The following amendments have been selected: amendment 1 in the name of Lesley Griffiths, and amendment 2 in the name of Siân Gwenllian.

Welcome back. The next item is the Welsh Conservatives debate on obesity. I call on James Evans to move the motion. 

Motion NDM7903 Darren Millar

To propose that the Senedd:

1. Expresses its concern that nearly two thirds of adults in Wales are currently overweight or obese.

2. Notes that COVID-19 has a disproportionate effect on those living with obesity, with more than half of critical care admissions having a BMI of over 30.

3. Further notes that weight-management services were paused or adapted as the Welsh NHS treated COVID patients.

4. Calls on the Welsh Government to:

a) urgently reopen those weight-management services which have been paused during the pandemic;

b) indicate when specialist multidisciplinary weight-management services will be expanded across Wales; and

c) provide extra funding to ensure that weight-management services are able to cope with increased need.

Motion moved.

Diolch, Deputy Llywydd. I move the motion in the name of Darren Millar. Obesity is one of the biggest health crises the world faces. For the first time in history, children are expected to live shorter lives than their parents, and most of this is due to obesity. COVID-19 has exposed the poor physical health of Wales. We have the highest death rate for COVID-19 per 100,000 of any of the UK nations, and currently, two thirds of the population is overweight or obese. It is clear that the physical health of the nation must be a priority for the Welsh Government, and for the Minister. Figures published by the Welsh Government's own StatsWales highlight that nearly two thirds, or 61 per cent, of those over the age of 16 in Wales reported in 2021 a body mass index of over 25. 

Being overweight substantially increases the risk of a number of chronic diseases. In particular, those who are overweight are at specific risk of developing type 2 diabetes, hypertension, cardiovascular disease, strokes. It also causes kidney disease, certain types of cancer, sleep apnoea, gout, osteoarthritis and liver disease, just to name a few. So, the case for prioritising obesity is clear. Obesity is projected to cost our Welsh NHS £465 million a year by 2050, but almost £2.4 billion to the Welsh economy and society as a whole. These costs will potentially deny life-saving, life-prolonging treatments to the patients in our Welsh NHS who need them. 

Figures from Cancer Research UK show that being overweight is the second biggest cause of cancer in the UK. More than one in 20 cancer cases are caused by excess weight. Cancer research also highlighted that keeping a healthy weight reduces the risk of 13 different types of cancer. We all need to work together on this. This is an important issue, and I think we should put politics aside. We all need to be rightly concerned that nearly two thirds of adults in Wales are currently overweight or obese. I'm sure everyone agrees that is a worrying statistic. 

In 2021, the Welsh Conservatives stood on pledges to improve the physical health and well-being of the nation by providing free access to local authority gyms and leisure centres for 16 to 24-year-olds. We said we'd invest more money in active transport, walking and cycling and that we would promote healthy lifestyles in schools. We did say we'd create a community sports bounce-back fund, and I'm really keen that Ministers have actually looked and put this in place. We all know the saying 'prevention is better than cure', but, sadly, we don't actually do what we preach. 

Maybe I'm just an overenthusiastic political newbie here, an idealist, someone who believes that things can change. I don't believe we should stick to the status quo. But what is the alternative here? For two decades, politicians and Ministers in this place have talked on this issue. They've created strategies, had public consultations, gone back and forth, back and forth, but we're getting nowhere, because things in Wales are getting worse. The world has changed, and we must understand that. People are living far more static lifestyles than before. In this place, we tend to sit down a lot of the time and don't live that active lifestyle. If you're overweight or obese, you need to do that because you are putting yourself at extremely high risk of becoming unwell. 

Lots of ideas have been tried, including sugar taxes and huge spending on public messaging, so why aren't we seeing the results? I think we need to move away from the current ideas and policies in place, and try and look at this from a strategic, objective standpoint. There's clearly a significant problem with the quality of food being consumed, not just here in Wales but around the world. But people aren't talking about obesity and taking it seriously. Being obese is as dangerous as being a chain smoker or an alcoholic, but it doesn't seem to have the same sort of public image as what those things do, about living a healthy lifestyle. We're all feeling the consequences, not just here in Wales but globally. Diabetes was virtually a non-existent disease in the nineteenth century. In the United States a bit ago, the percentage of diabetics was one in 10,000, and research now shows that's one in 11. That's a startling statistic. 

Diet has changed, though. We've gone from real wholesome foods to processed foods, low-fat processed foods to high-sugar processed foods. This, combined with the fact that people haven't got as active jobs as they used to have, that people are more stagnant, means we're seeing obesity get worse, because too many people in our schools and wider are just simply not educated about food and where it comes from. People do need to start living a healthy, balanced and active lifestyle, and that needs to be promoted by Government. This can be addressed by some of the points that I raised earlier around promoting healthy lifestyles in school, encouraging sport, free gym access for local youngsters and teaching people where their food comes from.

I believe we need to see a full-scale change of approach towards tackling this issue. The policy raised here by the Welsh Conservatives, Plaid Cymru, who unfortunately are not here, the Liberal Democrats—. Everybody in this place has good ideas, and not one party has a monopoly on those. So, I welcome all ideas, and I welcome almost everything the Plaid Cymru amendment said. So, I hope, today, we can back the changes, and the Welsh Government will put the support into place to hold a full-scale review of obesity strategy, because doing nothing simply is not good enough. If we do nothing, this will become the biggest health crisis of a generation. Diolch, Dirprwy Lywydd. 

Before I move on, just to highlight the fact that there are Plaid Cymru Members online who are taking part in this debate. 

I have selected the two amendments to the motion. I call on the Deputy Minister for Mental Health and Well-being, Lynne Neagle, to move formally amendment 1.

Amendment 1—Lesley Griffiths

Delete point 4 and replace with:

Acknowledges:

a) the new 2022-24 delivery plan, due to launch on 1 March, which supports the Healthy Weight: Healthy Wales Strategy and aims to prevent and reduce obesity over the next two years.

b) the £5.8m investment into obesity services accompanying the plan, to enable health boards to deliver a revised All Wales Weight Management Pathway and equitable services, including specialist multidisciplinary weight-management services in Wales.

Amendment 1 moved.

Formally. 

I call on Rhun ap Iorwerth to move amendment 2, tabled in the name of Siân Gwenllian. 

Amendment 2—Siân Gwenllian

Add as new point at end of motion:

Calls on the Welsh Government to prioritise preventative measures to reduce obesity in Wales, such as:

a) investing in resources to promote physical activity in all communities; 

b) improving health education; 

c) increasing the time allocated to physical education lessons in schools;

d) Investigate the use of taxation tools to encourage a better diet.

Amendment 2 moved.

Thank you very much, Deputy Presiding Officer. I thank the Conservatives for bringing forward this motion before us today. I will make some comments and mention our amendment.

I certainly don't disagree with what is in the original motion, and I've certainly tried to do what I can over the years to voice my concerns about the impact of obesity. It broke my heart to see Anglesey, some years ago, at the top of the national table in terms of how many children were obese, and that's why you'll hear me call for investment in physical activity and so forth. And that's what's missing from this motion, I think. You can't talk about the problem of obesity and the need to invest in weight management services without taking that step back and looking at the bigger picture. And I do welcome the clear suggestion there that the Conservatives will support our amendments because of that.

If obesity is a global pandemic, and it is, if being obese does increase the risk of chronic illnesses, diabetes, if it is one of the main causes of cancer, if it imposes great costs on health services, if it decreases people's living standards, if it leads to psychological problems, and it affects two thirds of the people in our country—well, we need to go to the core of that problem, don't we, from birth, and we need to tackle the preventative agenda.

As a paper that I read in the National Library of Medicine in America says:

'The most promising strategies are education and efforts by individuals to make responsible choices several times every day to protect, most effectively by prevention, their most valuable asset.'

There's nothing more valuable than our own health, and somehow we have to ensure that we do invest in all of those things that are going to give the best possible start to people in their lives. Our amendment talks about resources for promoting physical activity, improving health education, more time for physical education. I welcome the pilots that are currently taking place on the school day to create more time for PE. We talk again about the idea of having some kind of levy on the least healthy foods. In Mexico, there was a 10 per cent reduction in the consumption of unhealthy foods after a tax was introduced. Let's look at all of these things in their entirety. We've used the word 'pandemic' a lot in another context over the last two years; this is a genuine pandemic and we need to look under every stone to look for the solutions.

I very much agree with the sentiments expressed in terms of the importance of obesity and tackling obesity if we are to create the sort of Wales we want to see in terms of health and well-being. It is a major challenge and it has been for some time a growing challenge, and we do need to make sure that the NHS responds effectively when people have health problems connected with obesity. But I very much agree that, beyond that, we need to move much more onto the preventative agenda, and I do believe that schools are absolutely crucial. 

We had Tanni Grey-Thompson's report talking about the importance of making sure that our young people, our children, get into good habits early on that will stay with them for life; the importance of the school curriculum in ensuring that children are active enough in schools, they realise the importance of staying fit, active and healthy, and that there are those extra activities beyond the school day. Because I think we all know that some children get the mum or dad taxi experience where they develop their interests and their abilities through sport and activity and other extra curricular matters. Other children, particularly children in more deprived communities, do not so often get that experience, but they will get it, hopefully, through school if it's provided at the school during or beyond the school day. I really think we need to ensure that we do everything we can with and through our schools. 

Others are helping that effort. In Newport, for example, Newport Live, which is the leisure trust, has a school sports programme and makes its facilities available to schools and works with our schools. They're also very active in the community, dealing with those deprivation factors around inactivity. They have a Positive Futures programme, for example, which reaches out to communities. They also work with the NHS through the Wales national exercise referral scheme, and we have Newport county's County in the Community arm working with schools providing a six-week programme for 900 nine to 10-year-olds every single year, and they are also reaching out into our communities using facilities to deliver sport and activity throughout the year. They do find, though, during the winter months, that half of that community outreach programme has to stop because there isn't lighting at some of those facilities, and they also find that the surfaces aren't everything they should be, and I think that's something we should look at addressing through Welsh Government, local government, Sport Wales and other partners to ensure that the facilities are up to the mark. And similarly for all those grass-roots sports clubs, such as Undy football club, for example, which has over 500 people active on a weekly basis—lots of youngsters, girls, women, getting active, enjoying sport and also enjoying the social aspects. I do believe we need to provide more support to these community players, Dirprwy Lywydd. Diolch yn fawr.

Thank you, Deputy Llywydd. Can I thank James Evans for bringing forward this important and timely debate? And as everybody in the Chamber I'm sure would agree, obesity is a serious public health issue; James pointed out the issues, as well as Rhun. The Welsh health service—it's costing that millions a year to treat, and things are getting worse. It is an issue that clearly needs to be tackled head on, but, to do so, we need to look more widely at the issue, rather than simply encouraging people to be more active, because, fundamentally, issues like obesity and malnutrition are interlinked with people's diets, which is dependent on the availability and accessibility of food. And so the question is how we improve the accessibility and availability of good quality, nutritious and healthy food to help prevent issues such as obesity in the first place, as well as responding to the various socioeconomic issues that can lead to obesity.

In a recent report, the Food Research Collaboration has argued that a substantial body of evidence has shown that connected integrated policy making is vital for tackling complex cross-cutting issues such as food and obesity, rather than piecemeal policy approaches. This is not necessarily a simple thing to achieve, but the Organisation for Economic Co-operation and Development has previously called on Governments to undertake a stock take of policies relevant to food systems, increasing the evidence base on policy interactions. I think there is also more scope for us to use education as a preventative measure to help improve the health and well-being of future generations. Something that Food Sense Wales has called for is an integrated policy around food in schools, better aligning Government policy to improve food and education, offer more opportunity for local producers to supply more of their products locally and increase the supply of healthy food in schools. This would benefit the environment, improve the well-being of children, and boost local economics. Those overarching aims are something that my proposed food Bill aims to establish. In drafting the Bill, I've heard an increasing body of evidence that points towards the need to rethink how the food system here in Wales is designed and how to integrate issues like malnutrition and obesity into the wider food system to ensure that the various Government policies and plans all pull together in the same direction.

To conclude, Deputy Llywydd, I thank my colleagues for bringing forward this timely debate and urge all Members to support the original motion. This is so important a subject; we can't shy away from it. Thank you.

Thank you very much. James was right to mention that this is a global tragedy. The poorest countries are also the ones who are being absolutely bombarded with advertising of sugary drinks, otherwise known as fizzy drinks, and also processed food, when these countries absolutely cannot afford to treat the diabetes that is the inevitable consequence. So, it is appalling that these multinational companies behave in this way.

The rare countries that do not have the advertising ubiquitous all over the place are the ones that are the healthiest, and we have to remind ourselves that the healthiest that the British population has ever been was during the second world war and afterwards, when we had rationing, and therefore people were unable to eat more than a very small amount of food that was actually poisoning them.

So, obesity is the second biggest cause of early death after smoking, and it will soon overtake it, because we are being very effective in stopping people from smoking. Amongst the many tragic failures of the UK Government is the failure to legislate to have clear, traffic-light labelling on all food products, so people can see just how disastrous particular foodstuffs are for your health. Far too many takeaway food outlets are drowning in fat, sugar and salt, as that is the cheapest way of disguising tasteless food. And it is also how the multinational food processing companies make their billions. So, to counter that is really, really difficult, because people have forgotten how to cook, and we are having to rectify that in everything we're doing, whether it's in our schools or in other community centres. We simply have to revive the idea that you can cook a meal with some very, very simple ingredients, and it's much tastier than anything that's dished up by somebody who's only really wanting to take your money off you. 

So, I do recall a very important move by the then Deputy Minister for Health and Social Services in the last Senedd, which was Eluned Morgan, to ensure that there were weight-management programmes targeted in all local authorities on people were in danger of becoming type 2 diabetic, and I hope that it may it be possible for the current Deputy Minister to be able to tell us how well that roll-out is going, because I think it's an extremely important programme. Prevention is always cheaper than treatment after the event, so this is a way we can definitely try and halt the absolute epidemic in type 2 diabetes. 

I'm grateful for the opportunity to speak in this Chamber once again on obesity, and I thank James Evans for bringing this to the floor today and shining a spotlight on the absolute need to tackle obesity head on once again. Obesity isn't just a cosmetic problem; it's a complex disease and concerning medical problem that increases the risk of major health complications, including many outlined by my colleague James Evans earlier, including heart disease, diabetes, high blood pressure and even cancer.

In 2016, 1.9 billion people were classed as overweight, with 650 million people obese, and worldwide obesity has nearly tripled since 1975—worrying figures. Worryingly, we face a stark picture in Wales. Statistics show that nearly two thirds of people aged 16 or over reported in 2021 that they have a BMI of more than 25, making them obese or overweight. Incredibly worrying, this picture is not good for our young people either, with obesity and overweight levels amongst Welsh children now the highest they've ever been, and they will keep rising unless we act now. Although the Labour Welsh Government have launched numerous initiatives since I've been here under the 'Healthy Weight: Healthy Wales' programme, three years on and it appears that little progress has been made to engrain healthy habits into the Welsh population. 

There are various factors that play into the obesity crisis, one of the recent contributors, obviously, being the pandemic, as was outlined earlier. Over the past two years, we've seen the closure of gyms, swimming pools and even outdoor exercise limited. We saw millions of people forced into inactivity, and this had a truly devastating impact on our nation's health. It's clear that we need a serious action plan to combat obesity. Any forthcoming plan needs to be all-encompassing, a truly cross-portfolio recognition, and a recognition again that prevention is always better than cure. New sporting facilities in all parts of Wales—not just in cities but in rural areas, to give everyone a chance to get fit—are needed, and improved roads so that it's safe and enticing to take up cycling, running and walking. Yet we seem to be governed by an anti-road Labour Party, who have allocated the roads resilience fund quite literally nothing in the budget.

Being the shadow education Minister, in any part of a plan to combat obesity, I want to see healthy, nutritious school meals implemented, and better education on how important a balanced diet is, and how important an active lifestyle is. Prevention and education are always better than cure, and I hope to see this form part of the new curriculum. Crucially, we need to start thinking outside the box, as what we're currently doing isn't working. Why not look at something simple like adult outdoor gyms placed next to playgrounds so that both children and parents can stay fit simultaneously? These are simple, effective and not costly ideas that we need to look at.

To conclude, we need to see proactivity from the Ministers and fresh ideas on how to tackle obesity. It's not enough to think that banning bad foods or adverts will be enough; the magnitude of the economic impacts presented by obesity are so significant, and help us really understand that now is the time for urgent action. We need to encourage and promote lifestyle changes and make it as easy as possible for everyone in Wales to keep fit and lead an active lifestyle. Now is the time to act. Thank you.

I call on the Deputy Minister for Mental Health and Well-being, Lynne Neagle.

Diolch, Dirprwy Lywydd. I'd like to begin by thanking Darren Millar for bringing forward this important topic for debate today. Obesity is a complex condition and it cannot be solved by the Government or by the NHS working in isolation. The evidence suggests that a partnership and whole-system approach is the only way to achieve change.

The Welsh Government's 'Healthy Weight: Healthy Wales' strategy is the first step towards a cross-Government approach to reduce obesity in Wales on a population scale. As a direct result of the Public Health (Wales) Act 2017, passed by the last Senedd, the strategy was launched in October 2019 and is supported by a series of biennial delivery plans. In the development of the strategy, we brought together the best international evidence for change. We're fully committed to utilising all the levers at our disposal, from funding to policy and legislation. Delivery began in earnest in 2019. We set out our ambitious plan to support delivery for 2020-22 and we aimed high. However, the pandemic fundamentally changed the course of our delivery and has more deeply entrenched and worsened pre-existing challenges. Services funding at capacity across Government and key partners were shifted to meet urgent needs caused by COVID-19, meaning that many of the commitments set out in the plan were paused. Our NHS staff were redeployed to areas of urgent need during the midst of the pandemic response, which is where they were needed most.

As we look to be moving past the peak of the omicron wave, health boards are looking to restart existing services whilst continuing with new plans. On 1 March, I will be publishing the 2022-24 delivery plan, which takes this learning from the last two years. This will include a funding commitment of over £13 million over two years. I will be making a statement in Plenary that will highlight the scale and ambition of our plans to achieve tangible and real change. Out of this investment, there is £5.8 million specifically allocated to health boards, which will support the development of equitable person-centred support through the delivery of an all-Wales weight management pathway. This will help to pump prime services alongside wider investment through health boards. The all-Wales weight management pathway is designed to ensure that we achieve parity across Wales. In recognition of the importance of this work, work on it continued in earnest over the course of the pandemic and I was delighted to officially launch it last summer. We know that it will take time to build the required infrastructure as the service evolves, and work is ongoing with local leaders, demonstrating their commitment to progress. A suite of programmes from exercise options to nutrition skills will bring together a life course approach.

Local health boards have planned and developed expansions to access community services at level 2. This will provide a suite of support for individuals to be able to access support at the right time for them. For the first time in Wales, there will be equitable children and families' specialist level 3 services delivered across Wales. We have asked local health boards to prioritise this and advanced plans are in place to enhance service provision. With the support and collaborative working of our primary care professions, there is now a primary care obesity prevention plan to support and drive delivery of the pathway, including making every contact count through person-centred and psychologically informed approaches. And we are building a digital offer at level 1 of the pathway with Public Health Wales. This will be underpinned by a long-term behavioural campaign approach and will provide helpful support and advice for people across Wales. And can I reassure Jenny Rathbone that we are continuing to trial the all-Wales diabetes prevention programme in all health boards across Wales? And I will have more to say about this in my statement on 1 March.

Through our recently published NHS planning frameworks, health boards will be monitored and held accountable to Ministers to ensure that progress continues at pace. Local health boards are also submitting annual monitoring to Welsh Government. We will be supporting Plaid Cymru's amendment today. We're absolutely committed to increasing physical activity opportunities and have allocated £4.5 million funding to invest in community sports facilities, with a further £24 million investment in facilities over the next three years. Health education is essential, and our new Curriculum for Wales includes health and well-being as one of six statutory areas of learning and experience. We are committed to expand physical activity opportunities in schools. We've invested in the winter of well-being and are committed to exploring reform of the school day. Through our 'Healthy Weight' plan, we're also developing a new daily active programme for schools with partners. I'm also keen to explore the use of taxation powers to support a healthy diet, and my officials will scope initial proposals on this matter.

In closing, Dirprwy Lywydd, I look forward to the launch of our 2022-24 'Healthy Weight: Healthy Wales' delivery plan on 1 March, which will ensure that we continue to focus on delivery, recognising the significant efforts that health boards have begun to make. I ask all Members to support our amendment to the motion today. Diolch.

I call on Samuel Kurtz to reply to the debate.

Diolch, Dirprwy Lywydd, and I'm grateful for the opportunity to close today's debate, following some very detailed and informative contributions from across the Chamber. And can I say how wonderful it is to be back in the Siambr, doing what our constituents have voted us to do?

What has been made clear this afternoon is that obesity is a chronic disease caused by health inequalities, genetic influences and social factors, and, as the Royal College of Physicians has said, this is a problem that must be owned by every Cabinet Member across the whole of Government. As the Member for Ynys Môn rightly pointed out, obesity is a pandemic.

The Welsh Government strategy, launched in 2019, was worryingly vague, despite being well meaning and, as the Deputy Minister has just said, was very ambitious. But, despite this, as many initiatives have been, it was sidelined due to the COVID-19 pandemic. The point has been made that it is vital that we get this back on track with urgency and we'll be keeping a close eye on this.

The Member for Brecon and Radnorshire made it clear in listing the illnesses, ailments and diseases that obesity can exacerbate, and the Member for Newport East highlighted the point of preventative measures to alleviate burden on the NHS. The Member for Cardiff Central made reference to the poor quality of food, and I agree with her, so all I can do is urge her and her constituents to back British, back Welsh, buy locally sourced produce of high quality, including meat and dairy, which is not only high quality, but healthy and environmentally sustainable.

The Member for Newport East also highlighted the fact of lack of facilities of high quality, and the Deputy Minister did make reference to the funding available. But this point was also referenced by Noel Mooney, the Football Association of Wales's chief executive, at the recent cross-party group on sport, which is chaired by my colleague, Laura Anne Jones, who made the correct point in stating that obesity isn't just a cosmetic problem; it's also a health problem as well.

There is no one-size-fits-all approach to tackling obesity, and every individual is different, but there have always been common themes. I hope the Welsh Government take note of our debate today and re-energise their efforts to prioritise tackling the problem of obesity in Wales. Therefore, I urge all Members to show their commitment towards the battle of the bulge and support our motion. Diolch yn fawr.

The proposal is to agree the motion without amendment. Does any Member object? [Objection.] Yes. I will therefore defer voting until voting time.

Voting deferred until voting time.