What Works Network: Centre for Food

Debate between Maria Miller and Alex Norris

Wednesday 2nd March 2022 Westminster Hall

[Mrs Maria Miller (in the Chair)]

I will call Alex Norris to move the motion and then call the Minister to respond. There will not be an opportunity for the Member in charge to wind up, as that is the convention in 30-minute debates.

[Alex Norris (Nottingham North) (Lab/Co-op)]

I beg to move,

That this House has considered the addition of a centre for food to the What Works Network.

It is a pleasure to serve under your chairship, Mrs Miller. I have brought today’s debate to bring attention to what would be a terrific addition to the What Works Network and a significant opportunity for the Government to help make the national food strategy report a success. I suspect that the Minister might be glad that for once I am taking a break from pressing her on fish mawl, although I am grateful for all the work she has done in that area. So we will move on to food more generally.

The agrifood sector is a crucial part of British life. It is a major driver of our economy. In 2018, the wider system employed 4.3 million people and contributed £121 billion—nearly 10%—to our national gross value added. It is an anchor sector in our economy and it touches all of us every day. However, we are living in a challenging period when it comes to food.

People are struggling to meet their living costs, of which food is a major part. According to the Food Foundation, 4.9 million adults, or 9% of the population, are affected by food insecurity. In comparison, 5.6% of the population experienced food insecurity five years ago, based on the threshold set by the United Nations Food and Agriculture Organisation. At the time, the FAO also considered that 2.5% of the UK population would be considered undernourished, with 1.8% facing severe food insecurity.

We know from global trends, as stated in the food strategy report, that the food we eat and how we produce it can damage both the planet and our health. Globally, 37% of greenhouse gas emissions come from the food system. Here in the UK, the sector engages 70% of our land, contributes 45% of the nitrogen and phosphorus pollution in our rivers and creates 2.2 million tonnes of plastic packaging every year, less than half of which is recycled. Turning to our own bodies, 80% of processed food sold in the UK is unhealthy and we get 57% of our calories from processed foods rich in fat, salt and sugar, with 35% of the population overweight, 27% obese and nearly 5 million people suffering with diabetes due to the over-consumption of processed foods.

Market factors end up turning this into a vicious circle—the junk food cycle. The market for processed foods makes them cheaper and more accessible, which makes them more desirable. All the while, we get unhealthier and unhealthier, and the planet suffers. I am a sinner in this regard, so I do not cast the first stone on policing my constituents’ diets—I do not feel that that is my role, and I am not sure that I would have complete credibility—but it is hard not to see that we live in an obesogenic environment.

We owe our constituents leadership that tackles the situation and gives them true, informed choice and a range of options. We see elements of that in the Government’s obesity strategy. I was keen to support that strategy as shadow Public Health Minister, but it remains quite modest and what I am suggesting today could turbocharge that approach. The incredible contribution the sector makes to our economy, as well as some of its challenges, shows both positively and negatively why it is vital that we have an understanding of the best developments in food, so that we can harness them to improve the system. That is why I am enthusiastic about a What Works centre for food.

The network of nine independent What Works centres, three affiliate members and one associate member currently cover policy areas that account for more than £250 billion of public spending, to allow decision making to be supported by an evidence base worthy of the decisions that have to be made in this place and will be made, going forward, across the country. As gov.uk puts it:

“What Works is based on the principle that good decision-making should be informed by the best available evidence. If evidence is not available, decision-makers should use high quality methods to find out what works.”

That is a very noble principle that commands cross-party support.

Examples of such centres include the National Institute for Health and Care Excellence, the What Works Centre for Local Economic Growth and the What Works Centre for Wellbeing. The current network of What Works centres has transformed the use of evidence in public services across medicine, policing, schools, hospitals, GP practices and care homes. The Government have been wise in listening to them in the way that they have.

I feel that I am in good company, because the Early Intervention Foundation is also part of the network, and my predecessor, Graham Allen, was instrumental in its development, so we are perhaps re-establishing a tradition for Nottingham North MPs today.

The networks follow the six impact principles: they are independent, methodologically rigorous, practical, accessible, capacity-building and transparent. Those are noble pursuits that would enhance our food policy.

As with most ideas, I have stolen this one from someone else: the Government’s own food strategy report recommended that the Government establish two What Works centres, modelled on the Education Endowment Foundation, to collect and analyse evidence on the effectiveness of food-related policies and business practices. One would focus on diet, and the other on farming methods. Although my instinct and preference would be to have a single centre, I am concerned not with minutiae today but with the wider importance of the principle of establishing such a centre.

People far more qualified than me are already working on the details. Academics from the University of Nottingham, the University of Leeds and the University of Newcastle, led by Professor David Salt of the University of Nottingham’s School of Biosciences, have recently proposed a project to blueprint such a centre, in line with the recommendation. There is significant interest in this space. The Agriculture and Horticulture Development Board is also working on some of these ideas in a farming context. The Food Standards Agency is thinking about a What Works centre in the diet space. That shows the traction that the idea is getting, and that there is great interest in it across academia, business and industry. My view is that it should be under one roof.

Tobacco Control Plan

Debate between Maria Miller and Alex Norris

Thursday 10th June 2021 Westminster Hall

[Alex Norris (Nottingham North) (Lab/Co-op)]

It is a pleasure to serve under you in the Chair, Mrs Miller. I say a big thank you to my hon. Friend the Member for City of Durham (Mary Kelly Foy) and the hon. Member for Harrow East (Bob Blackman) for their doughty leadership on this issue, for their work in the APPG on smoking and health and for securing this debate, which has been a particularly good one. The points that my hon. Friend made about regional disadvantage and the way in which that links to every indicator of social deprivation and then to smoking were really good ones. It was very interesting and pleasing to hear about the work that has been done in the north-east about closing the gap. That, to me, served as an endorsement of regional approaches and, beyond that, sub-regional approaches, which I think we have lost in recent years and which I hope, through this plan, we can rebuild.

On the regional theme, my hon Friend was joined by a fine array of north-east MPs, who surround me here— I did feel rather out of place. My hon. Friend the Member for North Tyneside (Mary Glindon) made a really strong and compelling case for alternatives such as e-cigarettes and vaping. The thing I took away from that was how unequivocal it was. There is a real danger of being squeamish and equivocal about these new models, and I do not think that serves anyone. That is a theme that I will come to shortly.

That theme was shared by the right hon. Member for Clwyd West (Mr Jones). I agreed with the points he made about the new regulatory framework and the regulations. The review gives us a real chance to look at these things, so I hope we will hear some more from the Minister on that. Similarly, the hon. Member for Windsor (Adam Afriyie) talked about data and evidence. We have a common goal: we want fewer people to smoke and die. It behoves us, therefore, to follow the data and evidence about how to do that and not to be squeamish when they point one way.

My hon. Friend the Member for Blaydon (Liz Twist) made very poignant points about baby loss and smoking during pregnancy. She and other hon. Members will have heard some of the reasons why women smoke in pregnancy, which include perceptions about having a smaller baby and family traditions of doing so. The reasons are complicated and various, so we need ground-level, peer-led services to tackle that. Much of the content of the Leadsom review will help us in that space, so I hope to hear a commitment to that from the Minister.

My hon. Friend the Member for Jarrow (Kate Osborne) talked about regional inequalities and made a point about having services nearer to people. I will return to that shortly. My hon. Friend the Member for Ealing, Southall (Mr Sharma) also talked about inequalities—this time around ethnicity. We should not lose that in this debate. He also talked about localised approaches by service leaders who know their communities and have effective ways to reach different people. I think that is the whole battle here.

The hon. Member for Harrow East spoke with characteristic plainness, but we needed a bit of that. The 2030 target is a stretching one. At the current rate, we are seven years behind, but in the poorest communities it is 14. That means that we need big ideas. The document that he co-authored through the APPG has big ideas, and I will touch on a couple shortly.

I agree with the points that the hon. Member for North Antrim (Ian Paisley) made about organised crime. Again, that can form part of a tobacco control plan. I think there is complete political consensus about that. I do not agree that increasing the cost has not been an effective way of reducing smoking. Over two decades, it absolutely has. I also do not agree that tobacco control plans over the past couple of decades have not had an impact. Clearly, they have, and I will touch on that shortly.

For me, smoking is the ultimate equalities issue. It accounts for half the difference in premature death between the best and the worst off, so if levelling up is to be the theme of this Parliament, post covid, it seems that smoking is a very good place to start. I have similar statistics to those of my colleagues. In Nottingham, where I live, smoking rates are well above the national average: 20.9% of our community smokes, compared with an England average of 13.9%; and 16.5% of pregnant women are smokers when their baby is born, compared with 10% nationally. The cost to us is about £75 million every year through health and care needs, lost productivity and premature death, so tackling this is a really big prize for a community such as mine.

We should be confident that we are building on a platform of two decades of good progress on smoking cessation. Under Labour and Conservative Governments, we have implemented a comprehensive approach to tobacco control, including banning smoking in public places and cars, point-of-sale display bans and standardised packaging. All that has contributed to driving down smoking rates and discouraging young people from starting. We are here in a spirit of cross-party co-operation, and we are in lockstep in support of the goal of being smoke free by 2030.

I very much welcome the APPG’s report, which sets out the bold steps that we ought to take if we are to achieve this extremely challenging ambition. Among other things—this is always a very good place to start—it highlights the strong public support for that ambition: three quarters of the public are in favour, and that includes majority support for key recommendations from voters of all political parties. There is a clear mandate for action. I want to take the opportunity to thank Action on Smoking and Health, both for its work as the secretariat to the APPG and for the support it has given me in developing policy.

In this debate and the one we had a few months ago, colleagues have given the Minister plenty of content for the new control plan—in fact, probably a whole control plan and a bit more—but I want to offer a few points myself. First, the focus must now be on inequalities. Yes, this is a national goal and effort, but to make the most progress, we need locally led, community-sensitive smoking cessation services. The evidence for those is very strong indeed. It is a source of sadness that the Government have lopped away at the public health grant to the point that it has reduced by more than 40% since 2013, and those cuts have of course fallen disproportionately on poorer communities. If we are wondering why progress is stubborn in those areas, that is a significant reason, so I hope to hear a commitment from the Minister today to restore funds lost, with a particular focus on need. The report helpfully suggests an industry fund to cover the cost. Frankly, we should never have disinvested in the first place—cutting smoking cessation services is the falsest of false economies—but if the Government come up with an alternative along those lines, we will of course be supportive.

I want briefly to mention raising the age of sale to 21. We know that the best way to reduce smoking is never to start and we know that young people who start smoking generally tend to regret doing so. Seventy per cent. of adult smokers in England want to quit and an even bigger proportion—three quarters—regret ever having started, which makes an interesting point about raising the age of sale to 21. One of the things that surprised me in the report was the level of public support for that proposal—I did not think it would be as popular as it is—so the recommendation of at least a public consultation is a sound one. I would be interested to hear the Minister’s views on that, because it would be a very interesting public debate to have.

Turning to e-cigarettes, vaping and similar, this must be a feature of the tobacco control plan. I hope that the Minister and the Government more generally, via their role in the World Health Organisation, can push harder for stronger and clearer messages, based on the data and evidence, at the WHO level. I looked at the WHO website yesterday, and while I fancy myself as quite a smart guy—I might hide it well sometimes—I could not fathom what it was trying to tell me. It was incredible. That sort of equivocation makes it really hard for people thinking about alternatives to know whether they are supposed to go ahead or not.

I always rely on the Public Health England position in 2018 that these products represent a 95% reduction in harm, which seems a pretty good place to start. The APPG report says that in 2017 they helped 50,000 people to stop smoking and that concerns around children’s starting have not materialised. The 2017 tobacco control plan included a promise that:

“The Medicines and Healthcare products Regulatory Agency...will ensure that the route to medicinal regulation for e-cigarette products is fit for purpose so that a range of safe and effective products can potentially be made available for NHS prescription.”

This has not happened; it now must happen, and I hope it is a main feature of the new plan. The Government should also seek to regulate this market through the regulations review, to ensure that it promotes quality, safety and protection of young people.

Finally, the 2030 target is a vital and unifying goal, but we cannot wait until 31 December 2030 to look at the stats and see whether we have made it. We know it is a stretching target and we know we are currently not on course, hence the need for a new plan as soon as possible, but that plan has to have interim goals so that we know whether we are making enough progress. Again, the APPG report made some very good suggestions on that.

The report also makes strong recommendations on the data we do not currently have, which is a particular challenge in the case of people living with mental health conditions, who we know have disproportionately high rates of smoking. Data is collected in primary care on smoking status and mental health, but not routinely analysed. Smoking status data can also be collected through the mental health services dataset, but this is not done routinely. As a result, our data for folks with serious mental illness and others in secondary mental health services is not good. Reliable data is an important part of being sure that we are making the progress that we want to in this area, so I hope we will hear a commitment from the Minister on interim targets and better data.

To conclude, if we want a big public policy win—and goodness, this is about as big as they come—whether it is early intervention we are into or reducing inequalities, this is a major chance to make a step change. We need a plan, we need a good plan, and we very much look forward to playing our role in that process.

[Mrs Maria Miller (in the Chair)]

May I remind everyone that only Members physically present can intervene on the Minister?