12 November 2009
Mike Penning winds up a debate on the Health Select Committee's inquiry into health inequalities and highlights the committee's criticism of the lack of joined-up government on the subject.
Mike Penning (Hemel Hempstead) (Con): This is an important debate. I congratulate the Select Committee on Health, of which I have had the privilege of being a member for many years. When I first came to the House in 2005 and was asked what Committee I wanted to be on, there was only one answer: health. It took me a couple of months to convince the Whips, but I convinced them and joined the Committee. It is enormously important and considers the evidence very well, and it is exceptionally well chaired by the right hon. Member for Rother Valley (Mr. Barron). I pay tribute to the Committee.
Interestingly enough, the report, when it first came out, drew on a lot of previous reports by the Committee, particularly its excellent report done at the time of the smoking debate. Without the Committee and its proposed amendments, the present legislation would not be on the statute book. I know that whenever the right hon. Gentleman speaks, he always likes to bring up smoking and how we can encourage more people to stop. It is an important issue that I know is close to his heart. Other reports include work on deficits and the funding formula. We looked at inequalities not just in socially and economically deprived parts of the country but in other parts of the national health service, to which I will return in a minute.
The issue of inequalities is nothing new. Beveridge was discussing health inequalities long before I was born, and the House has been discussing it for many years. Increasing progress has been made, but sadly, over the past few years, even according to the Government’s own statistics, the situation has been falling back.
As we have heard today, the Government have had a golden opportunity, with more than £100 billion—there will be a debate about just how much, but it looks to be about £110 billion by the time the election comes—of taxpayers’ money being spent on the NHS. The report highlights criticisms that have been around for some time, not just from political parties but from experts in the field, about how that money has been spent and why so little of it seems to get to the front line. The evidence in the report shows clearly that one reason is that it is really not known whether the money is being spent efficiently or is working.
The contributions that we have heard today have been eminently sensible. They show that the House really cares about the issue. It is not party political, although we have had a bit of banter. I was disappointed with the hon. Member for North Norfolk (Norman Lamb)—I will call him my friend from the Liberal Democrats—who did a bit of pre-electioneering for a few moments, but he is better than that and he knows it, so I will not bother to comment on the silly remarks that he made.
Mr. Bone: My hon. Friend is making a powerful speech as usual. Am I right in thinking that only the Conservative party has guaranteed to increase spending on health?
Mike Penning: That is absolutely right. I would have thought that anyone commenting on Conservative party policy would balance their arguments.
Norman Lamb: Will the hon. Gentleman give way?
Mike Penning: Certainly.
Hugh Bayley (in the Chair): Order. I remind hon. Members to concentrate on the issue of health inequalities.
Norman Lamb: I am grateful, Mr. Bayley. Does the hon. Gentleman agree that the causes of health inequalities are largely beyond the NHS?
Mike Penning: Absolutely, which is why my party, should we be lucky enough to be elected, will change the Department of Health to the Department of Public Health so that we can start locking other agencies into a better working environment. The report criticises the lack of joined-up government on such an important subject, so it agrees in many ways with me that we need to come together as a Government. Different Departments need to work together. The hon. Gentleman is absolutely right: no one Department can solve the problem, but Government can start to get there.
One of my concerns about the report is that although it is crucial that we consider social and economic deprivation, it is not just about deprivation in big cities; there are small pockets of deprivation in the most affluent parts of this great country of ours. We stand in the Palace of Westminster, while not far from here—probably literally within a couple of hundred yards—there is deprivation on the streets of this great city that we are not touching. We heard earlier, when hon. Members were discussing Sure Start, that there are people whom we are not getting to. Sure Start catches all, but it is not targeted at the families who desperately need it. That is one thing we need to look at.
Inequality is not just about social and economic deprivation. There are other kinds of inequality in the health service as well. Older people, for example, face inequalities that younger people do not face. As people get older—although, thank goodness, they are living longer—they start to suffer more problems. Are those problems being addressed in the right way? Is funding going directly to the patient? Is rationing of any description occurring? The accusation has been made in the press for many years that as people get older, the money does not necessarily follow them.
Sadly, ethnic minorities also suffer health inequalities. I accept fully that some ethnic minority groups live in the most socially deprived areas of this country, but others do not. There are issues involving language and how people are helped. At the Conservative party conference in Manchester this year, there was an interesting debate on how to reach groups of people in this country who not only do not speak English as their first language but do not speak it at all. Fantastic work on health inequalities is being done with the Bengali community around Brick lane, particularly with ladies who do not speak any English at all, on how to reach them to get them to come in for breast scanning, cervical smear tests and so on.
That sort of innovation in our communities is the way forward, rather than the Government knowing everything. I agree that the Government have a role, but it involves commissioning rather than, as in most cases, providing. The work done on Brick lane, interestingly enough, used a speaking card that was sent directly to the people whom the hospital thought were at risk. When the card was opened, the message in Bengali was, “You may be at risk; you need to come forward.” Such things need to be considered for our GPs’ surgeries and so on.
The hon. Member for Wyre Forest (Dr. Taylor), as usual, brought expertise and knowledge from many years—I nearly said centuries—to the debate. I want to touch on one point that is close to the heart of the Chairman of the Select Committee and that we have debated—although, sadly, not for long enough—on the Floor of the House in Committee and on Report: smoking. It is the great pariah out there in our country that causes so many problems. In particular, I want to pick up on the point made by the hon. Member for Wyre Forest about the illicit smoking of tobacco products.
For many years, no matter which party has been in power, the Government have tried to reduce the number of people who smoke in this country. They have done so using many different measures, but mostly through duty and taxation. If we believe that to be right, as I do—I believe that if cigarettes were cheaper, more people would smoke more—how can it be right that millions of cigarettes are brought into this country duty and VAT-free and sold illicitly to whoever comes along at that particular moment in the marketplace, pub or club, without anyone checking their age or anything about them? That affects health inequality in this country in many ways.
Three main types of illicit cigarettes are sold in this country. The first is the new cheap whites, which look like cigarettes that are sold legally, but most of which are made in the eastern bloc and smuggled here. The second is the counterfeits, which concern manufacturers most because they do not make a profit from them. As hon. Members know, I have no truck with tobacco manufacturers and would be more than happy if they went bust tomorrow morning. The third is the simple black market cigarettes that are brought into the country. Those are the greatest problem. It is estimated—it is only an estimate because we really do not know—that they cost £3.6 billion in lost revenue, and there is lost VAT on top of that. That money could be used in public health programmes across the country or to help the Chancellor and Prime Minister fill the black hole of Government borrowing.
We should not only attack the drug barons who are moving into tobacco smuggling; we could tackle the issue immediately by changing how many cartons of cigarettes can legally be brought into the UK from other EU countries. It is often argued that that is a European issue. However, if we wanted to, we could set the level at as few as 40 cigarettes. Other countries have a level as low as 400 cigarettes, which is two cartons. Our current level is 3,500. Every day, Transit vans go to the continent and return with cigarettes that are supposedly for personal use, but which end up in the pubs and clubs in the towns of our constituencies. We could make 400 cigarettes the maximum that can be brought in from other EU countries, and deem anything more as being for use on the black market. We could do that tomorrow morning. That would send a strong message to the black market racketeers and move the smoking debate forward.
A few moments before this debate began, I was on the Floor of the House. The Minister noticed and was worried that I would be late. I was raising the issue of the proxy purchasing of alcohol because during a debate on smoking a couple of weeks ago, the Minister did not accept amendments on the proxy purchasing of cigarettes because they would not be enforceable. Proxy purchasing is a loophole whereby somebody who can prove that they are 18 buys a product and gives it to a minor, whether for profit or not. During today’s debate on the Policing and Crime Bill, I asked the Under-Secretary of State for the Home Department, the hon. Member for Tynemouth (Mr. Campbell) whether he thought such a measure would be enforceable. Sadly, he was not able to respond, but looked at me strangely. I said to him that if it is not enforceable, we should find a way of enforcing it so that we can protect our young people. It cannot be beyond the wit of a Government to bring in legislation that bans someone over the age of 18 from supplying cigarettes to a minor. That is an obvious thing we could do to tackle smoking and inequality.
The report is so big that I cannot cover it all. Another topical area it covers is food labelling. For years, the Government and the Food Standards Agency have gone back and forth on what should appear on the front of food packaging to protect the public and give them knowledge about what is in the products they buy. Guideline daily amounts and traffic lights have been considered, and still we wait. There is confusion in the industry and among consumers. Obviously, it would be helpful to have one kind of labelling on the front of all British food products that outlines how good they are for people, what percentage of the recommended daily intake they constitute and how much salt and fat they contain. I hope the Minister will say that that will happen.
Dr. Stoate: Is the hon. Gentleman aware that one of the main reasons why we do not have uniform food labelling, which I am in favour of, is that many manufacturers and large supermarkets will not agree on a system that they can put up with? How does he think we could compel them to sort that out?
Mike Penning: I have met many manufacturers and producers over the years, as have the Minister and the Select Committee. It is claimed that Europe will not allow us to compel certain things. Apparently, the traffic light system is not legal. We should accept that. However, the GDA system is legal. All the manufacturers seem to have agreed about GDA so why can we not come to an agreement? It would be more logical for a Government who want to protect the public to consider how we could do it, rather than prevaricate and say why we cannot.
Mr. Bone: If we passed legislation that required manufacturers to use one kind of labelling, it would be done. Nobody in the EU would do anything about it, such as fining us. Are we not in favour of bringing powers back from Europe?
Mike Penning: Absolutely. Rather than go to war, it would be better to find something that can be done within EU law and do it. There is a type of front-of-pack labelling that could be used. We called for it in 2004 and are still waiting in 2009.
I would like to talk about the excellent report for longer, but I want to give the Minister longer than I have had so that she can respond to the questions of hon. Members. If she cannot respond, I am sure she will write to us with the answers.
Finally, obesity is a major issue. To be fair to the Government, some positive research has come out recently that shows a slow-down in obesity rates among children and youths. However, one report does not make the problem go away. As the hon. Member for North Norfolk said, it cannot be just the Department of Health that deals with this issue. However, it must drive it forward because ultimately, it has to sort out the mess caused by obesity. Hospitals are full of people suffering from acute illnesses caused by obesity. There is a social stigma attached to people who are obese, and ever-increasing amounts of bullying are being reported. All too often, the national and local press report the attempted or successful suicides of people who have been bullied because of their weight. That is fundamentally wrong. We must give every possible assistance to tackle obesity.
Christopher Fraser (South-West Norfolk) (Con): I am listening to my hon. Friend carefully and listened to the other contributions while I was in my office. Does he agree that there is an obligation on supermarkets and food retailers to be more explicit about issues of obesity on the labelling of products that they sell, so that people have a proper idea of what they are eating and the consequences of doing so?
Mike Penning: I agree completely. It fascinates me that manufacturers get away with some of the comments they make about how healthy their products are—particularly in TV advertising—when they are certainly not healthy.
Norman Lamb: The hon. Gentleman is making important points about labelling. Does he agree that there is a powerful case for labelling on alcoholic products? On a related issue, does he think that minimum pricing for alcohol should be introduced? That is a key public health issue and is a recommendation of the chief medical officer. It is another area in which the Government have ignored the scientific advice they have received.
Mike Penning: We are continuing to look at the latter point and have not committed ourselves one way or the other on minimum pricing. As a Conservative, I find the whole concept of minimum pricing very difficult, but we will continue to consider the evidence.
I am becoming increasingly convinced that alcohol products should provide an indication of calorie content, because the simple fact is that if any of us or our partners were to go to any weight-reducing organisation, whether it is run by a local authority or is one of the national programmes, it would tell us that if we consume more than an average amount of alcohol, our weight will be difficult to control. I am a perfect example of that. Since I have given up drinking pints of one particular brand of alcohol—I will have to say that it is Guinness—I have lost in excess of two stone in six months. That was done on the advice of my cardiologist. Do I miss that particular form of alcohol enormously? To be truthful, yes. However, has giving it up helped me enormously? Yes, it has—it has cost me a few more pounds in suits, but I think it was worth while.
The Minister, the hon. Member for North Norfolk and I were at a meeting the other day; again, I am not going to advertise or pick on the hon. Gentleman for being rude at that meeting about my being overweight. It was fascinating to find out there that it can be fun for people to reduce their weight and improve how they feel, particularly in their youth, and that people’s self-esteem completely changes. If there is one thing we can do on obesity, it is to stop stigmatising it and encourage people to enjoy themselves in controlling what they eat, particularly through portion size, and in burning off energy through exercise. If we can address that and make it fun, rather than making those people the pariahs of society—as, sadly, much of the media and fashion industry do—we will go a long way towards addressing the whole issue of health inequalities.
As I said, I would love to have spoken for much longer because the report deserves a debate. However, I am conscious that other colleagues have curtailed their speaking time so that the Minister has long enough to respond to the questions and important points raised. If she does not have time, I am sure we would all understand if she responds by writing to us during Prorogation.
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Mike Penning (Hemel Hempstead) (Con): This is an important debate. I congratulate the Select Committee on Health, of which I have had the privilege of being a member for many years. When I first came to the House in 2005 and was asked what Committee I wanted to be on, there was only one answer: health. It took me a couple of months to convince the Whips, but I convinced them and joined the Committee. It is enormously important and considers the evidence very well, and it is exceptionally well chaired by the right hon. Member for Rother Valley (Mr. Barron). I pay tribute to the Committee.
Interestingly enough, the report, when it first came out, drew on a lot of previous reports by the Committee, particularly its excellent report done at the time of the smoking debate. Without the Committee and its proposed amendments, the present legislation would not be on the statute book. I know that whenever the right hon. Gentleman speaks, he always likes to bring up smoking and how we can encourage more people to stop. It is an important issue that I know is close to his heart. Other reports include work on deficits and the funding formula. We looked at inequalities not just in socially and economically deprived parts of the country but in other parts of the national health service, to which I will return in a minute.
The issue of inequalities is nothing new. Beveridge was discussing health inequalities long before I was born, and the House has been discussing it for many years. Increasing progress has been made, but sadly, over the past few years, even according to the Government’s own statistics, the situation has been falling back.
As we have heard today, the Government have had a golden opportunity, with more than £100 billion—there will be a debate about just how much, but it looks to be about £110 billion by the time the election comes—of taxpayers’ money being spent on the NHS. The report highlights criticisms that have been around for some time, not just from political parties but from experts in the field, about how that money has been spent and why so little of it seems to get to the front line. The evidence in the report shows clearly that one reason is that it is really not known whether the money is being spent efficiently or is working.
The contributions that we have heard today have been eminently sensible. They show that the House really cares about the issue. It is not party political, although we have had a bit of banter. I was disappointed with the hon. Member for North Norfolk (Norman Lamb)—I will call him my friend from the Liberal Democrats—who did a bit of pre-electioneering for a few moments, but he is better than that and he knows it, so I will not bother to comment on the silly remarks that he made.
Mr. Bone: My hon. Friend is making a powerful speech as usual. Am I right in thinking that only the Conservative party has guaranteed to increase spending on health?
Mike Penning: That is absolutely right. I would have thought that anyone commenting on Conservative party policy would balance their arguments.
Norman Lamb: Will the hon. Gentleman give way?
Mike Penning: Certainly.
Hugh Bayley (in the Chair): Order. I remind hon. Members to concentrate on the issue of health inequalities.
Norman Lamb: I am grateful, Mr. Bayley. Does the hon. Gentleman agree that the causes of health inequalities are largely beyond the NHS?
Mike Penning: Absolutely, which is why my party, should we be lucky enough to be elected, will change the Department of Health to the Department of Public Health so that we can start locking other agencies into a better working environment. The report criticises the lack of joined-up government on such an important subject, so it agrees in many ways with me that we need to come together as a Government. Different Departments need to work together. The hon. Gentleman is absolutely right: no one Department can solve the problem, but Government can start to get there.
One of my concerns about the report is that although it is crucial that we consider social and economic deprivation, it is not just about deprivation in big cities; there are small pockets of deprivation in the most affluent parts of this great country of ours. We stand in the Palace of Westminster, while not far from here—probably literally within a couple of hundred yards—there is deprivation on the streets of this great city that we are not touching. We heard earlier, when hon. Members were discussing Sure Start, that there are people whom we are not getting to. Sure Start catches all, but it is not targeted at the families who desperately need it. That is one thing we need to look at.
Inequality is not just about social and economic deprivation. There are other kinds of inequality in the health service as well. Older people, for example, face inequalities that younger people do not face. As people get older—although, thank goodness, they are living longer—they start to suffer more problems. Are those problems being addressed in the right way? Is funding going directly to the patient? Is rationing of any description occurring? The accusation has been made in the press for many years that as people get older, the money does not necessarily follow them.
Sadly, ethnic minorities also suffer health inequalities. I accept fully that some ethnic minority groups live in the most socially deprived areas of this country, but others do not. There are issues involving language and how people are helped. At the Conservative party conference in Manchester this year, there was an interesting debate on how to reach groups of people in this country who not only do not speak English as their first language but do not speak it at all. Fantastic work on health inequalities is being done with the Bengali community around Brick lane, particularly with ladies who do not speak any English at all, on how to reach them to get them to come in for breast scanning, cervical smear tests and so on.
That sort of innovation in our communities is the way forward, rather than the Government knowing everything. I agree that the Government have a role, but it involves commissioning rather than, as in most cases, providing. The work done on Brick lane, interestingly enough, used a speaking card that was sent directly to the people whom the hospital thought were at risk. When the card was opened, the message in Bengali was, “You may be at risk; you need to come forward.” Such things need to be considered for our GPs’ surgeries and so on.
The hon. Member for Wyre Forest (Dr. Taylor), as usual, brought expertise and knowledge from many years—I nearly said centuries—to the debate. I want to touch on one point that is close to the heart of the Chairman of the Select Committee and that we have debated—although, sadly, not for long enough—on the Floor of the House in Committee and on Report: smoking. It is the great pariah out there in our country that causes so many problems. In particular, I want to pick up on the point made by the hon. Member for Wyre Forest about the illicit smoking of tobacco products.
For many years, no matter which party has been in power, the Government have tried to reduce the number of people who smoke in this country. They have done so using many different measures, but mostly through duty and taxation. If we believe that to be right, as I do—I believe that if cigarettes were cheaper, more people would smoke more—how can it be right that millions of cigarettes are brought into this country duty and VAT-free and sold illicitly to whoever comes along at that particular moment in the marketplace, pub or club, without anyone checking their age or anything about them? That affects health inequality in this country in many ways.
Three main types of illicit cigarettes are sold in this country. The first is the new cheap whites, which look like cigarettes that are sold legally, but most of which are made in the eastern bloc and smuggled here. The second is the counterfeits, which concern manufacturers most because they do not make a profit from them. As hon. Members know, I have no truck with tobacco manufacturers and would be more than happy if they went bust tomorrow morning. The third is the simple black market cigarettes that are brought into the country. Those are the greatest problem. It is estimated—it is only an estimate because we really do not know—that they cost £3.6 billion in lost revenue, and there is lost VAT on top of that. That money could be used in public health programmes across the country or to help the Chancellor and Prime Minister fill the black hole of Government borrowing.
We should not only attack the drug barons who are moving into tobacco smuggling; we could tackle the issue immediately by changing how many cartons of cigarettes can legally be brought into the UK from other EU countries. It is often argued that that is a European issue. However, if we wanted to, we could set the level at as few as 40 cigarettes. Other countries have a level as low as 400 cigarettes, which is two cartons. Our current level is 3,500. Every day, Transit vans go to the continent and return with cigarettes that are supposedly for personal use, but which end up in the pubs and clubs in the towns of our constituencies. We could make 400 cigarettes the maximum that can be brought in from other EU countries, and deem anything more as being for use on the black market. We could do that tomorrow morning. That would send a strong message to the black market racketeers and move the smoking debate forward.
A few moments before this debate began, I was on the Floor of the House. The Minister noticed and was worried that I would be late. I was raising the issue of the proxy purchasing of alcohol because during a debate on smoking a couple of weeks ago, the Minister did not accept amendments on the proxy purchasing of cigarettes because they would not be enforceable. Proxy purchasing is a loophole whereby somebody who can prove that they are 18 buys a product and gives it to a minor, whether for profit or not. During today’s debate on the Policing and Crime Bill, I asked the Under-Secretary of State for the Home Department, the hon. Member for Tynemouth (Mr. Campbell) whether he thought such a measure would be enforceable. Sadly, he was not able to respond, but looked at me strangely. I said to him that if it is not enforceable, we should find a way of enforcing it so that we can protect our young people. It cannot be beyond the wit of a Government to bring in legislation that bans someone over the age of 18 from supplying cigarettes to a minor. That is an obvious thing we could do to tackle smoking and inequality.
The report is so big that I cannot cover it all. Another topical area it covers is food labelling. For years, the Government and the Food Standards Agency have gone back and forth on what should appear on the front of food packaging to protect the public and give them knowledge about what is in the products they buy. Guideline daily amounts and traffic lights have been considered, and still we wait. There is confusion in the industry and among consumers. Obviously, it would be helpful to have one kind of labelling on the front of all British food products that outlines how good they are for people, what percentage of the recommended daily intake they constitute and how much salt and fat they contain. I hope the Minister will say that that will happen.
Dr. Stoate: Is the hon. Gentleman aware that one of the main reasons why we do not have uniform food labelling, which I am in favour of, is that many manufacturers and large supermarkets will not agree on a system that they can put up with? How does he think we could compel them to sort that out?
Mike Penning: I have met many manufacturers and producers over the years, as have the Minister and the Select Committee. It is claimed that Europe will not allow us to compel certain things. Apparently, the traffic light system is not legal. We should accept that. However, the GDA system is legal. All the manufacturers seem to have agreed about GDA so why can we not come to an agreement? It would be more logical for a Government who want to protect the public to consider how we could do it, rather than prevaricate and say why we cannot.
Mr. Bone: If we passed legislation that required manufacturers to use one kind of labelling, it would be done. Nobody in the EU would do anything about it, such as fining us. Are we not in favour of bringing powers back from Europe?
Mike Penning: Absolutely. Rather than go to war, it would be better to find something that can be done within EU law and do it. There is a type of front-of-pack labelling that could be used. We called for it in 2004 and are still waiting in 2009.
I would like to talk about the excellent report for longer, but I want to give the Minister longer than I have had so that she can respond to the questions of hon. Members. If she cannot respond, I am sure she will write to us with the answers.
Finally, obesity is a major issue. To be fair to the Government, some positive research has come out recently that shows a slow-down in obesity rates among children and youths. However, one report does not make the problem go away. As the hon. Member for North Norfolk said, it cannot be just the Department of Health that deals with this issue. However, it must drive it forward because ultimately, it has to sort out the mess caused by obesity. Hospitals are full of people suffering from acute illnesses caused by obesity. There is a social stigma attached to people who are obese, and ever-increasing amounts of bullying are being reported. All too often, the national and local press report the attempted or successful suicides of people who have been bullied because of their weight. That is fundamentally wrong. We must give every possible assistance to tackle obesity.
Christopher Fraser (South-West Norfolk) (Con): I am listening to my hon. Friend carefully and listened to the other contributions while I was in my office. Does he agree that there is an obligation on supermarkets and food retailers to be more explicit about issues of obesity on the labelling of products that they sell, so that people have a proper idea of what they are eating and the consequences of doing so?
Mike Penning: I agree completely. It fascinates me that manufacturers get away with some of the comments they make about how healthy their products are—particularly in TV advertising—when they are certainly not healthy.
Norman Lamb: The hon. Gentleman is making important points about labelling. Does he agree that there is a powerful case for labelling on alcoholic products? On a related issue, does he think that minimum pricing for alcohol should be introduced? That is a key public health issue and is a recommendation of the chief medical officer. It is another area in which the Government have ignored the scientific advice they have received.
Mike Penning: We are continuing to look at the latter point and have not committed ourselves one way or the other on minimum pricing. As a Conservative, I find the whole concept of minimum pricing very difficult, but we will continue to consider the evidence.
I am becoming increasingly convinced that alcohol products should provide an indication of calorie content, because the simple fact is that if any of us or our partners were to go to any weight-reducing organisation, whether it is run by a local authority or is one of the national programmes, it would tell us that if we consume more than an average amount of alcohol, our weight will be difficult to control. I am a perfect example of that. Since I have given up drinking pints of one particular brand of alcohol—I will have to say that it is Guinness—I have lost in excess of two stone in six months. That was done on the advice of my cardiologist. Do I miss that particular form of alcohol enormously? To be truthful, yes. However, has giving it up helped me enormously? Yes, it has—it has cost me a few more pounds in suits, but I think it was worth while.
The Minister, the hon. Member for North Norfolk and I were at a meeting the other day; again, I am not going to advertise or pick on the hon. Gentleman for being rude at that meeting about my being overweight. It was fascinating to find out there that it can be fun for people to reduce their weight and improve how they feel, particularly in their youth, and that people’s self-esteem completely changes. If there is one thing we can do on obesity, it is to stop stigmatising it and encourage people to enjoy themselves in controlling what they eat, particularly through portion size, and in burning off energy through exercise. If we can address that and make it fun, rather than making those people the pariahs of society—as, sadly, much of the media and fashion industry do—we will go a long way towards addressing the whole issue of health inequalities.
As I said, I would love to have spoken for much longer because the report deserves a debate. However, I am conscious that other colleagues have curtailed their speaking time so that the Minister has long enough to respond to the questions and important points raised. If she does not have time, I am sure we would all understand if she responds by writing to us during Prorogation.
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