(2 days ago)
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Lord Rooker
To ask His Majesty’s Government, further to the answer by Baroness Merron on 11 September (HL Deb col 1562), whether it remains their intention to lay regulations before Parliament to amend the Bread and Flour Regulations 1998 in 2024.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)
My Lords, I am delighted to be able to say that, a month ago, this Government laid the legislation to introduce the mandatory fortification of non-wholemeal wheat flour with folic acid. We are the first European country to do so, providing pregnant women with protection for their unborn babies from neural tube defects and the devastating impact on families. I pay great tribute to my noble friend and many others in this House who have championed this momentous intervention over a number of years.
Lord Rooker (Lab)
My Lords, I thank my noble friend for that Answer. Will she formally thank the Opposition, who spent six years saying no and five years organising the consultations that have led to this decision—just a few minutes ago, I was looking at four Ministers who had answered Questions on this? I do not want to be too negative but, in the department’s extensive press release on the day it published the regulations, why was there not a single reference, even in footnotes, to the Medical Research Council’s work of 1991, which over 80 countries have already followed? Has the Secretary of State picked up the phone to talk to Nicholas Wald, the research scientist who led that work in 1991, which has been followed by so many countries and now, belatedly but welcomely, by his own country, the United Kingdom?
Baroness Merron (Lab)
I am glad my noble friend welcomes the announcement that I am making today. With respect to any phone calls made by the Secretary of State, I will gladly find out; I certainly cannot comment at this Dispatch Box. I thank previous Ministers and officials who, over the years, have contributed to where we are. In respect of the delay, all I can say is that I am very glad to be the Minister announcing it today.
Baroness Manzoor (Con)
My Lords, I welcome the announcement; I think it is very good news. I also welcome the tenacity of the noble Lord, Lord Rooker. He has done an amazing job, so well done to him. For me, it is important to have a widespread strategy to include folic acid in flour and to look at previous programmes to, say, reduce rickets, to ensure that we do not increase inequalities by not thinking about the outcomes—for instance, ensuring that folic acid is included in chapatti flour.
Baroness Merron (Lab)
The addition of folic acid is to non-wholemeal products. Flour is not just used in baking but is in all sorts of other products. That is part of the reason for it being a 24-month transition, and of course industry can act quicker than that. The reason that it is in non-wholemeal flour is that wholemeal is already a higher source of folate. In respect of chapattis, all products will be considered. I should add that some of the transition time is due to the labelling changes that will be required. We are not stopping industry acting quicker, but we are being realistic about how long it will take.
Lord Krebs (CB)
My Lords, I congratulate the Government on introducing this legislation and the noble Lord, Lord Rooker, on his tenacity. However, I would like to ask about another vitamin. We know that between one in five and one in six people in the country have low vitamin D levels; the previous Government had a consultation on this back in 2022. Will the Minister update us on what the Government’s policies will be to try to address the issue of low vitamin D levels?
Baroness Merron (Lab)
I will be glad to look into that and to update the noble Lord and your Lordships’ House on the matter.
Baroness Walmsley (LD)
My Lords, I congratulate the noble Lord, Lord Rooker, on his persistence; these Benches have always supported him. I welcome that more NTDs will be prevented. However, given that we have to wait yet another two years and that the Government’s guidance for women who wish to become pregnant or who are pregnant is to continue taking folic acid supplements, are the Government looking at creative ways of making it easier for them to do that —for example, having them available for free in antenatal clinics or at family hubs?
Baroness Merron (Lab)
As I mentioned earlier, while 24 months is a realistic transition, not everything will wait that long. It is the case, as the noble Baroness says, that there is still advice to women who could become pregnant to take folic acid supplements, and it is important that we keep that message going. However, 50% of pregnancies are not planned, so it is not possible to prepare by taking supplements. We are looking at all ways of effectively getting the message across.
Lord Kamall (Con)
My Lords, I congratulate the Government on publishing the regulation. I pay my own tribute to the noble Lord, Lord Rooker—although he may not welcome it—for his tenacity on this particular issue. One of my frustrations when I was a Minister on this was how long the processes and consultations took. For future reference, if other supplements are to be introduced into our food, I wonder whether the department has looked at ways in which it could possibly shorten the process without compromising patient safety.
Baroness Merron (Lab)
Patient safety is at the forefront of this. I do not want to look backwards, but I gently suggest that there are all sorts of reasons for delays. Still, we are where we are now, and what is important is moving ahead. We are working closely with the Chief Medical Officers across the UK. We are very much in lockstep with the devolved Governments, and I think that will also assist.
Lord Winston (Lab)
Given the Government’s excellent initiative to reduce the serious risk of neural tube defects, which cause such despair to so many people, will they tell us where we have got to with fluoride addition to the water supply to prevent dental disease?
Baroness Merron (Lab)
My noble friend is right, and we anticipate that this policy will reduce the number of neural tube defects in pregnancy by around 200 a year. Those are life-changing brain and spinal defects, such as spina bifida. The question about fluoridation goes a little wider than I had anticipated.
Baroness Merron (Lab)
Please do not apologise. We are seeing through all the measures that are possible to reduce dental decay as part of our prevention policies, and that includes introducing supervised toothbrushing for young children. I know that a number of noble Lords are interested in the matter of fluoridation—they have raised it with me in discussions about dentistry—and I will be pleased to write to my noble friend.
Lord Patel (CB)
My Lords, the noble Lord, Lord Rooker, is right to mention Nick Wald; he pioneered the study that I was part of when I was on the steering committee of the MRC. The important point I want to make is that it is before pregnancy starts and in its early phases that folic acid is most important; it is not about prescribing it once the pregnancy is established. I speak as someone who had to look after many mothers who had neural tube defects, such as anencephaly.
Baroness Merron (Lab)
The noble Lord’s observation is, obviously, right. Folic acid contributes, for example, to tissue growth during pregnancy, as well as to the normal function of the immune system and to reducing tiredness and fatigue. As for the point I made earlier, one of the strong reasons for this policy is that 50% of pregnancies are not planned. Therefore, it is about ensuring that folic acid is available in a diet before pregnancy, whether or not that pregnancy is planned. That is vital.
Lord Kennedy of Southwark (Lab Co-op)
My Lords, we will hear from the noble Lord, Lord Dodds, next.
Lord Dodds of Duncairn (DUP)
I warmly welcome what the Minister has said. I thank the noble Lord, Lord Rooker, for his work on this, as well as those who worked with me when I had the honour to co-chair the all-party group on this in the other place. On working in partnership with the devolved Governments, can the Minister commit to continue that work of implementation and enforcement through to 2026, so that families will be spared the pain of having babies born with neural tube defects, which is a particular issue in Northern Ireland?
Baroness Merron (Lab)
I am grateful for the comments of the noble Lord, who himself has brought much to this campaign. I am glad that, in Northern Ireland, the legislation was laid a few days later, on 20 November. I assure him that we will continue to work with the devolved Governments on this matter; it is crucial that we do. I finish by thanking again all noble Lords, including my noble friend Lord Rooker, who has led from the front on this to ensure that we could announce it today.