My Lords, this Bill is one I have come up with with an almost total lack of original thought. This is because it is taken from a combination of a good idea that the Government came up with, but then slightly back-pedalled from, and the recommendations from a committee that I served on with many of the other people here, which was chaired by my noble friend Lord Willis. It was called—let us get this right—the National Plan for Sport and Recreation Committee and it called for that national plan. The proposal here is that two ideas are combined: to have somebody who combines active public health with a national plan for sport. Why? Quite simply, it is because exercise is the wonder drug.
It is the wonder drug that does not just affect your physical health but, done correctly, usually supports your mental health. This is something we can do and something the public have already bought into on a massive scale—so much so that the Government are often let off the hook because most of our sporting establishments were made without government help, fund themselves and allow sporting activity to go on. Indeed, the national sports—football, rugby or cricket; you name it—provide quite a lot of the funding and government is a late player to this field.
I am calling for the Government to come in and take their fair share of the weight because, so far, they have not. They have allowed the old boys’ club or the old works team to provide the physical activity. Allowing them to do it means that amateur sport, which is what we are talking about solidly here, is something provided by people going into their own pockets to help others and using their own time to make sure it happens. That is one reason why I feel the Government have been let off the hook here. If you are running your local team and playing in it, giving X nights a week and your weekends to it, you are probably not interacting with a political process that keenly because there are only so many hours in the day. The same, by the way, can probably be said of the arts.
My Lords, I am glad to follow the noble Lord and to welcome his Bill, not only because I agree with its content but because it affords us an important opportunity to discuss how we might improve public health through not only legislation but local, voluntary and community action. I declare an interest: I have a long-standing relationship with ukactive. In that context, I mention the recently retired chair of ukactive, our own noble Baroness, Lady Grey-Thompson, who participated in the debates about a national plan for sport and recreation to which the noble Lord referred. I thoroughly endorse what that committee had to say and the purposes of his Bill.
I will go a bit wider in the public health context and talk about the structure of support for the promotion of public health in this country. Noble Lords will recall that I was responsible for health in the coalition Government for two and a half years. We published the Healthy Lives, Healthy People White Paper in December 2010—exactly 12 years ago—and if anyone wants to see my prescription for public health, they still only have to look at that. It followed and reflected Sir Michael Marmot’s ground-breaking work on the social determinants of health and a “life course framework” for working on public health issues.
The Government have recently talked about the importance of preventive work through the NHS, which I thoroughly endorse. But, although preventive services are a key priority for the NHS, they are not a substitute for a government-wide and societal focus on improving public health. Inequality, poor housing, environmental quality—we discussed this on Third Reading of the clean air Bill—and, not least, economic disadvantage are the major social determinants of health. They require Governments to provide leadership, resources and structures to help us improve public health across society.
This was the originating purpose of Public Health England, which pursued both this agenda and the complementary tasks of combating the key risks associated with poor mental health: tobacco and smoking; obesity, both in terms of diet and activity; air quality; drug misuse; and sexual health. The then Government brought forward plans to address each of those causes of poor health. For example, my noble friend will, I hope, tell us that a tobacco control plan renewal will not be far off.
My Lords, I welcome this Bill and congratulate the noble Lord on promoting it. I very much support the focus on health promotion, physical activity and cross-government action. After all, the department is called the Department of Health and Social Care and not the department of health services and social care, and the noble Lord is the Minister for Health and not just health services.
Like the noble Lord, Lord Lansley, I will also be widening the debate slightly. I am particularly pleased that the Bill widens the debate on health. Too often, we talk just about health services and healthcare, and sometimes prevention, but we almost never talk about the third important area of creating health, of which health promotion is a part. All three are important and essential.
All of us understand what we mean by healthcare but it is important to distinguish prevention, which is about the causes of disease, pathogenesis and pathology, and about activities focusing on, for example, heart disease, stroke, cancer and tackling air pollution, and health creation, which is about the causes of health, salutogenesis, but not the causes of disease. I describe this as creating the conditions for people to be healthy and helping them to be so. Those causes include, for example, opportunities for social interaction; healthy working environments and development; being in touch with nature; having a meaning in life; relationships of all sorts; being well-fed and well-housed; the agency to act and decide, as opposed to alienation and anomie; and self-respect. We want healthcare, the vital services of the NHS, and the approach to prevention that this Government are moving on, but we also want the positives of actively creating health.
I have often quoted in your Lordships’ House the saying from a great Ugandan doctor:
“Health is made at home, hospitals are for repairs”.
Indeed, I know that the former Minister, the noble Lord, Lord Kamall, has quoted this back to me on occasion. It is a very valuable point. It is why I talk about a health-creating society and why I am promoting the Healthy Homes Bill. The first time I raised this in your Lordships’ House was in a Cross-Bench debate on 26 November 2015, when I moved that this House takes note of the case for building a health-creating society, where all sectors contribute to creating a healthy and resilient population. There were many powerful speeches from all sides of the House. I believe we need this even more than ever, and that we are not going to make progress on health unless and until we recognise that creating health is as important as disease prevention and healthcare. Obviously, there are links and overlaps, but let us recognise these very important distinctions.
My Lords, it is a pleasure to follow the noble Lords, Lord Crisp and Lord Lansley. I applaud and thank the noble Lord, Lord Addington, for his leadership in pursuing this debate.
Like many noble Lords, I have spent a lifetime trying to improve health and social care in my backyard, alongside the work we do in this House. It would be remiss of me to not acknowledge the immense results we achieved back in the early and mid-1980s, which saw great improvements, particularly in perinatal and postnatal mortality rates, immunisation and breastfeeding. Most of those changes are under much stress now, adding to the improvements required in maternity services, which need urgent attention, and to the gross disparities we have talked about in this place and elsewhere on health and well-being, as well as air pollution, mental health and long Covid, particularly for those people living with disabilities and from minority communities.
Alongside this, the dissatisfaction rate among the general population for our GPs and much-beloved NHS and A&E services suggests that services have become inadequate. There is a lack of good quality maternity services, with women unable to receive adequate care during pregnancy, childbirth and postnatal care; one can see the trajectory of the health and well-being deficit in the family being set very early on. This is worsened if there are disabilities, mental health and care needs, in addition to the bullying, racism and discrimination within the system and which staff experience. If this is embedded in the services, is it any wonder we are facing this crisis? If noble Lords are minded to underestimating the effect of racism within institutional structures, I ask the Government to speak with Dr Chaand Nagpaul prior to setting up the new office proposed in the Bill to ensure that we do not just consult but involve those who have a track record of achieving changes within communities, even with restricted and constrained resources.
My Lords, I congratulate the noble Lord, Lord Addington, on securing time to debate the Private Member’s Bill. I approach this debate with three words in mind: apathy, sympathy and empathy.
Let us start with apathy. During the debate on the then Health and Care Bill, I reassured your Lordships of the Government’s commitment to a national plan for sport and physical activity, and that it would be published later this year. I also informed noble Lords that the Government were working across departments—and I referred to the health promotion task force, led by the Health Secretary, and pledged to keep your Lordships up to date on the progress. I believe that it was this commitment that convinced my noble friend Lord Moynihan to withdraw his amendment.
Unfortunately, in response to a recent Written Question, the Department of Health and Social Care explained that the health promotion task force was not a part of an updated Cabinet committee structure. To be fair, the Answer also explained that the Government’s Our Plan for Patients would address preventable ill health through collaboration across government and the National Health Service. However, it gives the impression that the Government’s approach to health promotion now appears to be one of apathy—or, perhaps more kindly, lethargy. One of the ironies is that part of encouraging physical activity is to overcome individuals’ apathy. Whatever the true picture, I am afraid that there is now a perception that the Government cannot be bothered to take health promotion seriously. I hope my noble friend the Minister will be able to address this perception head-on.
However, this is where I also feel sympathy—indeed, sympathy for my noble friend the Minister, since none of this is his fault. These decisions were made way above his pay grade. While noble Lords can attach no blame to him I hope that, by challenging the Government in this debate, they will empower him to raise your Lordships’ concerns with his department and across government.
My Lords, I thank my noble friend for his work on this invaluable Bill. I concentrate on the issue of sport, and general physical activity and its importance. I want to praise the Bill’s emphasis on the importance of a cross-governmental approach.
Not surprisingly, given my remit in this House, I start with transport. It is no good encouraging people to participate in sport if they cannot access the facilities because there are poor or no public transport links. This issue applies in particular to young people. For example, at the end of the school day it is common to have sports clubs but, if you are a pupil who relies on the school bus to get home, you miss that school bus if you stay for the sports club. You then have to rely on the regular, scheduled bus service and, if it does not exist, you have no choice but to fall out of regular sport and of attending the sports club. That is one of the commonest reasons in schools why children stop participating in sport.
It is also very important that local authorities develop good, safe and active travel routes for cycling and walking. At issue is not just the existence of public transport facilities but the cost. If the bus fare is too expensive, young people and adults are not going to be able to afford it. There has to be cross-local government thinking on this.
I also emphasise the importance of location. A sports club being in the centre of a town or city is often much more important than the size of its pitches. It is where it is that is so important, rather than how big it is. I give you the example of my own home city of Cardiff which, because of a wonderful donation hundreds of years ago by the Earl of Bute, has an enormous park in the centre. There is the Sport Wales National Centre, Glamorgan Cricket Club and rugby facilities in the centre of the city, all within a short walk of the Central station and near where all the buses start and stop.
My Lords, I refer my interests as set out in the register. I congratulate my noble friend in sport, the noble Lord, Lord Addington, on securing this debate and introducing a Bill that seeks to take forward one of the main recommendations from the House of Lords National Plan for Sport and Recreation Committee. The noble Lord has made a strong case for the measures contained in his Bill, which builds on then Prime Minster Boris Johnson’s commitment that the new office for health promotion, which began work earlier this year, should tackle the causes, not just the symptoms, of poor health and improve prevention of illness and disease.
As we have heard in earlier deliberations on the subject in your Lordships’ House, the then Minister, my noble friend Lord Kamall, who did an excellent job in government, emphasised the Government’s commitment to developing a national plan for sport and physical activity, informing the House that it would be published “later this year”. As he would agree, and indeed accepted very honestly in his contribution just now, we are fast running out of time. One reason, which the committee recognised, is that, departmentally, sport lies on the fringes of the Whitehall machinery. The case for sport and recreation to be moved to the Department for Health and Social Care has once again, this year, demonstrated that we need a concerted, co-ordinated and cross-departmental effort, placing sport and recreation at the centre of a proactive health policy. The benefits are clear to your Lordships, but that has sadly withered on the political vine.
We may have hosted a great Olympic Games in 2012, yet we have not, beyond even the imaginations of the most optimistic observers, been able to deliver a sports legacy for this country. One-third of the adult population receive less than two and a half hours of moderate activity per week and schoolchildren face unprecedented levels of obesity and inactivity, with PE marginalised and woefully inadequate primary school training for teachers—less than three hours in a three-year course. That has all combined to the point where the chair of our sport and recreation committee, the noble Lord, Lord Willis of Knaresborough, concluded in this House that we have become
My Lords, I rise to make the range of cross-party and indeed non-party support for this Bill even broader. I thank the noble Lord, Lord Addington, both for bringing it and for introducing it so comprehensively.
The noble Lord, Lord Crisp, made a powerful point when he talked about prevention of ill health; he then got to the point where we really need to be when he emphasised that physical activity is absolutely crucial to well-being and a healthy society.
Ahead of today’s debate, I looked back to a speech that I gave in July 2015 to the University of Manchester’s Festival of Public Health UK, which was in fact an international event. I said then that we have in the UK
“a society that’s making … its members ill. A society that’s failing to provide clean air … adequate housing … a healthy diet … safe jobs and decent benefits … opportunities for exercise … an education that prepares pupils for life.”
Seven years on, I do not believe that there is a single measure that I set out then on which we have seen positive progress, which is extraordinarily terrible—although I note that it is not through want of the efforts of my noble friend Lady Jones of Moulsecoomb. Indeed, this House has, with broad support, just put through the Clean Air (Human Rights) Bill. I hope that that might be one area where we could see very rapid progress.
I shall concentrate in my speech on sports—appropriately, since the noble Lord, Lord Addington, is such a champion in your Lordships’ House in this area. I stress the need to change the conversation. I was on the politicians’ panel on BBC’s 5 Live this week. For reasons that my accent makes obvious, perhaps, there was a discussion of the England-Wales World Cup game to which I was not asked to contribute. However, had I been asked to contribute, what I was sitting there bursting to say was, “Where is the huge programme around this high-profile event to get people out, during and after the event, kicking a ball around, throwing a ball around, running around, as people are watching so many high-profile celebrities doing on television now?” That was one question, but another question, which other noble Lords have already raised, is: where will people, particularly children, kick that ball? Where will they be able to run around?
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Government really should have done more; in most other places, it does. I remember the FA talking to its German counterparts and when it said, “We spend a lot of money on maintaining pitches”, the German response was apparently, “That’s a local government duty.” In France, you play at the stade municipal. I hope the Government will say, “We’ve got to get more involved here.” Now, I am sure the Minister has a brief in front of him that says, “There are lots of initiatives here. Departments will talk to each other because several committees will sit down to do this, so we’ve got lots of initiatives.” That is the answer I would have got 30 years ago. It is quite clear that, while they may have talked to each other, of decisions and cohesive action there have been little.
I could run through all the provisions in the Bill. It would not take that long but would rather try the patience of everybody here. If I can read them, I am sure we can all go through them. I would have claimed to be one of the most out dyslexics in public but I believe there is currently someone in the House of Commons challenging that position. I have two favourite provisions in the Bill: the inclusion of
“measures to promote physical access to the countryside for sports and recreation”
followed by the linkage between schools and clubs. Both depend on action across the board with local government and the departments for education, agriculture and transport all talking together.
Clause 2 has seven lines, which, as they stand, are probably more important than any other individual subsection, and say that government must work together. For instance, if we want to get the best out of our recent innovation that farmers will be helped to create footpaths, are we making sure that these footpaths are linked to traditional foot-pathing walks and that there is access to somewhere you can park a car or, better still, catch a bus to them? Would there possibly be some village where you could get a meal or a drink afterwards, and make a day out of it? That requires a huge co-ordination of government and unless you have something that drives it forward, you will not get there. We would be back to hearing, “This committee wants that”, and then there is the lobby. The less said about the planning or maintenance of a footpath, the better, because that has never been a happy story. How do you get that access out there?
On schools’ links to other bits of amateur sport, it does not matter if a headmaster has a row of trophies for various sports outside his room, because those children will be gone if they do not play the sport later on. A school should get awards for filling second and third teams in all of the local sports around it, not for winning the odd trophy, because that is where the benefits of social interaction and mental and physical health come in. We are rather too fond of saying, “Oh, we won something”. Many of us here were champions of our schools for something or were great debaters at the age of 11, 12 or 15. That does not matter; what matters is if you do something with it later on. It is just a tick along a pathway, but the pathway itself is important.
I declare an interest: I have played rugby union for probably far too long. My physiotherapist is probably quite happy about that. I advise everyone to read the House magazine for a report of the Commons’ and Lords’ most recent rugby matches. It is true that the photographs with it are from another match, but it is there. I will give a little commercial: anyone who is a passholder and has any knowledge of the game or would like to acquire a strange knowledge of it is welcome to participate. Golden oldies’ rules allow this.
Having done the commercial, I will come back to the serious matter here. Unless you co-ordinate better, you will not facilitate this. Public health starts with clean air and water, which have certainly saved more lives than penicillin, although it was pointed out to me not a few moments ago that penicillin is also a good thing. We have to have some form of co-ordination. You have something that benefits society holistically, if you allow it to happen properly. If someone is going to move a clubhouse from inside a small town to outside it because there is a wonderful development deal, make sure that there is a bus route, or at least a cycle path, to it. Why? Because you will not have an under-18s team when their parents get fed up with ferrying them around, or possibly cannot do so. If anyone wants an example of that, I can provide a list that goes on and on.
Let us get some coherent leadership from government here—not a series of diverse initiatives and schemes, but a coherent plan. You will have to upset someone and upset government a little bit, but, unless you do that, you will not get the best out of all of this. It all comes together under the heading of public health and improvement of our society. I hope that the Bill will be given a fair wind by this House.
This was not done at the expense of the health security functions, in respect of which UK expertise was, and is, internationally recognised. For example, in the year following the White Paper, the pandemic flu preparedness plan was published. However, within two years of its establishment, Public Health England’s capacity to meet its responsibilities was progressively limited because of budget cuts and staffing limits. From 2015 onwards, local government’s public health grant was cut by £200 million, and Public Health England saw a 40% reduction in its real-terms funding, reducing its capacity by a quarter.
The classification of Public Health England as not part of the NHS was wrong at the time and a mistake in public policy terms, and in the pandemic we paid for the results of that mistake in lives and many billions of pounds. Public health policies should seek to address both communicable and non-communicable diseases. The pandemic demonstrated, not least in this country, the interaction between vulnerabilities to infection and the effects of chronic disease in the population, often as a result of smoking, poor diet or inactivity.
The resulting division of Public Health England into two organisations is therefore a mistake. The perceived reduction in the independence of the Office for Health Improvement and Disparities, compared with Public Health England—although both are in fact executive agencies directly accountable to the Secretary of State—is also a mistake and risks undermining future responses to public health challenges, not least by failing to engage and mobilise local government. During the pandemic, we saw how important this was and what might have been, had the Government engaged it more fully at an early stage.
The scapegoating of Public Health England, which in reality resulted from a lack of investment in it, should be called out in the coming public inquiry. Public health should, like tackling climate change, be a priority across government, with leadership from the top and dedicated funding. I believe that Public Health England was the right structural approach, as was the transferring of public health responsibilities to local government. We lose tens of thousands of lives prematurely every year because of smoking, alcohol abuse, poor diet and inactivity. During the pandemic, deaths in all of the older age groups were much exacerbated by obesity and diabetes.
So improving our public health, including by enhancing our environments, reducing inequalities, increasing physical activity and reducing average calorie intake—with less alcohol abuse and drug misuse, and stopping smoking—would be central to our future health security every bit as much as the investment in surveillance and the response to infectious diseases. There is a case not only for the changes proposed in the Bill, but to go further and reintegrate the public health function in an agency that leads for this purpose both across government and in society.
It is also worth noting that health creation operates at four levels: the health of each of us as an individual is intimately connected to the health of the local community in which we live, to the health of wider society and to the health of the planet. I will think about this while turning specifically to the Bill and its focus on health promotion and sport. Health promotion as usually described is generally about the individual, lifestyles, activity and diet. It is also about the important point that the noble Lord, Lord Addington, made about walking, rather than physical activity in general, which has been recognised since the Greeks as being vital to health. As the noble Lord pointed out, what he is proposing is also about sociability and bringing people together, creating purpose and creativity. I am pleased to see that he has included nature in the Bill. It is also about self-respect, being successful and achievement. All these factors are for the individual as well as for communities: bringing people together, sharing and community facilities. It is also about opportunities in a wider sense, and sport has long been a driver for social mobility. As he has drafted the Bill, it is also about the planet, nature and the environment.
I commend the noble Lord for the Bill, with its focus on health promotion, sport and wider physical activity, and for promoting a national plan for sport. This is not the whole story—of course it is not; he does not present it as if it were—but it is a very important part of a health-creating society. As he said very eloquently in his speech, the public get this; this is a win-win because people will understand why the Government, in creating a health-creating society, are promoting sport in this way.
I ask the Minister whether the Government will recognise that they need to think about three distinct elements of health—health services, prevention and health creation; each distinct but linked to the others—and whether they will promote health creation. Finally, I say to the Minister that many people and groups around the country are actively involved in creating health. Would he be willing to meet representatives of the Health Creation Alliance, which brings many of these groups together?
The Health Promotion Bill contains potential and important milestones to achieve better services. However, I would like us to pay the requisite attention to ensure that the issues of workforce balance, leadership in commissioning and senior management, and board representation are given equal attention and support. I welcome this Bill and agree that the national plan must be integrated, as has been said. What it does not explain is how we will set and benchmark standards, how implementation will be monitored, or how this will be embedded within the equality framework. This must be based on an absolute commitment from the Government to address workforce balance and leadership in commissioning and senior management. This must be a perquisite to the changes that are required.
This new office can flourish only with the determination of better collaboration which integrates sufficient resources and a commitment to achieving this, and by placing at the heart of any changes the service users and leadership which reflects all the communities in which these services are based.
My disappointment at the Government’s apparent apathy and my sympathy for my noble friend the Minister leads to my empathy, since I completely understand and share the concerns of the noble Lord, Lord Addington, in bringing forward this Private Member’s Bill. I share the noble Lord’s concerns about the lack of progress, but I am afraid that I will have to respectfully disagree with some of his Bill. One reason why I welcomed the establishment of OHID is because I hope that having the word “disparities” in the name of the organisation will force it to do what it says on the tin—that is, to identify and address health disparities, as the noble Baroness, Lady Uddin, said. This reminds me in some ways of the debate when many noble Lords asked for mental health to be explicitly on the face of the then Health and Care Bill, even though health is generally understood as both physical and mental health.
Whether we term it health improvement, health promotion or health creation, I know that noble Lords agree that it is important, but I hope that we can move on from the debate around health improvement, which seems sometimes to be reduced to the question of whether you burn off calories versus reducing calorie intake. It should not be a question of either one or the other. We can argue about the data and whether reducing calorie intake is more effective than physical activity, but surely the important thing is to encourage both. Indeed, some believe that physical activity may lead to less calorie consumption. A 2019 article in the International Journal of Obesity concluded that
“15-week exercise training appeared to motivate young adults to pursue healthier dietary preferences and to regulate their food intake.”
But everyone is different. There are also studies of people with eating disorders doing excessive exercise followed by binge eating, so we really need to understand it at the level of the individual.
I think that most noble Lords would agree that we should all do more to encourage physical activity. Fortunately, a lot has changed since my youth, when it was about selecting the best and forgetting about the rest. If you did not make the first or second team, you were more likely to be discouraged and give up. Unlike the noble Lord, Lord Addington, I am unable to refer noble Lords to the register of my interests, although I really wish I could for this debate. I was still playing five-a-side football into my 50s and playing with people 30 years younger, and my wife expressed some concerns. I needed allies, so I went to see my physiotherapist, hoping that she would be my ally, and she said, “I’m afraid I agree with your wife—you should give up playing football with people 30 years younger than you.” But that does not stop one from doing physical activities. Nowadays we see more clubs in local communities encouraging people to play sport, no matter their ability. We also see an emphasis on physical activity rather than just sport, encouraging individuals to find the physical activities that they enjoy the most—or perhaps dislike the least.
During my brief time in the Department of Health and Social Care, I became interested in the idea of social prescribing, helping people with physical and mental health conditions through the power of music, the environment, arts and physical activity. I recognise that there is scepticism from some clinicians, but I have heard of so many positive stories of people for whom it worked. But with an ageing population and increased pressures on the state, we should also remember that the state cannot do this all or alone. We need to encourage more local neighbourhood civil society groups, which better understand the people in their local communities. By asking the Government to be more involved, we should be wary that they do not squeeze out civil society but better co-operate and co-ordinate cross-government initiatives in partnership with it.
To sum up, I am disappointed by the Government’s apparent apathy in promoting better health. I sympathise with my noble friend the Minister, since none of this is his fault, and I empathise with the noble Lord, Lord Addington, and his frustration at the lack of progress, even though I disagree with renaming OHID. I end with a question to my noble friend the Minister. Now that the health promotion task force no longer exists, how will the Department of Health and Social Care drive cross-government action to improve health outcomes?
My second point relates to my time as Sports Minister for Wales from 2000 to 2003. We started work on a sports and activity strategy specifically linked to promoting good health. As part of that work, we did an analysis of grant funding from what was then called the Sports Council for Wales. On the face of it, it all looked okay. We did proper due diligence, and officials checked that the money had properly been spent, and so on. There was nothing suspect or dubious, such as VIP lanes. However, I could immediately see, at a glance, that it was badly skewed towards football, rugby and cricket—male-dominated sports—and very often to areas that were more prosperous. A proper alternative analysis showed that the vast majority of money went to men and boys’ sports clubs which were well established and had buildings, facilities and pitches of their own, and so on.
So, on equality issues, Sports Council funding failed women, girls, young people, people in poorer areas and people with disabilities. It also failed newer sports and their development—the sort of thing more likely to bring in a wider range of people. In other words, it failed the people and communities who needed it most. We therefore had to rethink the whole thing, putting equality at the centre of it and making sure that we addressed the issues of capacity to make bids and so on. We set up a small bids fund for small amounts of money, for example. I emphasise, therefore, the importance in Clause 1 of the reference to tackling discrimination. That is a key part of this Bill.
Finally, the Bill states in Clause 3 that it extends to England and Wales. I raise this question with my noble friend, because health, sport, education, transport, housing and local government are all devolved to the Welsh Government and Senedd. It is therefore important that we take into account that there is variability across Wales, and that this would need a legislative consent Motion from the Senedd if it were to become law. I will end with this thought: Wales is small enough to be a very good pilot project for this way of thinking.
“one of the most lazy, inactive nations in the modern world.”—[Official Report, 4/2/22; col. 1208.]
So I would like to put a number of questions to my noble friend the Minister today. I accept that he is not responsible for enacting the outcome of these questions, but it is an opportunity for the House to hear the reasons why we continue to slip further behind countries around the world in promoting participation in sport. None of us is talking about elite sport; we are talking about participation. It is there where we need to develop measures to ensure that sport and recreation facilities operate as safe and non-discriminatory environments. We need a healthier, more proactive population, yet we have dropped the clear benefits of implementing the Prime Minister of the day’s full commitment to establishing an office for health promotion, to place prevention through an active lifestyle in all its connotations at the centre of our approach to the National Health Service.
I therefore ask the Minister: what work has been undertaken by the DfE to increase the number of schools making physical activity facilities available to communities after school, at weekends and during the school holidays through the opening of school facilities programmes? How many schools have built closer and reciprocal links with local, grass-roots sports clubs? Where is the physical activity facilities strategy, capable of improving everyone’s access to opportunities to be active? Can the Minister report on whether we have doubled the Sport England local delivery pilots this year —or can he at least indicate what progress has been made on this fund? Have the Government moved forward with the healthy schools rating scheme, strengthening the physical activity elements, improving the response rate and increasing its visibility and use among schools?
Does the Minister agree that the DfE should pursue a six-sports pledge to promote the ambition that all children experience at least six different types of sport and physical activity through curriculum PE, extracurricular and out-of-school provision? Why did the Government drop the idea of introducing a summer activity challenge, linked to schools and holiday provision, and creating a 10-week summer activity programme this year and beyond for every school child, not just the enthusiasts? What additional active travel interventions have been delivered this year to promote health and well-being in society as a whole?
What is the current status of social prescribing—admirably referred to by my noble friend—and how successful have the pilots been? Is it the intention to roll these out nationally, because they should be? What is the current level of cycling training programmes for children, which was announced over a year ago? Has Bikeability reached its objective of widening participation from its baseline of 60%? What has been done to embed active design principles into national planning guidance as part of the review of the National Planning Policy Framework?
These are just a few of the vitally important areas that my noble friend in sport—as I always refer to him—the noble Lord, Lord Addington, seeks to embed in his legislation into the office for health promotion’s activities. Can the Minister report why sport and recreation are still on the fringes of government? Why has this portfolio not been moved to a department of state, in this case the Department of Health and Social Care, and why are we destined to reflect that, despite the cross-party support in your Lordships’ House, we meet today, 10 years on from the hugely successful London Olympic and Paralympic Games, having failed to take forward a true sports legacy?
The Bill of the noble Lord, Lord Addington, is not only necessary but signals to the Government the need to act—if it is not already far too late. I wish my noble friend the Minister well in persuading his colleagues and ensuring that the current Government deliver on the undertaking that Prime Minister Boris Johnson publicly welcomed.
I submitted a Written Question to the Cabinet Office on 24 November:
“To ask His Majesty’s Government what assessment they have made of the public health impacts, including on loneliness, lack of opportunities for physical activity and provision of services locally … of the sale of public buildings and spaces each year in England.”
I got the Answer a couple of days later, quite surprisingly; it perhaps suggests not a great deal of involvement. I was told:
“Any decision … will consider social cost and public value, in line with HM Treasury Green Book guidance.”
I think the noble Lord, Lord Addington, is really making a point in this Bill about the need for a change of mind in the Government: they need to regard physical activity and sport as a crucial issue, which I do not think the Answer I received suggests that they currently do.
This is not a new situation. I draw noble Lords’ attention to an interesting campaign just launched by the Carnegie UK Trust and Fields in Trust charities, with the hashtag #FieldFinders. It is looking to find lost playing fields. Between 1927 and 1935, the Carnegie UK Trust gave nearly £200,000—£10 million in today’s money—for nearly 900 playing fields across the UK. It is interesting because, as is often typical with history, it did not keep a record of where they all are, so now it is asking the public to help find them and, very interestingly, to find out how many of them are still playing fields. Because that money was given so that those fields would continue to be in use in perpetuity. I think I can guess the result: it will find that many of them will not now be playing fields.
That is focusing on playing fields, but of course the space that is very near every child, every person, is a road. Again, we have seen not government leadership in this area but civil society leadership in the form of the Play Streets campaign, which started in Bristol in 2011 and has since grown around the country. This is a scheme by which streets are temporarily but regularly closed off to become sites of play, organised and managed by people in the neighbourhood. Of course, these are not just sites of play; they are sites of interaction. What this campaign is saying is that we need a long-term culture change: it needs to be safe for children to play out on the streets all the time.
I say many radical things in your Lordships’ House; I suspect that many might regard that as the most radical, but let us think about recapturing the streets for people. That is the space we all need to be able to use freely, without danger, and, circling back to my noble friend’s Bill, in a clean air environment. That would be a huge step towards a radical society and one which, as the Bill of the noble Lord, Lord Addington, makes clear, is absolutely a government responsibility.