Speeches by George.

“I congratulate my hon. Friend the Member for Tiverton and Minehead (Rachel Gilmour) not only on securing this debate, but on the manner in which she introduced it. As a member of the Health and Social Care Committee, which keeps this and other issues under constant review, I have been listening very intently today, and…”

“I congratulate my hon. Friend the Member for Tiverton and Minehead (Rachel Gilmour) not only on securing this debate, but on the manner in which she introduced it. As a member of the Health and Social Care Committee, which keeps this and other issues under constant review, I have been listening very intently today, and…”

“On the point of geographic inequalities, as my constituency is in west Cornwall and on the Isles of Scilly, it is impossible to call on emergency services from the north, the west or the south. The consequence of that geographical reality is that it is much more expensive and challenging to provide those services in su…”

“It is an enormous pleasure to follow my hon. Friend the Member for Gloucester (Alex McIntyre)—I call him my hon. Friend as he is a fellow member of the Health Committee. The 2012 Act was mentioned earlier, and I am one of the few Members who was in this House when it was passed. I was sitting on the coalition Benches a…”

“I am grateful to the hon. Gentleman, but the representations made by both the CQC and HSSIB itself seem to refer to its amalgamation into the CQC. The point is that, as he rightly says, a really important role is played by HSSIB, which could be lost as a result. It is a vital safety agency, and its independence is real…”

“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 …”

“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?”

“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?”

“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?”

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

“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…”

“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?”

“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?”

“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.”

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

“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?”

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

“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…”

“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?”

“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?”