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Dr Huq
Yes, sorry. I am a secret lemonade drinker—no, I’m not.
I want to be brief, but we are discussing something important. Voluntary agreements do not seem to be moving fast enough. As everyone has said, we need a range of different approaches, and hiking up sugary drink prices by pennies is part of that. As for the industry’s worry that the cost would have to be passed on to consumers, the industry itself could absorb or partly absorb the cost.
Eleven to 18-year-olds will choose drinks based on price, because they are short on cash, although other factors could come into play—peer pressure, habit, availability and so on. We need to think smartly about things such as advertising bans, which have been mentioned, encouraging physical activity, curbing “buy one, get one free” types of promotions, discounting fruit and veg, and considering portion sizes. In New York the authorities have banned the largest size of soda cups.
I want to ask the Minister what happened to the ban on fried chicken shops at school gates, because I still seem to have them in my constituency. Such a ban was talked about, and it would be good if its implementation could be accelerated. Also, what about minimum unit prices for alcohol? If sugary drink prices go up but alcohol prices are low, there could be some awful, cataclysmic thing going on as a result, possibly—
The Parliamentary Under-Secretary of State for Health (Jane Ellison)
Hopefully not at primary schools.
Dr Huq
No, but alcopops and such things have always been popular with young people, because they look harmless, but some of them have a high alcohol content. We have a golden opportunity, because the Government are working on a childhood obesity strategy, and we must not waste that opportunity We must think long-term and heed the BDA chief’s words:
“Public health policy must be guided by evidence, not by personal prejudice or commercial interests.”
So happy Sugar Awareness Week, one and all. I will be interested to hear the summing-up speeches.
The Parliamentary Under-Secretary of State for Health (Jane Ellison)
What an excellent debate we have had. It has been a real pleasure to listen to so many extremely well-informed contributions. Let me start by acknowledging the strength of public feeling about the issue. We are responding today to an e-petition with a great many signatories, and I thank everyone who signed it. I also praise the passion and commitment shown by Jamie Oliver, as other Members have, in raising the profile of healthy eating and, in particular, the impact of sugar on our diets and health. I will attempt to respond to most of the specific points made, but I am a little constrained by the timing of the debate.
Let me reflect on where we start from. A number of Members have cited the current obesity statistics. The most recent figures, published only last Thursday, show that there has been a relatively small overall change in overweight and obesity prevalence in the past five years. In that sense, levels remain unacceptably high, but there is a degree of stability. We saw some slight encouragement in the figures for children in reception, but we then see obesity prevalence more than double between reception and year 6. As the Chair of the Health Select Committee, my hon. Friend the Member for Totnes (Dr Wollaston), and others have rightly underlined, there is a very wide gap in obesity prevalence between the most deprived and the least deprived areas. I share the deep concerns expressed in all parts of the Chamber about that.
We have seen some good progress made on school food in recent times, so there are reasons to think this is a good moment to move forward, as there are areas in which we have encouraging building blocks. This debate, alongside the Health Select Committee report published today, is a valuable and timely opportunity for Members to make their views known at a critical juncture in the development of our comprehensive cross-Government childhood obesity strategy. That is a perfectly sensible reason for the timing of this debate and the publication of the Committee’s report; it is extremely helpful to have them.
Earlier in the debate, one Member wondered whether I was feeling isolated. Far from it: it has been wonderful to spend the past few hours with Members from across the House who feel as passionately as I do about tackling this issue and, in particular, to hear the challenge of tackling childhood obesity framed in the context of improving the life chances of so many children, particularly those from the most deprived communities. That is certainly a strong strand of my thinking as I look at this issue. I have listened carefully to the comments made and will look in greater detail at the Select Committee’s report, to further inform our ongoing policy development.
It is no secret that the Government have no plans to introduce a tax on sugar, although all taxes are kept under review. Such decisions are a matter for the Chancellor, as part of the Budget process. That being said, driving sustained behaviour change will require broad-ranging and concerted action of the kind we have discussed. It is extremely welcome that, whatever Members’ views on a sugar tax, there is consensus across the House on the fact that there are no silver bullets in this debate. That is a really important point.
Geraint Davies
I happen to have introduced econometric modelling to Unilever. Would the Minister accept that if a sugar tax is introduced, less sugar will be consumed, and the Government will make money and save money on the health service? Is it not a no-brainer? What is the justification for her resistance to this obviously sensible measure?
Jane Ellison
I will touch on some of those points, but I want to take this opportunity to update the House on what we are already doing, to give some sense of our direction of travel and, in particular, to reassure people who have been urging us to look widely at a whole range of things beyond the silver bullet arguments. I hope to give some reassurance in the course of my remarks that we are, indeed, doing that.
Geraint Davies
What is the Minister’s justification for not introducing this measure?
Jane Ellison
Unless the hon. Gentleman continues to chunter at me from a sedentary position, I will come to the vital issue of teaspoons, about which he and I have spoken before, and upon which a number of Members have remarked.
Today, I will principally talk about some of the steps the Government are already taking to improve children’s health, particularly in relation to food and diet. I fear my response is rather limited in its scope by the proximity to the publication of our strategy, but I want to reassure Members that this is a major priority and a manifesto commitment of the Government. There is no argument from us about the scale of the challenge, which has been outlined well in a number of speeches today. As I said, I passionately agree with the Chairman of the Health Committee, my hon. Friend the Member for Totnes, about the impact on health inequalities of childhood obesity, so there is no argument there either.
We can all agree, and have all agreed, that as a society we are eating too much sugar. It is bad for our health and can lead to excess weight gain. That, in turn, increases the risk of heart disease, as other have said, as well as type 2 diabetes—my hon. Friend the Member for Erewash (Maggie Throup) gave a very good speech about that—stroke and some cancers. The link to tooth decay has also been brought out in a number of very good speeches.
I was interested to hear the, as ever, extremely well informed contribution from the hon. Member for Central Ayrshire (Dr Whitford). As a very distinguished clinician, she will be aware of the links between obesity and many of the big health challenges of our age, but I think that is less well understood more generally in the population. We need to talk more about that—I have challenged a lot of our major charities to talk about it more—so that people become as understanding of that as they have of the link between tobacco and some of the very significant disease groups.
However, public awareness is increasing. In recent evidence, 92% of people said that they were trying to manage or reduce the amount of sugar in the foods that they buy, while 26% of households were very concerned about sugar in food and 30% reported being more concerned than they were a year ago. Concern was higher for sugar than for fat or salt.
Before I talk about the report by the Scientific Advisory Committee on Nutrition, I would just say that I regret the comments made by the hon. Member for Newport West (Paul Flynn), who is not in his place. He spoke about some extremely respected clinicians—members of that committee—who have done great service not just to the committee, but to the nation’s nutrition more generally. The point was made very well by the hon. Member for Heywood and Middleton (Liz McInnes) about transparency and the need for people to declare their interest. That is all done by the members of that committee, and I want to thank them, on behalf of the Government again, for the work they have done for the committee’s report on carbohydrates and health, which it published in July. I accepted, on the Government’s behalf, the report’s recommendations, which were that no more than 5% of energy in our daily diet should be from sugar. That is the equivalent of about seven sugar cubes or five or six teaspoons and there are wider implications for the general dietary advice from the Government from that policy shift. We are working through those with Public Health England.
As the House knows, and as many speeches have touched on, we are currently consuming more than double the recommended limit for sugar, and teenagers’ consumption is nearly three times the recommended level. Again, we are under no illusion that we need to take action in this area. Earlier in the year, I requested that Public Health England prepare evidence for the Government on effective approaches for reducing sugar consumption. That is the report that the Health Committee has had chance to respond to.
Geraint Davies
As the Minister would accept, there is an elasticity of demand for any product—namely a relationship between the price and the demand. Will she focus a few comments on why precisely she is resisting simply putting up the price of sugar through a tax? I appreciate what she said about my hon. Friend the Member for Newport West (Paul Flynn), but if no reasons are being given, he probably cannot understand why. If there is no rational reason for doing so, he is assuming it is because of the lobbyists.
Jane Ellison
That is not right. Again, I come back to the point stressed in the report by Public Health England—indeed, the Health Committee’s excellent report underlines it—that there is no silver bullet. It is really important that we address the fact that a number of wide-ranging issues need to be tackled and that several options are available to us in policy terms. PHE concluded that no single action on its own will be effective in reducing the nation’s sugar intakes. Its report shows evidence to suggest that higher prices in targeted high-sugar products, such as sugar-sweetened drinks, tend to reduce the purchases of such products in the short term.
Mention was made of the possibility of Cochrane reviews in coming years. An interesting article in the current issue of The Economist notes that the longer-term effect on public health is as yet unknown. Obviously that is because in most cases these measures have not been in place long enough, but it is an important concern—and the hon. Member for Swansea West (Geraint Davies) will have noted a degree of reticence on the part of those on his own Front Bench about the evidence, but anyway. We are, of course, well aware of what Public Health England said in its report about the evidence on higher prices. However, its report also argued strongly for implementing a broad, structured programme of parallel measures across all sectors, if we are likely to achieve meaningful reductions in sugar intakes across the population. As we have heard, it identified areas for action that include restrictions on marketing, advertising and price promotion, and work to reduce levels of sugar in food and drinks—I welcome the focus of a number of speeches on reformulation of product, as we think it has a significant role to play. Areas for action also included improving public food procurement and improving knowledge about diet and nutrition. We are considering all the evidence and working closely with Public Health England to develop our policies.
A number of Members have talked about education. This debate provides the opportunity for me to talk in more detail than I generally can in such debates about the Change4Life programme, in which we continue to invest significant sums. The Change4Life campaign has provided motivation and support for families to make small but significant improvements to their diets and activity levels. Last January, Change4Life’s Sugar Swaps campaign encouraged families to cut back on sugar through two TV advertisements focusing on sugary drinks and after-school snacks. That campaign also included radio, digital and outdoor advertising.
Barbara Keeley
I expressed concern about budget cuts for Public Health England. Will the Minister address that? I, too, admire the work it has done, but it is not helpful to cut the budget, is it?
Jane Ellison
As the hon. Lady will see, the campaign is going to be very significant again this coming January, so as I say, we continue to invest significant sums. It is a very important campaign and a very important brand that is being developed, and we see it as something we want to build on.
Jane Ellison
I am going to make some progress and develop my point about Change4Life, because Members have asked questions about that.
The campaign included radio, digital and outdoor advertising; public relations and media partnerships; work with 25 national food retailers and manufacturing partners; community events and schools programmes; and, importantly, work with all 152 local authorities. More than 410,000 families registered with the last campaign. Families who signed up purchased 6% less sugary snacks by volume and 6% less sugary puddings by volume, while increasing consumption of lower-sugar snacks and puddings. For each person who signed up, another two in the general population said they had also made a food swap.
The Change4Life team is developing the next Sugar Smart campaign, to launch in early January 2016. The campaign will alert families to the problems of consuming too much sugar, reveal the amount of sugar in the most popular food and drink and tell them about the new guideline daily amounts. It will encourage people to download the Sugar Smart app, which I have seen being used and is very impressive—hidden sugars no more, I can assure the House. People will be able to see for themselves how much sugar is in the products they are buying. The campaign will include advertising on TV and online and posters, in addition to social media activity and PR. Five million information packs will be given to families through schools, commercial partners and local authorities, and there will be digital support to help families who want to cut back on sugar.
However, obesity is a complex issue, which the Government cannot tackle alone.
Jane Ellison
I am going to come on to teaspoons, and I do not want to run out of time before I do so. I will make a bit more progress and then see how we are getting on for interventions.
The Government cannot tackle obesity alone. I welcome the fact that we have consensus across the House on that, and the Committee draws that point out in its report. Businesses, health professionals, schools, local authorities, families and individuals have a role to play, as my hon. Friend the Member for St Austell and Newquay (Steve Double) brought out.
I want to talk about some of the industry action that has been taken. There has been progress in recent years on reducing sugar consumption. The focus under the voluntary partnership arrangements, which have been discussed, has been on overall calorie reduction, of which sugar can form a part. Billions of calories and tonnes of sugar have been removed from products and portion sizes have been reduced in some areas. Some major confectionery manufacturers have committed to a cap on single-serving confectionery at 250 calories, which is an important step.
We have to be realistic about consumer relations, which are important. Before I was an MP, I worked for the John Lewis Partnership—John Lewis and Waitrose—and I know only too well the important role that retail relationships play in an average family’s life. We need to involve those partners. Some retailers have played a part, for example by removing sweets from checkouts. Interestingly, they did so after asking their customers in surveys what support they wanted, as family shoppers, from industry to help them to make healthier choices. Much of the action that retailers have taken was in response to that.
I was very interested in the point that my hon. Friend the Member for Salisbury (John Glen) made in an intervention about consumer power. There is much greater consumer power to be unleashed, but the challenge to the industry to make further substantial progress remains. Like the Chair of the Health Committee, I have had some encouraging conversations in that regard, but we need to make more progress.
Providing clear information to consumers to help them make healthier choices is important, as a number of hon. Members have set out. The voluntary front-of-pack nutrition labelling scheme, introduced in 2013, plays a vital part in our work to encourage healthier eating and to reduce levels of obesity and other conditions. The scheme enables consumers to make healthier and more balanced choices by helping them better to understand the nutrient content of foods and drinks.
I turn to the issue of teaspoons of sugar, which has come up a lot in the debate. It is more complicated than something so simple should be; “teaspoons” sounds straightforward, but labelling is an EU competence, so member states cannot mandate additional forms of expression, such as spoonfuls of sugar, for pre-packed food. Under EU legislation, it would be possible for companies to represent sugar content in the form of spoons of sugar or sugar cubes on a voluntary basis, as long that met a number of EU criteria—I will outline what some of them are. It would sit alongside front-of-pack nutrition information, which I remind the House is voluntary, not mandated, in order to meet the same criteria.
Dr Philippa Whitford
For the public nowadays, “teaspoons of sugar” is more helpful than “sugar cubes”, because very few people use sugar cubes.
Jane Ellison
I am aware of that; the point has been made to me a number of times.
Let me mention a few of the criteria that would apply if we were to move in that direction. There would be a requirement to consult, and we would have to ensure that any measure was supported by scientific evidence and did not constitute a barrier to trade. Any such form of labelling would need to be agreed with the Commission before it was implemented, to avoid future infraction proceedings.
I have heard the strength of feeling in the House and I understand the point being made, but references to sugar cubes are quite powerful; last year’s Sugar Swaps campaign proved that they can be made meaningful. However, I will ask my officials to look carefully at the issue, because I have heard a great deal of interest in it being expressed today, and I know that the Health Committee took evidence on it. I wanted to underline the point that it is not as straightforward as it might seem, but we will look closely at it again in the light of the interest in it.
Dr Whitford
Did the same apply to cigarettes? Were we not allowed independently to add the warnings and so on that we put on cigarettes in this country? Did that have to be EU-wide?
Jane Ellison
As we approach the transposition of the new EU tobacco directive, the hon. Lady will see that the measures being taken are EU-wide, but those are two slightly different things. I am happy to come back to her in more detail after the debate, but generally speaking, packaging and labelling are EU competences.
I was delighted to hear so many hon. Members say that front-of-pack labelling was important. The scheme is popular with consumers. It provides information on calories and levels of specific nutrients in an easy-to-read, intuitive format. Businesses that have adopted the scheme account for two thirds of the market for pre-packed foods and drinks. Within the Change4Life programme, front-of-pack colour-coded nutrition labelling will continue to be included as a key message whenever there is a campaign focused on healthy eating. We use that in all the Change4Life materials, across a wide range of formats.
I want to reassure the hon. Member for Worsley and Eccles South (Barbara Keeley), who spoke from the Opposition Front Bench, that there will indeed be a physical activity strand in our childhood obesity strategy. I agree with the balance that the Health Committee struck on tackling childhood obesity, which is an important strand of the work. The great news about physical activity, as the Committee’s report underlined, is that it is good for everyone, whatever their weight. There is no downside to being more physically active, so of course we will want to reflect that.
This has not been touched on much this afternoon, but there is also a significant role for the family of health professionals in giving advice and supporting families to make changes to their lives. That relates particularly to families in more deprived communities. Only this morning I was talking about the role of health visitors, for example, in family education and family support. Again, a strand of our strategy will develop that.
Jane Ellison
Yes, but this will be the last intervention I take, because I want to leave time for the hon. Member for Warrington North (Helen Jones) to respond at the end of the debate.
Geraint Davies
I simply want to ask whether there will be any space for views to be heard on restricting advertising, whether that relates to high-sugar products being described as low-fat products, to watersheds or whatever. In the same way as we imposed restrictions on the advertising and pricing of cigarettes, will the Minister come forward with any suggestion on restricting advertising in this case?
Jane Ellison
We have already said that the childhood obesity strategy will be a comprehensive, cross-Government strategy. I commissioned advice from Public Health England, and of course I have been working closely with that organisation on policy development for many months now. I am paying close regard to the advice that it has provided us with, and I welcome the fact that the Health Committee found it so useful in producing its report.
I welcome the debate as an opportunity to respond to the important campaign on the e-petition and the important new Select Committee report. It is a timely opportunity. I want to reassure the House that the Government are considering a wide range of options for tackling obesity, and particularly for reducing sugar consumption among children and the wider population. I hope the House agrees that all of us—central Government, local government, the industry, schools, families, communities and individuals—have a part to play. I will reflect carefully on the speeches that I have heard today, on the Committee’s recommendations and on its overarching challenge to us to be “brave and bold”—a message that I have heard loud and clear this afternoon. I look forward to making progress, and I very much look forward to publishing our childhood obesity strategy in the new year and making progress throughout this Parliament, and indeed well beyond it, on one of the greatest health challenges of our age.