§ 6. Miss Anne McIntosh (Vale of York) (Con)
If the Government will make a statement on the role of exercise in preventive medicine. 
§ The Minister for Sport and Tourism (Mr. Richard Caborn)
Inactivity is inextricably linked to obesity-related diseases, and to psychological illness. A key objective of the Government's investment in sport and physical activity is improved public health in those areas. The activity co-ordination team is producing a 17-year national activity strategy across nine Departments to increase activity levels.
§ Miss McIntosh
Can the Minister confirm that the level of activity that used to take place among young people—particularly in schools—has fallen dramatically between 1997 and 2004? Does he agree that obese children have a tendency to grow up into obese adults? What proposals do the Government have to tackle the growing level of obesity that is due in no small part to lack of exercise?
§ Mr. Caborn
The reference period 1997–2004 is probably driven more by political considerations than by the reality of obesity. A child 30 years ago had 70 per cent. more physical activity than a child today. That is the structural weakness that we have in the system for all sorts of reasons, one of which could be the built environment.
We have discussed the issue of children being taken to school by car rather than cycling. We are tackling the matter in what I hope is a holistic way. Sport England has recognised that sport will comprise only approximately 8 to 10 per cent. of the physical activity of the nation, so 60 or 70 per cent. will have to come through a different type of activity. Sport England is addressing that matter—along with the Department for Education and Skills—by setting up 400 sports colleges and 3,000 school sports co-ordinators. For the first time, we will have a sustainable structure within the education system that governing bodies and others involved in sport can lock into.
§ Miss McIntosh
The Minister will recall that at departmental questions I raised the issue of the increasing burden that the Government are placing on local authorities, and especially in relation to sports facilities. I refer in particular to coaching levels. Each and every one of us can point to a sports project that is affected in that way. For example, in my constituency there are the playing fields in Poppleton and a bid for an all-year-round tennis court in Bedale, and there are many other projects within the Vale of York.
477WH How does the Minister expect local authorities to meet the additional commitments that he has outlined to us?
§ Mr. Caborn
It is very simple. We are investing well in excess of —500 million in the local education authorities. There is also likely to be some new thinking about sports facilities. Although open spaces and playing fields are very important, the generation of tomorrow demands a little more than that. The private sector is showing the way. If one looks at how JJB Sports has developed indoor five-a-side, or one goes to Trafford, where 24 indoor pitches are booked a year in advance, one sees that the demand for such facilities is considerable.
We need to invest in indoor facilities, as well as in the new surfaces with floodlighting—and we are investing in them. We are also investing just under £30 million in developing a new coaching structure and the national coaching certificate, and we will employ some 3,000 community coaches during the next two to three years. For the first time we will have a recognised national coaching certificate, which every governing body has bought into. Coaching will become a profession. That is a major advance, and it will help us to develop the amateur clubs up and down the country.
§ Huw Irranca-Davies (Ogmore) (Lab)
On the role of exercise in preventive medicine, in a previous incarnation I was an advocate and a practitioner of exercise on prescription and GP referrals on the leisure side. However, GPs had difficulty in persuading people that exercise rather than a prescription at the local chemist was the solution; another obstacle was the difficulty of keeping people on such schemes. Will the Minister or one of his colleagues advise us on what the state of play on exercise and prescription is, and on how we can take that very beneficial scheme forward?
§ Mr. Caborn
Perhaps we can have a double answer to that. I want to deal with what has just been said on coaching. It is very important to get that into context. We would like to see multi-skilled coaches, obviously specialising in sport and exercise, but trained to go into a doctor's surgery and help on questions of obesity and related issues. They would be able to work with the National Association for the Care and Resettlement of Offenders and the probation service or be able to help develop and deliver sport in primary schools. We will expect the new coaches to be multi-skilled in a number of areas, one of which will be health. My colleague the Health Minister has also been active in this area. She may want to say a word.
§ The Parliamentary Under-Secretary of State for Health (Miss Melanie Johnson)
Exercise referral is an important tool available to GPs, and is increasingly used by them. I was in Manchester a week or so ago, where a big scheme is running that involves a lot of exercise-referral prescription. I agree with my hon. Friend that sometimes it may be difficult to persuade patients. We hope that the debate about the role of physical activity and diet for the public health White Paper will help to convince people.
§ Mr. John Randall (Uxbridge) (Con)
I think that I heard the Minister for Sport and Tourism saying that 10 per cent. of exercise in schools came from sport. What is the other 90 per cent. made up of?
§ Mr. Caborn
I think that the hon. Gentleman misunderstood. I said that between 8 and 10 per cent. of the nation's activity comes through sport. The rest comes from gardening, DIY or walking to work rather than going by car, for example. That is where the bulk of the nation's activity is. A third of the nation is physically active, according to the World Health Organisation definition, and another third could probably be persuaded to be that active, but it would be pretty difficult to persuade the final third.
§ Mr. Malcolm Moss (North-East Cambridgeshire) (Con)
According to the national food survey, we consume less energy per household now than in the 1970s. That would suggest that the principal cause of rising levels of obesity is changes in energy expenditure rather than an increase in energy intake. Does the Minister agree? If so, does he accept that his Department should lead in tackling the problem of obesity, which, as the Joint Committee report published this week suggested, is a growing problem?
§ Mr. Caborn
There is no lead Department as such; one of the problems has probably been that we have not been thinking the issue through in a holistic way. From the media reports yesterday, anybody would think that obesity has come about in the last couple of weeks. It has not. A National Audit Office report published 18 months to two years ago clearly showed that that was the trend. I agree that physical activity is a major part of the problem. For the first time, life expectancy in the US and UK is decreasing. The cost of obesity to the economy will rise to about £3.5 billion by 2010. It is a serious issue that must be tackled across Departments.
The hon. Gentleman is right that as we move to a post-industrial society in which physical activity has been removed from our daily lives, we must for the first time consciously build it back in. That is something new for Governments to tackle. Calorie intake is roughly the same as 30 years ago, but the level of physical activity has decreased, and the quality of food—the content of fat, sugar and salt—has changed.
§ Miss Johnson
I want to add to my right hon. Friend's comments and remark that, although he is broadly right about the intake of food in the house, there is a question about how much food intake there is outside the home, and that contributes to the problem. Physical activity and diet are both aspects of the problem. It is wrong to emphasise one at the expense of the other. We must decrease the food intake and considerably increase the physical activity.
§ Mr. Moss
The Minister for Sport and Tourism accepted that his Department has an important role, if not the lead role, to play. Why then has it presided over a decline in the amount of time spent on sport and physical activity by five to 16-year-olds since 1999? That has been a continuing decline, as the recent report by Sport England confirmed. Furthermore, why has his Department reduced the commitment, first announced 479WH in October 2002, that all five to 16-year-olds will have access to at least two hours of high quality PE and school sport by 2006? That was reduced in the most recent public service agreement to only 75 per cent.
§ Mr. Caborn
That is a bit rich coming from a Conservative Member on the subject of facilities for physical activity.
§ Mr. Caborn
No, it is not true, because we have given a commitment to provide two hours of quality physical activity or sport for every child from the age of five to 16. We have had to invest, because the lack of investment over the previous 15 to 20 years left us in a difficult position. We are now investing more than £500 million through local education authorities to achieve that objective and to arrest the serious problem that 75 per cent. of young people do not continue active sport on leaving school. Therefore, a precondition of the investment through the local education authorities is that facilities will be open to the community.
We are working with the governing bodies on the club-to-school links. I know that the hon. Gentleman was there a week last Monday when I announced that 15 more governing bodies will link their clubs to schools. That will at least start to arrest some problems that young people have when they leave school. We are on course to achieve the target of two hours of quality physical activity or sport, but we have to work through the backlog of under-investment that we inherited on coming to power.