Bread and Flour Regulations: Folic Acid

Lord Kamall Excerpts

Wednesday 6th July 2022 Lords Chamber

[Lord Rooker]

To ask Her Majesty’s Government, further to the answer by Lord Kamall on 6 April (HL Deb col 2076), what progress they have made towards amending the Bread and Flour Regulations to include folic acid fortification.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)]

I am grateful to the noble Lord for continuing to promote this important policy. I hope that, following our meeting in May, the noble Lord is sure that the Government share his commitment to getting folic acid fortification done as part of the Bread and Flour Regulations review. The review continues to progress, we are aiming to launch a consultation shortly and I am able to share an indicative timeline for the process.

[Lord Rooker (Lab)]

I am grateful to the Minister for his Answer and confirmation, but just in case there is any backsliding in his department, may I suggest that he asks them a question? Can anybody name any one of the 85 countries that have made fortified folic acid mandatory, some for over 20 years, that has pulled out; and can the Minister name any one of the 85 that has found a bad side-effect? The answer to both questions is no. Then, he can go and face the 18 women last week, this week, next week and the week after who have terminations after the 20-week scan. The department is sitting on a cure to stop 80% of that distress among our fellow citizens. We are going at a glacial pace— I accept it is in the right direction, but it is glacial.

[Lord Kamall (Con)]

I hope the noble Lord appreciates that there is debate here. He has written to me a number of times about Professor Wald’s paper, which has been put before the advisers in the department. I think what we are seeing is scientific contestation: some people say that the science is settled, but others say that you have to be very aware of the unintended consequences. The NHS website advises people with certain conditions not to take folic acid, the worry being that, for people who do have levels of folic acid, we may end up solving one problem and unintentionally creating another.

[Lord Patel (CB)]

My Lords, we have now discussed the scientific validity several times. The Minister arranged a meeting, and I thought we had resolved this issue. Which scientific evidence is confusing the departmental advisers?

--- Later in debate ---

[Lord Kamall (Con)]

The advice still does not accept Professor Wald’s paper. But we did say in the meeting, if the noble Lord remembers, that we should not let the scientific debate be the enemy of progress. We are progressing, and I am able to share an indicative time- frame. We can debate at appropriate levels after that, but we are progressing where there is consensus.

[Lord Cunningham of Felling (Lab)]

My Lords, why does the Minister refuse to implement the regulations when there is abundant evidence internationally in support of this? Even worse, what does he have to say to those 18 women each week who lose a baby because of the Government’s failure to act?

[Lord Kamall (Con)]

The noble Lord has a couple of questions there, and I will try to answer them as quickly as possible. We are hoping to launch a consultation in August/early September, with a close date 12 weeks after that. There should be a government response on the final position in Q1 2023. After that we have to notify the World Trade Organization and the European Commission, because of the Northern Ireland aspect of this issue. After that, we have a notification period of between two and six months. Assuming that that is all cleared as quickly as possible, we will be ready to lay the provision by Q4 2023. It is glacial, but I assure the noble Lord that we are doing this as quickly as we can.

[Lord Addington (LD)]

My Lords, will the Government give us an assurance that they have identified all the checks and balances? That might be a good start. Also, exactly how long did it take some of the other nations that have already done this process to get through it?

[Lord Kamall (Con)]

The Government are clear that we are doing this, but we also have to be aware of the debate regarding high levels of folic acid. We are progressing in areas where the consensus is that there are no unintended consequences or damage. However, the NHS website plainly says that you should not take folic acid if you have had an allergic reaction to it; if you have certain forms of cancer, unless you have folic deficiency anaemia; if you have a type of kidney dialysis called haemodialysis; or if you have a stent in your heart. Let us make sure that this is based on evidence. We have to make sure that we address the worry of unintended consequences; otherwise, what do we tell the relatives of those who have died because of high levels of folic acid?

[Baroness Hayman (CB)]

Does the Minister accept that that sort of advice is given regarding life-saving treatments across the board? In more than a quarter of a century, I have heard Ministers at that Dispatch Box prevaricate and obfuscate on this issue, while the rest of the world has moved on and given us scientific evidence, in 85 countries, that this works—that it saves lives and saves distress. There is scientific evidence, and evidence in practice as well. The Minister has the opportunity not to be one of those prevaricating and obfuscating Ministers; I hope that he will take it.

--- Later in debate ---

[Lord Kamall (Con)]

I hope that the noble Baroness is not mis-stating the fact that we are looking to go through proper processes as our trying to kick this down the road.

[Noble Lords]

Oh!

[Lord Kamall (Con)]

I have been advised on this issue, and I have asked if this could be done quicker. Let us put it this way: I anticipated the reaction that I might well get in this Chamber to some of these answers. Indeed, I had to go back to the department on some of the answers and ask for clarification. The point is that there has to be a consultation. Think back to where there has been improper consultation, or where certain evidence has been ignored—the dash to diesel, for example. That consultation identified that while diesel might have lower levels of CO₂, it has higher levels of other things that damage air quality. But that advice from the consultation was ignored. They pushed ahead, and the situation end up worse as an unintended consequence. We have to be careful on this one.

[Lord Dodds of Duncairn (DUP)]

My Lords, the Government first announced that they were going out to consultation on this issue in October 2018. That was very welcome after many years of delay. Given the number of countries that have implemented this very sensible policy, what on earth are the scientific arguments for not proceeding? Surely, all these other countries have tested this in real terms, in actual practice. Can the Minister give us a target date for when all the consultations will have finished and the regulations will come into force?

[Lord Kamall (Con)]

Perhaps I have not made it clear enough that we are proceeding with this; there is no stopping the process or review. We are clear that the scientific debate should not hold up progress, so we want to launch the consultation in August/early September. The closing date will be 12 weeks after that, and we should have a government response on the final position in Q1 2023. We would then notify the WTO and European Commission, and once that is all cleared, it should result in legislation being ready to be laid in Q4 2023, and the transition period for the industry would be discussed after that. When I spoke to the noble Lord, Lord Rooker—I hope he would acknowledge this—he believed that I was one of the few Ministers who is very intent on progressing this.

[Baroness Merron (Lab)]

My Lords, as the noble Lord, Lord Patel, has said, the scientific evidence is readily available and evidenced across the world. Can the Minister tell us what, on this new timeline, he thinks the new consultation and process might reveal that we have not seen so far?

[Lord Kamall (Con)]

The reason we have a consultation is so that we are aware of unforeseen circumstances and that, hopefully, we deal with unintended consequences before they occur. It is all very well saying that the science is settled; we have reached a level of consensus where both sides can agree, and that is what we are progressing from. Once it is implemented, we can start reviewing whether it should be a higher level and whether there are unintended consequences. The history of contestation in science goes back a long way; think of the heliocentrism versus geocentrism debate. People thought that the universe revolved around the earth, but Aristarchus of Samos, al-Battani, Islamic philosophers and others challenged that, and Copernicus proved that heliocentrism was right.

[Lord Cormack (Con)]

My Lords, will it take as long for my noble friend to come to this conclusion? If there were a Nobel prize for prevarication, he would win it.

[Lord Kamall (Con)]

I am not sure that I should thank my noble friend for that question. I really do not mind being heckled, as long as I am not being asked to resign, frankly.

[Noble Lords]

Oh!

[Lord Kamall (Con)]

If I let your Lordships laugh a bit longer, maybe I will run out of time. We are absolutely clear that we will do this; I am sorry that we have to go through this process, but the advice I have been given is that we have to go through the proper consultation and notification process. I apologise if that annoys noble Lords.

[Baroness Symons of Vernham Dean (Lab)]

My Lords, the noble Lord will have followed the argument of my noble friend Lord Rooker for a very long time. Actually, he is one of the very few Ministers that I hope will not resign, because he is always honest and clear with this House and has a level of respect which Ministers in another place perhaps do not have. But I ask him quite sincerely: does he really want the risk of another 500 or 600 babies who are much wanted being lost, on the timetable he has outlined to the House, because that is what will happen?

[Lord Kamall (Con)]

I first express my relief that the noble Baroness does not want me to resign—but, as others say, give it time.

[Noble Lords]

Oh!

[Lord Kamall (Con)]

You always have to be careful what you say at the Dispatch Box. I am afraid that I have to follow a process; I can take it back to the policy team, but they advise that this is the process we have to go through. We have to notify the WTO and others.