Folic Acid Fortification

Sharon Hodgson Excerpts

Thursday 25th October 2018 Commons Chamber

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

I thank the Government for allowing time for this important and very timely debate. It is a pleasure to be here responding on behalf of the Opposition on World Spina Bifida and Hydrocephalus Awareness Day, as the Minister pointed out, to speak about folic acid fortification, particularly after the announcement by the Under-Secretary of State for Health and Social Care, the hon. Member for Winchester (Steve Brine), earlier this week that the Government will be consulting on fortifying flour with folic acid. After decades of campaigning, I know that the announcement has been welcomed by campaigners and their families, and I thank my hon. Friend the Member for Pontypridd (Owen Smith) and the right hon. Member for Belfast North (Nigel Dodds) for their tireless campaigning on this issue. I too welcome the announcement although I have some further questions, and I would appreciate it if the Minister could elaborate on them later.

As early as 1991, the Medical Research Council published a report recommending that white flour in the UK should be fortified with folic acid, which had been shown in other countries to prevent neural tube defects in foetuses. Similarly, mandatory fortification, with limits on voluntary supplementation, was backed by the Scientific Advisory Committee on Nutrition in 2006 and again in 2017. Why, then, has it taken successive Governments so long to get to this point? The latest national diet and nutrition survey statistics state that 91% of women of childbearing age have a red blood cell folate level below the level estimated to lower the risk of NTDs. It is therefore clear that more needs to be done. In fact, the Public Health and Primary Care Minister said during Health and Social Care questions this week that he was

“convinced that the evidence shows overwhelmingly that this is something we should be doing.”—[Official Report, 23 October 2018; Vol. 648, c. 135.]

I therefore wonder about the purpose of the consultation.

The Minister may have already answered some of my questions, but is the consultation about seeing whether flour should be fortified with folic acid or is it just about establishing what the upper limit for folate levels should be? Modelling undertaken by Food Standards Scotland in 2017 indicated that fortification at the recommended levels, with a capping of voluntary fortification and supplements, can achieve the reductions in NTD risk without increasing the number of people consuming the upper recommended limit. Is this a scenario that the consultation will consider? Up until now, the Government have continued their policy of voluntary folic acid supplementation for women of childbearing age. Does the Minister expect that advice to continue throughout the consultation and evaluation period?

The press release published this week by the Department of Health and Social Care says that the consultation

“will launch in early 2019”.

Is the Minister able to tell the House exactly when the consultation will launch and how long it is expected to last? The evidence has been available for decades, and people have been campaigning on this issue for many years, so it seems only right that the consultation should conclude as quickly as possible. With that in mind, does the Minister have any expectations of when we will have the results of the consultation? Finally, as the Minister will know, not everyone eats bread or is able to eat wheat flour, so will the consultation make any assessment of how we reach those who do not eat bread or wheat flour? Will the fortification include only wheat flour, or will it extend to other flours, such as corn, rice and gluten-free flour?

That is a lot of questions for the Minister to answer, especially as it is not his brief—he is doing a fabulous job of stepping into various areas across Government—and I am sure that colleagues across the House will have further questions for him, but as this change has been such a long time coming, we are very keen to get an answer to the key question: when will flour be fortified with folic acid in the UK? I look forward to this debate and to hearing the Minister’s answers at the end.

--- Later in debate ---

[Mrs Hodgson]

With the leave of the House, I wish to say what an excellent debate this has been. I thank the Members who have taken part: the hon. Member for Glasgow North (Patrick Grady), my hon. Friend the Member for Pontypridd (Owen Smith), the right hon. Member for Belfast North (Nigel Dodds) in particular for his very moving speech, and my hon. Friend the Member for Leeds North West (Alex Sobel). We really have heard excellent and moving speeches. Most Members present were in Westminster Hall for the debate in May when together we called on the Government to look again at this issue. The Under-Secretary of State for Health and Social Care, the hon. Member for Winchester (Steve Brine), did listen. He assured us all when we were lobbying him on the way out that he had listened. He told us to watch this space, so it is really good that within six months we are back, that we are all in agreement that there are benefits to fortifying flour with folic acid, and that we are keen to have that happen as soon as possible.

As we have heard, charities such as Shine, from which I have received very detailed and helpful briefings, have been campaigning on this issue for decades, and I pay tribute to Lord Rooker, who has also shown great leadership on this matter over decades. Will the Minister say whether charities and campaigners will have an opportunity to be involved with and to engage in the consultation? How will they be able to do that? Many of them have not only first-hand experience of why fortification is needed, but the expertise that should be utilised during the consultation. My last question, I promise, is: will the Minister please tell the House, if the information is available, which Department is facilitating the consultation and who it will be led by?

After this issue has been on the table for two and a half decades, we all agree that it is now time for our flour to be fortified with folic acid. I look forward to hearing the Minister outline the timeframe in his closing speech.