National Food Strategy and Public Health

Clive Efford Excerpts

Wednesday 15th December 2021 Westminster Hall

[Clive Efford (in the Chair)]

Before we begin, I remind hon. Members that they are expected to wear face coverings when they are not speaking in a debate. This is in line with Government guidance and that of the House of Commons Commission. I remind Members that they are asked by the House to have a covid lateral flow test twice a week, if coming on to the parliamentary estate. That can be done either at the testing centre in the House, or at home. Please give one another and members of staff space when seated and when entering and leaving the room.

[Jo Gideon (Stoke-on-Trent Central) (Con)]

I beg to move,

That this House has considered the National Food Strategy and public health.

It is a pleasure to serve under your chairmanship, Mr Efford. I am delighted to have secured this debate on such a vital topic. As chair of the all-party parliamentary group on the national food strategy, I have been examining closely the key themes that we need to address to produce a lasting, holistic solution to food system failures. As the Member of Parliament for Stoke-on-Trent Central, I see the impact that food poverty has on health, education and life chances. Developing long-term solutions to level up our access to healthy food, whether that be through tackling affordability or raising the standards of school food, is as vital to creating a fairer society as investment in major infrastructure projects.

In 2019, the Government recognised the need for a new approach and the Department for Environment, Food and Rural Affairs commissioned a review of the food system by Henry Dimbleby to inform a new national food strategy. In 2020, the Government published their obesity strategy, which recognises that tackling obesity and improving our nation’s diet require a partnership between consumer and producer. A comprehensive national food strategy will be a positive and universally welcomed step in the right direction. The Government are committed to publishing a White Paper in response to the recommendations of the national food strategy report. May I ask my hon. Friend the Minister when the White Paper is likely to be published?

As we approach Christmas, supermarkets are full of luxury food items and advertising features happy families sitting around bounteous feasts. I do not advocate the “Bah, humbug!” attitude to Christmas celebrations, but we must acknowledge the pressure that our consumer culture puts on low-income families and on our general health. We all know that in the new year we will be deluged with advertising for diet products, fitness videos and gym memberships.

Food is at the heart of community cohesion. Religious festivals in many faiths feature food; and when we share food, it shows we care. Last Saturday, I visited the volunteers preparing meals for Food For All in the Guru Nanak gurdwara. They deliver hundreds of portions of nutritious food weekly to local hostels. As I ate the tasty dal and rice, I learned of the importance of sharing food in the Sikh community and how their doors are always open to those needing food.

The issue of food security has been highlighted during the pandemic. As community meals, such as at YMCA North Staffordshire in my constituency, had to stop in the spring of last year, across the nation a volunteer army, organised through charities, faith groups, local businesses and local authorities, ensured that the most vulnerable in our communities were able to access food. Schools looked after their pupils with food deliveries during holidays and lockdowns. The already extensive network of food banks expanded and found new ways of operating in order to ensure that no one went hungry during the most difficult time that this nation has experienced in our lifetime. Government played a vital role in funding many of the volunteer organisations, and the success of the distribution depended on a close working partnership across all sectors and sections of our communities.

Access to food is the most basic of human rights, and the challenges around access to a healthy diet are major indicators of inequality. Eating lifts our spirits and gives us energy, but it is also a source of anxiety for those on low incomes. The Government have introduced guidance on what constitutes a healthy diet through Public Health England’s “Eatwell Guide”, but they have not fully evaluated whether the diet that it recommends is affordable to everyone. A Food Foundation report estimated that the poorest decile of UK households would need to spend 74% of their after-housing disposable income on food to meet the cost of the “Eatwell Guide”, compared with just 6% in the richest decile.

In its July 2020 report, “Hungry for change”, the Lords Select Committee on Food Poverty, Health and the Environment concluded:

“The UK’s food system—the production, manufacture, retail and consumption of food—is failing.”

The report, written a year before part 2 of the national food strategy was published, made many of the same recommendations to Government. It concluded that the Government need a unified food policy to ensure that we reduce the production and consumption of processed products and tackle food inequalities so that everyone can access a healthy diet. Only then can we produce food sustainably and protect the health of our planet and its populations. The report added:

“The COVID-19 pandemic has reinforced the need, and provided the opportunity, for the Government to act now with commitment and focus to deliver the improvements to the food system, public health and environmental sustainability that are so urgently required.”

I believe that the Minister, in her previous role in the Department of Health and Social Care, agreed with the ambition of the national food strategy. She told the Select Committee:

“We have a teachable moment, and we should seize it.”

This Government have shown their commitment to tackling environmental challenges by showing leadership at COP26. They should now consider the national food strategy’s recommendations as part of their approach, because our food system is driving climate change and biodiversity loss, which threaten our future food security. Food production is responsible for 34% of global emissions and is the leading cause of nature’s decline. The current system has driven huge losses in biodiversity, from deforestation in the Amazon to intensive industrial farming in the UK. In the future, climate change threatens to cause crop failures and nature loss, which makes our land less productive. That is a system failure, and not the fault of individual farmers or consumers. The new environmental land management schemes should include payments to farmers to provide public access to nature, which is demonstrably beneficial for mental health. It is essential that the Government hold firm on the transition to an environmentally ambitious ELM.

We have seen this Government’s ability to innovate when facing health challenges. They have shown global leadership by investing in world-leading research to develop vaccines to tackle the covid pandemic, and the roll-out of the vaccination programme has been superb. We need the same level of innovation in public health when designing preventive measures to tackle obesity. Billions of pounds are spent each year by the national health service on the treatment of significant but avoidable levels of diet-related obesity and non-communicable disease. By 2035, we will be spending 1.5 times as much to treat type 2 diabetes as we currently spend on all cancer treatments. From a health perspective, we need to resolve this.

Britain has the greatest levels of highly processed food in Europe, with the exception of Malta. Those products—containing unhealthy types of fat or salt, or highly refined carbohydrates, such as sugar—are aggressively marketed and promoted to the consumer. They are more likely to be on promotion, making them appealing to those on tight budgets. Manufacturing, retail and the food sector play central roles in this. The less healthy choice has become the easier, cheaper choice for the consumer, but this is inflicting profound costs on public health and the NHS. The Government have made some inroads into this agenda, by banning junk food advertising on TV before 9 pm, legislating to end the promotion of foods that are high in fat, sugar or salt, and restricting “buy one get one free” promotions.

Industry progress against voluntary reformulation targets should be subject to transparent and regular monitoring to highlight where successes and failures occur. The Government should make clear what regulatory action will follow if the industry does not respond comprehensively and swiftly to voluntary targets. Mandatory—that is, fiscal—approaches can work, as evidenced by the soft drinks industry levy. These taxes can also incentivise innovation and reformulation, which can help to build a better food system, such as through the use of potassium chloride, which is less harmful to health than conventional salt. Any measure that encourages innovation and moves the food industry to invest in healthier alternative products is welcome. I ask the Minister whether more work can be done to encourage innovation by incentivising good practice, as well as ensuring that foods that contribute negatively to the nation’s health bill share the cost of that bill.

Successive Governments have adopted different approaches to tackling obesity, which until now have relied heavily on encouraging individual behaviour change rather than addressing the structural issues and external factors that shape the food environment. Factors such as the affordability and accessibility of unhealthy foods help us understand the association between levels of deprivation and rates of obesity. The Government must clarify the vision for a healthy sustainable diet and set out a clear path towards achieving that. We must reward farmers for measures that promote improved public health, and ensure that trade agreements do not allow for the import of cheap food produced according to lower environmental and animal welfare standards than our own.

The Government have pledged to level up our country. Does the Minister agree that underpinning any economic levelling up must be a levelling up of life chances? Health inequalities cannot be tackled without a national food strategy that considers the entire food chain, from field to fork. That requires cross-departmental co-ordination and a dedicated system of oversight to bring about a tangible change in the way we produce, purchase and consume food. The complexity of the challenge requires the establishment of an independent body responsible for the strategic oversight of the implementation of the national food strategy. That independent body should have the power to advise the Government and report to Parliament on progress. Does the Minister agree that the Food Standards Agency might play a greater role in that regard?

Turning to my constituency, I know that people with limited resources often find it hard to access healthy food. Less healthy diets and their adverse consequences are not limited to those in the lowest income groups, but they affect those groups disproportionately. Adults and children in deprived areas are significantly more likely to become obese or suffer diet-related ill health. Research shows that adults on low incomes are more likely to have diets high in sugar and low in fibre, vegetables, fruit and fish. Children from the least well-off 20% of families consume around 29% less fruit and vegetables, 75% less oily fish, and 17% less fibre per day than children from the most well-off 20%. Such inequalities are particularly relevant in Stoke-on-Trent Central. Data shows that 41.4% of adults in Stoke-on-Trent eat the recommended five a day fruit and veg on a usual day—the lowest percentage recorded of any upper-tier local authority in England.

[Jo Gideon]

I absolutely agree that schools have a key role to play, both in the curriculum and in school food. Unfortunately, I have not been able to cover that, so I hope my right hon. Friend will be able to cover that aspect in his speech. The topic is wide ranging and I want to leave time for colleagues to make their points. However, I absolutely endorse what he has just said.

In the city of Stoke-on-Trent, around 92,000 adults aged 16 or over are not eating the recommended five portions on a daily basis. Data shows that 76.1% of adults in Stoke-on-Trent are overweight or obese, and that is the third highest figure of all local authorities in England. Research shows that people living in local authorities with the highest level of deprivation live closer and have access to almost five times as many fast-food outlets than those in more affluent areas. In Stoke-on-Trent in 2018, 55.6% of food outlets were classified as fast food outlets compared with 38.4% in the UK. Between 2010 and 2018, the average number of fast food outlets across the city increased from 48.5 per 100,000 to 69.5. An extra 55 takeaways opened in Stoke-on-Trent between 2010 and 2018, and I have yet to find a really healthy takeaway. I hope that someone will rise to the challenge and open one soon or let me know whether there is one.

The difficulties in producing healthier diets are not limited to the price of food. For many people in low-income groups, considerations such as equipment, energy costs, limited space to store purchases, and the cost of travelling to a wider choice of shops are real barriers to consuming healthier diets. In line with the Government’s levelling-up agenda, we must urgently help low-income families to eat well. Improving the diets of those with the lowest incomes and the poorest households would have both immediate and long-term benefits not just for those people, who would live longer in better health. It would also increase productivity and improve the economic outlook for the whole country.

The national food strategy report features several recommendations to reduce diet-related inequality that the Government should consider. They include extending the eligibility for free school meals, funding holiday activities and the food programme for the next three years, expanding the healthy start scheme, and initiating a trial “Community Eatwell” programme, thereby supporting those on low incomes to improve their diets. The national food strategy presents a critical opportunity to improve the health of the next generation. Young people spend 190 days of the year in school, and what they eat there is incredibly important. School meals significantly improve educational outcomes, and they provide access to nutritious meals for the millions of children experiencing food insecurity.

Research from Bite Back 2030 suggests that school food standards are routinely not being upheld, healthier options typically cost more, pupils who receive free school meals often experience great injustice, and young people’s experiences are vastly different from school to school. I was on a call with young people yesterday and asked them directly about their experiences of school meals. One of them said that they were from the school—Members may remember this crisis—where people had been handing chips through the fence. Another said that the only way for them to get good food would be for the local sandwich shop to move into the school, because that would be the only good alternative. There are really big issues around school food. We must ensure that school pupils have equal access to a good amount of food that is affordable and healthy. Students who both do and do not receive school meals deserve that.

Food policy has an impact on all sectors of our economy, environment and society, and the ability to access a healthy diet has a profound impact on people’s health and wellbeing. The most important commitment that the Government could make in the national food strategy would be to acknowledge the importance of this agenda by creating a cross-departmental structure with a specific brief for food, championed at the highest level. While DEFRA may look at environmental challenges in agriculture, there is a role for almost every Government Department in ensuring that a cohesive plan across the food system is delivered, to create a resilient, healthier and more sustainable food system.

The importance of reform is clear, and now is the time for the Government to seize the opportunity to reduce obesity, tackle health inequalities and protect the environment. I am grateful to the Minister for her support on this vital issue, and I ask that the recommendations to transform our food system for the better be embraced fully in the Government’s White Paper.

[Clive Efford (in the Chair)]

There are six Back Benchers seeking to speak. There is no time limit, but each speech should last about eight minutes if we share the time evenly.

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[Robert Halfon (Harlow) (Con)]

It is an honour to serve under your chairmanship, Mr Efford. I congratulate my hon. Friend the Member for Stoke-on-Trent Central (Jo Gideon)—friend being the operative word—on all her campaigning on food. She is doing an incredible job, and I congratulate her on securing the debate.

The outbreak of the pandemic posed significant challenges for children and families across the country, especially those just about managing to put food on the table. It has been a very difficult issue for the Government. I was sad to vote against the Government on free school meals last year, but they did a significant amount after that vote, not just with the publication of the food strategy but the extension of the holiday activities programme, with hundreds of millions of pounds to support children and families over the summer.

As I have seen in my constituency, Essex Council does a huge amount to support holiday activities programmes in schools across Harlow and around Essex. It makes a significant difference. I have been to schools where children are doing science, technology, engineering and mathematics subjects, having mental health and wellbeing support, and taking part in sports activities. I think that should be continued and I welcome the commitment that was made to it in the Budget.

On the provision of school breakfasts, the statistics are clear. We know that children who regularly eat breakfast achieve, on average, two higher GCSE grades than children who do not. The Institute for Fiscal Studies has shown that children in schools with breakfast clubs make two months’ additional academic progress. According to Kellogg’s, food hunger could cost the English economy at least £5.2 million a year through lost teaching time spent on dealing with the needs of hungry pupils. So, we have to make certain that there is a laser beam of focus continually aimed at prioritising academic catch-up because of food hunger, as well as mental health and wellbeing.

Lockdown and school closures have had a devastating impact on children’s learning, especially on those from disadvantaged backgrounds. Ofsted’s latest annual report shows that pupils lost 33 million days of learning. Even before the pandemic, disadvantaged pupils were 18.4 months behind, compared with their better-off peers. I hope very much that schools continue to remain open from January.

The Government are rightly boosting support for schools, with nearly £5 billion of catch-up funding, targeted through the national tutoring programme, but all the extra tuition in the world will not work if children arrive at school without having eaten a nutritious breakfast. Some will argue—and I get it—that that should be the responsibility of parents and carers. In an ideal world it should be, but sadly, that is not happening in too many cases. We cannot let the child suffer because of what might be going on in their family circumstances.

On our side of the House, we should rightly be concerned about public finances and the provision of funding for measures such as guaranteeing breakfast for all disadvantaged pupils. There is an answer that is staring the Government in the face: the co-called Coca-Cola tax or soft drinks industry levy. To be honest, I was not a great fan of that levy when it was first introduced, because I felt it disproportionately affected those on lower incomes who might want to buy a sugary treat for their kids now and then, but it does generate revenue of £340 million each year.

Given that the money was supposed to be hypothecated to fund healthy living initiatives, instead of just being snaffled by the Treasury, why not use it to fund hunger-reduction programmes? That way, no one needs to ask the taxpayer for more money. Currently, the Department for Education’s new breakfast provision service reaches just 30% of schools in high levels of disadvantage, and invests just £12 million a year. By comparison, last year taxpayers spent £380 million on free school meal vouchers.

Magic Breakfast is a wonderful organisation, for which I have huge respect. I meet a lot of charities in my job as Chair of the Education Committee and Magic Breakfast is one of the finest. It has calculated that for £75 million more per year, funded by the sugar tax, the Government could ensure that 7,300 of the most disadvantaged primary and special educational needs schools could provide a free, nutritious breakfast to every pupil who needs it. That would reach an estimated 900,000 pupils throughout the year, targeted at the most disadvantaged.

That could complement other initiatives, such as the £500 million funding for family hubs, championed by my esteemed colleague my hon. Friend the Member for Congleton (Fiona Bruce). If support could be made available to businesses feeling the brunt of the pandemic, surely we could provide welfare in the form of breakfast clubs, holiday activities and free school meals to children. In Wales, for example, the Government have recently introduced an extended school day pilot scheme for 14 schools. As part of the enrichment activities that schools will plan, I suggest that free school breakfast clubs should be included in the pilot.

I urge Ministers in the Department for Education to consider implementing a similar pilot scheme in England, especially in areas of high disadvantage. Those pilot schemes should be evaluated to the highest standards in order to better understand the outcomes. It is imperative that civil society groups involved in schemes are held to account in providing the best service possible for these young people. We need to be clear in looking at the success of outcomes.

In conclusion, dealing with child hunger is not a left-wing or right-wing issue. The levelling-up agenda has the potential to heal some significant social injustices in our country and provide every child with a hand up to climb the ladder of opportunity.

Supporting high-quality education and increasing academic attainment in schools is crucial to levelling up, but we cannot expect pupils to succeed on an empty stomach. No one has to ask the taxpayer for more money to do this; it is waiting to be used in Treasury coffers. As we look towards the new year and a new start, let us make free school breakfasts for all disadvantaged pupils a new year’s levelling-up resolution.

[Clive Efford (in the Chair)]

Where would a Westminster Hall debate be without Jim Shannon?

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[Andrew Selous]

I agree. I, too, am in very close touch with my local farmers, who as a group are one of the heroes of this piece. We need to be on the side of farmers. As my hon. Friend the Member for St Ives (Derek Thomas) said, we need to help them to do the right thing. I think they absolutely want to do the right thing.

I do not think we realise quite how bad the food that we eat is in this country compared with the rest of Europe. It is truly shocking. This is all in the House of Lords Food, Poverty, Health and the Environment Committee’s July 2020 report, “Hungry for change: fixing the failures in food”, and it was repeated in the national food strategy. As a country, we are an absolute outlier in the amount of highly processed food that we eat. More than half of all the food that we eat is highly processed. The figure is only 14% in France, 13% in Italy and 10% in Portugal—already cited favourably by the hon. Member for Liverpool, West Derby (Ian Byrne). We are five times worse than Portugal in the amount of highly processed food that we eat.

Why does that matter? I will tell you why it matters, Mr Efford. In 2018, a scientist called Monteiro did a report across 19 European countries that showed that a 10% increase in the amount of highly processed food we eat leads to a 12% increase in cancers, a 12% increase in cardiovascular disease and a 21% increase in depressive symptoms. Is it any wonder that one in seven people is on antidepressants? I wonder whether that has anything to do with the food we eat. These figures are just appalling, but I think they are quite a closely guarded secret. I do not think people know about them, and it is our job to get them out there and to challenge the food companies so that they do better.

Some food companies are on a journey. For example, the Obesity Health Alliance told me that Tesco—it particularly singled Tesco out—has committed that two thirds of all that it sells will be healthy product. It is not there yet; it is on a journey, but it is starting to get this. There is a supermarket in the Netherlands called Marqt. It is only small; it has about 16 stores, I think. It has a commitment to its customers to sell only healthy food that is good for them, because that is part of its philosophy, and it makes money as well. This is possible. We do not have to be on the treadmill of selling people the wrong things, which are bad for them. Their brains do not develop properly and they cannot achieve the potential from all the God-given talents that they were created with. We really can do better.

In schools and in so many of our public institutions, we are not doing well enough. I am waiting for a meeting with the Children’s Minister—he promised at the Dispatch Box to give me a meeting—on school food standards. The campaigners at Bite Back 2030, Jamie Oliver’s foundation, have already been mentioned today. Let me quote what one of its panellists said:

“I’m racking my brain because I don’t think my school does a single healthy option”.

The campaigners at Bite Back think that the food is not as it should be in about 40% of schools; the Soil Association thinks that the figure is 60%. I do not know whether it is 40% or 60%, but it is far too many.

The mechanisms for effective monitoring of the Government’s school food standards are not good enough and they are not being observed. I have been a school governor for 20 years, and we have a lot to do. I have sat with the children and eaten school dinners with them—what I had in Studham Village school was particularly good—but the dinners are not always that good. We need to do better. Why? Because the figures are absolutely appalling. Even before children get to school, the figures are awful, and they have got worse during the pandemic.

The figure for obesity among reception-aged children went from 9.9% in 2019-20 to 14.4% in 2020-21. That is even before children get to school. By the time they leave school, two in five are above a healthy weight and a quarter are living with obesity. Obese children are more likely to become obese adults, with the associated type 2 diabetes, cancer, heart disease and liver disease. This stuff really matters—it is really important, and we really can do better.

I agree with my hon. Friend the Member for Stoke-on-Trent Central: It is not about being a killjoy; it is not about “Bah, humbug!” We should actually be incredibly positive and upbeat about the business opportunities for British farmers and food manufacturers. Good, healthy food is delicious; it is wonderful. There is so much pleasure and enjoyment to come from it. I am very upbeat and positive, not at all negative, because there are so many better, delicious foods that we could have, and so many opportunities for our farmers.

Fundamentally, this is about making the right, good and proper thing the easy and affordable thing to do. Too often, healthy food is more expensive. It need not be that way—it really need not, and it is not always the case in Europe. There are issues about giving people a little confidence in how to cook and so on. This is a big national effort. I am looking forward to the White Paper. We have a lot to do, because we are not in the right place.

[Clive Efford (in the Chair)]

I am grateful to the Back Benchers for being disciplined. I would like to bring Jo Gideon back in for a couple of minutes at the end of the debate. I call Daniel Zeichner.