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Obesity

My Lords, I too thank the noble Lord, Lord Darzi, for repeating the Statement. The Government are launching a new cross-departmental strategy for obesity—again. They did exactly that in 2004 as part of the public health White Paper. As the noble Earl, Lord Howe, intimated in his response, while the report is interesting and contains much that the House will wish to see followed up, it is an indictment of the Government’s lack of action on the recommendations made in 2004. Yet again we have an announcement of a strategy but no action plan. Sir Derek Wanless, in his recent review of the 2004 report, has made clear that the Department of Health promised that when that report came out the CSR would address issues of lifestyle, and yet we see nothing specifically about that in the recent CSR. As a newspaper points out today, the Government have in fact changed the targets they agreed in 2004; as the noble Earl said, they have changed their targets on child obesity from 2010 to 2020. The noble Earl is also right that since 1997 public health budgets have been raided to tackle deficits. Non-public health consultants and registrars have increased in the NHS by 60 per cent since 1997, but the number of public health consultants and registrars has gone down. I too wish to know what the department intends to do to reverse that trend so that there are enough informed officials working in public health to ensure that whatever strategy the Government finally decide to fund is implemented. The Obesity Awareness and Solutions Trust has conducted some interesting research that reveals that 80 per cent of general practitioners believe that obesity is a patient’s own fault. That was echoed in August 2007 when Dr Hamish Meldrum from the BMA made his announcement that obese people were greedy. Those are strange statements when there is an increasing amount of research to show that obesity is caused by a combination of lack of knowledge about diet, mental health issues such as depression, and not just a lack of access to sports facilities but a lack of confidence to use those that are available. We know, for example, that many older people would like to take part in healthy activities but are frightened to go to sporting activities when there are going to be younger people around. They lack confidence. Where are people who want to tackle these issues going to get their support from? Key to that are families and parents. In Scotland in 2007 some interesting research was produced that showed that children and toddlers who had poor diets did so not because of lack of knowledge—their mothers knew what constituted healthy food and a good diet—but because the mothers were concerned about their own cooking skills and did not know which healthy foods could be given to children to fill them up. They therefore tended to resort to foods that were not healthy. Some of the issues that are identified in the Foresight report show that there are initiatives that are worth following up in a slightly different way from the department’s over the past few years. It signals that there is perhaps a different track from the one which the department has gone down in encouraging weight programmes for children in schools and programmes of ““naming and shaming”” obese children, programmes that have faltered in their efficacy because of resistance and resentment on the part of the very people who would benefit from them. The noble Earl, Lord Howe, mentioned the role of employers. We all agree that employers have a role to play. British industry is becoming aware of the costs to it of obesity. Schemes such as BT’s Work Fit scheme are good. How are we going to encourage employers to introduce them? Bariatric, or gastric by-pass, surgery is known to be effective in addressing diabetes. It is a NICE-approved clinical intervention; PCTs are legally obliged to fund it. However, there is a backlog of 60,000 people who are waiting for the procedure. What is the department’s attitude to that issue? Like the noble Earl, Lord Howe, I am pleased to see that another strategy exists. I hope that the noble Lord, Lord Darzi, will tell us when it will be backed up by resources and action.