Asked by
To ask Her Majesty’s Government what steps they are taking to
support people at high risk of developing type 2 diabetes who
have gained weight during the COVID-19 pandemic.
The Parliamentary Under-Secretary of State, Department of Health
and Social Care () (Con)
My Lords, helping people to achieve and maintain a healthy weight
is one of the most important things we can do to improve our
nation’s health, as I am sure many noble Lords agree. Our
world-leading strategy to meet this challenge was published in
July 2020 and reflects the significant work undertaken over
recent years to halve childhood obesity and create a healthier
environment to help people maintain a healthy weight.
(Lab)
My Lords, new NHS research reveals that people seeking help to
lose weight are significantly heavier now compared with those who
sought help pre-pandemic. With type 2 diabetes closely linked to
obesity and local public health services shown to be highly
cost-effective in helping people to lose weight, what assessment
has the Minister made of the link between the cuts in funding and
the increasing levels of obesity and diabetes, and will the NHS
evidence now drive the Government to commit to reversing public
health grants and properly funding services that are essential to
tackling obesity?
(Con)
I am sure that noble Lords will agree that it is really important
that we tackle these issues and respond to the weight increases
over the Covid-19 lockdowns. In March, the Government announced
£100 million of extra funding for healthy weight programmes to
support children, adults and families to maintain a healthy
weight. Additionally, more effort has been put into providing
access to information.
(Con)
My Lords, currently one in 10 people in the UK are suffering from
type 2 diabetes, a figure which has doubled in the past 15 years.
It already gobbles up an unsustainable 10% of the NHS budget. As
my noble friend said, it is preventable and treatable through
maintaining a healthy weight, diet and exercise; there is no need
for expensive medication. Can my noble friend continue to
encourage systematic support so that people can achieve these
objectives?
(Con)
I thank my noble friend for that question and recognise the work
she did with the Centre for Social Justice on this issue. The
Government are keen to drive the NHS diabetes prevention
programme, which plays a pivotal role in supporting those at risk
of developing diabetes. During 2018-19, over 100,000 people took
up the programme. In 2019-20, NHS England delivered the
long-term-plan target, supporting around 120,000 people on the
programme.
(CB)
My Lords, does the Minister agree that all those over the age of
40 who are obese, and those who record a high score on the
diabetes type 2 assessment, should be offered a blood glucose and
haemoglobin A1c test? If he does not agree, can he say why?
(Con)
The Government, in conjunction with the Department of Health and
Social Care and many other partners, including Diabetes UK, are
looking at the most effective way to tackle diabetes but also to
understand the trade-offs that must be made and the balance of
considerations. I will write to the noble Lord on the detail of
his question.
of Cheltenham (LD) [V]
In addition to the link between Covid and weight gain, some
people can develop diabetes after an acute Covid-19 infection.
The causes are not fully understood. What research into this
connection are the Government encouraging?
(Con)
The Government and the Department of Health and Social Care are
reviewing the many impacts of Covid-19 that noble Lords will
acknowledge. We are still trying to understand the various
implications of lockdown. We have seen increases in weight
leading to more type 2 diabetes. I will write to the noble Lord
giving a detailed answer to his question.
(Con)
My Lords, as my noble friend Lady Jenkin has already mentioned,
we have known for many years that reducing weight can reverse
type 2 diabetes. With others, I was doing this successfully over
60 years ago. This draws attention to the urgent need for an even
greater campaign to deal with the 71% of people in the UK over
the age of 30 who are obese or overweight.
(Con)
The Government have implemented weight-management services. Tier
2 behavioural weight-management services have been provided by
98% of local authorities thanks to the distribution of £30.5
million as part of the adult weight-management services grant.
Additionally, £12.8 million was invested in an NHS digital
weight-management programme for individuals with multiple
long-term conditions, as well as NHS staff. There are a number of
other programmes related to weight management which I may well go
into in answering a later question.
(CB)
I am sure that the Minister is aware of the great social
inequality in levels of obesity, as there has been with Covid
levels. If you cannot afford a healthy diet you run a much higher
risk of developing obesity. What measures will the Government
explicitly put in place to support those on lower incomes to
easily afford healthy diets—for example, factoring the costs of
healthy diets into benefit levels, boosting healthy-start
vouchers and introducing fruit and vegetable prescriptions? Right
now, if you want to get a lot of calories to make you feel full,
the cost differential is around a factor of 10.
(Con)
In response to the increases in weight due to Covid-19, but also
before, which led to more type 2 diabetes, the Government, the
DHSC and the NHS have been looking in detail at how to respond.
Further details will be made available.
(Con)
My Lords, I am glad that the Government recognise that this is a
huge problem, and the dangers that being overweight brings,
especially during Covid. However, does my noble friend not
recognise that the strategy, good as it may be, is not working?
Is it not time to revert to the situation when I was young, when
it was not socially acceptable to be grossly overweight, and to
push individual responsibility? Government policy should tell
people that they must not eat so much.
(Con)
I am beginning to wish I had eaten a full breakfast. With any
strategy or programme, we always have to be careful about
unintended consequences. As we focus more on obesity and make
more people aware of healthy living and healthy eating, it is
important to have the right balance and to be aware of the impact
this can have, so that we are not creating more problems,
concerns and anxieties for those who suffer from eating
disorders.
(LD)
My Lords, one in three deaths during the first period of the
pandemic were among people with diabetes. Obesity accounts for
most of the risk of developing type 2 diabetes and, even without
the problems of the pandemic, a type 2 diabetic, such as me, at
my age, is expected to put on one or two kilos every year. Will
the Minister now look to reverse what the King’s Fund says is, in
real terms, a £1 billion cut in local authority public health
budgets since 2015, and at providing even more support for
programmes such as GP referral to fitness classes, which can help
people manage their diabetes more effectively?
(Con)
As well as looking at the important role that funding can play,
it is important to do better with the money available. There are
many things we can do to make sure that the programmes we have
are more effective, but I repeat that we have to make sure that
they work and we have to look at the evidence. When discussing
the evidence internally in the department, I have been told that
many of these programmes will be reviewed after five years to
make sure that they are effective and do not lead to unintended
consequences.
(CB)
My Lords, the Minister made reference to the well-being strategy
in his opening Answer. In the interest of joined-up government, I
also urge him to take notice of another strategy, the Dimbleby
review of the national food strategy. None of these problems will
be resolved unless we go to their root, which is our attitude to
food availability and the supply chain.
(Con)
The Government will consider a number of inputs in looking at the
most appropriate strategy to address type 2 diabetes and, as many
noble Lords have referred to, the increase in weight of many in
our population during lockdown. The Government will consider the
evidence of the Dimbleby independent review throughout the
development of our food strategy.
