[Lord Speaker] My Lords,
first oral question, Baroness Parminter.
[Baroness Parminter] My Lords, I beg leave to ask the question
standing in my name on the order paper.
[Lord Evans of Rainow] My Lords, we are committed to ensuring
that everyone with an eating disorder
has access to timely treatment based on clinical need.
Under the NHS Long Term Plan 2023-24 we will invest almost £1 billion
extra in community mental health care for adults
with severe mental illness, including eating disorders.
Since 2016, investment in children and young people's
community eating disorder services has risen every year with an extra
£35 million per year from 2021-2022.
[Baroness Parminter] As the cricketer
Freddie Flintoff showed, anyone can get an eating disorder,
but there is very little information about the inequalities in access
to community based treatment and treatment outcomes.
So can the minister say when the national clinical audit,
which was promised this year by NHS England, will take place
so that we can get the proper data that we need
and give everyone the service and support they need?
[Lords] Hear, hear!
[Lord Evans of Rainow] The noble Lady raises a very, very good point
and she gives a very good well-known example but sadly,
so many men do suffer from this disease and there are community
groups that help men with mental health issues
such as Men in Sheds.
When I was serving in the other place, I always made a point of seeing the Men
in Sheds in my constituency, and they did an outstanding job in so many places.
But I cannot give a direct answer - a full answer - to the noble Lady's answer.
But I've asked and requested
for an actual specific time when I can answer that question in full.
And once I have that, I will reply.
[Baroness Bull] My Lords, my Lords, my Lords.
The noble Lord, the minister will be aware that NHS recommends
that adult males require, on average to around 2,500 kilocalories a day.
Can he therefore explain why the calorie
labelling regulations which came into force last year
require qualifying businesses to display prominently a statement
that adults need around 2,000 calories a day?
[Lord Evans of Rainow] Well, the noble lady raises a very good point.
And sadly not all manufacturers have gone along with the
legislation to make it crystal clear, notwithstanding
the alcohol industry, but so many other industries
really do need to step up to the plate to make sure it's crystal clear
on what the calorific intake is per day.
[Baroness Chisholm of Owlpen] I thank the noble Baroness, Lady Parminter
for bringing this question which is such an important one.
And also
we know that boys and men
are very unwilling to come forward when there's a problem.
Can I ask my noble friend what's being done as far as schools being
made aware of this problem and teachers being made aware of how to notice boys
who may have a problem with an eating disorder?
[Lord Evans of Rainow] I thank my noble friend for that very good point.
Eating disorders are serious life threatening conditions
and they can affect people of any age, gender, ethnicity or indeed background.
People with eating disorders can face stigma around this disorder,
which can stop them from reaching out for help and reaching their true potential.
We have committed to offer all state schools and colleges
to train a senior mental health lead by 2025, enabling them to introduce
effective whole school approaches to mental health and wellbeing.
This is backed by £10 million in 2022-23 and over 8,000 schools and colleges,
including half state funded secondary schools, have taken up the offer so far.
[Lord Hunt of Kings Heath]
My Lords, if I can just follow up Baroness Chisholm's question,
where she suggested that men may be reluctant to go and see
their doctor or seek advice on some health issues,
which has been I think, very well researched.
One of the puzzles is why the government seems to set its face
against establishing a men's health strategy,
given that the outcomes for men in health terms can be so poor
in so many parts of the country.
Would his department actually give this further consideration
and come forward with proposals to establish such a strategy?
[Lord Evans of Rainow] Well, the noble Lord raises a very good point,
and I agree with him.
I will take his excellent question back to the department and come back to you.
But in terms of the subject of
this question, a significant number of young people affected are females
and a relatively small part are young people.
But the whole strategy is to encompass all men and women.
[Baroness Manzoor] My Lords, as the minister has just said, around 70% of those
affected by eating disorders are indeed girls and women.
However, there's an increase with young boys and men.
Therefore, can my noble friend the minister say,
what is the relationship and the perception of boys
and men regarding their body image
in light of their physical health and their mental health,
and what resources quite specifically, are going to be dedicated to this issue?
[Lord Evans of Rainow] Well, again,
that's an excellent question from my noble friend.
Poor body language has the potential to affect anyone at any point in their life.
The pressure to achieve an idealised body image has wide
ranging consequences for mental and physical wellbeing.
The growth of social and digital media has increased its exposure
to images of beauty and are unrealistic and in some cases untenable.
Body image is recognised as a risk factor for mental health problems
and more commonly identified
as a key risk factor for eating disorders and unhealthy eating behaviours.
And for members who have teenage children in their families,
they will know how much time they spend on their mobile
devices.
[Lord McDonald of Salford] My Lord, the noble Lord
the minister did not answer Baroness Bull's question.
Calorie labelling talks about a daily intake
of 2,000 calories, which is calories recommended for a woman not a man.
For a man, it's 2,500 calories per day.
Why is this the case?
Will the minister undertake to look at this and change it and make it accurate?
[Lord Evans of Rainow] You raise a very good point,
and I apologise to the noble Lady for not being more specific.
I cannot give a specific answer to why it's 2,000 rather than 2,500.
But I will ask that specific question and come back to the noble Lady.
(Chatter from the crowd)
[Lord Allan of Hallam] My Lords, my noble friend's question brought back a memory
from my own teenage years of being told by a nurse that she would say
that I had anorexia, but that couldn't be the case because I was a boy.
And fortunately our understanding has moved on since then.
So we now recognise
that eating disorders can affect everyone, irrespective of gender or age.
Will the noble Lord the minister agree that public health services
have a vital role to play in broadening that understanding amongst
the general population and what resource is the government providing to them
for that essential educational work?
[Lord Evans of Rainow] Well, the noble Lord raises a very good point there.
When you and I were young boys, there wasn't the Internet perhaps,
and therefore it just shows that this issue
did occur before the Internet.
But in terms of funding under the NHS
long-term plan 2023-24, we will invest almost £1 billion extra in community
mental health care for adults with severe mental illness, including dietary issues.
[Lord Brooke of Alverthorpe] Is the noble Lord the minister aware
from his previous experience that there are 12-step recovery programs
available both for over eaters under eaters?
Is he aware that there's an all party parliamentary group that is
advocating and pressing for these to be extended over a wider area,
and particularly because they are free?
And if such, would he be prepared to meet with the group and talk about
what they have to offer?
[Lord Evans of Rainow] Well,
I'm most grateful to the noble Lord for that very kind invitation.
I'd be delighted to attend the APPG.
(Members chatter)
[Baroness Cumberlege] Does my noble friend agree that community pharmacies
are able to provide men and indeed women
with advice on healthy lifestyles, including advice on diet?
And will he urge the government to introduce in England
a properly financed “pharmacy first” service,
that they actually have in Scotland and we know it works well,
so that services like those that are provided
in Scotland can be provided in England by all pharmacies and
people can have access
to those services.
[Lord Evans of Rainow] I thank my noble friend
for that excellent question on pharmacies.
There are over 11,000 community pharmacies in England.
All of these provide advice
on healthy living that is already part of their terms of service.
We know that people know and trust their local pharmacies,
but people don't always know just what pharmacies are able to do
and how skilled pharmacists are in diagnosing minor illnesses.
In terms of the specific question on “pharmacy first”, we want to go further.
We are exploring what more pharmacies could do, learning from the “pharmacy
first” approach in Scotland, including enabling the supply
of some prescription only medicines without a prescription.
[Baroness McIntosh of Hudnall] My Lords, the focus of the questions
and some of the noble Lord
the minister's answers has been understandably on young people
but eating disorders admittedly frequently start
in early years, but they are lifelong disorders and they can
go away and then flare up again
when adverse life events
sometimes cause them to do so.
Following on from the question from my noble friend Lord Brooke,
can the noble Lord
say what particular kinds of therapy the government is planning to invest in?
He spoke earlier about investment.
And what research it has done into the efficacy
of different therapies at different points in people's lives.
[Lord Evans of Rainow] I'm most grateful for the noble Lady for that
excellent question.
I don't want to mislead the House
that it's all about young people because she's exactly right.
Disorders start in early life, but continue through adult life.
The government are taking steps to expand the number of practitioners
who can deliver evidence based psychological interventions
that are intended to treat those with an eating disorder.
This includes expanding
the number of individual trainees and qualified practitioners
who are competent to deliver cognitive behavioural therapy for eating disorders,
as well as the Maudsley Model of Anorexia Nervosa therapy in adults.