Health Improvement and Food Production

Lord Kamall Excerpts

Thursday 7th July 2022 Lords Chamber

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

My Lords, I also congratulate the noble Baroness, Lady Walmsley, on securing this debate. I am also grateful to all noble Lords for their considered and thoughtful contributions. It is a self-evident truth that we all need food to survive. However, as with many things in life, it is not enough simply to restate this. As noble Lords have rightly said, there are many factors to be considered. How is the food produced? Is it done sustainably? How affordable is it, and what is its impact on our health?

We know that access to good-quality, healthy food is essential to achieving our ambition to halve childhood obesity by 2030, to reduce the gap in healthy life expectancy and to reduce the number of people living with diet and weight-related illnesses. The Government are committed to supporting the production and availability of good food to help improve the nation’s health.

As noble Lords have referred to, our recently published food strategy puts food security at the heart of our vision for the food sector. Our aim is to maintain broadly the current level of food that we produce domestically and to boost production in sectors where there are the largest opportunities. It sets out our ambitions to create a sustainable and accessible food system, with quality products that support healthier and homegrown diets for all. Our farming reforms are designed to support farmers to produce food sustainably and productively and in a more environmentally friendly way, from which we will all benefit. I am sure we all want to see a sustainable and healthy food system, from farm to fork and catch to plate, seizing the opportunities before us and levelling up every part of the country so that everyone, wherever they live and whatever their background, has access to nutritious and healthier food.

We all know that the food we consume plays a role in our overall health. Covid-19 highlights the risks of poor diet and obesity, driving home the importance of better diets and maintaining a healthy weight. As noble Lords have referred to, the Eatwell Guide outlines the Government’s advice on a healthy, balanced diet. It shows the proportions in which different types of food are needed to have a well-balanced and healthy diet, to help meet nutrient requirements and reduce the risk of chronic disease. We know that too many of us are eating too many calories, too much salt and saturated fat and too many large portions, and are snacking too frequently.

While some parts of the food and drink industry are leading the way, by reformulating products or reducing portion sizes, and I think we should pay credit to those parts of the industry that have done so and sometimes met targets in advance of target dates, the challenge to go further remains.

We know that obesity does not develop overnight. When you look at the behavioural contributions, it builds over time through frequent excessive calorie consumption and insufficient physical activity. It is not the stereotype of Billy Bunter stuffing his face with 75 cream cakes. Even eating small amounts of excess calories over time can add up for both adults and children. It catches up with many people over time.

As noble Lords have rightly said, obesity is associated with reduced healthy life expectancy. It is a leading cause of serious non-communicable diseases, such as type 2 diabetes and heart disease, and it is often associated with poorer mental health. We also know now that it increases the risk of serious illness and death from Covid-19.

Helping people to achieve and maintain a healthy weight and a heathier diet is one of the most important things we can do to improve our nation’s health. We all have a role to play in meeting this challenge: government, industry, the health service and many other partners across the country. As a government, we can play our role in enabling healthier food choices by making a greater range of healthier food more accessible; by empowering people with more information to make informed decisions about the foods that they eat; and by incentivising healthier behaviours.

As noble Lords have acknowledged, the food industry supplies most of the food and drink that we consume. Therefore, it plays a critical role in supporting the aims that we want to see, such as selling healthier food and drink. Through our reduction and reformulation programmes, we are working with the food industry to encourage it to make everyday food and drink lower in sugar, salt and calories. The programme applies across all sectors of the food industry: retailers, manufacturers, restaurants, cafés, pubs, takeaways and delivered food. We have seen some progress since the publication of chapter one of the childhood obesity plan in 2016, with the average sugar content of breakfast cereals and yoghurts decreasing by 13%, and drinks subject to the soft drinks levy decreasing by 44% between 2015 and 2019. These statistics are very welcome, but we know there is more to be done.

However, we also need to be careful about the unintended consequences. As an example, when the sugar content of Irn-Bru was reduced, customers complained about the taste. How did the company respond? By claiming to rediscover an old recipe from 1901, which contained even more sugar. It was a huge hit with Irn-Bru drinkers. How do we address these unintended consequences?

[Baroness Bennett of Manor Castle (GP)]

I thank the Minister for giving way. He referred to “everyday food and drink” and the formulation thereof. Will he acknowledge that, if we are talking about everyday foods, we should not be talking about formulation? You do not talk in that way about fruit and vegetables, and unprocessed food.

[Lord Kamall (Con)]

The noble Baroness makes an important point, but we have to recognise the reality: not where we want to get to, but where we are at the moment. People do eat food that will need to be reformulated if we want to make it healthier. Of course, we know that fruit and vegetables are healthy, but not everyone, as we help them transition, will eat fruit and vegetables, or make stuff from the raw products. They will buy products in supermarkets, and therefore if they are buying them, we have to make sure that they are healthier and reformulated. We do not yet live in that ideal world where everyone buys fruit and vegetables, and cooks everything for themselves.

Given that, we also need new regulations on out-of-home calorie labelling. As we know, many people go to restaurants, buy takeaways or have their food delivered. It is important that we have calorie labelling for food sold in large businesses, including restaurants, cafés and takeaways, which came into force on 6 April 2022. As noble Lords are aware, there will be further legislation, on restricting the promotion and advertising of products high in fat, salt and sugar, which will come into effect in the next few years. I know that many noble Lords disagreed with the Government’s views on delaying some of those measures. We will continue to have the end-of-aisle promotion on the target date, but others, such as “buy one, get one free”, are delayed because of the trade-off with the cost of living crisis, but will come. It is delayed, but we have set target dates.

Once again, we have to be open—

[Baroness Merron (Lab)]

I thank the Minister for referring to the delay, which I accept is a delay, to the restrictions on advertising. Can he explain what that has to do with the cost of living crisis, because I have heard that before?

--- Later in debate ---

[Lord Kamall (Con)]

The delay on “buy one get one free” was a cost of living delay. The delay on advertising was because the Act did not come in as originally intended. There was a delay in getting it on to the statute book and with the statutory consultation period. The industry has asked for some time. I know there was a debate among noble Lords about whether we should give in to industry requests, but in the end we will get there. It is important that we have as many people as we can on side. As the noble Baroness, Lady Walmsley, indicated in a previous debate, some companies actually met those targets in advance of the new target. That is to be welcomed and encouraged.

Once again, we also have to be open to potential unintended consequences. Mental health charities and experts—and some noble Lords who have worked in this area—have expressed concerns about the potential effect of anti-obesity measures on those with eating disorders. We must be careful and make sure that we learn and address those unintended consequences. We know that we have imperfect knowledge as humans and should not fall for the fatal conceit of knowledge. We have to rely on the discovery process. Not all pilots will work, but some evidence-led pilots will. We have seen some of the reductions but think, for example, about the minimum alcohol price in Scotland, which has been recently reviewed. The study found that there was

“a marked increase in the prices paid for alcohol by people with alcohol dependence”

and those drinking at harmful levels, but no clear evidence of any change in consumption or severity of dependence. Although such an effect cannot be ruled out, it demonstrates that we cannot assume that every intervention will work. Future interventions will need to be evidence-based. It is important not just to think that something will work; we have to see that it works.

To help ensure that all children have access to healthy diets, the Government provide a nutritional safety net to those who need it the most through the healthy food schemes. These are: Healthy Start, the nursery milk scheme and the school fruit and vegetable scheme. Together, these schemes help more than 3 million children. The schemes also help to support women through pregnancy, and babies and children when they are at home, in childcare and in early years at school. The schemes contribute to our priorities on obesity and levelling up.

Let us talk about some of the partnerships that we need to see if we are all to play a role in this. Schools have an important role to play. The school food standards are designed to restrict foods high in fat, salt or sugar, as well as low-quality, reformed or reconstituted foods. I have heard many noble Lords refer to ultra-processed or very highly processed foods. These standards are meant to ensure that pupils always have healthy options for their school lunch. They state that schools must provide fruit and vegetables every day—at least three different types each week—and no more than two portions of deep-fried food a week. There are also standards on the amount of salt, fruit juice and food cooked in oil. We hope these standards will play an important role in helping children get healthy options and the energy and nutrition they need throughout the school day.

One thing I feel very strongly about, as noble Lords will know, are the grave disparities we see across this country. Others have expressed concerns about this. One of the gravest inequalities faced by our most disadvantaged communities is poor health. The Covid-19 pandemic powerfully underlined the disparities in health across this country. As part of our wider ambition to level up health across the UK, we announced that the Department of Health and Social Care will publish a health disparities White Paper. This will set out a series of impactful measures, including legislation if required, to address health disparities at each stage when they arise. In addition, the Office for Health Improvement and Disparities is looking at many areas of disparity and making recommendations. The review will look at the biggest preventable killers, such as obesity, as well as the wider causes of ill health and access to the services needed to diagnose and treat ill health in a timely and accessible way.

I remind noble Lords that we also have to show some humility. I think my noble friend Lord Kirkham referred to this. As someone who comes from an immigrant working-class community, I say to noble Lords there is a limit to what any Government can achieve with the attitude of Westminster or Whitehall knows best, or by Soviet-style, top-down central planning. I am sure many noble Lords have seen television programmes about how we can eat well for less. The challenge is in how we get those messages from the living room—or the TV room—into people’s kitchens. The noble Baroness, Lady Bennett, talked about the empowerment of local communities and local people. I completely agree: we need to empower local communities through non-state civil society organisations, local community centres, local mosques, temples, gurdwaras, synagogues and churches, which are trusted by some of the hard-to-reach communities, to help them cook and eat more healthily.

I was talking to an official in my department the other day who comes from a Bengali background. She said, “One of the problems I see in my community is that we all love ghee—we think it’s delicious but we know it’s unhealthy.” I said, “How do we in the Department of Health and others encourage people to eat healthily?” She answered, “You’re not going to do it—it has to be from the grass roots up.” We have to work with local civil society organisations. Maybe there could be a national programme across the country, but it is about the local civil society people who are trusted in those local communities. We can call for it and ask for it here, but how do we get that message into people’s homes and kitchens?

I am slightly concerned by some of the anti-import sentiment that noble Lords expressed in this debate. As a development economist once said to me, “You either take our goods or you take our people.” I know that many noble Lords prefer white Europe to non-white, non-Europe, but on this particular issue we have to be quite clear about that. We will not produce everything we need and will have to import some food, and some of it will be healthy. We should not be against food just because it comes from overseas.

I hope to be able to address some of the other specific points made. I am afraid that I do not have all the details on some of the programmes, and I will ask my noble friend the Defra Minister to respond to some of the points that I am unable to at the moment.

Some specific questions were asked about seasonal labour shortages. Seasonal labour plays an important role in the agricultural sector each year. Since 2019, the Government have provided a seasonal worker visa route for horticultural workers in recognition of the highly seasonal nature of that work. To address the near-term need, we will release the additional provision of 10,000 visas under the seasonal worker visa route, including 2,000 for the poultry sector. That means that in total, 40,000 visas will be available for seasonal workers in 2022, providing labour for food businesses across the UK. We will also work with industry to support the upcoming Migration Advisory Committee review of the shortage occupation list. In addition, we will commission an independent review to ensure the quantity and quality of the food sector workforce; it will encompass the worlds of automation, domestic employment and migration routes.

The noble Baroness, Lady Bennett, asked about the agriculture sector growing more fruit and veg. We will bring forward a horticultural strategy for England which will examine the diverse worlds of small, large and emerging growing models and drive high-tech, controlled environmental horticulture to increase domestic production. We will work with growers during development of this strategy, and there will be an opportunity for those in the industry to feed into this, including potentially through a call for evidence, later this year.

A number of noble Lords asked about free school meals. The view from Defra is that a threshold has to be set somewhere. There will always be a debate about the level that you select, but the right one enables more children to benefit while remaining affordable and deliverable for schools. From 24 March this year, the Government have extended free school meals eligibility to include some children who have no recourse to public funds, subject to specified income thresholds; this permanent extension has been in place since the start of the summer term. We also have the school fruit and vegetable scheme, which is designed to benefit children at a vital stage of their development, providing a wide range of fruit and vegetables to children. The food strategy sets out our aim broadly to maintain domestic food production at current levels, in line with our environmental and climate goals. However, we are not asking anyone to choose between food and the environment; our view is that food production, farm businesses and the environment must work together hand in hand.

The noble Baroness, Lady Walmsley, asked about the Future Farming Resilience Fund, which provides free business support to farmers and land managers during the early years of agricultural transition. It does this by awarding grants to organisations, and it helps farmers and land managers to understand the changes that are happening and to identify how and what they may need to adapt their business models, and it gives tailored support to adapt. In July 2021 we awarded grants to 19 organisations so that they can deliver the interim phase of this resilience support. The organisations are listed on the GOV.UK website but I am sure that my noble friend the relevant Defra Minister will want to write about this.

Noble Lords also asked about food labelling. When I was in the European Parliament, we had constant debates about GDA labels versus traffic lights, and how sometimes food that may appear healthy under certain criteria shows a red light. We also debated the pros and cons of both systems. No system is perfect, but we agree that there has to be a system, and it is being consulted on.

I apologise to noble Lords if I have not addressed all the questions that were thrown at me. I know that I, my officials and Defra officials will look through Hansard and respond accordingly. I end by once again thanking the noble Baroness, Lady Walmsley, and all noble Lords who spoke on this important topic. Even though may not always agree on the merits of different approaches, I hope that we have shown anyone watching today that noble Lords share a commitment to improving the health of our nation, wherever people come from, wherever they live and whatever their background. This is a shared goal that the Government cannot achieve alone. We all have a role to play in this important mission, and I look forward to working with noble Lords, national, devolved and local government, industry and local civil society groups to improve the health of our great nation.