Chamber and committees

We had a long discussion about that earlier.

I know that time is against us, but I have a final question. I have been on your website and I looked at your X account. You have 6,000 followers, or maybe fewer than that, so that is certainly something that can be improved. I did not see anything about portions on your website or X account. The size of our plates has gone from a side plate to what used to be a serving plate. Portion control is possibly one of the most important ways to have a healthy, balanced diet that allows calorie control and allows us to think about what we are doing. Using hands is a great way of doing that. Do you have any thoughts on that and how to promote it?

Thank you.

I declare an interest as a practising NHS general practitioner.

Thank you for joining us, Dr Cass. I have grave concerns about the use of puberty blockers for children, given the paucity of evidence and given that the early intervention study did not demonstrate benefit. I feel that ideology and dogma have no place in medical treatment. Given that you have stated that young people’s gender identity is “fluid” and that there is “no hierarchy”, do you feel that there is an age where it becomes more fixed?

Certainly, the things that I believed when I was a child are very different from the things that I believe now, as are the things that I feel are or are not important.

In your report, recommendation 8 states that we should be looking to prescribe medication at 18, and recommendation 6 states that we need a trial. If medication were to be given below the age of 18, would it be appropriate for that to happen without parents’ knowledge, or do you feel that 18 is the right point? Also, given your previous statement, why did recommendation 8 state 18 as the age?

I have major concerns about private treatment. Throughout your report, you talk about a multidisciplinary team approach; it is, in fact, mentioned in recommendation 9. In that case, should a single private practitioner be prescribing medication? Is it appropriate for that to occur?

I will come back to schools. I do not particularly want to start banning things, but let us look at a meal deal from a supermarket. You get a sandwich, a drink and something else for a set price. I do not know many people who would choose a single banana over that massive chocolate bar. If we just look at value, a single banana in Aldi is 16 pence but the chocolate bar is £1-something, so people will go for the thing with value. Should we not be encouraging the supermarket to give that single piece of fruit, which has a very low value to the supermarket, free with that meal deal, regardless of what else someone is choosing? Maybe the person would choose to eat the fruit instead of the chocolate and save that for later and maybe not even eat it.

On that point, the supermarket knows everything about me through all my cards. I do not know, but they might even track the way that I walk through the supermarket. What we do know is that the most valuable spaces are the shelves that are at eye level, the end-of-aisle shelves and what you see when you walk in. Again, if you look at a Lidl or Aldi, it is fruit that you come to first, which is not always the case. In a lot of other supermarkets, you come first to that high-sugar content. Should we be looking at legislation or other ways of making sure that healthy foods are in the premium places rather than unhealthy foods, which I think is the case right now?

Certainly, a lot of people who speak to me say that Irn Bru has been ruined by reformulation. [Laughter.]

This is a big topic and it is not fair to give you just one question on it, but I want to ask you about school meals. We need to see big healthy choices for school meals, and they should be encouraged over other types of food. Do you feel that the best place to start is with very young children in nurseries, where teachers possibly have the time to introduce different flavours and tastes to children who might never have experienced that type of food? Teachers could help them to make those choices as they go through the school environment, so that the children actively make the choices.

I declare an interest as a practising NHS general practitioner.

Dr Fletcher, at the start of the meeting, I think that you said that funding was not an issue.

You are of course right, with the new GP contract rewarding those in better-off areas, with more money going there.

I want to focus on rehab. I visited Rainbow house in Glasgow, which is a residential rehab programme that offers peer support through volunteers. I spoke to three of the peer-support volunteers. It was a fantastic experience. The volunteers were very clear on what they wanted me to raise and discuss: it was to ensure that people who ask for help get it in the way that they ask for it and in a timely manner. They said that peer support is the best way of getting through to people.

I have another example from when I visited an innovative, award-winning Glasgow rehab facility. The person who works there as the only real employee is a former user who now does community outreach. He has seen a huge drop in the number of people using drugs. His funding has been cut, however. Those at Rainbow house are worried about their funding, too. How can we get people to stop consuming drugs if we are not funding rehab?