Sugary Drinks Tax

Baroness Keeley Excerpts

Monday 30th November 2015 Westminster Hall

[Dr Rupa Huq (Ealing Central and Acton) (Lab)]

I am a late contributor to a long debate, so some of what I say will have been touched on, but I hope it is not all déjà vu.

Apparently today is the first day of Sugar Awareness Week, after “black Friday” and “cyber weekend”, or whatever—it is all good to know. According to Mick Armstrong, chair of the British Dental Association:

“Britain is addicted to sugar, and inaction can no longer be justified, either morally or financially.”

The debate, which to some extent reflects Britain’s love affair with sugar, is not the result of an intellectual curiosity, as subjects discussed in this Chamber often are, but arises from a petition. We have heard the figures —150,000 people have signed it—and we see it reflected in the number of people in the Public Gallery today.

One in four children leave primary school clinically obese—the hon. Member for Totnes (Dr Wollaston) said it is one in three—so we have to do something about the ticking health time bomb. The cost to the NHS runs into billions—my hon. Friend the Member for Warrington North (Helen Jones) mentioned £6 billion. Some people argue that the state should not interfere in such things, but it would not be the first time, because it is something that Governments of both complexions have done before, and as a result we have seen a reduction in the number of adult smokers in this country.

The clamour for action on sugary drinks and the arguments in favour of the funds raised going to tackle public health problems have received not inconsiderable public attention, at a time when health budgets are being squeezed. There is also the weight of expert opinion, not only the much mentioned one-time “naked chef” Jamie Oliver, but the Health Committee, chaired by the hon. Member for Totnes, who spoke movingly and powerfully earlier—she was a doctor first and an MP second—the British Medical Association, the British Heart Foundation, Diabetes UK and the British Dental Association. Hitherto, however, all appeals have fallen on deaf ears in the Government. The Royal College of Paediatrics and Child Health conducted a poll that revealed that 53% of the public support a tax measure.

Public Health England, in its sugar reduction action plan, states that the recommended proportion of added sugar in people’s diets should be 5%, but at the moment it is more like 12% for adults in this country. Added sugar accounts for 14.7% of calorie intake for children and 15.6% for teenagers. I am a mum myself and understand pester power and the attraction of sugary drinks. For under-threes, 27% of added sugar intake comes from soft drinks; for 11 to 18-year-olds, the category that I am a mum of, that figure rises to 40%. Furthermore, it is the 11 to 18-year-olds with the least amount of money who are attracted by cheaper alternatives to drinks such as water. Why is it that in any sweet shop water is more expensive than fizzy drinks?

Sugary drinks give a short fix of energy and have no nutritional value, while at the other end of the process the NHS is treating people for preventable illness. We have heard how most children in this country who go under general anaesthetic are doing so for tooth decay. Many hon. Members have also mentioned the figures for type 2 diabetes; 22,000 people in my constituency live with it, and it is responsible for a death every seven seconds in the G20 member states, which is a higher rate than HIV and malaria combined. At a meeting of the all-party group on diabetes, chaired by my right hon. Friend the Member for Leicester East (Keith Vaz), who is no longer in his place, we heard an impassioned speech from “St Jamie”, as one of my constituents called him at the weekend. I believe that in Jamie Oliver’s own restaurants there is a 10p levy on fizzy drinks.

On the one hand we have campaign groups and medical professionals, but on the other hand there is the argument about the nanny state. Many hon. Members have said that the solution is severalfold. The food and drink industries need to act more responsibly—they are the main lobbyists against the sugar tax—instead of arguing that any tax would be passed on to consumers and end up being a tax on the poor. They have also warned of sinister factory inspections and claimed that the tax would be unworkable, but they are acting in their own interests and not with the NHS health bill at heart. In Mexico, as we have discussed, a reduction in sales took place when a tax was introduced. I am almost reminded of that television programme set in the 1950s or ’60s, “Mad Men”, which is about the advertising industry. The advertisers in it say, “It’s not bad for you”, when they know it is.

There are good commercial operators. In my constituency is the UK headquarters of the French dairy company, Danone, which has its “Eat Like a Champ” programme, which 35 children will go through this year. It is unbranded, so no one knows it is a Danone programme, but it introduces healthy eating, diet and so on throughout the London boroughs. The programme has been developed with the British Nutrition Foundation. Such initiatives should be encouraged. The programme is also supported by Diversity—the pop group, not the concept—as its ambassadors. Danone is doing that as part of its corporate social responsibility. The hon. Member for Britvic—the hon. Member for Rugby (Mark Pawsey)—has gone now, but—

[Barbara Keeley (Worsley and Eccles South) (Lab)]

Says the hon. Member for Danone.

[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—

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[Barbara Keeley (Worsley and Eccles South) (Lab)]

It is a pleasure to speak in the debate with you in the Chair, Mr McCabe. I thank my hon. Friend the Member for Warrington North (Helen Jones) for the excellent way in which she opened the debate. In fact, we have had some excellent speeches. There was a bit of discord in some of the interventions and speeches, but broadly we have settled on a similar set of views. I want to emphasise that the causes of obesity are complex and that a number of factors can be involved.

We need to tackle the problem at both ends. We have talked extensively about the supply side and the drink companies, but we also need to talk about the demand side. We need far better education about how we can look after ourselves. We also need to give people the means of eating better food. In addition, we need to encourage them to take more exercise—we have touched on that, but I will talk about it a bit more later.

To tackle obesity—I am sure that this is the consensus that is developing—we need a comprehensive and broad approach that helps families, schools and children to make the right decisions. That might include people seeking medical help—I have had constituents in this situation—to get them started on the path away from obesity. That might include a programme or a summer camp—some way of starting to have a different diet and lots of exercise.

Many Members have referred to the statistics on obesity. The Health and Social Care Information Centre statistics are quite frightening: one in five children leaving primary school is classified as obese, and one in every three children is obese or overweight. There has been a significant move towards healthier, more nutritious meals in schools, and that is vital. However, I have concerns about how children and their families manage in the school holidays, when those healthier school meals are not available.

[Geraint Davies]

On a point of order, Mr McCabe. Like you, I sit on the Panel of Chairs. I was here for the first one and a half hours of the debate, and I had to leave the room for 20 minutes. I have introduced a Bill on sugar, and I was wondering whether I could crave your indulgence and make a small contribution, given that the debate is meant to go on until 7.30 pm.

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[Steve McCabe (in the Chair)]

No, we are going to continue with the winding-up speeches.

[Barbara Keeley]

I was saying that I have concerns about how children and their families manage in the school holidays. For anyone who has not heard about it, I want to commend the Feeding Birkenhead project, and the work done on it by my right hon. Friend the Member for Birkenhead (Frank Field). The project makes sure that children have healthy food in the school holidays. It is sad that we need to think about that issue, but we do.

Between April and September 2015, Trussell Trust food banks in Greater Manchester gave more than 22,000 lots of three-day emergency food supplies to people in crisis. Of those, nearly 9,000 were directed to children. We have talked about choice, but if we think this through, we realise that, if families rely on food banks to feed their children, that will limit the number of healthy meals they can make with fresh food. Clearly, for people in the upsetting circumstances of not managing financially, feeding their child with something is better than seeing them go hungry.

At the start of the debate, we heard about people who do not have local shops that sell healthy food, and we have to take that into account, too. Some people are also fuel-poor, while others work a number of jobs, which leaves them with little time to cook. We must not, therefore, jump to conclusions about why people are in this situation.

We should look at the wider issues around poverty, which must be addressed to ensure that people can access a good-quality diet. There is an awful lot more to achieving a good-quality diet than just wanting to do that. How, therefore, does the Minister plan to help families that have to rely on food banks? Next weekend, I will be helping the Trussell Trust food bank to collect food in my local supermarkets. On a previous occasion, one donor gave me lots of vegetables—onions and things like that. I thought they were part of her shopping, so I ran after her to give them back. However, she said, “That is just to liven the donations up. All the packet food seems a bit dull.” However, that is not the way Trussell Trust food banks operate—they have to have packet and tinned food. We have to think through what is happening in families where there is a reliance on donated food, which will not always contribute to a good enough diet.

Education must play a significant role. We want to provide children and adults with information about how they can achieve a healthy diet. One of the most interesting things Jamie Oliver has done—it was not his recent interventions here in the House—was his programme showing people how to cook. There were families that existed entirely on one or two sorts of takeaway.

[Geraint Davies]

Does my hon. Friend accept that, if one wanted to make money out of a potato, the easiest way to do that would be not to sell it, but to smash it up, mix it with salt, sugar and fat, reshape it into something called “Dennis’s Dinosaurs”, freeze them, give them a jingle and sell them cheaper than a potato to get addicts of sugar and other additives for manufacturers? Should we not, therefore, focus on providing lower-priced fresh food, and on increasing the price of sugar-impregnated food?

[Barbara Keeley]

As I was saying, we should look at the whole range of options. I want to talk about health campaigns. The Public Health England campaign Change4Life is an excellent example of providing families with information about small changes they can make to improve their health, as well as with advice on healthy recipes, diet and exercise. However, I fear that the announcement of a 25% cut to the non-NHS part of the Department of Health’s budget will have a significant impact on Public Health England. I want public health bodies to be able to continue campaigns to tackle obesity, but I am worried that their ability to do so will be damaged by these significant cuts. I am concerned that we will not in future be able to fund campaigns such as Change4Life, and that they may just not happen.

We must also be careful that the huge cuts to the public health grant given to local authorities do not reduce the advice and support available to those wanting to lose weight. At many community events in Salford, I have seen health improvement staff working with community groups and running all kinds of sessions. I fear that we will not have that in future.

Although the debate is about a sugar tax, I want to mention the importance of increasing physical activity among adults and children. I was a member of the all-party commission on physical activity, which published its report “Tackling Physical Inactivity—A Coordinated Approach” in 2014. We have discussed various aspects of our children’s health, but inactivity is a key factor, which is why a number of Members have referred to it. It is important that we encourage children to maintain active lifestyles from an early age.

[Dr Whitford]

May I draw the hon. Lady’s attention to a novel approach that has come out of St Ninians primary school in Stirling, called the daily mile? A teacher got the children to go out and run round the field. That seems to have made a huge difference at the school. Obviously, it costs absolutely nothing, and it seems to help the kids to concentrate, because they have been outdoors in the fresh air and—in our neck of the woods—probably in the rain as well.

[Barbara Keeley]

That type of initiative is wonderful, but fewer and fewer children are walking to school, and an awful lot more are being taken there by bus or by their parents. The Health Committee report reminds us that the latest figures show a fall in physical activity. In 2012, only 21% of boys and 16% of girls did enough exercise to meet the Government’s physical activity guidelines. That is a fall from four years earlier, when the figures were 28% for boys and 19% for girls. We are therefore going in the wrong direction, and we are all becoming couch potatoes. We might worry about this for ourselves, but it is a great concern when children are involved.

I am a former member of the Health Committee, and it is a pity that little emerges from the report, which simply reiterates and endorses the findings of its predecessor Committee’s inquiry, in which I was involved.

[Dr Wollaston]

I absolutely recognise that physical activity is important and that it should be for everyone, irrespective of their weight or age. Like me, the hon. Lady will remember Julie Creffield, who spoke so powerfully before our Committee in the last Parliament. However, the current Committee felt that it did not want to be distracted by something we had already produced some work on. We therefore wanted to endorse everything that was said by our predecessor Committee, rather than to go over that ground again.

[Barbara Keeley]

I thank the hon. Lady for that intervention, but I think it is a bit too easy to lose sight of physical activity, and that is why I have raised the issue. I hope we can be brave and bold about these issues too—it is good to be brave and bold about children’s health, but let us cover all the issues.

It has been said that treating obesity and its consequences alone costs the NHS more than £5 billion a year. It is great that we are having this debate, because we are past the point where we can just let things trundle along. Let me come to the crucial point in the debate. Public figures such as Jamie Oliver have come out in support of a tax on sugar, and he has added stardust to the debate. However, this is a complex issue, and the solutions must deal with that complexity. We know that something must be done, but what is that something?

The problem goes deeper than the demand side. The food and drink industry has not been dealing with the real problems. A number of hon. Members have talked about the Government’s responsibility deal, which has not worked. Firms have made promises and then failed to carry out their pledges. We have talked about labelling, which I will come on to. Many of the suggested interventions involve better labelling of products, but research by a team at the London School of Hygiene and Tropical Medicine suggests that interventions that improve information about and awareness of the risks do not necessarily translate into positive behavioural change.

As has been touched on, the responsibility deal focused mostly on salt, which was perhaps welcome. There have been real moves in that area, although every time I have a bowl of tomato soup these days, I regret that it does not taste like it used to. It is clear that salt is being taken out of our diets, but not sugar, which is the focus of our debate. The research team also found that although responsibility deal partners claim there has been “considerable sugar reduction” under their calorie reduction pledge,

“the current progress reports do not substantiate these claims.”

In fact, responsibility deal partners say they have reduced sugar levels under the calorie reduction pledge, but they have not.

[Geraint Davies]

On the relationship between sugar and calories, is my hon. Friend aware of emerging science showing that if two people both eat, for argument’s sake, 2,000 calories a day, and one has a history of eating a lot of sugar, that person will be predisposed to convert more of the sugar to fat than the other person, irrespective of the amount of exercise they do? That is a particular reason we should target sugar.

[Barbara Keeley]

I did not know that; my hon. Friend clearly has background knowledge and experience that I do not.

I want to come back to the responsibility deal, which is important in terms of the Government’s approach. That deal is seen as flawed because firms were allowed to decide what pledges they signed up to, and there were no penalties for those that did not honour their promises or, indeed, take part at all. At the time of the responsibility deal’s introduction, organisations such as the BMA, the Royal College of Physicians and Alcohol Concern complained that the pledges were not specific or measurable and that, in fact, the food and drink industry had simply dictated the Government’s policy. We have to get away from that.

The Minister will tell us more about a sugar tax, but it seems that the Prime Minister has ruled out action on sugar, despite the independent report commissioned by the Department of Health. That leaves me wondering whether the Government are listening to vested interests, instead of the experts whom they commissioned to write the report. The corporations that make the bulk of sales of sugary drinks in the United Kingdom want to maximise profits for their shareholders. They will not voluntarily lower the amount of sugar in their drinks unless there is something in it for them, or unless they are required to do so by law. Likewise, they will not reduce the amount or nature of advertising of sugary drinks—not voluntarily, anyway.

We must look back to what happened with the tobacco industry, which consistently pushed for a voluntary approach to avoid legislation. The industry trundled along, smoking continued unabated and profits were left alone. In my local authority, Salford, smoking was increasing at levels that really concerned me, particularly among young people. However, once specific regulations were introduced, such as warnings on cigarette packets and the blanket ban on smoking in enclosed spaces, smoking levels started to decline. I am therefore inclined to think that one of the most effective remedies would be a modest but compulsory reduction in the amount of sugar in soft drinks. A fiscal solution such as a sugar tax could well form part of the solution, but the Opposition retain a concern about the impact that extra taxes will have on the pockets of parents, as has been mentioned, particularly in low-income families. If we have learned any lessons from what happened with the tobacco industry, it is that intervention will need to involve legislation.

The report produced by Public Health England makes a number of recommendations, which Opposition Members will study in full. We believe a fiscal solution such as a sugar tax may be necessary, but we are not yet fully convinced. As a number of Members have said, we should not focus on one thing as a silver bullet. The Opposition will consider all the evidence on what can be done to tackle childhood obesity as we review our policy over the coming weeks and months.

This has been a high-quality debate. I hope that the petition and the debate will ensure that the Government do not repeat past mistakes with voluntary approaches such as the responsibility deal, which has generally been seen to have failed. I urge the Minister to look at a wide range of activities to tackle childhood obesity, including doing much more on physical inactivity.

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[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?