Folic Acid Fortification

Patrick Grady Excerpts

Thursday 25th October 2018 Commons Chamber

[Patrick Grady (Glasgow North) (SNP)]

It seems that a lot of us are substituting for other people today, but it is nice to speak in a debate on a topic on which there is a little consensus and agreement for a change, so I welcome the Government making time for this debate and the announcement about the fortification of flour with folic acid. It is particularly appropriate, as the Minister said, to be holding this debate on World Spina Bifida and Hydrocephalus Awareness Day. As the hon. Member for Washington and Sunderland West (Mrs Hodgson) said, this change has been a long time coming—the Medical Research Council first called for it in 1991—so I hope that the consultation will be concluded as quickly as possible so that we can move to an implementation phase.

Since 1991, the evidence of the benefits of folic acid fortification has only increased to the point at which there is now clear consensus across the medical community about the importance of this step. Dr Linda de Caestecker, public health director of NHS Greater Glasgow and Clyde, and Dr Jonathan Sher, an independent consultant on pre-conception health, education and care based in Edinburgh, have both written and campaigned extensively on this issue. In February this year, they published a paper in which they said that folic acid, or vitamin B9, could accurately be described as “vitamin benign” given its strong benefits and lack of significant downsides. They also pointed to the important fact that the lack of fortification has led to a health inequality gap, saying in a recent edition of Holyrood magazine:

“Relatively well-educated, well-informed, well-off women tend to follow the advice”—

to take supplements before and during pregnancy—

“while their less advantaged sisters often do not. The gap has also grown between women with well-planned and well-timed pregnancies and the large percentage of Scottish women who become pregnant unintentionally, unexpectedly, or with minimal preparation.”

The challenge is particularly acute in Scotland, which has more live births of babies with spina bifida per head of population than anywhere else in the UK. In turn, as the Minister hinted at, the UK rate is higher than that in many other parts of the world where fortification has already been introduced. Over 70 countries have already adopted this practice and have seen a decline in neural tube defects as a result. That is one of the reasons why last year the Scottish Public Health Minister, my good friend—and now the Cabinet Secretary for Communities and Local Government—Aileen Campbell, along with her Welsh Assembly counterpart, wrote to ask the then Secretary of State for Health to move forward on fortification.

The Scottish Government have also made it clear that they are prepared to take their own steps on fortification if necessary, but the evidence and research mentioned by the hon. Member for Washington and Sunderland West shows that fortification will be more effective if it is rolled out at the same time across the whole UK. It is welcome that action is at last being taken. The focus of the consultation must therefore be on how fortification can be delivered effectively, not on whether it should be implemented in the first place. I echo some of the hon. Lady’s questions.

When the announcement was trailed earlier this month, the chief executive of Spina Bifida Hydrocephalus Scotland, Andy Wynd, said that the decision to proceed with fortifying flour with folic acid will have a monumental impact on the health of babies in Scotland. I pay tribute to the work of SBHS and other organisations, such as Shine and the Royal College of Obstetricians and Gynaecologists, which have long campaigned on this issue and which provided helpful briefings in advance of today’s debate.

My hon. Friend the Member for Cumbernauld, Kilsyth and Kirkintilloch East (Stuart C. McDonald) works very closely with SBHS, which is based in his constituency. SBHS does incredible work to raise awareness of spina bifida and to support people and families with the condition to live happy and fulfilling lives. On that note, I wish the best of luck to my friend, and former constituent, Tommy Ga-Ken Wan who, with his dancing partner Piotr Marczak, is taking part in SBHS’s “Strictly Come Prancing” event in Glasgow later this month, which will raise much needed funds and awareness—as does the annual SBHS gala Burns supper, which I had the privilege of attending in 2016.

I attended that Burns supper with another constituent, Jackie Lennox, whose sister Tracy was born with spina bifida. Tracy sadly passed away in 2014—as we have heard, spina bifida is a life-limiting condition—and in her memory Jackie established Tracy’s tree, which has become a new but much loved tradition in Maryhill. The memorial Christmas tree outside the burgh halls is decorated each year with baubles bearing the names of loved ones who have passed away.

It is difficult to know how Tracy’s life, and many others, might have been different if the fortification of flour with folic acid had already been routine, but what we do know is that the introduction of fortification will reduce cases of neural tube defects and complicated pregnancies and will allow more babies and families to live longer and less complicated lives. That is why it is important that the Government now move as quickly as possible to take these last steps towards implementation. We must make sure we take this opportunity to finally make it, and get it, right.