Speeches by George.

“Thank you very much.”

“Earlier, in relation to the potential conflation of diabetes with obesity, you mentioned that we are all polygenic individuals. When it comes to the success of this programme—let’s call it a success; there is a lot of remission and some good outcomes—can anything be learned in terms of widening it to address wider issu…”

“If you were advising the Government on rolling out the pathway to remission programme further and scaling up, what would your advice be in terms of the design of the programme itself?”

“Is there a good network of peer support across the country, as it were, to learn from good practice as well as from where things have not gone so well?”

“In terms of the future of the programme itself, do you have a view on how many patients should be reached? Are we talking about the whole population of type 2 diabetics? The evidence suggests that that would produce a saving in excess of £1 billion through the impact it would have.”

“I want to properly understand the interrelationship between obesity and type 2 diabetes. I know there are cases where people are far from obese but have type 2 diabetes. Clearly, the kind of programme you are describing will have less relevance to them. Is that reasonable to say?”

“That is interesting in itself. Although you said that the practice nurse would be reviewing cases, the actual training was undertaken by non-clinically trained staff. Are you content that that is sufficient for the programme going forward?”

“The other side of the coin is: what proportion of people over 40 who are clinically obese are likely to have type 2 diabetes? Or is that simply prejudice?”

“I would have thought that any Government Minister would be persuaded by the concept of scaling up. But how can that be done? Is there sufficient capacity within the system to be able to scale up to the level that we are talking about having a big impact on the whole population, which could benefit from this? What else …”

“Do you think the Government’s proposal for neighbourhood health hubs is the right kind of focus on which to build such a programme? Would that aid or disable such a delivery?”

“How does that compare with other treatments? Is the weight gain more or less significant following the programme?”

“You are saying that it is too early to say what the ultimate weight gain scenario is with regard to GLP treatments because so far we do not know enough about the people who have come off them. Is that right?”

“We have heard about weight loss. What do we know about weight gain following the completion of the programme and how that compares with other treatments? Alex referred to those who remain in remission after a certain period of time. The trial was from 2018 to 2023; do we know a great deal more now about the weight-gain…”

“And six years is a notional tipping point, in that sense.”

“The DiRECT study found that by three years ago only 13% of people remained in remission. Is that a concern? How can we improve on that? What have you learned that might improve the outcome?”

“You mentioned earlier that the programme was largely, I think, delivered by non-clinically trained staff.”

“”

“In the other place, Lord Teverson brought forward on Report amendment 31, which sought to add the following provision to the Bill:”

“It is a pleasure to follow the hon. Member for East Thanet (Ms Billington) and in particular her points about parish and town councils. In Cornwall, where we are completely parished and towned in that sense, they are an important vehicle for communication up from the community. They enable communities to articulate the…”

“The Minister responded to that proposal in March, explaining that the Government were minded to continue the conversation with the local authority, and indeed with the six Members representing Cornwall’s constituencies, to ensure that we can make some progress on this. I hope that the Minister will reflect on that when…”