Diabetes: 10-Year Health Plan

Question

Asked by

To ask His Majesty’s Government whether their forthcoming 10 Year Health Plan will reflect the priorities set out in Diabetes UK’s 10 Year Vision for improved prevention, early diagnosis and access to care and technology for people with diabetes.

My Lords, the 10-year plan is not focused on specific diseases and conditions but will instead set out the changes that our NHS needs to be fit for the future—from hospital to community, from analogue to digital and from sickness to prevention—all of which closely align with the priorities in Diabetes UK’s 10 Year Vision.

I thank the Minister for that positive Answer. More than 12 million people in the UK now have diabetes or prediabetes, with research showing a staggering 51% increase in the last eight years in the prevalence of type 2 diabetes among under-40s in England, at an age when the condition is more aggressive and the risk of complications is higher. To help reverse this trend, will the Government embed suggestions from Diabetes UK’s 10 Year Vision into their 10-year plan, including the creation of a healthier food environment, with a ban on TV advertising of unhealthy food and an extension of the soft drinks industry levy?

I can say yes to both of those because we have already committed to do that. The advertising restrictions were a manifesto commitment and will be implemented from 6 January. I can also tell the noble Baroness that from October this year, as the result of a consultation, the industry has already voluntarily agreed to abide by those restrictions. We had to make changes to make it more workable and I am glad we did that to get the right approach. I am also glad that we worked to get the voluntary agreement. I also said yes to the noble Baroness in respect of Diabetes UK’s 10 Year Vision, which we are very grateful for. I am also grateful for Diabetes UK’s interaction, which has been considerable, in the consultation on our 10-year plan. I thank Diabetes UK and I am sure the noble Baroness will join me in that.

My Lords, following the report from the charity Breakthrough T1D, which found that people in lower socioeconomic groups and those over 65 were least likely to be aware of new technologies such as the hybrid closed loop systems, what plans do HMG and NHSE have to raise awareness of the latest technologies available to type 1 diabetics of all ages and socioeconomic groups?

The matter of health inequalities is, obviously, one we are very concerned about. A national review is currently under way to update on monitoring, including of various groups. NHS England supports ICBs in improving diabetes care, including through the use of the medical technologies that the noble Baroness referred to, and, importantly, in reducing the variation in care that we still see across the country. It does that by using national data and insights, funding local clinical needs and addressing health inequalities through the national diabetes prevention programme. I certainly agree with the noble Baroness about the importance of raising awareness and the incredible contribution that new technology is playing. It has to be available for all and I hope we will establish that in the way I have mentioned.

My Lords, I declare an interest as a patron of the South Asian Health Foundation. The south Asian population has a very high incidence of diabetes, particularly type 1, which is probably related to a strong gene marker. Some 50% of people with type 1 diabetes have some kind of gene marker. Those who have a strong gene marker in a particular region, the HLA region of chromosome 6, have a very high incidence. My point is that, if we screen people, particularly those with a family history of diabetes, for genetic markers, we will identify them much earlier, even in childhood. The prevention that is therefore required—changing their environment and diet—becomes more effective. This ought to be one of the preventive strategies for diabetes in high-risk populations.

The noble Lord is quite right in his observations, which play to the point of the NHS that we want to see not just now but in the future. Noble Lords may have heard the announcement earlier this week that the Government are committing the necessary funding to screen babies early in their lives through the use of genomics, in order to, as the noble Lord said, identify underlying conditions that can be dealt with early on. There are some that cannot be prevented, but if they are diagnosed and anticipated, their management will be much better.

My Lords, continuous glucose monitoring and Mounjaro have helped me to come off insulin after 20 years of daily injections and have greatly improved my diabetic control. Such innovations are undoubtedly a cost saving to the NHS in the long run. Does the Minister think we are looking far enough into the future when we consider the cost-benefit analysis of their use? How can NHS spending plans take into account their long-term benefits to the economy by keeping people in work and getting many people back to work?

The noble Lord, Lord Rennard, knows that it is always good that we hear about his own experience, because he epitomises the changes that are possible. I believe there is an understanding—not least because, as noble Lords will know, the Chancellor very recently gave the department a settlement that was, in large part, because of not just immediate need but looking to the future and the kind of NHS that is fit for the future we will see identified in the 10-year plan when it is published. Technology is certainly a huge part of that, which is why CGM and the hybrid closed loop system—the latter of which began to be rolled out in April 2024—are so important. There have been huge advances and they will be part of that NHS of the future that we seek to build.

My Lords, I am delighted that the Government are producing their 10-year plan, and we look forward to seeing it. Following on from the question from the noble Lord, Lord Rennard, about protecting the labour force, can the Minister say something about fracture liaison clinics being rolled out across the country, to follow up on commitments made in the past that these clinics will be available across the country? These clinics can help boost productivity in the workforce; help older people, especially women, stay in the labour force; and prevent the fractures that so often force them out of work or cause accidents for older people.

Fracture liaison services do an incredible job. I refer the noble Baroness to the words of the Secretary of State—I will not quote them because I do not have them to hand and there is nothing worse than misquoting somebody, particularly the Secretary of State—who has made his intentions quite clear on fracture liaison services. We certainly appreciate their value and the need to make that kind of provision available across the country.

With regard to what the Minister said about the DNA database of children with diabetes and other conditions, what are the mechanisms in place if a child, at the time they reach Gillick competence, no longer wishes to have their data on that DNA database? Will there be mechanisms so that the child can at that point withdraw their data and prevent it being used?

All the usual provisions will apply, but, as we develop the system, all that detail will be confirmed. I will ensure that the point the noble Lord raises is fed into that consideration.