Health: Public Health Responsibility Deal

Baroness Hayter of Kentish Town Excerpts

Thursday 27th June 2013 Grand Committee

[Baroness Hayter of Kentish Town]

My Lords, I should declare that I am a patron of a charity that picks up those with drink problems, the Blenheim Trust. We should all thank the noble Lord, Lord Clement-Jones, for bringing this subject to us today and introducing the voluntary partnership, which is part of the nudge campaign to help people to make healthier choices. However, our Science and Technology Committee expressed its major doubts about the effectiveness of agreements with commercial organisations, particularly where there are conflicts of interests. The Labour Party shares those concerns. We are sceptical whether a voluntary approach can address those barriers to a healthy diet and lifestyle, which are threatening a public health crisis.

The responsibility deal covers alcohol, food, health at work and physical activity. Success on each of those has been questioned. Handing over significant responsibility is part of the reason for that querying, especially where there is no parallel government action. In the case of alcohol, we have seen no reduction of the drink-drive level, zero funding for Alcohol Concern and, despite Mr Cameron’s pledge, no action on minimum pricing.

As has been mentioned, six health bodies, including the BMA, declined to participate in the alcohol deal because of its alcohol commitment, where the industry claimed that it would,

“foster a culture of responsible drinking, which will help people to drink within guidelines”—

without, of course, any evidence of that. Those health bodies were concerned that the project gave,

“inadequate recognition of the need to reduce alcohol-related harm”,

that there was no indication of alternative actions if the pledges did not reduce harm and that,

“the pledges were those of the alcohol industry rather than of health bodies”.

The BMA, as has been mentioned, considered that voluntary agreement with the industry was inadequate—perhaps I should go on and quote the rest of what it said—because the industry has, “conflicts of interest”. It said that,

“the state should put the health of citizens before commercial freedom”.

On food, the Government have made a welcome announcement on front-of-pack labelling. We welcome that but, within days, it was undermined. Only 60% of foods will be covered, according to our figures, because Coca-Cola, Cadbury, United Biscuits, Unilever and Heinz will not take part. How can food labelling work if key players refuse to sign up? Of course, there are things that the industry can do and has done. Heineken took one high-strength low-cost product off the market.

Central to the problem is that the responsibility deal agenda is that of the industry—that is, education, choice and labelling—rather than of the health bodies, which talk about price and availability. The lesson of cigarettes is that regulation makes the difference. Higher prices and banning smoking in public places are what reduced heart attacks. Professor Hunter, giving evidence to the committee in another place, said that he was,

“disturbed at the shift”,

by the Government,

“from being a nanny to being a nudger”.

He recalled that interventions “shoving people”, such as with the ban on smoking, were effective, whereas the effect of nudging was little supported by evidence.

Where is the shoving? Where is the standardised cigarette packaging? Andrew Lansley said that packaging helped to recruit smokers and wanted to look at the idea of plain packaging. That, of course, was before the Conservatives hired Lynton Crosby, whose company has represented tobacco firms and has campaigned against standardised packaging in Australia.

On physical activity, the Government’s record is abysmal. There has been a drop in sports participation, an end of free swimming for the under-16s and over-60s, and reduced funding for the School Sport Partnerships. Where is Mr Cameron’s promise on minimum unit pricing? Has that disappeared because of lobbying by the drinks industry? It started in Scotland, first against the policy and then by a legal challenge; now in England it is at it again, with a campaign entitled, “Why should responsible drinkers pay more?”, even though it would cost moderate drinkers only 28p a week. Its website urges people to tweet the message to MPs.

The Opposition support anything that the industry does to reduce the cost of alcohol to the NHS and elsewhere. The noble Baroness, Lady Coussins, has mentioned some of the companies with lower alcohol strengths—Stella, Budweiser, Becks, John Smith’s, Carlsberg and Strongbow. There is a long list, and there are some new lower-strength drinks such as Carling Zest, Foster’s Radler, Carlsberg Citrus and Guinness Mid-Strength. These are to be welcomed and enjoyed—particularly, in my case, the Guinness Mid-Strength. But we need smaller glasses in pubs and restaurants and smaller containers, including 250 millilitre cans for beer. Is it really acceptable that a large wine glass with 14% wine contains more than the daily safe drinking level for a woman? How responsible is that?

Let us ask the industry to focus on what is in its remit—alcohol strength, measures and responsible advertising. However, along with the Independent and the WHO, we agree that we should not let the drinks industry set policy on alcohol. And where are the Government? The pledges are supposedly underwritten by the threat of legislation, but where is that? Could the Minister outline the Government’s responsibility for the targets that have been mentioned and for reducing alcohol-related harm? Could he tell noble Lords when David Cameron’s commitment to minimum unit pricing will be implemented?