Support for Infants and Parents etc (Information) Bill [HL]

Baroness Miller of Chilthorne Domer Excerpts

2nd reading
Friday 6th September 2024 Lords Chamber

[Baroness Miller of Chilthorne Domer (LD)]

My Lords, it is a great pleasure to follow the noble Lord, Lord Blunkett, and his very positive comments. Indeed, I congratulate the noble Lord, Lord Farmer, on using his high position in the ballot to continue his long-term campaign to secure a firm foundation for young families.

The Bill’s intention is excellent; my concern is that, given the extreme financial constraints on local authorities at the moment, loading them with extra duties may not be very easy or realistic. However, I hope that this Bill progresses and that I will have the opportunity to propose some constructive amendments to progress an absolutely foundational area for babies that impacts on their health for their entire life. The noble Lord, Lord Farmer, mentioned this, and it is, of course, feeding.

How babies are fed in the first months of their life is absolutely crucial. I am sure that noble Lords here do not me to spell out the advantages of breastfeeding in terms of health. But the shocking statistic for this country is that 81% of mothers start breastfeeding but by six months—and the World Health Organization and all the health organisations suggest that it should go on for six months—only 1% are still breastfeeding.

There was an infant feeding survey, which was discontinued in 2012 but then restarted in 2023, which is positive. Can the Minister tell me whether the results of that survey are expected shortly and whether the Government intend to continue this survey from now on? We need to do all we can to help those who breastfeed, at least for those first six months.

At the moment, however, the push all comes from the other direction, and has for 40-odd years—well, more. That was why the World Health Organization brought in the International Code of Marketing of Breast-Milk Substitutes, because the heavy way that the substitutes are marketed means that the incentive to breastfeed, the image of breastfeeding and the positive aspects of it are really undermined. In 2007, the previous Labour Government recognised how important this was and brought in the Infant Formula and Follow-on Formula (England) Regulations, which attempted to put the code on the books in the UK. The UK legislation on infant formula incorporates some but not all of the code into law. Would the Minister consider incorporating more of it into law?

UNICEF has some really helpful ideas specifically for the UK, including:

“Develop a National Infant Feeding Strategy Board … promote, protect and support breastfeeding in all policy areas”—


as the noble Lord, Lord Farmer, mentioned—and:

“Implement evidence-based initiatives that support breastfeeding”.


In 2023, the Lancet ran a very interesting three-paper series about the impact of the amount of advertising from the commercial formula manufacturers, which is used to target parents, healthcare professionals and policymakers. There are marketing practices which, on the face of it, comply with the law but actually undermine breastfeeding—that is the fact. The Lancet found that the monitoring and enforcement of UK legislation is very weak, which means that companies are rarely prosecuted for breaking the law. I cannot remember a case and I have been following this since about 1980.

That is an area where I would like us to be able to table some amendments to this very constructive Bill and make sure that the work of the WHO, the Lancet and UNICEF is underscored by our legislation.

Health Protection (Coronavirus, International Travel) (England) (Amendment) (No. 7) Regulations 2021

Baroness Miller of Chilthorne Domer Excerpts

Monday 22nd March 2021 Lords Chamber

[Baroness Miller of Chilthorne Domer (LD) [V]]

My Lords, there is much to regret in the way that the Government have handled travel issues during this pandemic. First of all there was far too much travel. Now, with these regulations, there are still some really big loopholes. The guidance is unclear. People cannot travel for holidays: that much is clear. But they can travel for business. What actually constitutes business and what checks have been done on that? There have been plenty of reports of so-called influencers travelling for business to places such as Dubai because it is sunny. Does that qualify?

There is another very unequal bit of these regulations. The very wealthy may well have two passports and fly in their private jets. If you follow a flight tracker, you will see that plenty of private jets are still going to places such as Farnborough. What checks are done on them? It would not really affect them hugely if they were fined, so what does the Minister intend to do about that? They are more likely to have been to many countries around the world as well.

I have one last point. Could the Minister give some guidance for those needing to travel for imperative family reasons? That has really been lacking. I am talking about family death or severe illness, for example. If your parent is at death’s door—say with end-of-life cancer— you can hardly quarantine for 14 days before arriving at their bedside. It is obviously different if they have coronavirus. A clear statement is needed on what are imperative and humane reasons to travel in family situations. Could the Minister make one?

Antimicrobial Resistance

Baroness Miller of Chilthorne Domer Excerpts

Thursday 2nd May 2019 Lords Chamber

[Baroness Miller of Chilthorne Domer (LD)]

My Lords, I congratulate the noble Lord, Lord Lansley, on securing this debate. My contribution will focus on just the farming aspect of the issue.

I thoroughly agree with the noble Lord that the whole point of this issue is that it is a one-health problem. One of the lessons is that we cannot divide human health from the health of the animals we eat. If animals are kept in a way that requires them to be dosed with antibiotics on a frequent and routine basis, then of course we should expect to affect human health as microbes learn to find ways around being killed.

The problem is very well exemplified in the pig industry, because when piglets are weaned very early, after say just 20 days as opposed to 40 plus days, they are likely to suffer from diarrhoea and lose natural resistance, so of course they are dosed. I praise the pig industry for making efforts to reduce the use of antimicrobials by about 50% in the last two years, which is a pretty big reduction. However, data from the Veterinary Medicines Directorate shows that in 2017, the last year I have data for, the UK pig sector still used about 130 milligrams of antimicrobials per kilogram of pig. Compared to our neighbours in Holland or Denmark, that is still very high. Why is it so high still? I am not sure; perhaps the Minister will know why. In the Dutch and Danish pig sectors, use of antimicrobials is less than half the UK’s use, at 53 milligrams per kilogram in the Netherlands and 46 milligrams per kilogram in Denmark. There is quite a big room for improvement. Moreover, reduction in the use of antimicrobials in the UK pig sector has in part been achieved by relying on extremely high use of zinc oxide in the feed. Perhaps the Minister can tell me whether it is true, but I understand that there is a link between such zinc oxide use and the rise of MRSA.

Turning to chickens, broiler chickens in particular, ionophores are the antimicrobial compounds that specifically target bacterial populations in chicken production. Those of your Lordships who have been around a broiler chicken plant will have needed a strong stomach to do so since they are kept very intensively. Ionophores are routinely added to the feed of the most intensively farmed chickens to prevent the serious intestinal disease coccidiosis. No veterinary prescription is required. This disease occurs when chickens eat other chickens’ droppings, so intensive systems where tens of thousands of birds are kept permanently indoors in overcrowded conditions are likely to need to be dosed frequently.

One of the issues for the Government is that, if Brexit happens, they will be looking at with whom to make trade deals. The Government should consider the effect of making deals with people who are encouraging intensive farming when looking at agricultural trade deals and where our food will come from. I do not think that it is any coincidence that antimicrobial resistance is much higher in the USA when we look at how much of its food comes from intensive farming. The Federation of Veterinarians of Europe is concerned about the overuse of ionophores in poultry production and has called for the drugs to be made prescription-only. I wonder whether that is something that the Government are considering.

I am pleased that the Government have brought in their five-year action plan, but there is an issue that I would like to ask the Minister about this afternoon. The plan fails to give a clear commitment to carry over and incorporate into domestic UK legislation, should we leave the EU, the EU’s recently agreed legislation that bans routine preventive use of antimicrobials. I am particularly worried because a Question was posed in the House of Commons by Kerry McCarthy MP as to whether the Government will ban routine preventive use. The Answer was simply:

“Ministers have confirmed the Government’s intention to implement restrictions on the preventative use of antibiotics in line with new EU legislation”.


That does not sound like a ban to me. There will be a couple of problems with that. First, it will be in conflict with the new five-year plan. Secondly, if we try to export any food products to the EU, they will of course be unacceptable in EU terms. The Government need to come off the fence and say that they will entirely implement the ban as envisaged by the EU.

Finally, I turn to the remarks made at Portcullis House on 13 February by Professor Mark Woolhouse, who is the professor of infectious disease epidemiology at Edinburgh University. He makes the point that, in the context of this, an issue is that the UK Government’s emphasis on actions and research is still happening in silos when it comes to surveillance. The challenge is joining up the surveillance across the human, livestock and environmental sectors. Cross-sectorial transmission studies have been unsuccessful because they are not large enough in scale, and research access to routine surveillance data will be crucial for understanding the spread of AMR. Coming from such an expert, this is a very serious issue, and one that the Government need to address by supporting research that is bold and, as he says, mission orientated, and funding it sufficiently so as not to undermine their five-year action plan.

Health and Social Care (Amendment) (Food Standards) Bill [HL]

Baroness Miller of Chilthorne Domer Excerpts

Friday 8th November 2013 Lords Chamber

[Baroness Miller of Chilthorne Domer (LD)]

My Lords, I start by paying tribute to my noble friend Lady Cumberlege not only for her excellent presentation of the Bill, but for all the work that she has done in preparing for today’s debate and in pursuing this matter over the years.

I also pay tribute to the Sustain organisation, which plays an important part in the Campaign for Better Hospital Food and has provided us with a lot of information and briefings. That organisation deals with every aspect of food from growing and procurement to sourcing local food. The campaign to make us healthier and keep us healthy through eating healthier food is one element of what that body does.

Amid all the gloom about the failure of voluntary initiatives in this area over decades, there are a few shining examples of good practice. I first came across one of them when I was a Somerset county councillor and the council was looking at food procurement. The Royal Cornwall Hospital took a very different approach by procuring its food locally, thereby ensuring that it was fresh and that it contributed to the local economy. It also commissioned a completely different approach to hospital kitchens by putting catering staff at the heart of making people better. As a result, the hospital’s food became much more appetising and the amount of waste went down. Food waste is still a tremendous issue. I think that that hub now supplies three other hospitals in Cornwall. It is an amazing example of what can be done when the will is there and the leadership of the hospital makes that effort. However, voluntary initiatives are not always sufficient, given that the Royal Cornwall Hospital initiative was introduced back in the early years of this century and if other hospitals had wanted to follow that example they would have done so by now. That is why I think the Bill is very important because unless we have mandatory standards nothing will happen. The Campaign for Better Hospital Food summarised the history of the past two decades as one in which every year a high-profile initiative is introduced by either a Minister or a celebrity chef, but one, two or three years later it bites the dust.

The people to whom I have spoken about the Bill have found it jaw dropping that there are no mandatory standards for hospital food. They find that incredible. As the noble Baroness, Lady Cumberlege, mentioned, I have the privilege of chairing the Food and Health Forum. Back in January 2012, we listened to presentations on this subject and I was struck by two points in particular. One of the presentations was given by members of the Royal College of Nursing, who forcefully made the point that hospital food contains too many harmful elements—salt, sugar and saturated fat have been mentioned in the debate—and far too few of the elements that provide good nutrition. For example, the noble Baroness, Lady Gibson, mentioned the lack of fresh fruit. We listened to another presentation from the charity Heart of Mersey, which seeks to combat heart disease. That charity has campaigned very hard to improve hospital food because diet is very much implicated in hospital admissions for people with heart disease. How on earth are they meant to get better if hospital food exacerbates their health problems?

Clause 3(b) of the Bill is very important. The Government may say that it is too onerous to impose requirements relating to good procurement and other issues. However, the clause asks only that account is taken of the food chain, animal welfare, fair trade and food waste. Those are all very important elements. The example of good practice I cited at the Royal Cornwall Hospital proves that these issues can be addressed.

The status of catering staff is a key issue. All too often they are seen as being at the bottom of the food chain, if noble Lords will excuse the pun. However, they play a key role in ensuring that patients recover. When I was talking to my husband about this debate, he reminded me that he is one of the closest living relatives of Florence Nightingale. She ensured that one of the key elements in her nursing regime was to give soldiers hot food every day instead of the old, putrid food they had received hitherto. That was a key element in improving the mortality rate in the relevant hospitals.

This small, modest Bill is absolutely key in this area. I hope that the Minister will welcome it as the efforts of medical staff are often undermined by the poor hospital food being given to their patients.

Public Bodies Bill [HL]

Baroness Miller of Chilthorne Domer Excerpts

Monday 28th March 2011 Lords Chamber

[Lord Judd]

My Lords, in the absence of the noble Lord, Lord Greaves, I rise to move Amendment 31 and to speak to Amendment 34. In doing that, I should also like to say a few words about the government amendments. When I arrived at the House today, there was a message from the noble Lord, Lord Greaves, asking me to move the amendment and saying that he was “confined to barracks”. I thought, “My goodness, the Whips are getting tough on the other side”. But, in fact, I am sorry to say that the noble Lord is unwell again. I am sure that it would be the wish of the whole House, because of the noble Lord’s commitment on these matters, to send him greetings and God speed for a rapid recovery.

After the profound issues of law and legal institutions that we have been having today, this issue might seem a bit ephemeral. However, I do not believe that it is ephemeral because it is central to the quality of our society and those things that make Britain a place worth living in. Before I speak to Amendments 31 and 34, I should like to put on record how much many of us appreciate the moves made by the Government in their amendments to remove some of the anxieties which were surrounding the future of the parks. No one could be in any doubt that we have Ministers, whatever our profound differences on all sorts of things, who are committed to the national parks. Indeed, I was very impressed when I took the chair at a meeting on Thursday to hear the Parliamentary Under-Secretary of State speak so positively about the parks. From that standpoint, I should like to express real gratitude that the Government have moved. In a sense, that makes my remarks on Amendments 31 and 34 sad in that I wish they were not necessary.

The amendments would remove national park authorities and the Broads Authority from Schedule 3, the schedule relating to constitutional arrangements. As has been the case on a number of other parts of this Bill, it is not clear why the wide scope of Clause 3 is necessary in the light of powers that are already available to Ministers and the absence, as I understand it, of radical proposals in the local responses to the Defra review of governance of national park authorities and the Broads Authority.

It has been suggested that the list of constitutional arrangements in Clause 3 could be tightened in relation to its application to national park authorities and the Broads Authority. However, the Government have indicated that they are not ready to do that because of the way in which the clause is set up. Clause 3(1) gives Ministers the powers to change constitutional arrangements and subsection (2) says that that includes X, Y and Z and so on. But it is not a definition of the power itself. So the Government could still make a constitutional change even if it was not listed in the examples.

It might be helpful if I put three specific questions, which I hope are constructive, to the Minister. First, why is it considered necessary to include national park authorities and the Broads Authority in Schedule 3 at all, given the powers that Ministers already have in relation to amending the membership of these bodies—for example, those introduced by the Natural Environment and Rural Communities Act 2006? Secondly, will the Minister indicate which proposals emanating from the Defra review of governance of national parks are likely to require legislative changes, particularly any proposals which relate to the composition of membership of authorities and which would anyway be covered by Section 61 of the NERC Act? Thirdly, can Ministers provide a definitive list of the constitutional arrangements of national park authorities and the Broads Authority that they consider will be covered by Clause 3? Which of these do they consider will need amending in the light of the Defra governance review, which, it seems, will not be published until May because of the local elections?

If greater flexibility is still deemed necessary by the Government, surely it would be better for the Bill to contain a dedicated clause relating to national park authorities and the Broads Authority which amended the relevant sections of the National Parks and Access to the Countryside Act 1949 and the Norfolk and Suffolk Broads Act 1988? It could specify what constitutional arrangements Ministers would have the power to amend by order. As it is, I hope that Ministers, with whom we have worked so well on this Bill, will agree that Clause 3 as it stands is unacceptably open-ended. I believe that it is time to reflect. I hope that the Government, as they have so readily done on some other issues, will move to meet these points. I beg to move.

[Baroness Miller of Chilthorne Domer]

I support the noble Lord, Lord Judd, in the questions that he put. I remember, when the NERC Act was going through, the lengthy debates that we had on how many representatives of the national interest should sit on national park authorities, what role councillors from the principal local authorities should have if, for example, they lived outside the park and so on. Many of the issues are worthy of deep consideration and consultation. It seems unfortunate—I know that it is just how the timing has worked out—that we will have to agree or disagree with the drafting here, before the consultation is completed. Up until now, the governance of national parks has evolved in a way that has carried support. My fear is that if it changes and becomes the subject of ministerial decree that consensus will be lost. I am very concerned, and I am very glad that the noble Lord, Lord Judd, put his questions.

[Lord Marlesford]

I support totally what was said by the noble Lord, Lord Judd, and by my noble friend. There are very few things which I mind so much about as the national parks; I have been very much involved in them for a long time. The national parks, along with the planning legislation of the same period of 1948-49 were one of the two great achievements of the Attlee Government—the other being the creation of the National Health Service. Let us remember that we created our national parks only some 50 years after the Americans created theirs in, I think, 1898.

I am afraid that it would be absolutely unacceptable for the Executive, whichever Government were in power, to make crucial changes to the organisation and administration of the national parks without specific parliamentary approval in each case. Of course, one is not saying that there should not be any changes at any stage, but I am afraid that my suspicion of Executives is such that I would never agree to something as crucial as changing the national parks without specific parliamentary approval.

It is quite interesting that the national parks and the Broads Authority are mentioned separately, and I am sure that all noble Lords know why that is. The national parks were formed under the 1949 Act and, as the noble Lord, Lord Judd, has pointed out, the Broads Authority was formed in 1988. I was very much involved in that because I was on the Countryside Commission at the time. The only reason that the Broads Authority was not a national park at the time was, first, because the original definition of “national park” was a wild area, which the broads clearly were not, and, secondly, because initially there was a lot of suspicion and opposition in the broads that commercial interests concerned with boating, although perfectly legitimate, might be interfered with by its becoming a national park. Therefore, frankly, it was something of a concession to say that the broads were not a national park and that they had their own separate Act of Parliament.

I am not saying that I would necessarily die in a ditch for that to continue. The crucial thing is that the national parks, including the broads and the parks created since the 1949 Act, should continue to have the complete protection at the pinnacle of our hierarchy of designation of countryside areas. Of course, they are obviously followed by heritage coasts and areas of outstanding natural beauty and so on, but they are so precious to this country that we need a lot of reassurance regarding exactly what powers the Government are seeking and reassurance that those powers will not be exercised without reference to Parliament in each case.

Food: Regulation and Guidance

Baroness Miller of Chilthorne Domer Excerpts

Thursday 7th October 2010 Lords Chamber

[Baroness Miller of Chilthorne Domer]

First, I thank the noble Lord, Lord Whitty, for giving us the opportunity, which we rarely have in this House, to discuss food nutrition. When these issues are so central to our lives for both our health and social well-being, it is remarkable how seldom we debate them.

It also gives me great pleasure to follow the noble Lord, Lord Rea, who, as chairman of the Associate Parliamentary Food and Health Forum, has provided a wonderful opportunity for those of us who belong to it—I declare an interest as an officer—to attend the seminars that it lays on, many of which have covered subjects that have been touched on today, such as trans fats, salts in food, and in utero nourishment. I have learnt a tremendous amount from the forum. The secretary, Patricia Constant, now produces a very helpful round-up of everything that has happened called “Food in Parliament”, which makes it much easier to see who is asking about what and who is not asking anything at all, which is also very interesting. Therefore, I express great gratitude to the noble Lord, Lord Rea, for all the work that he has put into the forum. It has made a huge difference to parliamentarians’ understanding of these issues.

I was very struck by the noble Lord, Lord Giddens, saying that we should not consider this matter simply by itself but that it is part of a much larger issue, which of course it is. Noble Lords who are here to debate the millennium development goals shortly could equally well have taken part in this debate, or vice versa, because 1 billion people in the world still suffer from chronic hunger. Even if millennium development goal No. 1 is reached by 2015, half a billion people will still suffer from chronic hunger. That is not to say that people suffering from malnutrition in this country have any less of a problem—it is all part of the same problem, and I shall give noble Lords one example.

The fact that there are so many quite obese people is partly due to the fast food industry and Big Macs and so on, because a lot of very fatty cheap meat was heavily promoted. Of course, the cost of that very cheap meat has been borne in countries where grain and soya prices have gone up. Grain and soya is fed to the cattle to provide the western world with the very cheap meat, which is ruining our health, and there is therefore a vicious circle. It is vicious for us for all the reasons that we have heard today, and it is vicious for those still suffering from chronic hunger, so I do not think that we can afford to take this matter lightly. We need to start taking a tougher line with the food industry, and I am glad that some noble Lords have said that today.

The FSA has done some good work, which I shall refer to in a moment, but I think that it lacks the necessary teeth in the face of the strength of the food lobby. It is therefore time for a new look at the FSA. Establishing the agency was an attempt to bring policy together, but the question of nutrition was fudged at the outset. The FSA was never given a strong enough remit to take on nutrition. It picked up the reins as best it could but nutrition was never in its original remit and so the agency was always on the back foot, reacting to the next food industry initiative.

For an example of how seriously the Government will need to take this issue we need only look at the excellent debate in this House on 13 July this year on nanotechnologies and food. The committee looking into this, under the noble Lord, Lord Krebs, who knows a great deal about food regulation, having been in charge at the outset of the FSA, highlighted a huge number of points that I could not hope to reiterate this afternoon. However, I draw attention to the sort of danger that the noble Lord sees. He said:

“First, by keeping quiet about nanotechnologies, the food industry leaves a communication vacuum into which pressure groups and/or inaccurate media reporting will happily step. Secondly, in contrast to what was said about GM products in the 1990s, there are real potential consumer benefits to be had from nanotechnologies”.—[Official Report, 13/7/10; col. 656.]

There is a need for a strong regulator to be able to rely on some very well researched issues as this is an extremely fast-moving field. Let us consider what nanotechnologies can do to food. For example, we could be offered ice-cream that will look like ice-cream and taste like ice-cream but will not be ice-cream. That might be good in that it will not fatten you, but it might be extremely dangerous in the sense that it would not contain any of the benefits of a dairy product that we have come to know. I know that the Minister said when replying to that debate that he foresaw a robust regulatory function that would still continue to be delivered through the agency, but he admitted that it was a fast moving picture. He went on to say that,

“the FSA could more sensibly and cost-effectively sit elsewhere”.—[Official Report, 13/7/10; col. 671.]

I do not take issue with that. Like other noble Lords, I want Ministers to be more accountable for some of the issues, but I hope that “cost-effectively” is not shorthand for saying that the nutritional element will completely disappear from the horizon. As has been highlighted this afternoon, it is incredibly important.

I join other noble Lords for whom nutrition begins before the baby is born by saying that we still ignore the diets of pregnant women too much. It is incredibly striking how brains develop during pregnancy and not thereafter, so I make a plea for the nutrition of pregnant women and breast-feeding to be particularly concentrated on. Only last week, yet more research showed that babies who had been breast-fed for up to six months had much better health outcomes in a large number of ways. Indeed, the NHS’s own figures show that 84 per cent of women know that breast-feeding is particularly good for the health of their babies, yet the figures still drop off dramatically a month after the baby is born. It is a cultural issue as much as anything. It is very difficult to get people to go back to providing for breast-feeding or encouraging it in the workplace and elsewhere. It is no more acceptable in pubs and restaurants than it was when I was a young mother. That is a pretty sad state of affairs considering that that was about 30 years ago.

Finally, I shall mention the Tudge principle which we have adopted in our house. It comes from an author called Colin Tudge, whom I have had the privilege to meet a couple of times. He has written a number of books on food and has done a great deal of work in this area throughout his life. Among his books, he has written So Shall We Reap and Feeding People is Easy. Primarily, his contention is that if we look at some of the places in the world that we consider to have terrific cuisine, such as the south of France, and the places that we go to to enjoy the sort of diet that they have, we see that they eat very little meat and a lot of vegetables, rice and other things.

It is going to be hard to get back to that sort of principle in the face of the biggest added value for the industry always being meat, but it is important in dietary terms and incredibly important environmentally. The UN’s most recent report on agro-ecology shows that, in climate change and sustainability terms, it will not be possible to continue with current meat consumption in either the western world or the countries that are now aspiring to join it. We all have to change our thinking and go back to meat being a small part of our diet. For example, in a risotto, there might be a few pieces of meat. A chicken is for high days and holidays. Yes, it will be hard for our generation and probably for our children, who have grown up with eating meat, but it is a matter of taste. That is where we come back to school meals. We educate our children's palates when they are very little, and it is very hard to get over that. That is why, when people are ill or far from home, they crave the things that they had when they were little. I hope that the Minister will be able to comment on what will happen with the future regulation of school food, because we need to get into schools to educate the children's palates for the future. It is no good regulating people when they are adults; that is too late.