Folic Acid Fortification

Lord Evans of Rainow Excerpts

Thursday 16th May 2024 Lords Chamber

[Lord Rooker]

To ask His Majesty’s Government what responses the European Commission and World Trade Organization have given after being notified of proposed changes to the Bread and Flour Regulations 1998 regarding folic acid fortification, on 8 and 9 February respectively.

[Lord Evans of Rainow (Con)]

My Lords, the Government remain firmly committed to mandatory fortification of non-wholemeal flour with folic acid. This policy is being delivered as part of the wider review of the Bread and Flour Regulations. In February, we notified the World Trade Organization and the European Commission, in accordance with international obligations, and there have been no official responses. The European Commission notification remains open. We plan to lay legislation in England in July.

[Lord Rooker (Lab)]

That is good news. It will be to the Government’s credit that those regulations are passed before the general election, because five years ago they changed their mind about the policy, and this is a benefit to the families concerned. I know that it will take time to implement, but we have still got 20 terminations a week and three babies being born every week with lifelong disabilities—we can cut those numbers substantially. This is a very important issue. The sooner these regs are passed by both Houses, the better it will be for those families concerned.

[Lord Evans of Rainow (Con)]

I pay tribute to the noble Lord and his doughty campaigning on this subject over many years, not just in this House but as a constituency MP in the House of Commons. This policy is being taken forward as a UK-wide measure, which has required co-ordination across the four nations, including respecting their different election cycles. Following notification to the EU Commission, in respect to Northern Ireland, and the World Trade Organization, in accordance with international obligations, in England we plan to lay legislation in July. Noble Lords will wish to be reassured that effecting this policy decision remains a government priority and will not be subject to any further delay.

[Lord Jackson of Peterborough (Con)]

My Lords, 19 years ago I led a Westminster Hall debate on the fortification of basic foodstuffs with folic acid. I was supported subsequently by the noble Lord, Lord Rooker, in his capacity as chairman of the Food Standards Agency. Hydrocephalus and spina bifida still affect many families, and the cumulative impact of expenditure to treat those conditions is huge on the public purse, as well as the trauma and tragedy involved for parents. I reiterate the points raised and welcome this Government’s imperative to get this done and fall into line with thousands of other politicians, and Governments across the world, who have taken this step.

[Lord Evans of Rainow (Con)]

My noble friend raises an important point and he is absolutely right. The sooner we get on with the implementation of folic acid, the better.

[Baroness Finlay of Llandaff (CB)]

My Lords, following on from the Question that has been asked, and the enormous welcome that there must be everywhere for the Government’s decision to implement this, have the Government undertaken a formal costing of the amount that they will be able to divert from having to provide support and care when families are devastated into other aspects of care for children with all kinds of conditions, so that this saving will not only affect those families who have avoided a tragedy but support better care for other families dealing with other devastating conditions?

[Lord Evans of Rainow (Con)]

The noble Baroness raises an important point. I do not have the details of the figures that she has asked for, but I will certainly write to her on that very good point.

[Lord Allan of Hallam (LD)]

My Lords, it is good to hear that the legislation will be coming forward in July. I am sure that it will have a fair wind, given the cross-party and cross-nation support. One of the questions that the Government consulted on was the implementation period. Passing the regulations is one thing; getting the folic acid into the flour is another. Can the Minister give us any indication as to how long that implementation period will be once the regulations have passed?

[Lord Evans of Rainow (Con)]

The noble Lord, as always, asks a very good question. The proposed transition period for industry to implement changes in the Bread and Flour Regulations review is 24 months. The provisions on folic acid fortification of flour will therefore become mandatory as of 1 October 2026, but there is nothing to stop earlier fortification, should industry wish to do so. I used to work in a bakery and I know that it is a very simple process to put the folic acid in. In my view, 24 months is a very reasonable time. There is nothing preventing the industry fortifying bread now.

[Baroness Merron (Lab)]

My Lords, I too look forward to the progress that we will make and will welcome the legislation when it comes before us. Will the data be in place to monitor the impact on preventing neural birth defects through the addition of folic acid to non-wholemeal flour? What are the plans to review it to see if any further steps might be necessary in the years to come?

[Lord Evans of Rainow (Con)]

The estimated figures show a reduction of 20% in neural tube defects with the introduction of folic acid into flour, but clearly that needs to be monitored—and from day one it will be monitored. That data will be collected and updated; it is very important that, for this to be successful, we need to know that there is a 20% reduction. That amounts to about 200 babies per year. Systems are in place to monitor the success—I hope—of this process.

[Lord Anderson of Swansea (Lab)]

My Lords, all credit is due to the Government and to my noble friend Lord Rooker for his magnificent campaign. Since the case is so overwhelming, why has it taken so long? Should there be a case study of the delays in government to reach this welcome decision?

[Lord Evans of Rainow (Con)]

The noble Lord raises a good point, but we had to go through due diligence and consult. The Government have consulted industry-wide the people who supply the bread and the folic acid, and have done due diligence. As I said in my initial Answer, we have had to go through the World Trade Organization and the European Union. I agree that such things seem to take a lot of time, but we have to go through due process.

[Lord Hannan of Kingsclere (Con)]

My Lords, the consultation has revealed a lot of support within the industry—UK Flour Millers and the Craft Bakers Association and all my noble friend the Minister’s former colleagues in the baking industry have welcomed this. However, the Question from the noble Lord, Lord Rooker, was about the response of international agencies. What would happen if, in the context of the Windsor Framework, the European Commission objected?

[Lord Evans of Rainow (Con)]

My noble friend always asks very powerful questions. The European Union has not notified us that it objects to this process. If it does, we will act accordingly, but I do not see why it would object.

[Lord Blunkett (Lab)]

My Lords, I have changed my mind on this issue, not least because of the campaign of my noble friend and many others. I commend the Government for what they are doing, but is there not an ethical issue that we should always have in the back of our minds about the nature and the appropriateness of mass medication?

[Lord Evans of Rainow (Con)]

I agree with the noble Lord.

[Lord Lexden (Con)]

Is it the Government’s intention that these regulations will apply throughout our country, or will they be limited to England or to England and Wales?

[Lord Evans of Rainow (Con)]

I can speak only for NHS England, but in this case, as I said in my original Answer, it is planned that all four nations of the United Kingdom will lay similar legislation to come into force on 1 October 2026, in line with common commencement dates. England and Wales plan to lay the legislation in July, as I have already said; Scotland will lay it in August; and Northern Ireland will do so in September.

[Lord Sahota (Lab)]

My Lords, a great deal of the flour imported either from Canada or the Indian subcontinent is used by the Asian communities for chapatis, et cetera. Will the Government make sure that is has folic acid as well, as in the regulations for the UK?

[Lord Evans of Rainow (Con)]

The noble Lord raises a very important question. I asked about this, and it is my understanding that the labelling of imported flours will make it clear that folic acid is present.

[Baroness McIntosh of Hudnall (Lab)]

My Lords, will the Minister clarify a point raised by my noble friend Lord Blunkett? I agree with his views, of course, but I was slightly troubled by the use of the term “mass medication” in relation to this intervention. We already fortify flour with a number of things; this is in addition to that—or it will be if it goes forward. Is it right to classify it as medication? I rather suspect not.

[Lord Evans of Rainow (Con)]

The word “medication” was used in this case, but, as the noble Baroness says, it is a supplement that is going into flour, along with lots of other minerals and vitamins that go into flour and other products. I agree with the noble Baroness.