All 2 Lord Krebs contributions to the Health and Care Act 2022

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Friday 4th February 2022

(2 years, 5 months ago)

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Lord Krebs Portrait Lord Krebs (CB)
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My Lords, on the one hand, I am strongly in favour of the government proposals in Schedule 17 to bring in further curbs on the promotion and advertising of junk food by introducing a 9 pm watershed and a ban on paid-for advertising online. I also support the amendments in the names of my noble friends Lady Boycott and Lady Finlay of Llandaff. On the other hand, I strongly oppose a raft of amendments in this grouping that we have heard a lot about in the last half an hour or so that seek to dilute or delay the measures in various ways. I do not have time to go through each one in detail, but if the Government were to accept any of them, it would be children, particularly those from disadvantaged backgrounds, who would suffer the consequences.

Before I move on, I want to try to find an area of common ground with the noble Lords, Lord Vaizey, Lord Clement-Jones and Lord Moylan. I agree with the implication of what they have said that this is not a single-fix magic bullet. Promotion and advertising of food makes a contribution to the obesity crisis, but there are many other factors, whether education, school meals or in-store promotions, which the noble Lord, Lord Clement-Jones, just referred to. I do not think anybody would claim that this is going to solve the crisis, but the question is: would it make any difference at all? We have heard various arguments that it would not, but I want to refer back to the evidence.

I first came across this nearly 20 years ago when I was chairman of the Food Standards Agency. We commissioned an independent review by Professor Gerard Hastings of the University of Strathclyde on the impact of the promotion and advertising of food on children’s diets. It showed incontrovertibly, with the range of evidence available, which was partly observational and partly experimental, that, yes, it does affect children’s diets. It affects not just brand loyalty but preferences for categories of food—chocolate versus apples, for example. In a way, that is blindingly obvious because, if it had no effect, why on earth would the food industry spend so much money doing it? We do not really need to have research to show it, but nevertheless the research is absolutely clear cut. Other reviews since then have supported the Hastings findings.

The second point I want to make is about the various objections that come from the food and advertising industries that this will have a negative impact on revenues and broadcasting. If noble Lords want to look at the analysis on this, I suggest they read pages 39 to 42 of Henry Dimbleby’s National Food Strategy Part One, where he thoroughly debunks the arguments we have heard. I will read a quote from the report, from John Hegarty, founder of the leading brand agency, Bartle Bogle Hegarty—I gather it created the Audi slogan “Vorsprung durch Technik” and is very well known. He said:

“Advertising junk food … is no longer a decent thing to do. Instead of fighting the new 9pm watershed rule, the advertising industry should be using its power to help fight the health crisis. We all have our part to play in encouraging food companies to invest in healthier meals, and encouraging the public to buy them.

No one is against profit – but profiting from illness and misery is not a sustainable business model.”

That is from the advertising industry itself.

I have talked about evidence and the impact on industry. My third point is really about inequality. Two days ago, we had the levelling-up White Paper, which contains a number of missions. One of the missions is to reduce health inequalities by 2030, and as we know, they are absolutely staggering. According to the King’s Fund’s latest analysis, males from the least deprived areas in the United Kingdom have a healthy life expectancy of 71 years; from the most deprived areas, they have a healthy life expectancy of 52 years. The White Paper states:

“we will act now to deal with one of the biggest contributors to ill health: poor diet and obesity.”

Whatever one thinks the average effect of these measures might be across the country, we must bear in mind that those effects will not be borne equally by different parts of society. The people who will bear the brunt if we do not implement these measures will be the poorest and most disadvantaged children in the country.

I thank the noble Lord, Lord Bethell, who, a week ago last Monday, organised a moving and interesting session with an organisation called Bite Back 2030. I hope he will not mind me quoting a little from that session. The facts and figures are absolutely mind-boggling. The raw statistics are that, in the UK, 15 billion junk food adverts are pumped out every year—in other words, 500 adverts per second—targeted mainly at young people. That is one of those numbers that is so outlandish that it is hard to grasp. That is why I found that the personal accounts of the young people and teenagers we heard from told a richer story. I will give your Lordships an example.

Dev Sharma, who I think is a 16 year-old boy, said:

“junk food advertising is part of my life”.

It is on bus tickets, Spotify, Instagram, YouTube, et cetera. Particularly chilling for me was the fact that Domino’s Pizza sends him an advert every day at 4 pm, just as he is leaving school and is really hungry, like any teenage boy. That is when he is at his most vulnerable, and he is being persuaded to buy calorie dense junk food then. Another witness, Becky Odoi, talked about “subliminal conditioning” of young people, and Yumna Hussen said that food companies are preying on young people when they are most vulnerable.

These are not my ideas; they are the ideas of the young people on the receiving end. I could go on at greater length, but I think I have made my point. I strongly disagree with the amendments that would dilute these measures, and I strongly support the measures. I regret that the Government’s own amendments introduce the possibility of delaying implementing the measures, and I ask the Minister to confirm that the Government do not intend such a delay. They will not be the total solution, but they will play a significant part in tackling the obesity crisis in this country, which, in the longer run, is a far bigger health crisis than Covid. We must not get distracted by the short term from looking at the long term.

Baroness McIntosh of Pickering Portrait Baroness McIntosh of Pickering (Con)
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My Lords, I am delighted to follow the noble Lord, Lord Krebs, and pay tribute to the work he has done in this area. I shall speak to Amendment 257C, but I shall first make just one general comment on something to which he alluded, and which follows from the earlier remarks of the noble Baroness, Lady Boycott. We are working in a vacuum at the moment, and it would be extremely helpful if the Government could say when they will publish their food strategy, drawing on the excellent work done by Henry Dimbleby, who is the main adviser to the Government on this.

I support and have appended my name to Amendment 257C in the name of the noble and learned Lord, Lord Hope of Craighead. He is unable to be here today, which he regrets greatly. The offending part of the Bill in this regard is on page 241, in proposed new Section 368Z18 on the guidance the Government intend to draw up from time to time. Subsection (2) states:

“The appropriate regulatory authority must consult the Secretary of State before drawing up or revising the guidance.”

Subsection (3) states:

“The appropriate regulatory authority must publish the guidance and any revised guidance in such manner as they consider appropriate for bringing it to the attention of the persons who, in their opinion, are likely to be affected by it.”

I draw the Committee’s attention to the Constitution Committee’s report on the Bill, and the following statement on Clause 144:

“This is a Henry VIII clause, enabling the Secretary of State to modify an Act of Parliament, an Act of the Scottish Parliament, a Measure or an Act of the Senedd Cymru, or Northern Ireland legislation. The Secretary of State is required to consult those he or she considers appropriate before making regulations via the affirmative resolution procedure.”

The Constitution Committee concludes:

“The House should consider amending Schedule 17 to require either the consultation of the relevant devolved administration or the consent of the relevant devolved legislature if the Secretary of State were to use this power to enact regulations modifying devolved legislation.”

I speak as a non-practising member of the Faculty of Advocates and must say that it is a source of concern to all of us who have an interest north of the border, west of the border in Wales or in Northern Ireland that, sadly, the Government are developing a history of not consulting the devolved Administrations where appropriate.

Regarding Amendment 257C, which is, in my view, a probing amendment, I put it to the Minister that the clause gives the Secretary of State the power to alter the legislation of devolved Administrations by regulations, as set out in the guidance to which I referred. The Committee will be aware that the Sewell convention does not apply to the exercise of delegated powers, so there is no obligation on the Government to seek consent. In its very helpful report on the Bill, the Constitution Committee suggests that, given the nature and extent of this power, consent should nevertheless be sought. There is nothing in the Bill to respect the spirit of the convention, not even a duty to consult. How do the Government square that with the respect they should give to the devolved Administrations, especially in view of my right honourable friend Minister Gove’s initiative on intergovernmental relations and the levelling-up agenda, to which the noble Lord, Lord Krebs, referred and which I, for one, support?

I conclude by asking my noble friend what precisely the Government intend to do, or what action they would be willing to take, to address this issue when the power in the guidance is being exercised.

Health and Care Bill Debate

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Lord Krebs Excerpts
Lord Bethell Portrait Lord Bethell (Con)
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My Lords, I shall speak to Amendments 149, 151 and 153 in my name and those of the noble Lord, Lord Krebs, and the noble Baronesses, Lady Walmsley and Lady Boycott. The amendments refer specifically to a deadline for the implementation of the junk food advertising restrictions.

I completely applaud the Minister for the approach of bringing in government amendments to try to refine the terms of the Bill; it is a collaborative approach, which I think all of us have really appreciated. However, in this matter, a government amendment has, I think, overshot, by removing the previous deadline in the first draft of the Bill. These amendments seek to rectify that.

I will not speak at length, but many have said, both in Committee and at Second Reading, how urgent it is to address the issue of obesity in this country. We cannot have any delay or rolling procrastination around these measures, so it is entirely right, proper and suitable for there to be a deadline in place in a Bill such as this.

It is also right to have certainty. I have huge consideration for Grenade and its low-sugar, high-protein bar. I will certainly look out for its excellent product when I am next in the gym, and I think the uncertainty it faces, which my noble friend Lord Moylan has described, is heartbreaking. That is why it is important to start the mechanisms now for answering its quite reasonable questions and to put a deadline on when those answers should be delivered.

I am not blind to the fact that many in the industry have voiced concerns that the deadline is too tight. I have looked at it and I do not accept those concerns. I think the bans have been around and on the books for a very long time and preparations have been in place. I worked in publishing during the tobacco ban: the turnaround for that was quite tight, but it was quite transparent and it happened without too much trouble. I think that a deadline is entirely right and suitable and that the deadline proposed is reasonable. I would like to hear reassurance from the Minister that there will be clear scheduling for these measures.

I would also like very briefly to address Amendment 151A, from my noble friend Lord Black, and the related amendments. On this, I feel utterly conflicted. The harms caused by online advertising have been mounting over several years. They are currently far too damaging and they are set to grow, both in scale and sophistication, without any clear sight of regulatory control. That is of grave concern, and the points made by my noble friend were very persuasive: I think he was right about bringing in compliance by the platforms. On the other hand, I accept that government regulation in this area is so off the pace; the online harms Bill is so far behind and the online advertising review has taken so long that the Government are just not in a position to implement the measures in this amendment.

I shall not be supporting these amendments in any votes that might happen, but my sentiments are very much along those lines. I ask the Minister to say very clearly what the Department for Health and Social Care and the Government will do around these concerns, not just on junk food advertising but on the advertising of alcohol, betting and non-surgical cosmetics, which all face similar concerns around the explosion of complex and persuasive online advertising which is underregulated.

Lord Krebs Portrait Lord Krebs (CB)
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My Lords, I shall speak in support of the amendments in the name of the noble Lord, Lord Bethell, to which I have added my name. I do not really need to say anything more than has already been said. We know that this country, according to the World Obesity Atlas published last week and supported by the World Cancer Research Fund, is now top of the European league table for projected levels of female obesity by 2030 and joint top for projected levels of male obesity. Sadly, it is probably already too late to stem this trend, but by acting now on these measures we might be able to protect the next generation. That is why I support the idea of having a firm deadline by which time the measures will be introduced.

I actually wanted to speak in slightly more detail about Amendments 148, 150 and 152 in the name of the noble Lord, Lord Moylan. As he explained, they are really just one amendment.

I promise you that this was not set up, but I have in my hand the very Grenade bar to which the noble Lord, Lord Moylan, referred. I wish to explain why this Grenade bar should definitely not be excluded. I am grateful to Dr Emma Boyland, of the University of Liverpool’s Institute of Population Health, for giving me a briefing on the Grenade Carb Killa bar—this particular one is high-protein, low-sugar, white chocolate and salted peanut. I bought it at the weekend from Holland & Barrett, in its health food section; it is marketed and advertised as a healthy product. Is it a healthy product? The answer is no.

First of all, no age group in this country is short of protein. We simply do not need to eat more protein. So the fact that this bar is high-protein is completely irrelevant in terms of health benefits. Secondly, remember that HFSS is high fat, salt and sugar. The bar may be low-sugar, but what about fat? It contains two-thirds of the recommended daily limit of the intake of saturated fat; it is definitely high in fat. It also contains more salt than a bag of salted crisps. Is it right to exclude something that is fatty and salty from the definition of HFSS? I am convinced it is not right, and therefore I completely reject the argument of the noble Lord, Lord Moylan. These products should not be excluded from the measures proposed in Schedule 18 to the Bill.

Lord Hunt of Kings Heath Portrait Lord Hunt of Kings Heath (Lab)
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My Lords, I have two amendments in this group—Amendments 154 and 155—though they are rather different from those discussed in the debates that we have just heard. I declare my interest as the president of the Hospital Caterers Association.

We have heard a lot about the risk of obesity, but we also know that many patients coming into NHS hospitals come in with nutritional issues, where good food and good nutrition could very much help them on their way to recovery. The research has indicated problems where patients are not feeding properly.

We are very grateful to Ministers for the meeting we had with the Hospital Caterers Association and the National Association of Care Catering, with the noble Baroness, Lady Barker. We are very grateful too that Clause 161 sets out specifications for hospital food standards.

There are just two quick points I want to make. First, it is a great pity that we do not have a similar process in relation to the care sector—care homes, in particular. One of the amendments relates to that: we want to see the provisions extended to the care sector. We also want to ensure that staff working in the care sector are suitably trained and that there is a suitable framework to ensure there is a high level of professional staffing.

My second point relates to the National Health Service. Although lip service has always been paid to good standards of hospital food and nutrition, unfortunately the boards of NHS organisations have often found it difficult to provide the resources to enable that to happen. The suggestion in my first amendment is, in fact, that a board-level director should be appointed to oversee this to ensure that the standards laid out as a result of the Bill, when it becomes law, will be put into practice. Alongside it go similar provisions in relation to ensuring that we have high-quality staff who can take advantage of a focused approach to training, which, at the moment, has been missing because a lot of the national infrastructure for training for staff in the NHS in the ancillary services has been neglected.

I hope that, following the discussions we had with Ministers, the noble Baroness will be able to be positive in relation to this tonight.