Health and Care Bill

Baroness Finlay of Llandaff Excerpts

Lords Hansard _ Part 1 & Report stage
Wednesday 16th March 2022 Lords Chamber

Moved by

[Baroness Finlay of Llandaff]

163: After Clause 164, insert the following new Clause—
“Alcohol labelling
(1) The Secretary of State must, no later than one year after this Act is passed—(a) publish a report on alcohol labelling, assessing which elements should be mandatory on labels to improve consumer knowledge, and this should include, but not be limited to—(i) warning about alcohol harms,(ii) calorific and other nutritional information,(b) lay the report before Parliament, and a Minister of the Crown must arrange to make a statement to each House of Parliament setting out any steps which will be taken to implement the findings of the report.”Member’s explanatory statement
This amendment requires the Secretary of State to publish a report on alcohol labelling to improve consumer knowledge.

[Baroness Finlay of Llandaff (CB)]

My Lords, we now come to an amendment on alcohol, and I declare that I chair the Commission on Alcohol Harm. This amendment is designed to get the Government to produce a report on labelling, which is long overdue. Some people in this Chamber have been asking for it for 20 years or so, and nobody can quite understand the delay.

My amendment looks at the feasibility of putting information on labels about the harms and calorie content, and it runs completely in line with the Government’s strategy on trying to do something about obesity across the nation. I know that some people in the alcohol industry have suggested that they would like to put a QR code on, but it seems almost impossible to imagine people going with their mobile phones along a supermarket shelf looking at all these QR codes. If they can put some printing on the QR code, they could put on some printing with proper health information, harms information and calorie information in a way that one can read it in a reasonably sized font.

Alcohol is the leading cause of death and ill-health among 15 to 49 year-olds. It is linked to more than 200 health conditions. Alcohol is highly calorific: two glasses of wine can contain almost the entire daily recommended sugar limit. If you have two glasses of some wines, you will have a calorific intake that is the same as that of a big burger. This is not small numbers of calories.

Currently, the only legal requirements on alcohol labels are alcohol by volume, the volume itself and the common allergens that may be present. This does not match up with other food and drink. Alcohol labels do not list ingredients, calories or other information such as health impacts. There is more information on a bottle of orange juice or a carton of milk than there is on a bottle of wine.

The Government have committed money for the drugs strategy. That is most welcome, but I hope it will not all get diverted into drugs of addiction and that it will actually be used to support alcohol treatment services. We know that, in the last few years, only about one in five dependent drinkers have been able to access treatment services for their alcohol addiction.

The problem for consumers when they start out is that they do not know what they are consuming. They do not realise how calorie-laden the drinks are, and they cannot make informed choices about their health. Nor can they make informed choices about the dangers they pose to others, which includes other people with whom they interact when they are intoxicated as well as the dangers in driving.

Voluntary labelling has failed. We have seen again and again that consumers will not get the information they need on alcohol labels unless it is required in legislation. Seven in 10 people think that the warning should be displayed on alcohol labels as a legal requirement. Even the symbol not to drink in pregnancy is so tiny that it is not getting the message across, and foetal alcohol syndrome featured on the “Today” programme just this morning.

I remind the House that we took forward the Domestic Abuse Act, and one in five people are harmed by other people’s drinking.

As for driving, the road death figures show that problem drinkers are responsible for many of the 2,000 seriously injured or killed each year in alcohol-related crashes. The long-awaited consultation on labelling must also look at lowering the blood alcohol limit to 50 milligrams per 100 millilitres of blood, with its potential to reduce fatal alcohol-related crashes by 11%. There is good evidence that those with blood levels between 50 and 80 milligrams per 100 millilitres are six times more likely to be involved in a fatal accident than people who are alcohol free.

The Government’s intention to consult on including more information on alcohol labels is welcome if it is realised, but we have been waiting almost two years for the announced consultation to be launched. During this time, alcohol harm has increased, and deaths from alcohol reached record highs in 2020. Can the Minister tell us when the consultation’s report will be formulated and when it will appear? We cannot leave this unattended to, with consumers not knowing what they are taking whenever they take a drink. I beg to move.

[Lord Shipley (LD)]

My Lords, in moving this amendment, the noble Baroness, Lady Finlay of Llandaff, has emphasised its importance to improving personal and public health. The amendment requires the Secretary of State to publish a report on alcohol labelling, with the aim of improving consumer knowledge about the contents and potential harms of alcohol products. Surely it is in the interests of consumers for labelling on alcoholic products to meet the standards we have come to expect from food labelling.

The context really matters. As the noble Baroness, Lady Finlay, said, alcohol is the leading risk factor contributing to ill health and death for 15 to 49 year-olds, and it is the fifth leading factor across all age groups. Drinking a bottle of wine is, for example, the equivalent of smoking 10 cigarettes, yet a packet of cigarettes must carry a health warning. Surely consumers should be entitled to know how many units of alcohol, how many calories and how much sugar is in a bottle or can. It is very clear that the alcohol industry’s self-regulation has failed, as the noble Baroness, Lady Finlay, said. Commitments were made a decade ago that labelling would improve in line with Department of Health recommendations, yet that has not happened.

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[Baroness Finlay of Llandaff (CB)]

My Lords, I am very grateful to everyone who has spoken and I note the tone with which “in due course” was uttered, which is really disappointing. Some very important points have been made, particularly about people really having the choice to know what they are taking into their bodies in the name of alcoholic drinks. May I assure the noble Lord, Lord Winston, that I really do not believe that fine wines will be sacrificed on the altar of public health? Very few people drink fine wines; most people drink drinks bottled and labelled in this country—the obesogenic effect is really important.

However, I am a realist and I am aware that the chance of this being thrown out when it goes to the other place means that it would not remain in the Bill. I hope the Government will take the message back to the Secretary of State to empower him to grasp the nettle, provide leadership in public health and, for the first time, proceed to make sure that people know what they are drinking and what the harms are—they might prefer to go out with their family and eat a large burger than have two glasses of wine. Given that, and the reality of the situation we are in, we will hold the Government’s feet to the fire over what “in due course” means; I hope it is a very short course. On that, I beg leave to withdraw the amendment.

Amendment 163 withdrawn.

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I strongly support these two amendments and hope the Minister is at least able to commit to urgent action to improve the experience of pancreatic cancer patients, preferably by accepting both the amendments but, if not, in some other way.

[Baroness Finlay of Llandaff (CB)]

My Lords, I was glad to have been able to put my name to Amendment 166 about PERT. In this Bill, the Government have introduced a milestone in changing the care of people who are facing serious illness at the end of life.

The reality, as we have already heard, is that the majority of patients with pancreatic cancer are diagnosed late, because it comes in the head of the pancreas. The pancreas has two parts—the head and the tail. But, because it can grow without causing much pain in the initial stages, it often goes undetected until it is fairly advanced. That means the outlook is poor. The other thing it does, as it grows, is block off the flow of enzymes into the gut. Without replacement, these patients get a malabsorption syndrome; they can get terrible diarrhoea and muscle wasting, because they are not absorbing the nutrients they need.

This amendment is very important. It could quite easily build on the network that will now be in place to commission specialist palliative care services. The move the Government have made has been welcomed across palliative care in this country and is being seen as a way to dramatically change the care of patients. With data information flows now integrated and networked across the NHS, we will be able to get accurate data on how many patients with pancreatic cancer are getting replacement therapy when they need it. Some people do not need it; some need it later on. This is part of building on the important foundation the Government have laid. It was that which persuaded me to put my name to Amendment 166.

Another point I would like to make is about improving things for the lowest quartile of the population. Incidence of pancreatic cancer is highest in the most deprived areas and it is higher in women than in men. Part of levelling up, to help people to live well for as long as they can, is making sure they get the enzyme replacement they need.

[Baroness Walmsley (LD)]

My Lords, I have in my hands the latest cancer waiting time figures. It is very unfortunate that, despite the hard work of NHS staff, every single metric was worse in January than in December. It therefore seems a great pity that not all patients who have a diagnosis of this dreadful disease of pancreatic cancer can get this medicine, which can improve and even extend their lives.

I well remember a senior, well-loved and well-respected Member of the Labour Benches who died of this dreadful disease. We lost him far too early, because this disease takes people very quickly. Anything at all the Minister can say to encourage us that this effective and approved medicine can be made fully available to everybody who needs it—depending on the conditions, as outlined by the noble Baroness, Lady Finlay—would be helpful.

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[Baroness Finlay of Llandaff (CB)]

My Lords, I feel I have to remind the House that we have had 95 hours of debate in recent years on this topic; and the implication that we have not debated this is a misrepresentation. The noble Lord, Lord Forsyth, has asked us not to talk about assisted dying but then actually did talk about some aspects. We are being asked to test the willingness in both Houses, but I remind the House that the Marris Bill started in the Commons, was debated there and was defeated there by 330 votes to 118. That is where a Bill like this should start.

It is true that, historically, there have been major changes. Those have been in Bills that started in the House of Commons, when the public understood what they were about. The public knew what capital punishment was, and they know what homosexuality is. These Bills started in the elected House, and they then came to this Chamber. That has been our procedure.

I would, though, like to challenge the claim that there is overwhelming support among the public. I think it is questionable. In the poll, when asked a bit more detail, 57% of the public did not understand what assisted dying is; 42% think it is your right to stop treatment, which is already a legal right; and 10% think it is hospice care. Dignity in Dying has said it wants to have the largest record of public support, yet to date it has less than 0.5% of the population of England and Wales signed up to this list. So I do think we have to look at some of the claims being made and think about them.

Whatever noble Lords think about assisted suicide and euthanasia, this amendment would set a dangerous constitutional precedent for any Government. It is surprising that the noble Lord, Lord Forsyth, with his deep respect for parliamentary processes and Governments being able to govern, has taken this approach, because this amendment would set a precedent enabling any Back-Bencher from any pressure group to disrupt a Government’s agenda. Does the noble Lord plan to bring judicial proceedings if his proposal is not tabled in a year? That is the criterion in the text of his amendment. A draft Bill leads to a Bill, assuming and forcing government support, before exploring evidence of the complexities of licensing doctors to provide lethal drugs.

We do indeed already have a Bill before us, and it is awaiting debate. The amendments laid are not vexatious. Based on the extensive evidence from abroad, they expose the problems with the proposals from the noble Baroness, Lady Meacher. Where assisted dying is legal, palliative care has dwindled, legislation has widened, the safeguards have been seen to fail, and non-assisted violent suicide rates rise disproportionately. Post-event reporting, as in her Bill, does not work because it relies on the clinician. I could go on, but I will not.

Yet surprisingly, no request was made for Committee until months after Second Reading, and no one seems to have sought to discuss the amendments that have been widely criticised by those who have spoken today. Some Members openly want the prognosis requirement to be dropped from the Bill to make legal drugs available on request. We have to at least know what the content of the Bill is even before we proceed. An 18 year-old with severe anorexia is already eligible under the Bill that is currently before the House. The answer to harrowing accounts of inadequate care is not to force the Government to draft a Bill that would allow doctors to supply massive overdoses of unevaluated lethal drugs to patients. Good, holistic, palliative care has been made a right in this Bill by this Government, and people should ask for it and insist on it.

This amendment is not the way to seek a careful analysis of the complexities of assisted suicide and euthanasia. It creates a constitutional headache for any future Government’s ability to govern. The procedure is to debate a Private Member’s Bill properly in Committee; and that Private Member’s Bill should start in the elected House.

[Baroness Jones of Moulsecoomb (GP)]

My Lords, I hate to disagree with the noble Lords who have spoken against this amendment, almost as much as I loathe supporting the noble Lord, Lord Forsyth, on anything. But, for me, this is a matter of democracy. Public opinion is constantly moving on this, and it becomes more and more supportive as the public understand the issues involved. It is partly the duty of the Government to explain exactly what it is about. Having a proper debate like this is something we should all support.

Personally, I want this on the statute book before I need it. I have five grandchildren, and I try to talk them all into pushing me over a cliff if I were to get too ill. As soon as their mothers told them that it was illegal, they refused me. The idea remains that this is something which many of us want for ourselves, because we fear being incapable. Therefore, I support Amendment 170.