumed; in my constituency, Suntory Beverage & Food Great Britain and Ireland, which produces Lucozade, Ribena and Orangina, has led the industry in taking more than 50% of sugar out of its products. It has also invested £13 million in new machinery at its Forest of Dean plant to produce those products—I was very proud to launch the new production line. However, although we have reduced the amount of sugar consumed, I have seen no evidence that we have therefore reduced the quantity of calories consumed or made any impact as a result.

    Alun Cairns

    My right hon. Friend is making a very effective, cogent argument. Does he agree that because there is a will to come up with a solution that will have an impact, there is a danger that unless we take account of all the evidence, including his points about the impact of the sugar tax, we might well feel better for doing something, but not quite achieve what we set out to achieve?

    Mr Harper

    That is right. I am very keen that we look at the evidence. I can see that through reformulation we have led the industry—the company that makes Lucozade and Ribena has been successful in doing that—but the real question is whether that has reduced the number of calories consumed, both by adults and by children, and had any impact on the number of people who are overweight or obese. It has clearly been successful in reducing the quantity of sugar consumed, but as my hon. Friend the Member for Buckingham said, sugar in itself is not a bad thing; people need to consume a certain amount of sugar to have a healthy diet. My worry is that we have reduced the amount of sugar in these products, but that will not actually make any difference to whether people have a healthy diet.

    All these measures need to be tested. The point that I was making to the Minister earlier is that I do not want us to introduce them, wait nine years until 2030, and then say, “Goodness, it hasn’t worked.” I absolutely accept the Minister’s point that national targets may not make sense, but we need to look, at a local level, at whether the measures are successful. If they are not working, we need to change them and look at what the evidence suggests would be more successful in getting people to a healthy weight so that we all lead a healthier lifestyle.

  • Wera Hobhouse – 2021 Speech on the Obesity Strategy

    Wera Hobhouse – 2021 Speech on the Obesity Strategy

    The speech made by Wera Hobhouse, the Liberal Democrat MP for Bath, in the House of Commons on 27 May 2021.

    I speak today as the chair of the all-party parliamentary group on eating disorders and I want to highlight the anxiety felt by many of those with an eating disorder about one specific aspect of the obesity strategy: calorie labelling on menus. Obesity causes serious health problems and there is no doubt that far too many people in this country do not have a healthy weight. I add my unequivocal support to the Government’s aim of addressing obesity, but obesity has to be considered as one side of our complex relationship with food. It is a form of disordered eating and therefore cannot be separated from other forms of disordered eating and cannot be dealt with in isolation. Calorie labelling on menus will not only be ineffective in tackling obesity, but will actively damage those with an eating disorder.

    Studies show that there is only a small body of low-quality evidence supporting the suggestion that calorie counts on menus lead to a reduction in calories purchased. While there is limited evidence that calorie labelling will support the public in losing weight, there is convincing evidence that it would harm people with an eating disorder. About 1.25 million people in the UK have an eating disorder, and the 2019 health survey found that 16% of all adults aged 16 or over screened positive for a possible eating disorder. Over the pandemic, the charity Beat has reported a 173% increase in demand for eating disorder support, and research shows that individuals with anorexia and bulimia are more likely to order food with significantly fewer calories when presented with a menu including calorie counts. Those with binge eating disorder are more likely to order food with significantly more calories.

    Many people with eating disorders also live with obesity. Up to 30% of people seeking weight management services would meet the diagnostic criteria for binge eating disorder. Clearly, a reductionist approach to nutrition means that the obesity strategy risks harming some of the very people it is designed to support.

    Mr Harper

    I am sympathetic to the point the hon. Lady is making, and she will know from my intervention that I think the evidence with respect to calories and out-of-home labelling is quite weak. Is labelling on products purchased in supermarkets also a problem for those with eating disorders? I ask that genuinely; I do not know the answer. Can she furnish that information?

    Wera Hobhouse

    I am particularly concerned about calorie labelling in restaurants. People who suffer from eating disorders are isolated and fearful of contact with others because they are thinking continuously about what they are going to eat or drink. Going out to a restaurant gets them through that step, and it is often a significant step towards recovery. As I say, my particular concern is labelling on restaurant menus.

    In response to the survey on calorie labelling conducted by Beat, one respondent said:

    “My eating disorder thrives off calorie counting and knowing all the calories in everything. I would feel compelled to look at calorie labels”

    in restaurants and

    “I would feel embarrassed asking for a different menu. Please don’t do it. Please.”

    The Mental Health Minister has been extremely generous with her time, listening to the all-party parliamentary group’s concerns about the plan to mandate calorie labelling on menus. The APPG is grateful for her interest in improving early access to eating disorder treatment. However, I must repeat my plea to the Government to look again at this element of the obesity strategy.

    Addressing obesity and tackling eating disorders should not be in competition. We must tackle them together. I look forward to working with the Minister to develop an obesity strategy that successfully addresses the obesity epidemic, but does not harm people with other forms of eating disorder.

  • Alun Cairns – 2021 Speech on the Obesity Strategy

    Alun Cairns – 2021 Speech on the Obesity Strategy

    The speech made by Alun Cairns, the Conservative MP for the Vale of Glamorgan, in the House of Commons on 27 May 2021.

    Thank you for inviting me to contribute to this extremely important debate, Mr Deputy Speaker. I pay tribute to my hon. Friend the Member for South West Bedfordshire (Andrew Selous) for securing the debate, and to the way in which the Minister and the Opposition spokesman have contributed so far. Obesity rates are too high, without question, and the long-term consequences include a range of diseases: covid, which has already been mentioned, dementia, cancer, diabetes, heart disease, liver disease and so many more. The need to tackle obesity therefore goes without saying.

    The challenge of obesity and its consequences among young children naturally has a very long tail. Introducing policies to meet the childhood obesity challenge naturally requires an understanding of the complexity of the causes if we are to have a real impact on the effect. Diet is obviously central to what we need influence, but it is not the full story. Contributing to the make-up of the diet there will be a series of complexities, and there needs to be clarity around the content of food products. I pay tribute to the work that the Government are doing and what they have committed to do in the Queen’s Speech, and to the work that has been done on labelling and on the sugar tax, which has contributed to a reduction in sugar in fizzy drinks and other products.

    Knowledge and skills are important, including, for example, on the availability of fresh vegetables. Fruit and vegetables are obviously important, as is knowing how to cook. Standards and approaches in schools are also difficult. We need education in schools and among parents, who are also central to tackling childhood obesity. Lifestyle is an issue. The slower lifestyle through the lockdown period has enabled many people to address their own weight, but others have not done so. All of these issues naturally have complexities associated with them. Exercise is clearly also an issue, as well as eating disorders, which have been highlighted. I am trying to highlight the complexity of all that we need to face.

    With these points in mind, I ask the Minister to consider the cause and effect directly, as well as the focus that has been given to the advertising industry and the marketing of food products, to establish whether it will have the desired impact. Whatever action we take, we must be sure that it will make a difference. There have been calls for many years for a television advertising ban. I can remember it being discussed in Cabinet and being resisted because the evidence was unconvincing. We need to consider that, although there is a call for a television advertising ban, habits have changed. Very few children these days watch television in the way that we might have done when we were younger, and that demonstrates the further complexity of the debate. Displacement is another issue. Advertising is more likely to move online, and I think all Governments recognise the challenge of tackling advertising online. Finding a solution is much more complicated when dealing with things online, as we have seen from the example of Governments struggling to tackle adult content online being accessed by children.

    In the very limited time I have, I want to ask the Minister to look at the consequences, both positive and negative, and to question whether one will outweigh the other. I ask her to engage with the industry to see whether a solution can be found in which the industry itself, including broadcasters and online advertisers, can support the Government’s aims.

  • Paul Blomfield – 2021 Speech on the Obesity Strategy

    Paul Blomfield – 2021 Speech on the Obesity Strategy

    The speech made by Paul Blomfield, the Labour MP for Sheffield Central, in the House of Commons on 27 May 2021.

    The Government are clearly right to say that this is one of the greatest long-term health challenges that we face, and it starts with our children. One in four enter primary school overweight or obese and, as the Minister pointed out, one in three leave in that position six years later. We have a shocking problem that gets worse during children’s primary years.

    Like any disease, there are two ways of tackling it: prevention and treatment. I broadly welcome the measures being proposed by the Government on prevention, although we should look carefully at the evidence and concerns around calorie labelling for those with eating disorders, but prevention is not enough in itself. We need proper treatment services for children, and currently we do not have them.

    Imagine for a moment that we were talking about another disease—say, cancer. Would we say, “We’ll invest in prevention, but I’m afraid we’ll not offer any treatment for children with the disease.” Of course we would not, but that is what we are saying for obesity currently. The Health and Social Care Committee highlighted the problem in its 2018 report, noting evidence from Public Health England that only 56% of local authorities

    “have a tier 2 weight management service for children”

    and that those services

    “are not intended to support individuals with complex needs. When looking at tier 3 and 4 services, service provision is bare.”

    It went on to recommend:

    “The Government must ensure there are robust systems in place not only to identify children who are overweight or obese, but to ensure that these children are offered effective help through a multidisciplinary, family-centric approach.”

    However, the Government’s obesity strategy does not acknowledge the issue. I have become aware of it through the work that I have done with Shine Health Academy in my constituency—a great local project providing the sort of tier 3 services that the Committee wanted. They take children on referral from GPs, teachers and social workers, and they have great outcomes, but they are funded mainly by charities, because neither clinical commissioning groups nor local authorities have responsibility for commissioning services.

    I know that the Minister recognises the problem because, together with the inspirational leader of Shine Health Academy Kath Sharman, I met her to discuss the issue about 18 months ago. There have been some positive initiatives by NHS England, and I welcome the work to establish complications related to excess weight clinics—CREW clinics—to support children and young people with severe obesity, but it is limited. As I understand it, the aim of such services is to manage the comorbidities associated with obesity rather than tackling the disease itself. There are just seven centres in the plan, each for 100 children. It is useful, but it is a very small step assessed against need, because the Obesity Health Alliance calculates that there are 450,000 children in the UK who, if they were adults, would be eligible for bariatric surgery. That is shocking, but it is the scale of the challenge.

    There are also worries about the CREW approach. Such clinics seem to place too much emphasis on the role of hospitals, and risk being about medical management rather than weight management. They definitely have a role to play and are fundamental to the treatment of comorbidities, but they should not be the only model of care. Above all, there is no certainty of future funding. In her summing up, I ask the Minister, who I know cares about this issue, to say whether it will finally be the Government’s intention to establish clear responsibility for commissioning tier 3 services for children as the Health and Social Care Committee recommended, because frankly nothing less will do.