Sugary Drinks Tax

Sarah Wollaston Excerpts

Monday 30th November 2015 Westminster Hall

[Dr Sarah Wollaston (Totnes) (Con)]

I pay tribute to the hon. Member for Warrington North (Helen Jones), Jamie Oliver and Sustain for giving us an opportunity to discuss the issue raised by the petition. I also thank all the members of the Health Committee and the Committee team, particularly Huw Yardley and Laura Daniels, for their contribution to today’s report, “Childhood obesity—brave and bold action”. Brave and bold action is what we need.

The first question is: how important is this issue? The answer is starkly set out in the first few pages of our report. There is a graph showing that a quarter of children leave primary school not just overweight but obese, and that an enormous and entirely unacceptable health inequality gap is opening up, and getting ever wider, between the most advantaged and the disadvantaged children in our society. Overall, a third of children are either obese or overweight by the time they leave school, which has enormous implications for them as individuals—it will blight their future life chances, and it exposes them to bullying when they are at school—and for the NHS.

As we heard, the estimated cost of obesity to the NHS is £5.1 billion. Obesity is one of the major contributing factors to developing type 2 diabetes. Diabetes now accounts for 9% of the entire NHS budget. If we are looking to make the NHS live within its means by preventing illness, we have to do something about childhood obesity. Most of all, we need to do it for the sake of the children. We need to be clear that no single measure will be the answer. We need a package of measures, and we have considered the issues in our report.

The Committee did not focus on the role of exercise in our report, primarily because we looked into physical activity and health just before the last election and we wanted to endorse the findings of that report. The message is clear: whatever someone’s weight or age, exercise is enormously beneficial, but we must not be distracted into thinking that increasing exercise alone will be the answer to childhood obesity. We often hear that view from industry—that all we need is a bit more education and a bit more exercise—but we will be disappointed if we go down that route. Of course those things are important, but ultimately, unless we address the food environment in which we live, we will not make a meaningful difference to childhood obesity. Yes, let us put exercise and education firmly within the obesity strategy—I am sure that the Minister will do just that—but we need to go further.

We made recommendations in a number of areas, for example on promotions. We considered marketing and the pervasive advertising to which children are now exposed wherever they go. We considered the role of reformulation and of clearer labelling, endorsing the powerful point made about teaspoon labelling in particular. We considered improving information about food and education in schools, and school food standards. We also touched on the powerful role that local authorities can play and how we can support that.

However, as I said, we also considered whether we should introduce a sugary drinks tax, and that is what I will discuss in this debate, because the Government have indicated that they will not take action in that area. I would like to make the case to the Minister for why we felt that that should be an important part of an overall strategy.

[Mark Pawsey]

rose—

[Mark Field]

rose—

[Dr Wollaston]

In tandem! I am spoiled for choice.

[Mark Pawsey]

Does my hon. Friend acknowledge that there is already a tax on sugary drinks, in that VAT is levied on them at 20%?

[Dr Wollaston]

Of course, but let me be clear that the point of a sugary drinks tax is to introduce a price differential between the full-sugar product and alternatives, which would then be cheaper. We know that we can nudge people into making healthier choices with a differential. That differential would have to be 10% at a minimum; in our report, we recommend 20%. The beauty of levying such a tax on sugary drinks is that there will always be an equivalent product that is not packed full of sugar. Let me be clear that a relatively small bottle of sugary drink can contain 14 teaspoons of sugar. That is more than twice the recommended daily allowance.

To those who say that such a tax is regressive and would hit the poor, I say: look at who is already hit by the problem. The burden of childhood obesity falls on the poorest children in our community. We know from the experience in Mexico that a 10% levy on sugary drinks has led to a 6% reduction in consumption. Perhaps more importantly, it has led to a 9% reduction in consumption among the heaviest users. That is the point. The heaviest users are not being denied a product that they enjoy; they are switching to a non-sugary alternative.

[Mark Field]

Does my hon. Friend recognise that one concern that some of us have about a tax on sugary drinks is that although it seems an attractive idea as a one-off, it would set a precedent? There would then be moves to outlaw discounting, impose portion sizes and implement similar rules. [Interruption.] Many of us believe in the idea of freedom and the responsibility of the consumer, and do not like the idea of the Government imposing that sort of change.

[Dr Wollaston]

In an ideal world, I agree, it would be nice not to have to do any of that, but I return to the point about whether the Government also have a responsibility for the health of the nation’s children. Should the Government step back? Should any of us feel that it is acceptable to condemn one in four—a quarter—of the most disadvantaged children in Britain to a lifetime of ill health? If we can do something simply to nudge people a different way, should we not consider the possibilities, and ask how different those children’s life chances could be? As I said, such a tax would not be regressive because there is always an easier, untaxed alternative. We are talking not about telling people that they cannot have a product that they enjoy but about nudging them to choose a healthier one.

There is an interesting phenomenon whereby education, for example, is sometimes taken up by the people in society who are already healthier, which can inadvertently end up widening the health inequality gap. We should target measures to help those who are suffering the most harm. As for this being regressive, look at who is suffering the most harm. Is my right hon. Friend happy with the situation as it stands?

[John Glen]

Does not that point also suggest that the distribution of education interventions is not being focused in the right way? The Government could do significantly more to improve support, advice and education to allow that group of people who consume too much to make informed choices before going down the route of a tax.

[Dr Wollaston]

I ask my hon. Friend to look later in our report, where we set out some of the evidence on delivering education and advice. I am afraid that it does not provide the solution that he imagines it will, but I encourage him to read the report. I wish education alone could solve the problem, but it will not, and it tends to be short-lived. The scale of the problem demands our attention.

A tax would not be regressive because there would always be an alternative. No one is thinking of introducing a sugar tax of the type that sometimes people imagine when they hear “sugar tax”, which is one that would apply to the bag of sugar that they buy off the shelf or to biscuits, cakes and sweets. We are not suggesting that, because it is difficult to reformulate those products as entirely sugar-free alternatives. We are considering only products with an easy alternative. Why did we choose sugary drinks? Look at the data in our report, particularly on teenagers’ diets. A third of their entire sugar intake comes from sugar-sweetened drinks. In other words, there is an easy win here, through which we can help to take calories out of children’s diets, but no one is suggesting that that is the entire answer.

[Maggie Throup (Erewash) (Con)]

Sugary drinks are not just about obesity; dental decay is also an important issue, and it affects self-esteem.

[Dr Wollaston]

My hon. Friend is absolutely right. In our report, we highlight that the single biggest cause of admission to hospital for five to nine-year-olds is the need to have rotten teeth removed. Are any of us happy with that situation? It is absolutely woeful that we are not doing more to tackle it.

As I said, the primary purpose of the tax is not to be a pointlessly punitive measure; it is to nudge people towards healthier choices. However, if the Government went down that route, I think it would be more acceptable to the public if every penny from the levy was directed to helping the most disadvantaged children, who suffer the most harm. That would also answer the point about whether the tax is regressive. We must be able to demonstrate what can be achieved with it. At a time when public health budgets are being squeezed and we are possibly looking at a 3.9% reduction in the public health grant, we must not cut back on the very measures that could make the greatest long-term difference.

[Emma Reynolds]

Does the hon. Lady agree that efforts to improve the education of parents tend to reach middle- class parents, not working-class ones, nor the parents of deprived children, whom we really need to reach? A tax on sugary drinks would send out a clear signal to those parents that they are doing their children harm by buying too many of these products for their children.

[Dr Wollaston]

Yes. As I pointed out, we could end up inadvertently widening health inequalities. The hon. Lady is absolutely right that a tax would send a clear message—right in front of people, on the shelf—that certain products are cheaper because they are not as harmful. That is the clear beauty of it.

I ask Members to consider what could be achieved with such a levy. If it might raise between £300 million and even £1 billion a year, the possibilities are extraordinary in terms of what we could do to improve the health and wellbeing of the nation’s children. We should not miss that opportunity. I hope that the Government will accept all the points and concerns raised by hon. Members and reconsider their policy, giving serious consideration to how much could be achieved for the benefit of our nation’s children and their health.

[Geraint Davies]

I support a sugar tax. In Mexico, the average person has half a litre of Coke every day. Did the hon. Lady consider the possibility of a tax on sugar as an input into other products? After all, if I was making Hobnobs and the tax was at 10%, and 50% of a Hobnob was sugar, I would only have to make a slight change to the price, the formulation, or the number of biscuits. Would it not be better instead to have a tax on all sugar inputs, to give the right incentives to both consumers and producers?

[Dr Wollaston]

I thank the hon. Gentleman for his intervention, but the point is that we wanted to respond to the issue about whether a sugar tax is regressive. It is much more challenging to use a direct replacement for the sugar, which would mean zero sugar for those kinds of products. That was partly why we took that view.

However, the approach that we recommend for the kind of products that the hon. Gentleman has mentioned is one of reformulation. During the last decade, there has been a successful programme of reformulating salt within our processed foods, but such a change takes time, because we have to adjust the nation’s palate gradually. Yes, we can make bigger step changes if we replace part of the sugar in one go, but there is sometimes something about the chemistry of sugar within cookery that means a sugar substitute does not do the same job. We wanted a tax where a sugar substitute did the same job as sugar, in effect.

I am confident that reformulation will be part of the Government’s response, because there is clear evidence that it works. Having said that, we know that it works better when there is some teeth to it, so I urge the Minister to go further than the responsibility deal and have something with real teeth. Things worked better when we had the Food Standards Agency and a bit of a stick in the background to make such changes happen, and industry wants a level playing field.

[Mark Field]

It is only fair that we give some credit to the industry, as my hon. Friend has done, particularly for the changes that have been made in relation to salt products. However, it seems to me somewhat insidious that, as we heard in an earlier contribution, the financial interests are being questioned, as though health professionals, who are often well funded by public funding, did not have a financial interest in this particular debate, as well as—[Interruption.]

--- Later in debate ---

[Fabian Hamilton (in the Chair)]

Order.

[Dr Wollaston]

I thank my right hon. Friend, and I should say for the record that I have no financial interest in any of this whatsoever. However, he is right that the industry has a role to play, and there is no point just beating industry over the head, because we would like to bring it with us. I was rather encouraged to see that, during our inquiry, the British Retail Consortium was very helpful in a lot of what it said, but it told us that it would like a level playing field. A very important strand of our recommendations was around price promotions and the kind of deep discounting that goes on in relation to the most unhealthy junk food and drink. It is very difficult if only one section of industry takes action on discounting. An extraordinary point that came out in our inquiry was that 40% of all the food and drink that we have in our homes tends to come through very deep discounted routes, and discounting is absolutely key to retailers’ marketing strategy in the retail environment, so we need a level playing field as far as industry is concerned.

[Mark Pawsey]

rose—

[Dr Wollaston]

I can feel another point coming on here.

[Mark Pawsey]

I declare an interest, because I have a Britvic plant in my constituency. My hon. Friend is talking about the industry. Does she accept that the industry has done a great deal to promote low-calorie variants of its products and to reduce the calorie content of the full-strength products?

[Dr Wollaston]

I am sure that will be part of it, but as I have said, I am not here to beat industry over the head. I want to bring industry with us. I celebrate what it has done, but it needs to go further. What we heard on our Committee was that industry needs a level playing field, and that a bit of regulation helps, because then everybody goes together. For example, take the chicanes of sugar that we have at checkout aisles, and the fact that we are being flogged a kilogram of chocolate when we go to buy a newspaper. With those types of things, we need a level playing field, so that we do not have any industry going down that route.

My view is not that we should not have discount promotions; we need those discounts and promotions to happen for healthier foods. The argument is often made that we will hit people in their wallets if we take these promotions away, but what we want is for people to be able to afford healthier, quality food. I would love that type of food to be the focus of deep discounting and promotions.

We then come on to the issue of clearer labelling. Jamie Oliver, in his presentation to us, made a compelling case about labelling. Let us put the number of teaspoons of sugar on drinks. This morning, I was trying to look at drinks labels, and I found them confusing. We need clear information that says whether the product contains 12, 13, or six teaspoons of sugar. To answer the point that my right hon. Friend the Member for Cities of London and Westminster (Mark Field) made about industry, it helps industry if people can clearly see that companies have made an effort to make a lower-sugar product. Let us allow that within clear labelling.

Let me come on to improved education. I would love to see more education about food in school, including proper cookery lessons, and for schools to have the resources to be able to do so much more in that regard. That is where I see one of the benefits of this levy going; it could go to support those kinds of lessons, not only in schools but in the wider community, and school sport. All those things are important. If we are to have school food standards, they should apply to all schools. Do we not care about every child in school?

[Geraint Davies]

The hon. Lady will know that I put forward a sugar Bill supporting sugar being denominated in spoonfuls. Does she accept that if there were two pasta sauces that were clearly labelled—one with six teaspoonfuls and one with three—there would clearly be an incentive for consumers to pick the lower-sugar one and that manufacturers would compete to get sugar content down, rather than up, in order to get people to buy their products?

[Dr Wollaston]

I completely agree with the hon. Gentleman. We have seen that where companies want products to be marketed as “healthier”, there is an incentive for them to reformulate, although we need honesty about that; sometimes, products can be marketed as “healthy” because they are low-fat, when they are packed full of sugar. We need to be clear about that.

Also, look at advertising: some products are allowed to be marketed to children, including breakfast cereals whose contents are 22.5% sugar; that was the rather shocking evidence that we heard. We need clearer guidance as to what constitutes a “healthy” product.

On that point about advertising, we felt that there was a clear case to have the watershed of 9 pm apply, so that we do not see junk food being marketed to children when they are watching very popular programmes. We were also very concerned about the pervasive nature of advergames on the internet: children think they are playing a game but, in fact, the games are the product of marketing companies, and the children are being sold particular items.

We are absolutely clear that all these things are very important and, as I said at the beginning, there is no one single piece of the jigsaw that will complete the picture. Indeed, the more pieces of the jigsaw that are put in place, the more effective a strategy there will be around childhood obesity.

I return to the point I made at the start: this issue matters and we cannot continue as we are. Also, although we did not go into this in great depth in our report, I urge the Minister to consider what interventions can be put in place for those children who are already affected by obesity. We were very supportive of the child measurement programme, but we were told by local authorities that funds are tight. As for extending the programme to bring in children from earlier years and pick them up before they get to primary school and run into difficulties, authorities do not have the resources to both put in place another year of monitoring and do what we need to in order to help those children who are already affected by obesity. Resources matter. I again urge the Minister, when she discusses this issue with colleagues, to consider what we can achieve, because we should not take the view that that nothing can be done about childhood obesity. We can do extraordinary good for the health of our children, and I really hope that when the Government bring forward their obesity strategy, they will be bold and brave, and recognise the urgency of this health emergency.

--- Later in debate ---

[Barbara Keeley]

That type of initiative is wonderful, but fewer and fewer children are walking to school, and an awful lot more are being taken there by bus or by their parents. The Health Committee report reminds us that the latest figures show a fall in physical activity. In 2012, only 21% of boys and 16% of girls did enough exercise to meet the Government’s physical activity guidelines. That is a fall from four years earlier, when the figures were 28% for boys and 19% for girls. We are therefore going in the wrong direction, and we are all becoming couch potatoes. We might worry about this for ourselves, but it is a great concern when children are involved.

I am a former member of the Health Committee, and it is a pity that little emerges from the report, which simply reiterates and endorses the findings of its predecessor Committee’s inquiry, in which I was involved.

[Dr Wollaston]

I absolutely recognise that physical activity is important and that it should be for everyone, irrespective of their weight or age. Like me, the hon. Lady will remember Julie Creffield, who spoke so powerfully before our Committee in the last Parliament. However, the current Committee felt that it did not want to be distracted by something we had already produced some work on. We therefore wanted to endorse everything that was said by our predecessor Committee, rather than to go over that ground again.

[Barbara Keeley]

I thank the hon. Lady for that intervention, but I think it is a bit too easy to lose sight of physical activity, and that is why I have raised the issue. I hope we can be brave and bold about these issues too—it is good to be brave and bold about children’s health, but let us cover all the issues.

It has been said that treating obesity and its consequences alone costs the NHS more than £5 billion a year. It is great that we are having this debate, because we are past the point where we can just let things trundle along. Let me come to the crucial point in the debate. Public figures such as Jamie Oliver have come out in support of a tax on sugar, and he has added stardust to the debate. However, this is a complex issue, and the solutions must deal with that complexity. We know that something must be done, but what is that something?

The problem goes deeper than the demand side. The food and drink industry has not been dealing with the real problems. A number of hon. Members have talked about the Government’s responsibility deal, which has not worked. Firms have made promises and then failed to carry out their pledges. We have talked about labelling, which I will come on to. Many of the suggested interventions involve better labelling of products, but research by a team at the London School of Hygiene and Tropical Medicine suggests that interventions that improve information about and awareness of the risks do not necessarily translate into positive behavioural change.

As has been touched on, the responsibility deal focused mostly on salt, which was perhaps welcome. There have been real moves in that area, although every time I have a bowl of tomato soup these days, I regret that it does not taste like it used to. It is clear that salt is being taken out of our diets, but not sugar, which is the focus of our debate. The research team also found that although responsibility deal partners claim there has been “considerable sugar reduction” under their calorie reduction pledge,

“the current progress reports do not substantiate these claims.”

In fact, responsibility deal partners say they have reduced sugar levels under the calorie reduction pledge, but they have not.