Fortified Flour

Lord Dodds of Duncairn Excerpts

Wednesday 16th May 2018 Westminster Hall

[Nigel Dodds (Belfast North) (DUP)]

It is a pleasure to be here under your chairmanship, Mr Hanson. I congratulate the hon. Member for Pontypridd (Owen Smith) on securing this important debate and on the eloquent and cogent way that he set out the case for the fortification of flour with folic acid.

When the facts are set out and the evidence is adduced, it is a very compelling case. It is all the more surprising, when one hears the weighted evidence of the arguments in favour of it, that something has not yet been done in this country to ensure the mandatory fortification of flour with folic acid. The hon. Gentleman said that that has happened in many major countries across the world with vast populations. He mentioned Brazil, the United States and Canada; they are big countries with very strong regulatory regimes in which this practice has been carried out. Therefore, there have been multiple opportunities to have all the scientific evidence evaluated and to have all the upsides and downsides considered. It is very clear that the upsides are so massive that they require this country to follow suit. It is a shame that we are not yet in a position in this country to have mandatory fortification of flour.

It has been 27 years since the Medical Research Council published its research demonstrating that supplementing women’s diets with folic acid before the early stages of pregnancy reduced the chances of the pregnancy being affected by neural tube defects. That was in 1991. It was in 1990 that my son, Andrew, was born with spina bifida. Very soon after he was born, we became experts in the whole area of spina bifida: the reasons for it, how it develops and all the rest of it. Even back then, the great Professor Norman Nevin, who was an expert in the field in Belfast and did a lot of research, was a massive advocate for the mandatory fortification of flour, even before it was widely known about. He wanted to ensure that young parents who were planning to have children were better educated about the need to take folic acid and the general low levels of folates in the adult population and young people generally, because it was a massive problem and would store up big problems in future.

The reality is that as a result of not taking those measures, children are born with spina bifida or anencephaly. Children need not be born with those conditions if the parents have the right information and the mothers take folic acid at the appropriate time. The evidence shows, and it has been spelled out already, that it is too late once pregnancy has started. Many pregnancies are unplanned; many people even today, in 2018—never mind back in 1990 when my son was born—have no awareness of the need to take folic acid. They think it is something rather exotic—why on earth would they even consider such a thing? Even the name sounds a little strange.

People do not take the necessary steps and, as a result, children are born with severe disabilities. That presents great challenges to them, and often life-changing effects on their families. Often, as sadly was the case for my son, these children do not live a long life. Our boy died when he was eight years of age. In the process of his short but extremely rewarding and rich life, he underwent numerous procedures in hospital and numerous hospitalisations, sometimes lengthy. That had an impact on him, his family and his siblings.

The reality is that for all those children who are born with spina bifida and who live with it and are treated, many other children in the womb who are diagnosed with having a neural tube defect are never born. The hon. Member for Pontypridd and I recently hosted an excellent meeting in Portcullis House, which a lot of people attended. One of the things that came out of that was that, sadly, it appears that in this country we effectively deal with this problem simply by terminating foetuses that are diagnosed with a neural tube defect. That is how the vast bulk of these foetuses are treated.

It is a terrible thing that otherwise healthy babies and foetuses are in this situation as a result of a lack of action by society, successive Governments and by all of us, who have not done what other countries have done, which could be done at very little cost with no scientific downside, and which would reap enormous benefits for everybody. This is something that we need to take very seriously.

Over the years, my wife and I have done some work to try to educate people about the need to take folic acid. My wife, very bravely, did a number of television interviews when Andrew was alive. He even appeared on the television programmes. The process of education and telling people is not cutting through. It is not doing the job. It is not reaching the people it needs to reach at the time it needs to reach them, before they fall pregnant. We need to step up to the plate.

I will not repeat the scientific evidence, which has been laid out well by the hon. Gentleman and the groups that support this necessary move. There is a lack of understanding. People sometimes get nervous about the idea of adding things to food for public health purposes. I understand all that, but we already add things to flour and to water—we already make interventions where that is important and necessary. A lot of scientific evidence has been produced. I was struck that Professor Blakemore and the other experts who came to the event we held in Portcullis House said that, scientifically, absolutely nothing more needs to be proved or evaluated. All the evidence is there; we now require action on the basis of that evidence.

I simply add my voice to the plea for the Government to act on the advice of their own Scientific Advisory Committee on Nutrition and listen to the voices of all those who speak in favour of this measure. They should listen in particular to the voice of Shine which, as the hon. Gentleman rightly said, is a fantastic organisation that does tremendous work to help kids with spina bifida and hydrocephalus, and parents who have lost children. As I learned over those many years of intense engagement with clinicians and others, who often said, “Well, you tell us how Andrew’s feeling, because you know better,” parents do know. The Government need to listen to parents and potential parents—people who lost children in the womb or, totally understandably, felt unable to have a child with that condition.

This is a very important issue. It does not seem to me to be taken seriously enough, primarily because, relatively speaking, not a lot of children are born with spina bifida nowadays in the United Kingdom. As I said, I think that is partly because a lot of children with the condition are simply terminated in the womb. If it prevents even one or two children from being born with spina bifida who otherwise would have been born with the condition, this will have been a step well worth taking.