(1 year, 9 months ago)
Lords ChamberThat this House regrets that the Communications Act 2003 (Restrictions on the Advertising of Less Healthy Food) (Effective Date) (Amendment) Regulations 2022 (SI 2022/1311) will delay for 33 months, until 1 October 2025, the implementation of the ban on advertising less healthy foods and drinks before the 9pm watershed on television, on radio and on online media.
Relevant documents: 24th Report of the Secondary Legislation Scrutiny Committee. Special attention drawn to the instrument
My Lords, the increasing level of obesity represents a clear and present danger to the health of our nation. I will not recite all the issues caused by obesity, but I direct anyone wanting to learn more to the Obesity Health Alliance.
Recognising this risk, Parliament has agreed on a number of tools to try to arrest, and ideally reverse, that increase, including restrictions on advertising less healthy foods which were agreed to in the Health and Care Act 2022. But while Parliament can will the ends as well as the means, in the shape of the proposed new advertising restrictions, it depends on the Executive to bring them into effect and to do so in a timely fashion, and yet we are faced here with the Government telling us that they cannot implement what we have asked them to do for the best part of two years. This makes the Government look powerless to respond to a public health crisis that needs action right now, and their defence seems to be that they are not impotent but merely incompetent.
We can expect the Minister’s response to explain the challenges of all the different processes that they have to go through to introduce the restrictions and why these all take time. While I am generally sympathetic to the need to regulate properly by consulting with affected organisations, I am afraid that my response on this occasion has to be that my heart bleeds custard for the Government. The need to go through these various steps was entirely predictable, as these measures have been under discussion since 2018 and were formally consulted on after the Government’s much-heralded tackling obesity strategy of 2020. With the additional delay proposed today, we are looking at these measures taking seven years to get from farm to table. The Minister can have a go at explaining this, but I hope that he will not try too hard to defend it.
I expect to hear about the challenges with Ofcom’s workload. Again, I certainly understand that it is stretched by all the new work coming under the Online Safety Bill, but this delay on these regulations now risks making matters worse. It would have been better to have had this all in place before the wave of new demands comes along. I fear that we may be back here again being told that, unfortunately, there has to be a further delay while more important online safety measures take up all of Ofcom’s bandwidth. We need to ask if there is more to this delay, and if the Government are backsliding on their commitments to anti-obesity measures; they are happy to announce and reannounce them but less willing to get the job done.
We can see that there are mixed views about giving advice to people among leading Conservative Party figures, which we might describe as, “Private nannies good, nanny state bad”. But this is not a nanny-state measure, as it does not stop anyone buying or selling any food products. Rather, it is aimed at changing the environment in which people make their own choices, so that they will be, to borrow language from election law, free from coercion and undue influence.
We also have to ask cui bono—who benefits—from any policy shift, and I hope that the Minister can tell us today who from the food or advertising industries has been lobbying for the delay. If we want to consider cui malo—who is harmed—we find that the Government have just not done their homework to look into the effects of the delay, as pointed out by the Secondary Legislation Scrutiny Committee in its 24th report, to which the noble Baroness, Lady Merron, refers in her Motion. The Explanatory Memorandum tells us in paragraph 12.3:
“A full Impact Assessment has not been prepared … because this instrument is being made only to delay the implementation date of the advertising restrictions by 33 months.”
Only 33 months—just in time for the third birthday of children being born today, whose lifetime health chances will be set during those critical early years. I wonder how long the Minister thinks a delay in legislation has to be for its impact to be worth assessing.
Even without the Government’s assessment, I do not think that any serious commentator would agree that there is no harm from this delay, as it means that there will be a longer period in which people trying to make healthier choices are exposed to messages pushing them in the opposite direction. We may not be able to quantify precisely the effect of those messages, but the promoters of less healthy foods are not stupid; they advertise only because it helps them to sell more.
This debate is obviously an opportunity for us to have a go at the Government for appearing to back-track on a measure which they said they were committed to and have previously agreed is in the public interest. I look forward to hearing other noble Lords kick their balls into this open goal.
My Lords, I support the regret Motions from the noble Lord, Lord Allan of Hallam, and the noble Baroness, Lady Merron. At the noble Lord’s invitation, I will kick a slightly different ball into the open goal.
I share the Government’s concerns about levels of obesity in the UK, but the failure to adequately explain or justify both the delay to and the rationale for these regulations is further evidence that the Government’s strategy to tackle obesity is disjointed, partial and careless of unintended consequences, and that it falls far short of the integrated public health approach that will be required if we are to meet this major public health challenge.
Research in obesity and eating disorders has often followed separate paths, but it is increasingly recognised that eating and weight-related problems need to be seen on a spectrum that goes from diagnosable eating disorders, through to disordered eating behaviours such as fasting, vomiting or laxative use, to body dissatisfaction, binge eating, being overweight and obesity. Studies show that individuals often present with more than one problem concurrently or move between different problems at different times in their lives, so eating disorders and obesity cannot be seen as separate and distinct issues. There is a raft of risk factors common to both: poor body image and low self-esteem; weight-related teasing; the modelling of poor eating behaviours at home; the stigmatising attitudes of teachers or sports coaches; and the socio-cultural norms around body shape that underpin everyday life. Any of these can increase the risk of both eating disorders and obesity in adolescence and adult life.
The interactions between the two mean that any strategy to address them needs also to be integrated. This is especially important when it comes to messaging. Many campaigns position being overweight and obesity as issues of personal responsibility and choice, shaming and stigmatising people, rather than acknowledging and addressing societal and environmental factors, as well as the powerful impact of genetics, epigenetics, metabolism and biology.
In 2020, 100 obesity specialists from around the world signed a statement in which they explained:
“The assumption that body weight is entirely under volitional control, and that voluntarily eating less and/or exercising more can entirely prevent or reverse obesity is at odds with a definitive body of biological and clinical evidence developed over the last several decades.”
Yet that same year, just months later, the Government produced an obesity strategy underpinned by the assumption that everybody is able to make the choice to modify behaviour and change their weight status. Not only does this stigmatise those who cannot, it can have negative consequences for people for whom the message is not intended. It can cause or exacerbate incipient or established eating disorders, promoting unhealthy dieting or inducing body dissatisfaction.
Children and adolescents are especially vulnerable to this kind of messaging, particularly those who are prone to anxiety. The simplistic portrayal of foods as good and bad, healthy and unhealthy, is risky for children, because they may not yet be at the developmental stage needed to appreciate the nuances involved. Many pre-adolescents report healthy eating initiatives at school as the trigger for an eating disorder, internalising messages such as “fat is bad” in a literal way, impervious to the importance of fat in their neurological development—of course they would be impervious to that; they are children. Children have a degree of cognitive inflexibility, and it can lead them to adhere very strictly to rules. In susceptible children, this can result in obsessive preoccupation with reducing calories, avoiding foods or increasing exercise to burn off what they have eaten.
The current obesity strategy, developed at speed as the links between Covid and obesity became clear, is far from the integrated approach that is needed to address these complexities. Its policies focus mainly on physical activity, diet and weight control and seem to have been designed in consultation with experts in obesity but with little or no input from specialists in eating disorders or body image. In my conversations with officials and Ministers about food labelling regulations, I was astonished at the levels of disconnect between eating disorder and obesity research, policy and clinical practice, and I found it hard to avoid the conclusion that concerns from an eating disorder perspective had been sacrificed to the perceived greater needs of the obesity crisis.
It is completely understandable that the Government have focused their attention on tackling obesity, given its increased prevalence, the long-term health consequences and the burden to both the NHS and the public purse. But it is regrettable that so many aspects of the strategy were not thought through: the complex interactions with other weight-related or eating-related issues; the particular risks to children; and, as the Secondary Legislation Scrutiny Committee has highlighted, the practicalities of implementation and the impact of this further delay on young people’s health.
Obesity is a major public health challenge, and it requires an integrated public health approach, one that balances risks and benefits and focuses on better education, healthcare and policies that modify the environment in ways that support healthier behaviours. The current patchwork of policies, with its partial focus and unexplained delays, is not going to be the answer.
My Lords, it is a pleasure to follow the noble Baroness, Lady Bull, who set out so clearly that we have to get away from blaming individuals for the fact that we have, as a society, a deeply damaging and disastrous relationship with food. Perhaps going even further than the noble Baroness, I stress that what is behind that is a broken food system—that what is supplied into the system is deeply unhealthy and damaging in all kinds of ways. It is both what is presented to people and what comes into the system that are problems.
It might be fairly said, as the noble Baroness just did, that tonight we are talking about partial, inadequate measures—and I offer the Green group’s support for both these regret Motions—but they are, at least, measures to do something. We can look at another partial, inadequate measure that has come into effect and we are starting to see the results of: the Soft Drinks Industry Levy Regulations 2018. It is very small and partial, but a recent study published in PLOS Medicine showed that we have seen an 8% reduction in obesity in girls aged 10 and 11 as a result of that. There is a gender aspect that I do not think anyone yet fully understands. It is a limited state of progress, but it is better than heading in the opposite direction.
Looking where we are now, here is one figure that is truly shocking: last year, 660 under-fives were admitted to hospital with obesity given as the primary cause of their admission. That is what our broken food system is doing. Restrictions on advertising were hard fought for and much discussed during the Health and Social Care Bill, and I remember sitting in your Lordships’ Chamber over what I suspect was many hours. Yet here we are today, and I cannot help reflecting on an earlier discussion in your Lordships’ House in which it was suggested that the Scottish Government were bringing in the bottle return scheme far too quickly. That was a three-year delivery from the regulations being passed to them being implemented. That was something Westminster could not imagine.
Looking to the general public, one of the things I have found again and again on that issue and issues tackling obesity is that people say, “We heard the government announcement, but it does not seem to have happened.” People think that once the Government have announced something it is happening, and the Government use that, announcing things again and again that never get delivered. It really is past time that we should be seeing the delivery here. I will finish with a question to the Minister: what is the higher priority here, the health of the nation or the profits of broadcasters?
My Lords, I am afraid I am a weary veteran of discussions about these regulations. As your Lordships know, the House’s Secondary Legislation Scrutiny Committee has absolutely slated them and the information provided with them. It mentions:
“The Explanatory Memorandum (EM) states that in 2019”—
that is a year after the industry was first warned that this sort of ban was going to be implemented—
“under current voluntary restrictions, children were exposed to 2.9 billion ‘less healthy food and drink TV impacts and 11 billion less healthy food and drink impressions online’”.
That is 13.9 billion hits. That was four years ago. In the four years between the measures first being announced and us legislating for the ban last summer, there were 13.9 billion every year, coming to 55.6 billion hits for unhealthy foods, which is an existential scale of influence on children’s food choices. Now we are being told there is going to be another three years of it; at the same rate, that is another 41.7 billion hits to persuade children to eat unhealthily. That comes to 97.3 billion adverts—a figure 12 times the population of the world. There cannot be a child in this country over that period of time who has not seen hundreds and thousands of adverts persuading them to make the wrong food choices.
We are told that the industry needs longer to prepare and the Government need longer to consult. The Government are consulting on simple technical issues that should not take many weeks, let alone another three years. Indeed, I understand there is an idea of changing the definition of these foods, but we already have a clear mechanism for deciding what these foods are. It is called the nutrient profiling model, and the industry knows it perfectly well, because since 2007, it has not been able to advertise those foods around children’s television programmes. So why do we have to wait another three years? How on earth do these delays line up with the Government’s strategy to halve childhood obesity by 2030? These things simply do not match up.
My Lords, I am grateful to the noble Lord, Lord Allan, for his Motion to Regret and for the excellent way in which he presented it, and to all other speakers who have contributed. I feel sorry for the Minister. He is one of several Ministers we have seen since 2015, since the Conservatives have been totally in charge of government, and, during that period, of course, we have seen obesity grow—it is the one area in which we have seen growth, growth, growth. It is an area that has now worryingly spread down, particularly to children. We can say what we will say today, but I know the Government are not changing their mind; they are kicking this ball into the long grass, into the next election and beyond. Really, I think we in this Chamber should start addressing ourselves to who will be in power next time around, and what we might try to do in persuading them to have policies that will effect changes, because the one thing that the Government should have learned is that relying on voluntary conversations and a voluntary response from the private sector and the businesses in the food and drinks industry rarely produces a response.
Yesterday, I had experience of where the Government have taken some action. I went out for lunch and I had a choice on the menu: I saw the number of calories available to me with the various foods that were in front of me. I chose to have food with 1,000 calories, as opposed to 1,500, which I might have chosen had they not got that legislation through—with our support. Where they failed, of course—we pointed this out at the time the legislation was going through—was when my colleagues sat down, my friends and family, and had the bottles of wine, the gin and tonics before and the rest of it. They had no idea what they were consuming. I have been talking about labelling on alcohol for years, and the Government have done nothing at all. They have relied on the private sector to try to effect changes; there have been some marginal ones, but we still do not have any knowledge of what people are consuming when they come to take alcoholic drinks. Often, they can be consuming far more calories in the form of drink than in food.
So, looking at a menu with calories on does work. Leaving it to the private sector to do it voluntarily does not. I am hoping that the next Government in power will recognise fairly early on that we have to take the action, do the research, get it on the statute book and then implement it and not fiddle around. Because we see that we now have type 2 diabetes emerging among children as young as nine, 10 and 11, and that was not the case back in 2010 when the Labour Government went out of power. It was not the case even in 2014. If we look at what is happening in America with type 2 diabetes, the projections of the numbers of citizens who will have it in the future are quite frightening. They are saying that there could be up to 90% with type 2 diabetes unless people start to address basic food and drink properly. Yet we are letting it slip through our fingers here today. I am hoping the Minister will sensibly recognise—he does endeavour to bring a business attitude to bear—that we need to get law and not rely on a voluntary approach.
Another approach linked to this—I hope my noble friend on the Front Bench might pick this up—is that we see increasingly that advertising is not so much influencing young people on television, but it is online, and these regulations do not touch on online advertising one iota. There may be a saving grace, in that there is a delay: whoever deals with it next will sweep up online advertising as well. Linked to that, there is a requirement to look at the whole advertising industry and see how it is operating and whether we should not contemplate introducing health taxes into advertising, so that those who are advertising the most harmful food and drinks should be paying taxes on their advertising, and those who are advertising good food should have encouragement and support. That is the kind of change that we may be looking for with a new Government—a different approach from the one we have had so far. So, I look forward with interest, as others do, to the defence the Minister is going to mount—a defence which will be about nothing changing while they are still in power.
My Lords, the Children’s Minister recently admitted that the nation had a problem with childhood obesity that should not be ignored. I am sure that noble Lords who have spoken today, and I am grateful to them, will share that view, not least because children with obesity are five times more likely to become adults with obesity, increasing the risk of developing conditions including type 2 diabetes, cancer and heart and liver disease. This is an extremely serious and pressing matter, as the Minister has been reminded yet again.
Two in five children in England are above healthy weight when they leave primary school and we now see the fastest increase in childhood obesity on record, as my noble friend Lord Brooke highlighted in his remarks. But it gets worse. Children starting school in the most deprived areas are three times as likely to be severely obese as those in the wealthiest, while NHS data shows that almost half of boys in England’s poorest areas are overweight or obese when they leave primary school. Last year, there were 3,400 severely obese children aged four or five in the most deprived parts of the country, as compared with 630 in the richest. So will the Minister give some indication as to what account is being taken of this great disparity between those who have more and those who have less in the Levelling-up and Regeneration Bill currently being considered in your Lordships’ House?
As we have heard today, it is absolutely right that we make informed choices about what we eat and drink, but choice can only really be choice if there is no distortion, and if those who are making the decisions have all the information they need and are able to interpret it. As the noble Baroness, Lady Bull, said, we actually need an integrated health approach to tackle the complexities of achieving a healthy weight. So the question for the Minister that has run throughout this debate is: how will the statutory instrument support this integrated health approach to tackle the complexities we know we have?
In the Government’s original analysis, they suggested a watershed on advertising, saying that introducing restrictions to prevent adverts for products high in salt, fat and sugar being shown before 9 pm could lead to 20,000 fewer obese children. I took it that this was, as others have said in the debate today, about shifting the environment, shifting the power of influences, in order to manage the challenges that we all face in supporting our wish to secure good health. So, will the Minister tell your Lordships’ House what will be the change in opportunity to tackle children’s obesity because of this regulation and the change it brings about? I refer in particular to page 33 of the Secondary Legislation Scrutiny Committee report. The noble Baroness, Lady Walmsley, referred to the figures. The report states:
“Analysis conducted to inform the Government’s Impact Assessment of the advertising restrictions found that under current restrictions children were exposed to 2.9 billion less healthy food and drink TV impacts and 11 billion less healthy food and drink impressions online in 2019”.
The committee observes that the effect of the delays means that, presumably, this level of advertising will continue and asks for an explanation as to why this is acceptable given the harms stated. Perhaps the Minister could refer to an answer on this point. The committee also asks for an explanation as to how the Government anticipate that they will still achieve the target of halving childhood obesity by 2030 if various elements of the strategy are delayed. Again, perhaps the Minister can tell your Lordships’ House his view on this.
Of course, there is a difficult balance to strike when seeking to improve public health and also when working with broadcast and online and the advertising industries. The Government have produced a regulation that has been drawn to the attention of the Secondary Legislation Scrutiny Committee once again, and this clearly does not assist the striking of that balance. It is not acceptable that the Explanatory Memorandum is described as “poor”, and that it fails to evaluate the effects on public health and the NHS from this delay. Nor is it acceptable that it fails to explain the use of a different definition from previous legislation. This refers to the unexplained shift from “high-fat, sugar and salt” to “less healthy foods”. The committee rightly asks whether the Government’s intended scope of products that they want to regulations to cover have been changed. Perhaps the Minister could respond on this point.
The SLSC also says that it
“provides insufficient information to gain a clear understanding about the instrument’s policy objective and intended implementation.”
It also says that, worryingly:
“The views of the NHS are not addressed or explained.”
This, I believe, is quite remarkable and suggests a breath-taking lack of engagement with those who should be engaged with. Once again, poor policy-making and poor administration have come together to leave your Lordships’ House unable to properly scrutinise what the Government are doing and why, even though it is the job of your Lordships’ House to do this. Perhaps the Minister could address these points of concern.
The Minister will recall that I have raised many times before the point about his department’s approach to legislation and the criticism that it has attracted. He kindly gave an undertaking that he would look into this with a view of doing better in future. Can the Minister could update the House of progress in this regard? Finally, I hope that the Government will not be diverted from measures that will have an impact on the health and weight of the nation.
My Lords, I congratulate the noble Lord, Lord Allan—despite his wish to invite people to kick our balls—and the noble Baroness, Lady Merron, for securing the debate to discuss these regulations. I also thank the Secondary Legislation Scrutiny Committee for its report on this, and I thank all noble Lords for their constructive discussion on how to tackle the pressing challenge on obesity. I thank the noble Baroness, Lady Bull, in particular, for her thoughtful contribution showing the complexities of the subject with regard to the impact on eating disorders, as well as obesity.
I like to think that we are all agreed on the scale and the gravity of the issue at hand. Data from the latest child measurement programme, as mentioned by others, shows that 38% of children leaving primary school were either overweight or living with obesity. One in four were living with obesity. This, as we know, is fuelled by the regular overconsumption of food and drink that is high in calories, sugar and fat—or HFSS food and drink for short. As the noble Baroness, Lady Merron, mentioned, we know that being overweight or living with obesity at a young age increases the risk of being overweight as an adult which, in turn, significantly increases the risk of diabetes, coronary heart disease, musculoskeletal issues and certain cancers. This impacts on both the individual’s well-being and wider society. As we all know, it comes at a very high cost. Not only does it cost the NHS £6.5 billion a year in the latest estimates—there is an economic cost estimated to be as much as £58 billion. For all those reasons, this Government are committed to tackling obesity: it is the morally and fiscally responsible thing to do.
My Lords, I am grateful to all noble Lords who have taken part in the debate. The noble Baroness, Lady Bull, gave us an important reminder that we need to think holistically about our entire relationship with food, including eating disorders as well as obesity. That is helpful, and something I am sure we will return to.
The noble Baroness, Lady Bennett, and the noble Lord, Lord Brooke, reminded us of other regulations in this area which seem to be having some success: the soft drinks levy and the information provided on restaurant menus. My noble friend Lady Walmsley’s institutional memory is extraordinarily helpful in explaining much of what has already been debated and agreed, undermining the Government’s argument that so much still needs to be done. The noble Baroness, Lady Merron, was right to criticise the process of presenting regulations, and I suggest a carrot and stick approach to the Minister. The carrot is a friendly, gentle debate in the Moses Room and the stick is to come here for another ball-kicking exercise.
Finally, on the substance of the regulation, the Minister has explained that the Government’s real goal is reformulation. This could be done perhaps more urgently than the Government are suggesting if they put their mind to it. If we can shift from being tomato eaters to turnip eaters in the space of a few months, I think we can shift from being unhealthy burger eaters to healthier burger eaters in less than two years. With that and the other contributions, I seek the leave of the House to withdraw the Motion.