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Obesity
Lord Clement-Jones asked Her Majesty's Government:
- What assessment they have made of the role of patient profiling in improving the targeting of National Health Service resources and services to meet the needs of the overweight and obese.[HL1458]
Lord Warner: It is for primary care trusts in partnership with strategic health authorities and other local stakeholders to determine how best to use their funds to meet national and local priorities for improving health, tackling health inequalities and modernising services.
Lord Clement-Jones asked Her Majesty's Government:
- How funding from the New Opportunities Fund is being used to address levels of overweight and obesity.[HL1427]
Lord Warner: The New Opportunities Fund supports 350 Healthy Living Centres across the United Kingdom. Of those in England, 114 provide activities covering diet and nutrition and 207 HLCs offer physical and sporting activities, which contribute to tackling obesity.
The Five-a-day programme aims to improve diet, by encouraging people to eat at least five portions a day of a variety of fruit and vegetables. Two important components of that programme are local community initiatives and the National School Fruit Scheme.
Sixty-six community Five-a-day initiatives led by primary care trusts in the most disadvantaged areas of England receive grants for this purpose from the New Opportunities Fund totalling £10 million over two years from 2003.
The National School Fruit Scheme in England has benefited from £42 million from the New Opportunities Fund since 2002 which has made it possible for children aged four to six in the West and East Midlands, London, the north-west and—from March 2004—the north-east to receive a free piece of fruit every school day, in advance of the roll-out of the scheme across all English regions later this year, funded with £77 million over the next two years from the Department of Health.
£581 million from the New Opportunities Fund is being invested to build and refurbish PE and sports facilities in schools. The funding is being used to fund a group of projects in each of the 150 local education authority areas in England, with priority given to areas of urban and rural deprivation. Sport England also distributes lottery funding and invest in a range of sporting projects, including the Active England fund.
Lord Clement-Jones asked Her Majesty's Government:
- What plans they have to review their current dietary advice in the form of the "Five-a-day" message to ensure that they are providing practical and adequate advice to those who are overweight and obese.[HL1428]
Lord Warner: The Government launched their major consultation on public health this month. The consultation will enable a wide range of stakeholders to contribute to the debate on overweight and obesity. The Government will draw up their White Paper in the light of the consultation.
The overall aim of the Five-a-day programme is to contribute to a reduction in preventable early deaths from coronary heart disease and some cancers and to a reduction in health inequalities.
The dietary advice given through the Five-a-day message is directed to the whole population. Dietary advice on weight maintenance, intake of salt, fat and sugar and portion sizes are given in the Five-a-day materials. The nutrition criteria for the use of the Five-a-day logo also aims to ensure increased consumption of a variety of fruit and vegetables. There are no plans to review the dietary advice given in the Five-a-day message but relevant issues will be taken into account as they arise.
Lord Moynihan asked Her Majesty's Government:
- What assessment they have made of the Obesity Awareness and Solutions Trust House project; and what consideration they have given to assisting with the estimated costs of the project.[HL1740]
Lord Warner: The Government are aware of the work of the Obesity Awareness and Solutions Trust (TOAST) by supporting its work programme over two years through the Department of Health's Section 64 Grant Scheme. This grant ended in March 2003 and TOAST has submitted an application for further Section 64 funding from April 2004. This application is under consideration.
Lord Moynihan asked Her Majesty's Government:
- What assessment they have made of the role of sport and physical activity in reducing levels of overweight and obesity; and what plans they have to address levels of inactivity among children and adults.[HL1742]
Lord Warner: The Health Development Agency (HDA) has carried out a review of the current evidence on diet, physical activity and behavioural approaches to the management of obesity and overweight. This was published as an evidence briefing in October 2003. A further review by HDA of the evidence on the effectiveness of public health interventions for increasing physical activity among adults is intended for publication in the next few weeks.
In addition, the National Collaborating Centre for Primary Care has been commissioned by the National Institute for Clinical Excellence to work jointly with the HDA to develop guidance on obesity.
The cross-government Activity Co-ordination Team (ACT) has been established by government to increase participation in physical activity and sport for those of all ages. ACT will publish proposals for consultation in due course.
Lord Moynihan asked Her Majesty's Government:
- Whether patient-carer organisations will be adequately represented on the membership of the National Institute for Clinical Excellence's Obesity Guideline Development Group; and what plans they have to support the application for membership from a representative from the Obesity Awareness and Solutions Trust.[HL1743]
Lord Warner: Patient/carer organisations are fully involved in the development of the guidance on obesity being developed by the National Collaborating Centre for Primary Care (NCC-PC). The NCC-PC has been commissioned by the National Institute for Clinical Excellence (NICE) to work jointly with the Health Development Agency (HDA) to develop this guidance.
A number of patient/carer organisations (including the Obesity Awareness and Solutions Trust) are registered as stakeholders in this guidance. All stakeholders will have the opportunity to comment on, and be involved in the development of, the guidance from its initial scoping phase through to the two periods of consultation on the draft guideline.
In addition, the Guidance Development Group (GDG) will include at least two representatives nominated through patient/carer organisations. The Patient Involvement Unit at NICE has written to all
patient/carer stakeholders involved in this guideline (including the Obesity Awareness and Solutions Trust) detailing how organisations interested in nominating GDG members can do this. The NCC-PC and the HDA, in discussion with NICE if necessary, will review the nominations to select the best combination of people to maximise the range of skills and experience of the GDG. This process should be complete by the end of May 2004.NHS Dentistry
Lord Colwyn asked Her Majesty's Government:
- How many letters the Department of Health has received since September 2002 from (a) members of the public, (b) Members of Parliament on behalf of constituents and (c) Peers, in regard to difficulties in accessing National Health Service dentistry.[HL1461]
Lord Warner: Between 1 September 2002 and 31 January 2004, the Department of Health has received 524 letters about access to National Health Service dentistry from the public and 399 letters from Members of Parliament. In the same period their Lordships have written 15 letters to the department on dentistry, mostly on water fluoridation.
Surgical Practitioners
Lord Hunt of Kings Heath asked Her Majesty's Government:
- What plans they have to increase the number of training places for surgical practitioners; and [HL1608]
Whether, in the light of the European Union Working Time Directive, there will be a need for an expansion in the number of surgical practitioners.[HL1609]
Lord Warner: The Changing Workforce Programme is working closely with the National Association of Assistants in Surgical Practice, the Royal College of Surgeons and the NHSU to develop a curriculum and national standards for practice, for surgical practitioners, so that the number of training programmes can increase to accommodate growing numbers.
It is not possible to estimate a figure for the number of surgical practitioners needed to ensure compliance with the Working Time Directive because compliance requires a range of different approaches in different trusts and services, only some of which will involve surgical practitioners.
The 20 Working Time Directive pilot projects currently in progress include one which is testing the role of perioperative specialist practitioner, in four trusts. While this is a different role from that of surgical practitioner, it illustrates how different staff can contribute to a team-based approach to providing patient care. The project has shown that practitioners
can be extremely effective both at saving junior doctor time, which can help a trust to achieve compliant rotas, and at improving the quality of patient care by, for example, reducing waiting times in clinics and enabling earlier discharge from hospital. It is working closely with the new ways of working in surgery project to share expertise and learning, and in all of these projects new practitioner roles are being combined with changes to working patterns of medical staff and to service delivery, which together improve Working Time Directive compliance.
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