Meeting of the Parliament

Meeting date: Tuesday, January 24, 2017

Official Report 879KB pdf

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World Cancer Day

The final item of business today is a members’ business debate on motion S5M-3275, in the name of Donald Cameron, on world cancer day: an opportunity to tackle obesity. The debate will be concluded without any question being put.

Members are allowed to take interventions in a members’ debate. It is the same as any other debate, in case there is some misconception lurking.

Motion debated,

That the Parliament notes that 4 February 2017 marks World Cancer Day; understands that it is estimated that one-in-two people will be diagnosed with cancer at some point in their lives; notes that Cancer Research UK highlights that four-in-ten cancers are preventable and that obesity, after smoking, is the single biggest cause of preventable cancer in Scotland, including in the Highlands and Islands region, and that it is linked to 13 types of cancer; understands that figures show that two thirds of adults and over one quarter of children in Scotland are now overweight or obese; notes the calls on the Scottish Government to take bold action in its new diet and obesity strategy to help tackle the problem; considers that tackling obesity would help to "scale down cancer", and notes that MSPs can show their support for World Cancer Day through the wearing of its unity band.

17:37  

I open by thanking Cancer Research UK for providing the impetus for this debate about world cancer day, which takes place a week from next Saturday, on 4 February 2017.

Given the nature of cancer, and the importance that society places on fundraising to find cures and to support people who suffer from cancer and to assist their families, I feel incredibly privileged to be able to open the debate, and I look forward to speeches from across the chamber. Similarly, I am delighted that the motion has received so much support from across the chamber.

However, that is not surprising. Given that it is estimated that one in every two people will receive a cancer diagnosis at some point in their life, it may be safe to say that everyone in the chamber and the gallery will know at least one person who has either battled cancer and survived or who has, unfortunately, succumbed to the disease. We will all have family members who have died from cancer—my grandfather and uncle, for example. Far too many people die from cancer, and although cancer death rates in Scotland have fallen by a fifth over the past 20 years, the incidence rate has risen.

Referencing a report from Information Services Division Scotland, Cancer Research UK has highlighted that, on current trends, the number of new cancer cases is expected to rise by a third by 2023 to 2027, which is simply staggering. We know that there are many causes that result in people developing cancer. In some cases, it is genetic. In other cases, it can develop as a result of an infection, or it can occur from exposure to a variety of natural and man-made elements. In those instances, there is little that we can do to prevent cancer occurring.

A matter that has been raised in Parliament recently is cancers that develop as a result of poor working conditions, including mesothelioma, which is a disease that affects about 1.2 per cent of Scots and has devastating long-term consequences. Members will recall the debate that was held on it a month or so ago.

However, as all cancer charities, government bodies and experts alike will acknowledge, there are many instances of cancer that develop simply as a result of lifestyle, habits and addictions—people taking little to no exercise, poor diet, alcohol consumption and excessive smoking. Those are all things which are within our own control and can be addressed, although—granted—that is much easier said than done.

It is estimated that around four in every 10 cancer diagnoses are preventable: 40 per cent is a huge proportion, which is why, in putting the motion together, we have decided to focus on an area in which the Government can make a real impact. Cancer Research UK has noted that obesity is the single biggest cause of preventable cancer after smoking, and is linked to 13 different types of cancer. In Scotland, almost two thirds of adults are classed as either overweight or obese, and almost a quarter of children are in the same categories. Those statistics are not only frightening—they are also a sad indictment of how we in Scotland manage our personal health.

As the World Cancer Research Fund UK notes, about 10 per cent of bowel, breast and womb cancers in the UK can be prevented by people being physically active for at least 30 minutes a day, five days a week. As part of its contribution to the debate, Macmillan Cancer Support has made clear the need for people to be more physically active to reduce their risk of developing cancer. It runs a number of “move more” programmes across Scotland; the importance of such programmes is significant. It is all very well for us to talk about the issue, but we need to act on it and—dare I say it?—fund it. I congratulate Macmillan for not only highlighting the issue but for investing time, money and volunteers in it. In fact, Macmillan acknowledged in its 2011 “Move More” report that more physical activity in our day-to-day lives could be considered a “wonder drug” for supporting people who have cancer. The report notes that

“physical activity after treatment for cancer can reduce the impact of some debilitating side effects”.

The side effects can be physical and mental and can include anxiety, depression, fatigue, impaired mobility and weight changes.

I also acknowledge Obesity Action Scotland, which provided me and other members with guidance ahead of the debate. It notes that obese and overweight people cost our national health service up to £600 million per year. That is an unbelievable sum of money, but given the statistics that I mentioned earlier, it is hardly surprising.

With all that in mind, it is important that we reflect on what can be done to stem Scotland’s obesity crisis and help bring down cancer incidence. The Scottish Government produced its last obesity strategy in 2010. At the time, it was viewed as groundbreaking. However, as Obesity Action Scotland pointed out, the report has since been reviewed and it has been judged that

“the number of interventions aimed at attitudes, values and behaviours outweighed those aimed at costs and regulation”.

That is why the 2017 obesity strategy that the Scottish Government announced last year is highly welcome and more crucial than ever.

Conservative members have been proactive in focusing on ways to reduce obesity, which will help to lower cancer incidence. My colleague Brian Whittle recently launched our “Healthy Lifestyle Strategy” document, which makes several suggestions, including early intervention in schools through ensuring that the highest-possible nutritional value in school meals is the primary goal for food procurement. It also supports the calls that were made by the Royal College of Physicians of Edinburgh, which argues that physical education should be fully embedded in primary care, secondary care, social care and health education, as well as in the health and social care workforce and workplace. I actively encourage the Scottish Government to review the document and all supporting reports and evidence as it considers its next obesity strategy.

I should mention the work of the Health and Sport Committee in the past few months. The committee, on which I sit, has had a number of meetings on obesity and has recently written to the Scottish Government calling for action.

It is vital that we tackle obesity and reduce the incidence of cancer. That is not an easy task, but it is not impossible. Most important is that there is a significant element of personal responsibility: we have to encourage everyone in society to take responsibility for their own health, both in terms of diet and lifestyle.

It is partly down to Government to look at what it can do, but it is also down to people in the public, private, voluntary and third sectors and beyond to promote a different attitude in our country: an attitude that means that we do not binge on unhealthy food but focus on the food that keeps us healthy; an attitude that means that we do not drink alcohol excessively, but drink responsibly; an attitude to exercise that views it not as a chore or unnecessary use of time, but as something that is so simple yet so effective in the long run.

I thank Cancer Research UK for all its work in promoting world cancer day and I wish it good luck in its “scale down cancer” campaign. I look forward to hearing what members have to say in this crucial debate.

17:44  

I thank Donald Cameron for bringing this important issue to Parliament today.

It is clear that obesity is a serious problem in Scotland. Almost two-thirds of us are overweight or obese, and people of normal weight are now in the minority. Obesity rates in Scotland are among the highest in the world. It is vital that we address obesity as a matter of public health because of the sheer number of people who are affected and the impact on quality of life and life expectancy.

The link between obesity and cancer is now well established and, as the motion states, obesity is now the second-biggest cause of preventable cancer in Scotland, after smoking. We know that we need to improve diet and exercise to tackle obesity and we know that, if we do that effectively, it will make a big difference to millions of people’s lives.

Although strategies that focus on education and public information are useful, they will never effectively address the problem alone. We need to tackle the obesogenic environment that we live in that promotes inactivity and overconsumption. Although personal responsibility plays a role in weight gain, we need to make it easy to do the right thing. At the moment, energy-dense foods are easily available, affordable and widely accepted, which is making an unhealthy lifestyle the default option.

Although I accept that exercise has an important role to play in improving health and preventing weight gain, the evidence is clear that the problem of obesity will not be effectively addressed without changing people’s diets and reducing the amount of foods that we consume that are high in sugar and fat.

The motion calls for us to be “bold” on diet and obesity. I agree that we should be bold and I am confident that the Scottish Government will be. It has been pioneering in tackling public health issues including smoking and alcohol in the past, and it has my complete confidence that it will be bold in tackling obesity in the future.

It will not be enough for the Scottish Government to act unilaterally. Parliament’s Health and Sport Committee, of which I am a member, has urged the Scottish Government to continue lobbying the UK Government to ban pre-watershed advertising of junk food. I hope that all members will lend their support to that.

We need the European Union to be bold on labelling regulations, and post-Brexit we must ensure that that power comes to the Scottish Parliament so that we can incorporate it in our obesity strategy.

Members will be aware that it is rare indeed for me to praise an action of the UK Government, but its soft drinks levy is the right sort of thing to do. It shows a willingness to use taxation to create an environment in which healthy eating is the easier choice. Unfortunately, I think that it does not go far enough. Fizzy drinks are not the only culprits—I love a bit of chocolate, myself.

We need to address the use of price promotions and till-prompted purchasing, both of which are used disproportionately for food and drink that is high in fat and sugars. Limiting the use of such pricing tools on unhealthy options or—better still—ensuring that they are used for healthier options, will make a difference.

We know that people who are on lower incomes or who live in poorer areas are more likely to be overweight or obese. The aim must be to make the healthy choice the more affordable one, so that if the grocery budget is tight, people will be more able to buy themselves and their families healthier foods.

Obesity remains a challenge facing Scotland and we will need a bold strategy if we are to address it successfully.

17:48  

I congratulate Donald Cameron on bringing focus to this discussion in the chamber this afternoon.

When the present Mrs Carlaw—I should say the only Mrs Carlaw, of 30 years’ standing—heard that I was going to take part in a debate on being overweight or obese, she gave me what my grandmother would have called an old-fashioned look. When I first spoke in the chamber on public health, I resolved to lose weight and I lost 3.5 stone. I was very proud of myself and it proved to me that it could be done. I am afraid, however, that it has not lasted. The truth of the matter is that I look around the chamber and see others who seem to be similarly afflicted by not necessarily paying proper attention to their weight, so I sometimes understand the frustration of people outside Parliament who find it difficult to take admonitions and exhortations from members of the Scottish Parliament on these subjects. As I regularly say, there are members who I have yet to meet on a staircase in the Parliament, and I look forward to it.

It is true that, in Scotland, two thirds of adults and more than a quarter of children are classed as overweight or obese. Those rates are among the poorest in the UK and the Organisation for Economic Co-operation and Development countries. Obesity costs the national health service some £600 million per annum and, if we take into account all other factors, it possibly costs the Scottish economy some £4.6 billion per annum.

I want to focus on children. I like chocolate, too, but I have always liked it. The promotion of chocolate to children is nothing new. When I was young and watched children’s television programmes way back in the 1960s, there was the Milky Bar Kid, Opal Fruits, which were “Made to make your mouth water”, the Cadbury’s Flake adverts—very seductive when we were young—Kit Kat and Mars Bar adverts, and Terry Scott in Curly Wurly adverts. We all indulged, but the truth is that we accompanied that with a much more physically active lifestyle. We walked to and from school and ran about. The television programmes for children started at 4.30 in the afternoon and finished at 5.20, and that was basically it. The whole nature of sedentary entertainment for children has transformed dramatically.

It is worth remembering that, when the Parliament first met in 1999, neither obesity nor dementia was even identified as a challenge that faced Scotland’s health service. Those issues have grown exponentially during the lifetime of the Parliament, and they require to be tackled.

I am not naturally one to look to a legislative solution. Scottish Conservatives worked with the Scottish Government on minimum unit pricing for alcohol—the Labour Party fought that to the death in the legislative process—because we felt that there was an opportunity to try something. We asked for a sunset clause to be included so that we could have confidence in trying the approach while knowing that, if the measure did not have the effect that was claimed for it, it could be repealed.

I simply say to the Government that I understand the watershed argument although, with digital entertainment, people record programmes and watch them at all times. I am not sure that that argument in itself can make the difference. I also worry that, if we advise and exhort all the time, that will become a kind of wallpaper in people’s lives that is too easy for them to ignore. However, if the Government seeks to go down a legislative route—we have to at least be open to ideas about how we tackle childhood obesity that might lead to legislative solutions—I commend to it the attachment of a sunset clause. That would allow Parliament to consider supporting initiatives with confidence and without the political dynamic of knowing that the change would be permanent. We would be allowed to assess what the impact of the change proved to be. If it was proven that it worked, we could support it, but people would know that, if it did not work, we would withdraw it at that point.

There is a huge challenge. That is why I commend Brian Whittle for the work that he has done, which focuses a lot on childhood exercise and physical activity.

Ultimately, people have a responsibility for their own wellbeing. That responsibility cannot simply be seconded to the Government. We all have a challenge in ensuring that we make progress on the issue.

Childhood days, Mr Carlaw—I remember them well.

17:52  

It is great to follow the Milky Bar Kid of the Parliament in the debate. Jackson Carlaw mentioned Curly Wurlys, but he failed to mention Toblerone, which is obviously the chocolate of choice for this parliamentary session.

I thank Donald Cameron for securing this really important debate on how to address cancer, which is Scotland’s biggest killer. I am sure that the debate unifies us all across the Parliament and, indeed, people throughout Scotland. I also thank Cancer Research UK for all the amazing work that it, its volunteers and staff do all year round in fighting to address this very important issue, and all the other cancer charities for the amazing work that they do all year round.

The Parliament has done bold things on tobacco, and it has been bold on alcohol. I genuinely believe that obesity is the next big challenge for us, and I hope that we can again find cross-party consensus in being bold and challenging on the obesity strategy.

Obesity is the second most likely risk factor for cancer. Throughout the country, around two thirds of adults and a quarter of children are overweight or obese. The figures have already been stated. The cost to the NHS alone is around £600 million per annum, and we should remember that that is absolutely preventable. How we challenge obesity and have a generational impact is really important.

I will briefly mention an ask from Macmillan Cancer Support. It is important to mention obesity and exercise not only when discussing the prevention of cancer, but when discussing how to live with and to recover from cancer. The charity has direct recommendations on activity being a “standard part” of a patient’s care plan,

“comprehensive rehabilitation ... services to include physiotherapy, exercise”

and

“commissioned schemes in leisure centres”.

Another recommendation is that

“Every person with a cancer diagnosis ... be offered a brief intervention of physical activity to encourage them to do the recommended levels of physical activity, appropriate for their age.”

It is worth remembering all those asks, as well as the rightful ask by Cancer Research UK for bold policy initiatives on portion sizes, advertising, the proximity of unhealthy foods around schools and, indeed, the watershed times for advertising on television. Those are all interesting ideas that I hope we can discuss in more detail as we see the refresh of the Government’s obesity strategy.

It is not lost on us that inequalities in, for example, health and income, have a direct impact on obesity levels and the diagnosis of cancer, so how we challenge inequalities throughout society will have an important impact, too. I hope that, as we develop the NHS action plan, we will see more emphasis on health inequalities being a key part of the plan.

It is worth mentioning the impact on activity of local budget and sports budget cuts. I hope that, through the bold action on the tax powers that the Parliament has and the money that will come from the sugar tax and other policy initiatives, we can find creative ways to use the money. For example, we could use the money from the sugar tax to give every secondary school £800,000 of direct funding to create space for children to exercise in and to learn more about how preventive health measures can help to protect them and future generations.

As Donald Cameron said, this issue touches every person’s heart not only across Scotland, but across the world. I pledge on behalf of my party to work with every other political party and every charity to make sure that we defeat cancer in all its forms.

17:57  

I thank Donald Cameron for securing time to debate the issue as we approach world cancer day. To Jackson Carlaw and Anas Sarwar, I have one word to say: Spangles. [Laughter.]

I thank the organisations that sent us briefings today. We have heard this fact several times, but we need to make sure that every person in Scotland is aware of it: obesity is the single biggest cause of preventable cancer after smoking, and it is linked to 13 types of cancer. That is important because, at the moment, only one in four Scots is aware that being overweight could cause cancer. Therefore, each and every one of us in the chamber must do what we can to get that message out, because we can change the situation.

Over recess, I watched a film called “84 Charing Cross Road”. Anne Bancroft plays a bibliophile who is addicted equally to English literature and cigarettes, and who carries out a long-distance correspondence with Anthony Hopkins, who works in a well-stocked bookshop in London during the 1940s. Whether she was eating lunch, meeting friends, watching TV or lying in bed reading, she was smoking. I watched in horror, but that was the norm. She was playing an educated woman in the role, but she did what she did because there was no understanding of the risks. The changes since then emphasise that we can alter societal behaviour. We have come a long way on smoking thanks to research, increased understanding, awareness raising and legislation. Change is possible.

The fact that some cancers are preventable means that we can take action—and we have to, because being overweight or obese has become the norm for adults in Scotland. People of normal weight are in the minority. That was not always the case—if we look back at footage of sporting or musical events in the 1970s and the 1980s, we can see that we were a leaner nation. Our population is not alone in getting larger, but our obesity rates are among the highest in the world. However, when one in four children are overweight or obese, the future is not the bright one that we want for our young people.

This evening, we are focusing on the relationship between obesity and cancer. Research in The Lancet—Maree Todd touched on this—points to “increased energy intake” as a central cause.

Obesity Action Scotland tells us that preference and demand for unhealthy products may be shaped by an environment that promotes junk food. In his excellent book, “The End of Overeating: taking control of our insatiable appetite”, David Kessler writes about the science and the huge investment behind the creation of some of the most intentionally addictive food on the planet. Therefore, the issue is about more than personal willpower.

Levels of obesity and overweight among women and children reflect patterns of social and economic inequality. Anas Sarwar touched on that issue. Ultimately, we need strong action to tackle health inequalities from the earliest age, because, compared with other European countries, Scotland has a very high level of obesity among pregnant women.

I welcome calls from Obesity Action Scotland and Cancer Research UK, among others, to tackle price promotions on unhealthy food. I am a member of the Health and Sport Committee, and we heard that over 40 per cent of food in the UK is bought on price promotion. That is the highest rate in Europe, and the vast majority of the food that is promoted is junk food. We therefore have two food cultures running side by side in Scotland. Our world-renowned meat and seafood produce is highly regarded and is flown around the globe to prestigious restaurants while, at home, many Scots have never tasted that food and we struggle to meet the calls of those who exhort us to eat five portions of fruit and vegetables a day—for all sorts of reasons including cost, affordability, lack of preparation know-how and lack of time for shopping and preparation.

I whole-heartedly support the calls for regulation from Obesity Action Scotland—all five calls are very welcome—the calls from Cancer Research UK for action at a population level and Macmillan Cancer Support’s calls for physical activity to become a standard part of care for all cancer patients.

18:01  

I will refrain from revealing my favourite chocolate bar—

It is all of them.

Members will probably have noticed that I have several favourites, as Anas Sarwar has pointed out.

I echo the thanks that have been given to Donald Cameron for bringing the motion before Parliament and providing members with the opportunity not only to mark the forthcoming world cancer day but to debate probably the most pressing public health issue that Scotland faces today: obesity.

Our complex and fast-moving modern world is exposing children to ever-more sophisticated commercial pressures, and changes to diet and lifestyle mean that an unhealthy lifestyle has become the default option. The consequence is that Scotland has the highest rates of obesity in the UK and among the highest rates of any OECD country. Two thirds of Scotland’s adults are classed as being overweight and, shamefully, almost a third of our children are at risk of becoming overweight.

As Anas Sarwar and Alison Johnstone highlighted, we know that there is a clear link between deprivation and obesity. A quarter of children aged four to five from the most deprived areas are at risk of being overweight, compared with about 18 per cent of children from the least deprived areas. If we want to tackle health inequalities, we need to tackle wealth inequalities.

What does the obesity crisis mean for our nation’s health? We know that obesity is linked to a number of health issues—including, as the motion states, 13 types of cancer. In fact, obesity reduces life expectancy by an average of three years, and severe obesity reduces it by eight to 10 years. It is now six years since the Scottish Government published its obesity route map and, although it provides a positive policy framework, it is clear that the route map’s action plan has not reached its milestones. Successful policy initiatives are often not scaled up to make a significant impact, and the number of interventions that focus on attitudes and behaviour significantly outweigh those that are based on regulation.

The Scottish Government’s promise to consult on a new strategy is, therefore, welcome. However, in the words of Obesity Action Scotland, it needs to be “brave and bold”. As Cancer Research UK says:

“this strategy presents a once in a generation chance to scale down cancer in Scotland”.

That means that any new strategy must ensure that the proceeds of any sugar tax are invested in after-school sports. It also means considering better regulation to tackle the fact that, as Alison Johnstone said, more than 40 per cent of food in the UK is bought on promotion—that is the highest rate in Europe—and the vast majority of that is junk food. A new obesity strategy also means ensuring that we have a comprehensive cross-governmental strategy to tackle the root causes of obesity, including inequality.

As Donald Cameron highlighted, however, not every case of ill health, including cancer, can be prevented through a change in diet and lifestyle. I will therefore touch on the importance of early diagnosis. In many cases, detecting cancer at the early stages is the intervention that is required to ensure that it can be successfully treated. For example, Cancer Research UK’s studies have shown that nine out of 10 bowel cancer patients survive for more than five years if they are diagnosed at the earliest stage of the disease. The debate and world cancer day provide us with an opportunity to remind everyone of the importance of regular cancer screenings and of speaking to their general practitioner should they feel that something is amiss.

When someone is diagnosed with cancer, the next step is to ensure the best possible treatment. For people who live in rural areas, that can often involve travelling some distance and spending time away from their loved ones.

Many patients from Dumfries and Galloway and the Borders receive radiotherapy treatment at the Western general hospital in Edinburgh. To avoid having to make the long journey to and from their home daily or taking up a bed in a medical ward, patients who are well enough to leave the ward can stay overnight at Pentland lodge, which is next to the hospital. I have spoken to many constituents who have stayed at Pentland lodge, who talk about the benefits of the invaluable peer support that they received there and how it helped them through a dark time for them and their families.

NHS Lothian is considering changing the use of Pentland lodge, which is likely to mean that patients from Dumfries and Galloway and the Borders will no longer be able to stay there when they receive treatment. I appeal to the minister and the Scottish Government to support the campaign by families in Dumfries and Galloway and ensure that Pentland lodge is retained for the use of patients who receive treatment at the Western general.

I again thank Donald Cameron for bringing his motion to the chamber for debate.

18:05  

As co-convener of the Parliament’s cross-party group on cancer, I congratulate my colleague Donald Cameron on securing today’s important debate ahead of world cancer day, and I am pleased to take part in it. I also thank the organisations that have provided us with useful briefings for the debate, which include Cancer Research UK and Macmillan Cancer Support.

Our cancer cross-party group recently heard from Professor Linda Bauld, who is professor of health policy at the University of Stirling, about cancer prevention. She outlined how, with good health, four in 10 cancers are preventable, and she highlighted the fact that—as has been mentioned—obesity is the single largest cause of preventable cancer in Scotland after smoking. I commend Professor Bauld for the excellent work that she is undertaking on cancer prevention. It is estimated that obesity is responsible for about 18,100 cancers in the UK every year and if current trends continue—this is the number that we must hold in our minds—it will lead to a further 670,000 cancer cases over the next 20 years. Those 670,000 cases are preventable.

There is a concerning lack of awareness about the risks of being overweight and obese—only one in four adults report that they are aware that that is a cause of cancer. The motion emphasises the scale of the challenge that we face, given that so many adults and children are overweight and obese, especially in more deprived communities across Scotland. It is of significant concern that the gap between the least and the most deprived is widening when it comes to obesity and ill health.

Scotland has the worst weight outcomes of all the UK nations; indeed, it is one of the worst-performing nations of any in the OECD in that regard. It is therefore clear that the Scottish Government’s forthcoming obesity strategy must be as comprehensive as possible and must offer practical policies on the twin themes of diet and exercise. I have been heartened by the fact that every party in the Parliament has put forward ideas on how to strengthen the strategy as much as we can.

As Donald Cameron mentioned, the Health and Sport Committee has been taking evidence in advance of the strategy’s publication, and it is clear that the strategy must offer a joined-up approach that works across all the portfolios for which the Parliament has responsibility, including education, local government and transport, as well as health. As the committee heard in evidence today, the proposed cuts to the sports budget could have an impact on encouraging people into grass-roots sport. I hope that the minister will comment on that when she responds. We must consider how we can encourage people to take part in sport and even walking, and how we can change our lives. The Parliament is one of the worst examples—we sit in our offices all day long, apart from when we go down to the canteen to have our lunch. We need to think about how we can transform workplaces across Scotland.

I agree with Cancer Research UK that the strategy must be underpinned by clear and enforceable targets and by interventions that are robustly monitored and evaluated. It is critical that we tackle obesity in the population if we are to scale down cancer by slowing the rise in the incidence of cancer, but Macmillan Cancer Support’s briefing for the debate rightly points out that it is also important to understand how valuable physical exercise is for people who have been diagnosed with cancer. I repeat what Anas Sarwar said: in some cases, physical exercise can significantly reduce the risk of dying from cancer.

Macmillan Cancer Support is right to call for physical activity to become a standard part of care for cancer patients, and that is perhaps another area in which the cancer strategy needs to be improved. The charity’s excellent move more programme of exercise for cancer sufferers, which has been mentioned, is running in Edinburgh and some other areas across Scotland, and it is important that patients are signposted to that and similar services. Macmillan also seeks comprehensive rehabilitation services that include physiotherapy, exercise on referral, commissioned schemes in leisure centres and signposting to walking and other exercise groups. I reinforce the importance of that and I hope that we will see improvements.

I welcome the debate and I hope that it will inform the development of the Scottish Government’s obesity strategy, which provides a real opportunity and which must be successful if we are to reduce the incidence of cancer and many other preventable diseases.

18:10  

I am sure that it was just a coincidence that when Jackson Carlaw was reflecting on the weight and fitness of MSPs, my Fitbit was buzzing to tell me to get moving. Perhaps we need to be more mobile during debates. I join colleagues in thanking Donald Cameron for bringing the motion to Parliament for debate tonight.

Like this debate, world cancer day is an important opportunity to highlight the impact that cancer has on everyone’s lives in one way or another. As Members of the Scottish Parliament, we have a particular responsibility over the course of this parliamentary session to explore what decisions and actions can be taken here in Scotland to reduce the prevalence of cancer and the impact that it has on people and communities.

As we learn more about the causes of cancer, it is becoming easier for policy makers to identify possible actions that could be taken to prevent the onset of ill-health. The more evidence that is gathered, the more we can state with certainty that, in so many cases, cancer and ill-health more generally are a result of structured inequality and deprivation. With that convincing and ever-increasing body of evidence, comes an increasing responsibility on us all, but especially those in positions of power, to think about how we can work together to eradicate that inequality.

Evidence from Cancer Research UK shows that four in 10 cancers are preventable, which is a shocking statistic. If 40 per cent of cancers in Scotland are preventable, that means that almost 13,000 people in Scotland who were diagnosed with cancer last year could have had their illness prevented. As colleagues have stated, obesity, after smoking, is the single biggest cause of preventable cancer in Scotland and has been linked to 13 different types of cancer. Cancer Research UK tells us that those include some of the most common cancers, including breast and bowel cancer. Despite that, however, only a quarter of Scottish adults are aware that being overweight can cause cancer.

In the past few months, I have had personal experience of a cancer scare, having discovered a lump in my breast. After going to my doctor and being referred to the hospital breast clinic, I was lucky and relieved to be told that it was a cyst. I was lucky to be referred quickly and lucky that it did not turn out to be cancer. Due to the fantastic awareness-raising campaigns of breast cancer charities in Scotland, during my early months as an MSP I have become more familiar with the importance of self-examination and of understanding prevention a lot better. I have therefore increased my activity levels; I have a Fitbit and go out walking, even when it is raining. I heard Alex Cole-Hamilton being grilled on the radio this morning about politicians saying one thing but perhaps not putting that into practice, and he admitted on live radio that some MSPs are a bit overweight. Being an MSP makes us all conscious—and self-conscious—of our own behaviours.

My experience of being initially reluctant and fearful about investigating what was wrong with me, made me think again about awareness raising and what more can be done to encourage people to have not only the confidence to get checked out early but the confidence to change behaviours and make different choices. We know that the earlier cancer is detected, the easier it is to treat.

I see that my time is running out, but I want to emphasise that to tackle the problems that we have been discussing, we need more joined-up thinking across government. I state for the record that I am a chartered town planner and a member of the Royal Town Planning Institute, because we will have a debate tomorrow in Parliament on the forthcoming planning bill. We have a real opportunity through that to assess how we can embed the issues of health and wellbeing in planning applications. The briefings that we have had for this debate have informed us about how our environments affect our health and our choices.

Tackling obesity is complex and not an easy task, but there are actions that can be taken that will help to reduce health risks. It is the responsibility of all parties across the chamber to work constructively together in an attempt to address the issue, and I think that the tone of the debate has shown that there is a commitment to that.

18:14  

Like all the other speakers in the debate, I thank Donald Cameron for lodging his motion and I welcome Cancer Research UK to the Parliament.

In reading Donald Cameron’s motion, I was interested in the last line, which mentions showing support by wearing the unity band. The wrist bands have a knot to represent strength in unity, and that is symbolic in a number of ways for us in the chamber this evening. First, it reminds us how united this Parliament is on tackling cancer, which has been shown in today’s speeches and is also demonstrated by the good work of the cross-party group on cancer. Also, as Donald Cameron rightly stated, we all know someone who has had their life impacted by cancer, and in Donald’s case, sadly, that impact is felt incredibly closely.

Secondly, we need unity if we wish to tackle, as this Government does, the complex issue of obesity. Success will require not only a commitment from individuals but the support of both our public and private institutions and support from this Parliament to enable more people, more often, to make the right choices to eat less, to eat better and to move more. That includes avoiding the Fry’s Chocolate Creams, the Spangles, the Opal Fruits and the host of other things that have been listed this evening, and instead opting for something a bit healthier. Unfortunately, Anas Sarwar stole my line about the uncanny resemblance that we all imagine a young Jackson Carlaw bearing to the Milky Bar Kid.

I thank Cancer Research UK, which has thrown itself into ensuring that we all know that there is a well-established link between cancer and obesity and, therefore, a compelling need for action—a point that I discussed with the organisation when we met last week to consider the Government’s commitment to a new diet and obesity strategy.

The Scottish Government fully recognises the damaging impact that cancer has on individuals and their families and friends. However, we also recognise that significant progress has been made. Over the past 10 years, the overall cancer mortality rate has fallen by 11 per cent. That improvement is thanks to the efforts of people across our NHS from primary and acute care to oncology, social care and the third sector. However, we know and recognise that there is a need to do much more to reduce the risk factors for cancer.

Last March, the Scottish Government launched our cancer strategy, “Beating Cancer: Ambition and Action”, which serves as a blueprint for the future of cancer services in Scotland and is backed by £100 million of investment. The strategy has embedded within it a set of very clear ambitions and actions to reduce the risk factors for cancer in Scotland. We want to create a generation of young people who do not want to smoke, with an aim of reducing smoking prevalence to 5 per cent or less by 2034. We want to reduce alcohol-related harm by helping to prevent problems from arising in the first place and to make it easier for people to be more active, to eat less and to eat better. We also want to help people to make healthier choices to reduce their exposure to ultraviolet radiation.

We are tackling the food environment that causes obesity through work in our schools and our communities and, importantly, work with the food and drink industry through our supporting healthy choices framework, which encourages a range of actions including better labelling and the reformulation of products. We are also continuing with campaigns to encourage healthy eating. I have launched the most recent phase of our eat better feel better campaign, which aims to support parents on the thorny issue of children eating their greens.

Maree Todd and Jackson Carlaw both mentioned childhood obesity and discussed in their own ways the rights and wrongs of our call for a ban on the advertising of junk food before the 9 pm watershed. It is important to remember that we need a range of actions to ensure that the unnecessary exposure of our children and our youngest members of society to unhealthy choices is reduced, and to help, support and encourage parents around what their children eat.

I note that my son has given me 17 of his own ideas for our obesity strategy. I sometimes think that it is tough in the chamber, but sometimes it is even tougher at home, with the demands of my child. However, I will be sure to take note of his very good ideas.

I want to highlight two pieces of work. One shows that change to the food environment can be made and the other shows how we are developing our services to support people to make the necessary changes.

The first is the healthcare retail standard, which is bringing positive change to retail outlets in hospitals. With the Scottish Grocers Federation and Food Standards Scotland, we have established a standard that requires 50 per cent of all products sold to be from a healthy range and which restricts promotions on items that are high in fat, sugar and salt. I had the pleasure of visiting the first Royal Voluntary Service shop to meet that standard in Edinburgh and I was impressed by what we can achieve in partnership to create an environment where the healthy choice is the normal choice or, as Maree Todd said, where the healthier choice is the easier choice to go for. I recommend that members of the Health and Sport Committee—and other members—visit that shop to see what is possible.

Secondly, we know that, if women prevent weight gain or lose a little bit, that will help to reduce their risk of breast cancer. More than 175,000 women attend breast-screening programmes each year, which provide an opportunity to give lifestyle advice and support to women when they attend the screening. However, a greater understanding of the benefits and impacts are needed to know whether that approach works. Therefore, we are supporting the act well initiative with up to £1 million of funding over the next five years to provide a personalised breast cancer risk reduction programme to women who attend routine breast screening clinics. That programme will be fully tested for effectiveness and for its potential for a wider roll out.

I thank Monica Lennon for sharing her story—it cannot have been an easy thing to do or to have gone through—as talking about it raises awareness in other women around the country. Alison Johnstone was also right to highlight the challenges of obesity in pregnancy, which is another issue that we will need to take notice of when developing the strategy.

As we develop our new diet and obesity strategy—I agree that that is a real opportunity—we will learn from the work that has gone before and Jackson Carlaw implored us to take on board lessons from the past on smoking, alcohol and physical activity. We will be bold, as we have been with minimum unit pricing; multifaceted, as we were with physical activity; and in it for the long term, the benefits of which are shown by the progress made by different Administrations on reducing smoking. The benefits to be grasped are personal, societal and economic. I am pleased that there is a unity in our recognition of the need to take action on obesity.

I finish by reiterating the importance of spreading far and wide the word that cancer can be prevented. I want to talk briefly about the walking strategy—the roll out of the daily mile—that has delivered benefits to workplaces. Perhaps we can be the first Parliament to embrace that as an opportunity to stop the sedentary lifestyle that we have in Parliament. I also mention that the Scottish Professional Football League Trust is hosting an event in Parliament tonight to highlight its commendable football fans in training project, which is well worth taking notice of. The project has had an impact in helping people who are harder to reach to lose a considerable amount of weight.

By supporting healthier lifestyle choices—promoting better diets, encouraging a healthy respect for alcohol, providing support to help people to quit smoking and championing the benefits of physical activity—we can make a difference to the lives of the people of Scotland now and in the future. I thank Linda Bauld and a host of others from Cancer Research UK who are articulating the link between obesity and cancer and allowing us to come together and unite as a Parliament to ensure that cancer does not have to be inevitable. It is not outwith our control and, if we work together, we can find ways to prevent it.

I close this meeting of Parliament.

Meeting closed at 18:23.