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The abolition of the agricultural wages boards was raised by the noble Lord, Lord Roberts of Llandudno, and the noble Baroness, Lady Quin. The noble Baroness will remember that we made the decision to abolish the AWBs in July of last year and to bring agricultural workers within the scope of the National Minimum Wage Act. Since those agricultural wages boards were set up, we have moved on. Employment legislation and protection for workers have changed, and there is no longer the need for special, separate arrangements for one sector. We want to reduce the regulatory burdens on the industry, and to allow it to decide on
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Broadband was raised by my noble friend Lord Plumb and, I think, the noble Lord, Lord Kennedy. They highlighted the fact that in this digital age too many rural areas still have limited access to broadband. Something like one-third of our farmers have no access at all. I believe that this is unacceptable, which is why we are committed to working with business and community groups to ensure the rollout of universal broadband with a clear focus on improving the situation in rural areas, on improving existing businesses and on kick-starting new ones. At this stage I cannot give any predictions of how fast we will be able to go in this matter, but I can assure the House that there is that firm commitment to making progress in this area.
My noble friend Lord Kimball and others stressed the importance of getting new skills into farming and encouraging new farmers. My noble friend Lady Byford also stressed the importance of succession in the smaller hill farms. I agree entirely and I appreciate the importance of providing encouragement. We will certainly continue to support the AgriSkills Forum, an industry-led project to increase skills in the farming industry and to improve the attractiveness of farming in order to recruit the best people in the future.
One is tempted to say that as most farms are small, family-run businesses, one should always remember that it is a matter for the parents in those small businesses to make the business attractive to their sons and daughters if they want them to join them. No doubt, that matter is beyond the control of the Government.
I am mindful of the time and I want to allow my noble friend at least one minute to wind up this debate. I conclude by confirming that we recognise and respect the varied, vibrant rural communities that exist throughout the country. We will do all that we can to assist those communities to prosper and improve. We believe that the Prince's Countryside Fund is an exciting and welcome initiative, which will be an important catalyst in helping to achieve this objective.
Lord Gardiner of Kimble: My Lords, I thank all noble Lords for participating in this debate. I think we have covered much country from all sides of the House as well as all parts of the kingdom. I am also particularly delighted that three noble Lords made their maiden speeches during this debate. I want to endorse what all noble Lords have said about the Prince's Countryside Fund, and I think that the contribution it will make is essential to our national life. The noble Baroness, Lady Mallalieu, mentioned all our yesterdays. My view is that the countryside is all our futures. I beg leave to withdraw the Motion.
Lord Whitty: My Lords, first, I must declare an interest. I am for a few weeks longer the chair of Consumer Focus. I mention that because Consumer Focus and its predecessor organisation, the National Consumer Council, has a long history of trying to influence food policy from the common agricultural policy to areas of nutrition. Indeed, our social marketing sector is currently working with the noble Earl's department on ways of changing consumer behaviour in relation to nutrition and other areas of public health. I cannot forbear from mentioning also that, along with many other public bodies, Consumer Focus has a question mark over it at the moment. I hope that it or another body survives to do this work in the future for the benefit of consumers and their role in food policy in general and nutrition in particular.
I shall focus on nutrition. No one can be unaware from reading the newspapers of the nutritional crisis facing the country and the consequent costs for the NHS. Yet in neither the Queen's Speech nor the coalition agreement, as far as I can see, is there any mention of nutrition. According to a parliamentary reply in another place, as of the end of July at least, Ministers in the noble Earl's department had not condescended to meet any consumer groups on this or any other issue. I hope that that has changed in the past few weeks.
Regrettably in one sense, the incoming Government have not been idle in this area because they have done at least three things, among which they have determined to abolish the School Food Trust, a body designed to improve the quality of school meals. The Secretary of State has issued a somewhat half-hearted apology to Jamie Oliver, having previously criticised his efforts. However, the area I want to concentrate on most is that as from last Friday, the responsibility for nutrition and dietary health was moved from the Food Standards Agency back to the Department of Health. I regard that as an extremely regressive step, in the wrong direction, that will seriously undermine the widely recognised need to tackle the problems of declining or largely declining nutritional standards.
Noble Lords will recall that the FSA was established in 2000 in the wake of the BSE scandal. It was established precisely because the public did not trust Ministers' pronouncements on food safety or dietary advice. It was therefore important that we set up an organisation that was based on scientific evidence, not on passing political whims or bureaucratic considerations. Under the leadership first of the noble Lord, Lord Krebs, then of one of my predecessors at the National Consumer Council, Dame Deirdre Hutton, and now of my noble friend Lord Rooker, it has gone from strength to strength. It is respected for three key
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Trust is key in the area of nutrition. We must try to do as much as possible through information, persuasion and education, augmented where policy is required by regulation and guidance. We are faced with a serious nutritional crisis in this country, particularly in childhood. It is bizarre that our nation suffers such poor nutrition when, at a casual glance, there is huge interest in gourmet food both on television and in our glossy magazines. But for all that such a widespread choice is now available to consumers through supermarkets and elsewhere, and despite all the apparent public interest in upmarket food, the problem is that our nutrition is not improving and has in fact seriously declined since the 1950s. Despite all the efforts of government, of the FSA, of Jamie Oliver and of everybody else, they are of course up against different forces of persuasion-the forces of advertising, particularly the advertising of foods that are limited in their nutritional value and some that are actually nutritionally counterproductive.
This is particularly a problem for the very poor since the two lowest deciles pay out about 17 per cent of their household budget on food, compared with around 7 per cent for the likes of us. If you are a family with several young kids and no car, you also have the problem that the food outlets in your area are small and you cannot get to the supermarket. Even if you do manage to get to the supermarket, a survey by the NCC undertaken two years ago showed in many respects that the lower-price-range foods were often-not always, but often-of the least nutritional value when rated pound for pound sterling or avoirdupois. Moreover, the problem of food poverty is likely to increase. The reality is that the West has enjoyed cheap or cheapish food for the past 40 years. The globalisation of the food supply, the cheapness of fuel, improved logistics and serious technological change have brought cheap food to the West, helped by subsidies in North America, Europe and Japan, so that the consumer has been paying relatively little for food.
There are clear signs that the era of cheap food is now ending and going into reverse, with global pressures on demand through growing prosperity in China and India competing with demand in Europe and elsewhere. There are also limits on cultivatable land supply, and the impact of the environmental cost of extending that supply, which will eventually be embodied in the cost of food to the final consumer. Costs are going up generally and that will hit the poor in particular, but
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The shocking result is that, for many of our children, their diet is worse than it was in the 1950s. The prevalence of obesity has increased in the past 20 years and is now affecting 24.5 per cent of all adults. While that increase has flattened out a little, partly as a result of interventions by the last Government and the FSA, it is still marginally going up and is dramatically worse than it was 30 years ago. Some 10.1 million adults and 716,000 children are clinically obese. Around 2.5 million adults never eat any fresh fruit or vegetables, and after 10 years of campaigning on the "five a day" slogan only 19 per cent of our children actually reach that goal, compared with 22 per cent who eat between nought and two pieces. The National Diet and Nutrition Survey, reporting in August, also showed that we are still consuming well above the recommended level of saturated fats and sugar. The intake of fibre is below recommended levels, as is oily fish for omega acids.
The balance of our diets, whether as adults or children, is not right-and I emphasise that I am talking about balance. Like several other noble Lords, I suspect, I am a war baby, and those who were brought up immediately after the war on national health orange juice ended up in the 1950s with a fairly good diet. However, on the day sweet rationing was abolished, I remember buying a farthing's worth of hundreds and thousands in my corner shop. Little did I know that that measure was the start of a decline in the nutritional standards of children. But of course it was not. The food industry always asserts when you attack some of its products that it is not a question of bad food but a question of bad diet-and that is true. However, it is also true that if we depend on foods of poor nutritious value such as crisps, sugar, butter and dairy products-and if the balance of our diet is made up of those foods-it is extremely bad for us whatever age we are.
In recent years there has been some improvement through a variety of sources, some of which are surprising. When I started as a Minister in Defra in 2001, the FDF, the manufacturers' association, was in denial. It was chaired at that time by the director of Cadbury's but, even so, it took a heavy line that its products had nothing to do with health and nutrition. Now, firms such as Mars, which you would think was an offender,
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Although there are still problems with the supermarkets, four years ago sweets were offered at the till, a location that gave maximum pester power to kids to harass their mothers who were trying to find enough money to pay the bill. I am pleased to say that that has gone in most supermarkets.
The previous Government helped by reintroducing and improving nutritional standards for school meals. However, the biggest contributor has been the Food Standards Agency, which has improved the situation through a combination of sustained persuasion based on firm scientific evidence; the use of regulation and targets-for example, by putting pressure and a target date on the manufacturers of bread and other products to reduce the salt content; the use of guidance and codes of practice, including most recently advice to caterers; and by pressurising for a restriction on advertising. A change was made by a rather reluctant Ofcom, although I, my organisation and many others, including the noble Baroness, Lady Thornton, in a debate not long ago in this Chamber, pressed it to go further. However, we have cut out television advertising during children-specific programmes.
We have moved hard on nutrition labelling, which is not a happy story. The FSA, supported by my organisation and others in the nutrition field, were going for a traffic light system. More than half of the supermarkets were prepared to do that but most of the manufacturers and the remainder of the supermarkets resisted. As a result we have had about a five-year delay before ending up with a less good form of labelling. Nevertheless, a coherent form of labelling is about to launch-which is at least progress-both here and at the European level. However, it took that long to get there. Incidentally, if we are not careful, we will do the same with the labelling of carbon products. We need a single, clear, significant and comprehensible system of labelling in that field was well.
The attack-led largely by the FSA-on major social and behavioural patterns, which have all been going the wrong way in the past 30 years, has combined information, education, guidance, regulation, social marketing and advertising. The FSA has served us well. However, in the last of those areas we need stronger intervention now. The Ofcom guidelines on advertising to children on TV relate only to children-specific programmes-which, as everyone will know, are a minority of the programmes that children actually watch. We had to see through a lot of opposition from the industry to get that far-it was a good first step-but we need to go further. Indeed, advertising what is clearly junk food should not be allowed any more than advertising tobacco and alcohol should-certainly on television.
It would have been better if responsibility for nutrition had remained with an independent, respected, scientifically based organisation. I accept that some parts of nutritional
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Lord Patel: My Lords, I thank the noble Lord, Lord Whitty, for securing this timely debate. I was encouraged to hear the Minister say during Questions today that the public health function in future will come under the direct responsibility of the Secretary of State. My reasons for saying so will become obvious.
I should like to speak about two substances added to our food which have a significant adverse affect on our health. The first, which has already been mentioned, is sodium chloride, which in small quantities is essential for our diet and for making food tasteful. The second substance, trans fats or trans fatty acids, has no nutritional value and is not essential to our diet.
Sodium chloride, or salt, is essential in small quantities. The maximum amount of daily salt intake recommended is six grams a day for an adult-about a teaspoonful-much less for children and no greater than one gram per day for a baby. It is not easy-in fact it is very difficult-to know exactly how much salt you eat in a day without knowing the exact content of salt in each type of food and the amount of food you eat. About 75 per cent of the salt we eat is already in the food we buy-cereals, bread, biscuits, ready meals, sauces, pizzas, yoghurt; the list is endless. Many prepared foods have a very high content of salt.
Is six grams of salt a day essential? No, it is not-the less the better-particularly if you suffer from hypertension or certain other diseases. The majority of the population consume more salt than the daily recommended amount. There is a strong link between salt intake and hypertension, which increases the risk of cardiovascular disease, coronary heart disease and stroke. Scientific evidence has shown that salt intake can vary blood pressure by as much as 9 millimetres of mercury. Certain foods-fast foods, crisps and ready meals-have a much higher content of salt. It is food often eaten by children and certain groups of the population. The food industry has responded but not well enough. The Food Standards Agency's target for salt reduction by 2012, in the view of many, does not go far enough. Labelling for food and salt content is often confusing. Salt is often labelled as sodium. To establish salt content from a label which gives sodium content, you have to multiply by two and
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The second substance that I referred to, hydrogenated fats or trans fats, which is added to many foods, is in some respects even more harmful. Hydrogenated fats, trans fats, or trans fatty acids, is found in a lot of our food, particularly food consumed by children and low-income families. Hydrogenation is a process for turning liquid oil into solid fat. During the process a type of fat-trans unsaturated fat-is formed. The process produces cheap fats, but also destroys labile omega 3 fatty acids. This reduces the propensity of fat to become rancid and therefore is useful to industry. It increases shelf life and helps deep frying. That is why industry likes it. It has no nutritional value and is not essential to our diet.
Consumption of trans fats raises cholesterol levels. It changes the ratio of good to bad cholesterol. Not surprisingly, trans fatty acid is associated with increased risk of coronary heart disease and stroke. Industrially produced trans fatty acids may also promote systemic inflammation in the vessels, endothelial dysfunction, resistance to insulin leading to diabetes, adiposity and cardiac arrhythmia. It is estimated that a reduction in their consumption by even 1 per cent of total energy intake would prevent 11,000 cases of heart disease and 7,000 deaths per year.
The risk to health from industrially produced trans fatty acids is far greater per calorie consumed than for any other dietary micronutrients, including saturated fats, which we are all told not to eat too much of. Risk occurs even at low consumption. Trans fats are found in deep-fried foods, prepared meals, biscuits, cakes, pastries, snacks, crisps and chocolate. Yesterday, I had a biscuit with my tea in the Peers' Dining Room which undoubtedly had trans fats in it.
What has been the response? In 2007, Alan Johnson, the then Health Secretary, asked the Food Standards Agency to investigate trans fats. It concluded that no action was needed because, on average, consumption was half the recommended amount; that is, 2 per cent of all energy comes from trans fats. However, as the then president of the Faculty of Public Health, Professor Alan Maryon-Davis, rightly said-I declare an interest as a fellow of the faculty-there is no known safe level of consumption of trans fats. More recently, the current president of the faculty, Professor Lindsey Davies, accused the food industry of being profoundly irresponsible for adding unhealthy amounts of fat and salt to its products and proposed introducing legal minimum health standards if food producers and retailers do not take action to remove such products from foods. Professor Davies has had support from many, including the Royal College of General Practitioners, the Royal College of Physicians and many patient groups. I, too, certainly support her call. Both the faculty and the Royal Institute of Public Health, as part of a 12-step manifesto for better health, proposed that consumption of trans fatty acids should be eliminated in the UK by next year.
The Department of Health asked the National Institute for Health and Clinical Excellence, NICE, to produce public health guidance on the prevention of
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Yes, people should take responsibility for healthy eating, but so should government, regulators and the industry that sells the food. They should make sure that food is healthy, nutritious and certainly not harmful. I hope that the Minister will reassure the House that the Government will take steps to implement the far-reaching public health reform guidance from NICE, particularly in relation to levels of salt and trans fats in foods and food labelling.
Baroness Hayter of Kentish Town: My Lords, I welcome this debate and congratulate my noble friend on having made it available for us today. I also pay tribute to his work. I had the great privilege of serving under his chairmanship of the National Consumer Council, and since then I have watched him develop that organisation into what has become the very successful Consumer Focus-a body which, as he said, works in this and a number of other areas. Its great success is a testament to his work in the very many areas in which he has been involved.
It is fairly obvious that nutrition is very good for individuals, but it is also very good for society. A healthy population learns better at school, it works better and it plays better. That is good for our economy and it is good for individuals. The public expenditure saving, particularly in the health service, is one which I should hope the Government are taking an interest in and, therefore, doing more to promote.
We have seen in this country a long-term interest in the quality of what we eat and drink, which includes the Fabians' early work on cleaner water. Safe food was perhaps regulated much earlier than other areas of our lives, and more recently there has been regulation on the labelling and promotion of healthy options. However, all of that works only if it has the confidence of all the parties concerned, including the Government, the producers of food, the distributers of food, the doctors and public health specialists and, above all, the consumers. That brings us to the key question of how food standards and nutrition are to be regulated such that the consumer is absolutely sure that the consumer interest is at the heart of regulation. As my
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That point is fundamental to all types of regulation, whether in financial services, in medicine, in legal services-I must declare an interest as chair of the Legal Services Consumer Panel-or in the regulation of actuarial work, on which I must also declare an interest as a member of the Board for Actuarial Standards. The great success of good regulation-what is admired by other countries that look at our UK regulation-comes where the end-user is at the heart of regulation. It is never in the consumer's interest to regulate unnecessarily, but where market failures arise due to the lack either of information or of opportunities to shop around or, as perhaps in this case, because there is too long a production chain so that the consumer cannot influence the market, regulation is needed to protect the consumer and to give advice and guidance. That is as much the case in food as in financial or legal services. I hope that the Minister will reassure the House that consumer protection will remain the Government's watchword as they take over responsibility for nutrition from the FSA and, indeed, elsewhere in their regulatory role. We want to hear from the Government that consumers will be part of the dialogue on policy development and that consumer trust in our food-both in the quality of the food and in its nutritional value-can, therefore, continue and, indeed, increase.
In closing these very short remarks, I will take up my noble friend's comments about our having come to the end of the era of cheap food. I take his word on that point. That being the case, let me end by asking the Minister about the impact on, for example, a widow with six children, given the Government's proposed cap of £500 a week on her income. What impact will that have on the nutritional standards and thus the health of her six children?
Baroness Finlay of Llandaff: My Lords, I am also most grateful to the noble Lord, Lord Whitty, for having secured this debate, particularly this week when we have seen the nation's passions enflamed by concern for the welfare of children. It is apt and welcome that we have an opportunity to focus on one aspect of welfare, which is that good nutrition feeds our children's life chances.
One concern is that, although we can all grasp the value of financial benefits in determining a child's outcome, the specific high currency of a nutritious diet is often undervalued and underexposed. It is particularly worrying-I think that we have a moral imperative now to act-that education about nutrition gets through to all sections of society. That has not happened to date, given that invaluable knowledge
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The difficulty of acquiring such knowledge is compounded by some of the bogus claims that are made about food and foodstuffs. I was asked recently, "Is plain chocolate good for you?". That seems such a ludicrous question, but the trouble was that it was asked in all seriousness by someone who was very ill. There was desperation behind that question. I have seen really bogus nutritional advice given to patients. The worst was to a woman with extensive cancer, who had been told by someone with a nutritional adviser label that parsnips would help her body to fight her cancer. As a result, she was eating more than 1 kg of parsnips a day, to the exclusion of everything else in her diet. When I saw her, she had magnesium toxicity as a result. That was a tragic outcome of the desperation that people can feel at times-they are desperate to do anything-because they associate food with the source of life itself.
Of the different aspects of nutrition, I want to focus on intrauterine nutrition, by which I mean the importance of nutrition before birth. There is evidence that the long-term effects of the way that the foetus is nourished carry on throughout the person's life. In 2002, Sir Derek Wanless's report to the Department of Health entitled Securing our Future Health: Taking a Long-Term View, identified low birth weight as a pivotal cause of the vicious cycle of poor health. He recognised that the cycle repeats itself from generation to generation and traps communities in poverty and health inequality. The UK now has the highest rate of low birth weight in western Europe. Our message concerning nutrition's significance from womb to tomb is clearly not resonating sufficiently.
A wealth of medical research and literature corroborates the impact of intrauterine nutrition. In a literature search in preparation for this debate, out of 904 papers listed on the subject, my eye was caught by one paper that examined the emergence of insulin resistance, visceral obesity and glucose intolerance in adult life. Evidence from the Sansom Institute for Health Research indicates that, in the uterus, the foetus adapts to being starved when it is being undernourished by upregulating insulin receptors so that glucose is driven into cells. That does not occur in the skeletal muscle to the same extent, so that organs and the brain are preferentially fed-a very good survival adaptation for the foetus. After birth, there is a general upregulating, so in the growth catch-up that occurs glucose is generally driven into cells. The problem is that, as it is driven in, it is driven into fat cells, so the fat cells get glucose more quickly than muscle and other organ cells can develop. At that point, the foundations of obesity and the metabolic pathways that are associated with it are laid down.
It may seem obvious that obesity is malnutrition, not simply overnutrition, but I think that that is often forgotten. Glucose is essential to our lives. We cannot survive without it, but all of the nutrients that we take
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In our supermarkets, the choice of food and drinks available is now overwhelming. We have to look at the way in which people shop and buy. Following on from the theme taken up by my noble friend Lord Patel, I shall focus on the use of artificial sweeteners, which so often appeal to the young. Another paper that caught my eye was written by Swithers and Davidson at Purdue, who looked at the effects of artificial sweeteners on calorie intake in rats. They did a clever experiment. They fed half the rats with artificial sweeteners and the other half not and they let them run around eating as much as they wanted. They found that the ones that had consumed artificial sweeteners became more obese. It seems that the artificial sweetener affects the whole physiology of the organism, making the animal want to take in more calories, because they are primed to expect a calorie load. I know that that research was on rats-it would be difficult to do it in our population-but it underlines the importance of research and of good knowledge about the problem that we face with this epidemic of obesity.
The problem for the Government is that they have to communicate risk in a proportionate and sensible manner. I am sure that the noble Lord, Lord Whitty, knows better than most of us the difficulty of trying to communicate risk to the public, allowing people to be risk intelligent while not creating food scares. We all remember the food scare in 1988 about eggs and egg production. Egg production plummeted following the statement that it was infected with salmonella. The risk was minute-less than 200 million to one-but that warning will always be remembered in relation to public statements. Indeed, in my own household, egg consumption at breakfast went from high to zero-not my doing, but because of other members of the family.
Nutritional outcome in our society is inextricably linked to socio-economic outcome. Sir Michael Marmot's review, Fair Society, Healthy Lives, conducted in 2008, although published only recently, shows clearly the importance of nutrition from the moment of conception, from when we can nourish and nurture every child's health and opportunity. Sir Michael reports that,
The Food Standards Agency certainly tries hard to communicate accurate information. I was interested in tartrazine, that yellow colouring in food, which fortunately fell out of favour some years ago. However, we have not banned it. In 2008, it was recommended that tartrazine should not be included, as a result of awareness that it is allergenic, is associated with behavioural problems in children and has been implicated in malignancy of the thyroid. The Food Standards Agency called for a voluntary phasing-out of tartrazine along with five other colourings and duly reported the link with hyperactivity. By then, tartrazine had already been banned in Norway, Austria and Germany, but an
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The information on the FSA website is helpful. It states that, if you have a child with hyperactivity, you should consider avoiding giving them certain artificial colourings, because this might help to improve their behaviour. It lists six colourings, which have absolutely no nutritional value. However, there is a problem. The colourings are listed either by name or by E number. I am sure that none of us can remember our PIN codes let alone the E numbers for six different food additives when we go shopping for children. These six have to carry a label saying that they may have an adverse effect on activity and attention in children, but it is impossible to read all the print on all the labels-we probably end up just reading the main name. Those who have difficulty with literacy may not be able to assimilate the information in a meaningful way.
Another problem with this brightly coloured food is that children become acclimatised to the notion that food should be brightly coloured; they begin to think that if it does not have food additives it looks dull and unexciting. In that way, we begin to condition the next generation to believe that food that is not psychedelically coloured is of less worth, particularly if the people who are responsible for their care are buying this food for them.
We should not forget the mantra "Every Child Matters", which is associated with the previous Government, or the importance of education. They touch the humanity of every individual. They are universal sentiments, which cut across all political lines. They point to universal education about the value and importance of nutrition, which is a fundamental contributor to affording equal opportunity and outcome for all. If we do not teach children how food grows, how to shop, how to cook, how to sit at table with others and how to eat well, it is hardly surprising that the cycle of malnutrition continues. If we do not have clear information for the public, put across in a sensible way, it will become increasingly difficult for well meaning parents to know how to shop appropriately for children. People need to be able to avoid being misled by the sensationalist headlines that appear so often in the press and skew shopping habits. It is interesting to talk to shopkeepers, who will sometimes say, "I don't know why we've had a run on such and such this week". The reason is that the product has probably been associated with a headline or a magazine article.
I suggest to the Government that they consider, in all that they do, the importance of communicating accurately and with sound information, to help people to understand risk. If we do not improve the nutrition of our nation, particularly for women about to conceive and in pregnancy, we will harvest the downside for many generations.
Lord Giddens: My Lords, let me join the queue to congratulate my noble friend Lord Whitty on initiating this debate, the importance of which is much greater than might be indicated by the paucity of noble Lords who are contributing to it.
About 10 years ago, I wrote a book called Runaway World. Its theme was that, in a global industrialised order, we have unleashed forces that we are losing our capacity to control. What is happening to world food production and consumption and their relationship to patterns of health is one example of that. Today the purchase and therefore the consumption of food have become increasingly isolated from food production. It is important to recognise that this is a recent development. It dates back only about 50 years-even later than the noble Lord suggested-in the industrial countries, while it is an ongoing process in developing countries.
The key retail entity in producing this separation, which I argue is structural and underlies many of the dilemmas that noble Lords have talked about, is the supermarket, as with the advent of supermarkets food becomes completely removed from the vagaries of the climate, the seasons and localities. The supermarket also offers the consumer an abundance of products on a scale completely unknown before in history. As this separation between the production and consumption of food becomes radicalised, advertising and marketing become the primary vehicles of information about food-again, a crucial difference from the past.
The modern food industry has been a vehicle of plenty for many; at the same time, it has helped to create an entirely new relationship between food and health. I am not in the business of self-promotion, but I also wrote quite a lot about anorexia and bulimia a few years ago. Why do people starve themselves to death in an era when we have far more food than we can possibly consume? I will not bore noble Lords with the answer, but it is directly bound up with the rise of supermarkets. Once you have that rise, food is no longer determined by what happens locally. There is a certain sense in which we all have to be on a diet in relation to how we want to be. The pressures that exist on young women to follow a certain bodily image become conjoined to that. Anorexia was virtually unknown in history before-it was known only in the activities of a few female saints-but now it and its less radical versions affect large swathes of the female population across the world.
The other side of this, which has already been mentioned, is the rise of obesity. I will concentrate on this, hoping that my remarks will slot in nicely with what was said previously. For thousands of years, obesity was rarely seen. It existed only among a tiny proportion of the very rich. In complete contrast, in 1997 the World Health Organisation formally recognised obesity as a global epidemic running out of control. One billion adults in the world are clinically obese or radically overweight. The most striking increase-already noted, I think-is among children and adolescents. The US and Mexico have the highest overall rates of obesity at roughly 30 per cent and 25 per cent of their populations. The UK is in an unenviable third place at 24 per cent. Some noble Lords might have seen reports in the newspapers of what happened in Australia, where they had to widen the entrances to crematoria because the coffins had got so huge that they could not get them in. This story is apparently not apocryphal.
Contrary to what is often argued, recent studies show quite conclusively that our lives are not more sedentary than was true three or four decades ago. The
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My opening remarks were due to show that this problem is structural. It is deep, global and unparalleled in previous history. It is perfectly obvious that marginal measures will not serve to control it. The food industry, especially its fast-food sectors, pays back no more than a tiny proportion of the total social costs it creates. In this country, it has been calculated to be £17 billion a year that is needed to treat obesity and obesity-related illnesses. Some medical specialists say that the prevalence of obesity alone in countries such as this one and the United States will overwhelm health services within 10 to 15 years, because of the associated problems of type 2 diabetes, heart disease and many other serious medical consequences that ensue.
That is a sort of epidemic running out of control. The knock-on costs are completely out of proportion to the existing regulation of the fast-food industry. The Chief Medical Officer in the UK recently spoke of a public health time bomb, which is completely correct. Even having listened to the interesting contributions of other noble Lords, I propose that if we look at this as a deep structural issue with massive social and medical consequences, it is not enough just to tinker at the edges-whatever resistance one might get from the food industry. I shall make three comments on this to which I would like the Minister to respond.
First, we should contemplate far more stringent controls on junk-food advertising to children than exist at the moment. We have to tackle the issues of advertising not just in the orthodox media but, I am afraid, on the internet. Noble Lords will know that there has been a certain advance of control in this country and elsewhere on advertising to children, but many companies have then simply turned to the internet as a vehicle for promoting the same thing. One thing that is well known is that children-and some adults too-find it difficult to discriminate between advertising and other messages in television and other programmes, so they are very vulnerable to those messages. We are not really near to controlling with the rigour that we need. There are some voluntary no-child marketing strategies, which enlightened companies have followed, and I commend them. In this country they include, for example, Mars and Cadbury-although that is pretty recent-but again it is nowhere near enough just to rely on that. In Norway and Sweden, all marketing to children under 12 is banned. Why should we not do the same in this country?
Secondly, the issue of trans fats has quite rightly been raised. I will not go over what the noble Lord said so eloquently and knowledgeably. However, research has shown that trans fats are an independent factor in weight gain. They contribute in other ways, which were noted, because of their use in frying and many other things that produce weight gain, but there is evidence that they independently contribute to it quite apart from how they are used in relation to other aspects of food. I think that the noble Lord, Lord Patel, mentioned that Denmark, Switzerland, New York and California have banned trans fats. Denmark is the most interesting example; it was the pioneer, and because it goes back some way we have more research on Denmark than on the other cases. The research shows amazing health benefits from that ban, with a 20 per cent reduction in some kinds of illnesses directly related to trans fats. Why can we not follow the Danish example in this country and simply ban trans fats?
My third point has not been mentioned by noble Lords, but in my view it is really crucial. Even though it is politically very problematic, we need a tax-based approach to play a part in regulating the food industries, specifically the fast-food industry. That is because, to repeat the point, the fast-food industry is creating social and medical consequences of a massive kind and not contributing to paying for those consequences. We-the rest of us-have to pay for those consequences. That is not morally right and not a situation that one should simply accept, so it is right that extra taxes should be added to food and drink which are high in fat, sugar and salt. The evidence that these foods do as much damage as tobacco and alcohol is strong. Tobacco and alcohol are very highly taxed, and quite rightly so. Researchers at Oxford have developed three models for the potential use of taxation to improve public health, which in the UK they calculate will save upwards of 5,000 lives a year, if they are implemented. Even though there is always fierce resistance from the fast-food industry, the tax-based approach has just as much legitimacy as it does in the case of the tobacco and alcohol industries. The fast-food industry will increasingly face the sort of litigation that has driven such regulation in those industries, so it is not completely against the interests of the fast-food companies to participate in accepting an increased tax-based regime, or at least look at the possibility doing so. That would not only help to limit the intake of noxious foods that produce such tremendous medical problems; it would also make it possible for the food industry to pay back some of the social costs that it creates. At the moment, it pays back virtually none of these costs.
I wanted to look at it from the point of view of whether regulation is effective and whether it is always right. I come from a tradition whereby I do not like being told what to do the whole time. I may well get it
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Lord Giddens: You cannot confuse the risk to a single individual with generic risk. That is like people saying, "My granddad smoked 50 cigarettes a day and, look, he lived to be 101"-as if that had anything to do with the risks of smoking, which it does not.
The Earl of Erroll: That almost proves the point. We are all different, and I do not like to live in a world where the Government tell me what to do, because we are all very different people. Those differences are important in society. I am talking about having total central controls; that is why I want to get on to balance. I want to demolish the concept that if you do something silly and you die early, although you may be a cost to the National Health Service in your obesity and the costs of dealing with your diabetes at that point, you have alleviated another budget-the cost of looking after you very expensively in your old age. That is quite expensive, and it is a bigger and bigger problem, as well as all the pension and other costs. I would like to see a true paper done academically on the economic balance between those costs, because I have not seen one. The only one that I ever saw was produced in Holland about the cost of the early deaths of smokers from cancer, and it said that the cost of the cancer care was much lower than the cost of the old-age care, with people living longer. But let us not get side-tracked into that for hours. It is for another day.
I wanted to look at the whole thing from end to end. You have to look at food distribution, diet, disease, and the effects of this on the system and people and everything like that. To take the nutrition bit first, I used to run around mountains and leap around the place energetically and one thing that I was always told was that we need balance. People always believe that advice, because they are told, "You are what you eat"; that is the problem-everyone believes that now. But actually we are individuals, and it depends what you do as to what you can do and cannot do. Sportsmen sweat salt. If you run around hills and take a lot of exercise, you have to take extra salt. I have heard of a chap who is the son of a friend of my wife's, who nearly died on the Welsh mountains because she had him on a salt-free diet, and he thought that it was poisonous to take extra salt. We have to be careful with these messages, because they are not universal messages. I remember talking some years ago to a nutritionist, who was quite concerned about how we were extrapolating the research on middle-aged men's diets to children, who have very different dietary needs. They need different minerals in different quantities, because their bodies are growing. I realise that these
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I am very reassured by the noble Lord, Lord Patel, that I was right to stick to butter throughout my life. I believe that it builds up calcium in my bones, and I should be worried about osteoporosis because men are living longer. I do not really know, because I am not a nutritionist, which is right and which is wrong; all I do know is that whenever I am told that I should not eat something, later on someone says that I should and then they say I should not eat it again. Messages throughout history are confused, and I do not think that there is probably one right or wrong. I had heard about the artificial sweetener thing, and I am hugely reassured, because I have stuck to sugar. I dislike artificial sweeteners and have always felt that they are inherently wrong. I wonder sometimes-although this is straight off the top of my head and I know nothing about it-whether if we reduce the salt content in all foods, that does something about our body's perception of what we are eating and we eat more bulk as a result. These are such complex things that we do not know. I know that noble Lords think that it is simple-they are shaking their heads-but I am not sure that I am convinced that it is so. I shall have to read up on it.
But I am like an ordinary general member of the public. When I was running around hills, the food I ate was very simple. You had protein to build up the body, some carbohydrates for long-term energy and you finished with some sugars to give you an immediate energy boost to keep you going while the body was digesting, or you hit a sugar low otherwise. Equally so, if you are going to take all the sugar out at the end of meals in schools, I bet you that pupils will fall asleep with inattention in the afternoons. That was the concept of the pudding. If you overdo it and do not get the balance right, they are going to get fat-I agree. But you do not just kill and ban something just because of that. The real problem is that we are now so frightened of children running around the place and doing dangerous things that they are kept sitting down the whole time. When I sit in an office, I drink more cups of tea and eat things on the side, whereas if I am moving around and doing things I am not only burning up more energy-I do not have the time to eat as much. The exercise point is the unintended consequence of us getting parents terrified that there is a paedophile standing on every corner, which is probably also driving obesity. You may think that I am mad about this, but a lot of people would agree. We have stopped children walking to school so much. All right, we are now starting with walking buses, and things like that, and that is good. But we must attack this problem not only from the diet point of view.
I shall give your Lordships one other story about this that is quite interesting. Years ago I was travelling in the south of France. Because I did not know how to cook, I lived on Spanish vegetable omelettes for a month, with no meat. When I hit Italy just after that, I had deep intense cravings for ham and I used to go down the street buying it from every shop: "Etto
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Leaving that aside, the other thing that I wanted to look at was disease-the excessive cleanliness that can come out of regulation. We are born with an immune system that you need to train early. When my children were young, they used to try to drop things that they did not like on the floor for the dogs to eat, but we would make them eat them. They said, "Oh daddy, we'll get diseases". "I said, "Don't worry, it builds up your natural immunities". Years later, when my daughter went to Tanzania to help build some loos for a school there, she was the only one who did not go down with severe dysentery. She said, "Daddy, you were right". One of the problems is that we sometimes transfer the risks of some of these things. If we had slightly less food safety and cleanliness, would we increase people's capacity later on in life to survive? Are we merely making it safer at one end to make it more dangerous at the other? Those are the sorts of things that I worry about quite a lot.
The other thing that I worry about is the general build-up of regulations. Often, all these individual regulations are very reasonable but in aggregate they just become excessive-they bog the entire system down. To horrify the noble Lord, Lord Giddens, I have a Kit-Kat here. Have I read any of this stuff on it? No, I haven't got time, but I am sure it is all good, well meaning labelling. I have not got powerful enough glasses for that any longer, anyway. In order to make the text bigger they would have to make the packaging bigger, in which case they would increase the waste, in which case we would have more landfill and other undesirable effects.
That brings us to the problem that some of these regulations are very good for one thing but bad for another. I declare an interest here that I am married to a farmer. We are at the start of the food production chain. People are working further and further back with the regulations. Great. I do not have a problem with that in principle. I do not have a problem with the fact that all the glass light bulbs anywhere near a barn should be covered; we do not want glass falling into raw wheat before it is ground up. It would end up with ground glass in it. So that is very sensible. But when you start looking at all the other bits and pieces, you realise that you need an A-level at a minimum to be a farmer. Farmers were not that sort of person; they were people who loved the soil, the land and producing things. They loved the animals. They did not have to tick boxes the entire time and recognise all sorts of obscure things.
You might decide to take the pressure off and sign up to a thing called the Whole Farm Approach. It is a wonderful thing. You go online and tick the boxes, and it checks whether you have ticked them right. But there can be problems. My wife has a few cows that graze some grass, because it is environmentally correct to do so and it is all done under environmental schemes. They are rare-breed South Devons, a native species, and they are hardy animals that live out all year. They are very happy and they have plenty of shelter out
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You get other asininities. Because these cows are not housed, there is no manure to spread. Do not worry, in case any NVZ people are listening in, we are very careful about manure loading on the ground-we do all that stuff with compliance, stocking rates and so on. So no, we do not produce any manure. Do we obey RB209 on the correct calculation for manure loading? We do not, because we do not have to do the calculation, so we have failed. Instead, we have to say that we calculate our non-existent manure loading properly. If people are running these sorts of schemes, could they at least employ someone who has bought a pair of decent practical wellies at some point and spent some time on a farm, not just someone who has done an environmental studies course at university and then gone straight into an office?
Some of these things worry me-there is a lack of common sense throughout. The certification you need for everything means that nowadays everything has to be trained for. Now you have to have a certificate on how to move a cow into the back of a horsebox and move it over a couple of miles or whatever. It is just getting out of control. This worries me because it induces a lack of respect for the system and the sensible regulations, and everyone starts working their way around them. If we are going to have regulations, let them be sensible. At the common sense end, people say, "Yes, that makes sense". It is not just seen as a load of nonsense everywhere.
We overuse the precautionary principle all the way down the chain. I hear all the messages from the noble Lord, Lord Giddens, and others, and I know that to a large degree they are right, but at an individual level I want to make a decision about whether I am going to eat something because it has the right mouth-feel or the right taste, or to buy a bag of crisps because I know that that will keep me awake better when I am tired. I know I should not be driving tired, but sometimes it just happens; you are between stops, there is not another motorway services for 40 miles and you need to keep going. I happen to know that, for me, crisps are better than chocolate for doing that, even though I am doing the wrong thing.
The other thing that worries me, thinking back to what the noble Lord, Lord Whitty, said at the end, is the control of agencies, of which, unfortunately, he has bitter experience. One of the unfortunate things that happened at the end of the previous Conservative Administration was the growth of agencies that were outside ministerial control. That lack of control right up the chain of command-so that there is, in effect, a separation-has always worried me. I am rather pleased that these matters are being taken back in-house so that Parliament can look at them properly and the
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I suppose my message is very simple. Let us have some common sense. I know it is not common and I do not know whether I have it. Let us watch out for having such strict rules that, on the one hand, we say that we do not want waste but, on the other, we have to package so tightly that waste is created by having rules. I do not mind if my bread is wrapped up or handled. I have enough natural immunity, as others should. That is my message. Human beings survive quite well. If you do not, that is bad luck. It may happen to me. However, we were born with responsive systems, which can manufacture antibodies to protect us from viruses, bacteria and so on. Let us train those up early. Let us have a little less regulation and a little more danger in the system, and not go overboard in trying to control everything.
The Earl of Erroll: I do not suggest that for society-not at all. I am saying that we should not go overboard in saying that the sole goal in life is its length, rather than its quality or doing the things that you want to do. We control people out of being able to take risks and do dangerous things themselves. I am not saying that we are trying to kill people off early. If people want to do things their way, they should be allowed to do so.
Lord Rea: My Lords, I thank the noble Earl for giving us a little light relief in a debate on rather a serious topic. I especially thank my noble friend Lord Whitty for bringing this subject to our attention. Faulty nutrition today is of huge importance for public health. As almost every other noble Lord has said, it plays an important part in causing obesity, type 2 diabetes, arterial disease and high blood pressure, which lead to coronary heart disease and stroke, as well as some cancers.
Today it is mainly overnutrition with the wrong nutrients, rather than undernutrition, which is the main problem. However, too many elderly people are undernourished when they are admitted to hospital and sadly still are when they are discharged. Evidence is also emerging of the importance of nutrition for mental health and behaviour, particularly in corrective institutions. I declare an interest as chairman of the All-Party Food and Health Forum, a trustee of the National Heart Forum and a former trustee of the Caroline Walker Trust, a charity that aims to improve "public health through good food".
The history of public health in the UK since Edwin Chadwick's monumental report on The Sanitary Conditions of the Labouring Classes in England in 1842 has been one of regulating or restricting activities or products that are harmful to health, and setting up local and national bodies to ensure that necessary measures are taken to achieve those aims. We benefit to this day from some of the subsequent results of the Public Health Act 1848, including London's water supply and sewerage system. That is only now being replaced, so well was it built by Joseph Bazalgette. His project was hastened by the "great stink" of 1858, when Parliament had to cease its activities until the weather changed and it was washed away.
These early measures, such as sewerage and clean water, were driven by the need to control illness caused by pathogenic bacteria, although to begin with it was not known that they were the cause of such illnesses. It has been so successful that now infection, while still with us, has been supplanted in importance by chronic diseases, mainly affecting adults in the second half of life. However, it has been shown that these conditions, like mental health problems, often have their origins in early childhood. Poor nutrition in infancy, and even pregnancy, can plant the seeds of chronic disease later in life. That was fully discussed earlier by my noble friend Lady Finlay.
Improving public health may mean restricting the freedom of individuals and commercial enterprises; Chadwick's Public Health Act 1848 had many enemies. If these restrictive measures result in loss of livelihood or lower profits, they will naturally meet with resistance, and they do. After all, we live today, as in 1848, in a competitive, capitalist world dependent on profit whether we like it or not. This resistance may take the form of denial of the deleterious effects of the product or activity concerned. Considerable resources may be put into efforts to discredit the evidence and disprove the need for public health measures. The long-running rearguard action of the tobacco industry is one of them. It is still running in resisting the banning of tobacco displays in shops and the banning of vending machines. Another example was the initial reluctance of the food industry to accept that high salt intake was a cause of hypertension.
As many noble Lords have pointed out, it is unlikely that voluntary guidelines will be followed if they have an impact on profits. There must be legislation, or the serious prospect of it-the sticks-or, on the other hand, incentives-the carrots-to encourage or enforce compliance. This does not apply only to the private sector. A rather sad example of this, recently described by Sustain, is the series of programmes, taskforces, plans and packages which have exhorted hospital trusts to improve the quality of the food given to patients over the past decade. There is no evidence that they have had any lasting effect, despite costing at least £54 million. The quality of hospital food is still poor in many hospitals, as we know, particularly also in care homes. The proportion of malnourished elderly patients admitted to hospital is still high and has not changed much in the past decade. Department of Health figures reveal that in the past decade 2,600 patients died in hospital in the UK directly as a result of malnutrition. More important were the many others
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A major difficulty in improving eating patterns today is the high proportion of our diet that consists of processed food, as other noble Lords have pointed out. It is impossible to tell by appearance or taste alone how much salt, sugar, saturated fat, trans fat, preservatives, artificial colouring or flavouring is incorporated in many popular brands; hence the need for a clear, easily understood system of food labelling, which was also discussed by many other noble Lords. The Food Standards Agency's research found that the simple traffic light system was the most popular among consumers, and some retailers have adopted it-about half of supermarkets-but it is not popular with the food industry since a red light label indicates that a product should be consumed sparingly. The industry's preferred labelling system, using the RDA or recommended daily amount, is more confusing and shoppers find it difficult to understand. Some retailers use a combination of both. The labelling system in use is voluntary and therefore inconsistent. Progress is slow as we have had to conform to EU guidelines, as has been said. However, there are ways around EU regulations by citing particular public health problems. The Government could explore how that provision could be used more fully.
Many manufacturers market healthy versions of their products, thus indicating their social and ethical responsibility. They may hope to attract a greater market share. These healthier options, such as low saturated fat, low trans fat, low sugar or low salt products, may indicate the direction that ideally the rest of their products, and those of other manufacturers, should follow. The food industry would then become part of the solution, not part of the problem. However, progressively increasing the market share of these good foods is likely to be very slow or incomplete unless the healthy ranges cost less than the standard range. Unfortunately, the reverse is usually the case. The National Consumer Council, before it changed its name, reported in 2006 that many economy-range foods contained more salt, fat and sugar even than the standard products. Thus the poorer sections of the population, the people on tight budgets who most need an improved diet, will continue to buy this energy-dense, less nutritious, obesogenic-I like that word-food, thus perpetuating the increasing health divide in obesity, heart disease and cancer.
If statutory regulations were to ensure that all manufacturers sold food products that conformed to an optimum standard, this problem would be solved. In fact, several manufacturers and at least one major catering firm, Compass, have said that they would welcome legislation of this sort. It would not end competition, but all products would have to conform to the nationally agreed standards. These standards
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This brings me to an important question for the noble Earl. In the bonfire of the quangos that was trailed in the Daily Telegraphtwo weeks ago, SACN was included among the 170-odd bodies to be abolished-as was the School Food Trust and a number of other health-related organisations. If these are to be abolished, what is to take their place? The Government will always need expert advice, particularly now that we have major nutrition-related health problems. I hope that the noble Earl will assure us that these useful-I would say vital-watchdogs will be retained. If not, I hope that he will explain what is to take their place.
A crucial feature of scientific advisory committees is their independence from government and from industry. How is this to be retained? Perhaps the noble Earl will bring us up to date on the future of the Food Standards Agency. Which of its functions will be retained by the part of it that remains and which will be merged with existing departments? The current information is that its nutrition division is to go to the Department of Health and its food safety responsibilities to Defra. If so, this would be a backward step indeed, since the FSA was created in part to take this responsibility away from Defra following its mishandling of the BSE epidemic. What will happen to the much admired independence and transparency of the FSA?
I think that noble Lords will see where I am coming from. If we wish to see an improvement in the nation's health, more use must be made of statutory regulation of food manufacturing, advertising and marketing. This is another area that I would like to cover, but I have not got time. The noble Lord, Lord Whitty, spoke about advertising, as did other noble Lords. I think that regulation will be effective, even sometimes without being enacted, if the industry feels that there is an imminent possibility of its introduction. That may set the ball rolling, as we have seen in the case of salt reduction. However, here, as other noble Lords have said, there is still a long way to go.
In conclusion, I think that the Government would be wise to follow more closely the independent scientific advice which is available on the action that needs to be taken to improve our diet and thus reduce the burden of chronic illness.
Baroness Miller of Chilthorne Domer: First, I thank the noble Lord, Lord Whitty, for giving us the opportunity, which we rarely have in this House, to discuss food nutrition. When these issues are so central to our lives for both our health and social well-being, it is remarkable how seldom we debate them.
It also gives me great pleasure to follow the noble Lord, Lord Rea, who, as chairman of the Associate Parliamentary Food and Health Forum, has provided a wonderful opportunity for those of us who belong to it-I declare an interest as an officer-to attend the seminars that it lays on, many of which have covered subjects that have been touched on today, such as trans fats, salts in food, and in utero nourishment. I have learnt a tremendous amount from the forum. The
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I was very struck by the noble Lord, Lord Giddens, saying that we should not consider this matter simply by itself but that it is part of a much larger issue, which of course it is. Noble Lords who are here to debate the millennium development goals shortly could equally well have taken part in this debate, or vice versa, because 1 billion people in the world still suffer from chronic hunger. Even if millennium development goal No. 1 is reached by 2015, half a billion people will still suffer from chronic hunger. That is not to say that people suffering from malnutrition in this country have any less of a problem-it is all part of the same problem, and I shall give noble Lords one example.
The fact that there are so many quite obese people is partly due to the fast food industry and Big Macs and so on, because a lot of very fatty cheap meat was heavily promoted. Of course, the cost of that very cheap meat has been borne in countries where grain and soya prices have gone up. Grain and soya is fed to the cattle to provide the western world with the very cheap meat, which is ruining our health, and there is therefore a vicious circle. It is vicious for us for all the reasons that we have heard today, and it is vicious for those still suffering from chronic hunger, so I do not think that we can afford to take this matter lightly. We need to start taking a tougher line with the food industry, and I am glad that some noble Lords have said that today.
The FSA has done some good work, which I shall refer to in a moment, but I think that it lacks the necessary teeth in the face of the strength of the food lobby. It is therefore time for a new look at the FSA. Establishing the agency was an attempt to bring policy together, but the question of nutrition was fudged at the outset. The FSA was never given a strong enough remit to take on nutrition. It picked up the reins as best it could but nutrition was never in its original remit and so the agency was always on the back foot, reacting to the next food industry initiative.
For an example of how seriously the Government will need to take this issue we need only look at the excellent debate in this House on 13 July this year on nanotechnologies and food. The committee looking into this, under the noble Lord, Lord Krebs, who knows a great deal about food regulation, having been in charge at the outset of the FSA, highlighted a huge number of points that I could not hope to reiterate this afternoon. However, I draw attention to the sort of danger that the noble Lord sees. He said:
"First, by keeping quiet about nanotechnologies, the food industry leaves a communication vacuum into which pressure groups and/or inaccurate media reporting will happily step. Secondly, in contrast to what was said about GM products in the 1990s, there are real potential consumer benefits to be had from nanotechnologies".-[Official Report, 13/7/10; col. 656.]
There is a need for a strong regulator to be able to rely on some very well researched issues as this is an extremely fast-moving field. Let us consider what nanotechnologies can do to food. For example, we could be offered ice-cream that will look like ice-cream and taste like ice-cream but will not be ice-cream. That might be good in that it will not fatten you, but it might be extremely dangerous in the sense that it would not contain any of the benefits of a dairy product that we have come to know. I know that the Minister said when replying to that debate that he foresaw a robust regulatory function that would still continue to be delivered through the agency, but he admitted that it was a fast moving picture. He went on to say that,
I do not take issue with that. Like other noble Lords, I want Ministers to be more accountable for some of the issues, but I hope that "cost-effectively" is not shorthand for saying that the nutritional element will completely disappear from the horizon. As has been highlighted this afternoon, it is incredibly important.
I join other noble Lords for whom nutrition begins before the baby is born by saying that we still ignore the diets of pregnant women too much. It is incredibly striking how brains develop during pregnancy and not thereafter, so I make a plea for the nutrition of pregnant women and breast-feeding to be particularly concentrated on. Only last week, yet more research showed that babies who had been breast-fed for up to six months had much better health outcomes in a large number of ways. Indeed, the NHS's own figures show that 84 per cent of women know that breast-feeding is particularly good for the health of their babies, yet the figures still drop off dramatically a month after the baby is born. It is a cultural issue as much as anything. It is very difficult to get people to go back to providing for breast-feeding or encouraging it in the workplace and elsewhere. It is no more acceptable in pubs and restaurants than it was when I was a young mother. That is a pretty sad state of affairs considering that that was about 30 years ago.
Finally, I shall mention the Tudge principle which we have adopted in our house. It comes from an author called Colin Tudge, whom I have had the privilege to meet a couple of times. He has written a number of books on food and has done a great deal of work in this area throughout his life. Among his books, he has written So Shall We Reap and Feeding People is Easy. Primarily, his contention is that if we look at some of the places in the world that we consider to have terrific cuisine, such as the south of France, and the places that we go to to enjoy the sort of diet that they have, we see that they eat very little meat and a lot of vegetables, rice and other things.
It is going to be hard to get back to that sort of principle in the face of the biggest added value for the industry always being meat, but it is important in dietary terms and incredibly important environmentally. The UN's most recent report on agro-ecology shows that, in climate change and sustainability terms, it will not be possible to continue with current meat consumption in either the western world or the countries that are now aspiring to join it. We all have to change our thinking and go back to meat being a small part of
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Lord Ramsbotham: My Lords, I am very grateful to the noble Lord, Lord Whitty, for giving me the opportunity to speak in the gap to raise two points. One is a cautionary tale of an organisation which tried to have guidance issued on improving the nutritional outcomes for adults and young offenders in institutions. The other is to plead with the Minister to do what he can to prevent that ever happening again.
I refer to an organisation now called the Institute for Food, Brain and Behaviour, which was called Natural Justice, and must declare an interest as vice-chairman of the board. About 20 years ago, the organisation started work trying to use the right mixture of vitamins, minerals and fatty acids with people on community sentences with the probation service in Cumbria. It was then developed and, in 1998, a random double-blind trial was conducted at the young offender establishment at Aylesbury, which proved that the right mixture reduced violence and anti-social behaviour by 40 per cent in those who were taking the right mixture, produced an enormously changed atmosphere in the young offenders' institution and enabled the young to take part in things which they had previously rejected. That was noted not just by the measurement of crimes committed but by the very hard-bitten prison officers, who noticed the change.
The results were published. They were doubted by the Home Office, which sent in a professor from Warwick University to examine the data. He proved that they were 92 per cent statistically pure and said that he had never come across a trial of that kind conducted so well, which speaks volumes for Natural Justice and for the Oxford University department of physiology, which is where the work was based.
We then tried to get replication. The trial had been picked up in America, Scandinavia, Holland and France, where they were repeating the work. The Wellcome Foundation recognised its value and granted us £1.5 million to enable us to do it again. We were welcomed in Scotland, where they said, "Please come and do it here", but we had a seven-year fight with the Home Office and the Ministry of Justice to be allowed to do it again, because successive Prison Ministers took an opposite view about the trial. The trial is now taking place, and the report will be published next year. The work has been picked up by Manchester probation service, which wants it looked at in connection with those on intense supervision orders.
The Robert Clack School in Dagenham is very interested in the application of the right mixture of vitamins, minerals and fatty acids to young children at school. In other words, there is an enormous amount of evidence about what the right mixture does. What worries me about this is that it is despite the fact that it has been officially evaluated and promoted. I am very grateful to the noble Lord, Lord Rea, for including it in his report. Here, I hope, is an opportunity for the Department of Health, if it is really going to take responsibility in this area, to pick up the work that has been done and apply cross-government action rather than leaving it to separate ministries to do what they have been doing in isolation and not promoting it. The Institute for Food, Brain and Behaviour stands ready to help in any way it can.
Baroness Thornton: My Lords, I congratulate my noble friend Lord Whitty on obtaining this important debate and I congratulate all the other speakers. On 30 July 1999, during the winding up of the Second Reading debate on the Food Standards Bill, the late and much loved Lord Carter, the Chief Whip at the time and an enthusiastic farmer and fruit producer, said on behalf of the Government:
"We have had a wide-ranging debate on this Bill and the related issues concerned with the food standards agency. We feel that the Bill represents a major step forward. It shows how the Government are continuing to give public health and the interests of consumers the high priority they deserve. The proposals have from the start been exposed to the fullest scrutiny and comment, despite what some noble Lords have said. We feel that the Bill is now a well developed piece of legislation, with three rounds of consultation having shown what consumers want ... The painstaking process of consultation, with two years of hard work by Ministers and officials, have laid the ground for these major changes".-[Official Report, 30/7/1999; cols. 1819-20.]
I was a bit player at the time and made a speech in that debate as well as participating in debates throughout the passage of the Bill. I mention that because of the contrast with the approach that this Conservative Government have taken in introducing their proposals to change the work of the FSA. Given the number of times that the Minister has chided me over the past few years for what he called a lack of evidence base for the various proposals that the Labour Government brought forward, it is a bit rich and a great contrast to the way that the Secretary of State announced major changes to the FSA and its work. We are entitled to ask: where is the evidence base that food labelling will do better back at Defra, since some will argue that it did not do so well before the creation of the FSA, and where is the evidence base that national policy on nutrition will be improved by putting it in the English and Welsh departments?
I suggest that the Minister visits this website as it is a marvellous library of the evidence of the food-base archive that has underpinned some of the campaigns that the FSA has led in the past 10 years or so, setting targets, as it did, for reductions in salt, sugar and fats
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I should like to explore a little further the powerful medical health case for salt reduction put forward by the noble Lord, Lord Patel. In 2006, the FSA published the original voluntary salt reduction targets for 85 categories of food as guidance for the food industry. The agency committed to review the target in 2008 to formally assess progress to date and to establish what further reductions were necessary to maintain progress towards a six grams daily intake target, as mentioned by the noble Lord.
The setting of the targets, backed by scientific and nutritional evidence, gave the exercise credibility and led to some serious improvements. For example, salt has been reduced by one-third in pre-packed sliced bread. There has been a 44 per cent reduction in branded breakfast cereals and a reduction of between 16 per cent and 50 per cent in cakes and biscuits. There has been up to a 55 per cent reduction of salt in snacks and crisps, 50 per cent less salt in UK white cheese and a 32 per cent reduction in retail standard cheese slices. I am sure that the noble Earl, Lord Erroll, probably will disapprove of this, but I think that this is great progress and that our food manufacturers should be congratulated. Huge progress is still to be made, but it is a success story. How does the department propose to maintain reductions of salt in food?
As my noble friend Lord Whitty said, it is no exaggeration to say that there is a crisis in children's diet. The National Diet and Nutrition Survey found that 92 per cent of children consume more saturated fat than is recommended, 86 per cent consume too much sugar, 72 per cent consume too much salt and 96 per cent do not get enough fruit and vegetables. As my noble friend Lord Giddens said, the Chief Medical Officer has compared this to a health time-bomb which we have to diffuse.
The history of the previous Conservative Government in this matter is truly abysmal, so the Minister should not be surprised at the anxiety and scepticism being expressed today. For years, school meals services suffered from neglect and underinvestment with kitchen and
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There is no question that we have Jamie Oliver to thank in part for what happened next, which is why the Secretary of State's remarks to the BMA on 30 June about Jamie Oliver's efforts to provide healthy schools were singularly inappropriate. Combining his other utterances on these issues with the facile comments from his colleague, Anne Milton, about obesity and calling people fat instead of obese, creates legitimate concerns about the seriousness that exists within the ministerial team to deliver on this agenda and their willingness to do so.
When the Labour Government established the Schools Food Trust, a non-departmental public body, in 2005, new standards for the type and nutritional quality of school food were introduced in primary and secondary schools. After the success of campaigns, such as the schools food campaign and Jamie Oliver, we need to thank them for their efforts. The new rules for food in schools ensure that school lunches are free from low-quality meat products, fizzy drinks, crisps and chocolate. Deep-fried items are restricted to no more than two portions a week. Schools have also ended the sale of junk food in vending machines and tuck shops, including confectionery, chocolate and fizzy drinks. The School Food Trust now works with schools and vending operators to promote the sale of healthy snacks and drinks such as water, milk, fruit juices and yoghurt drinks. In addition to the school food standards, a series of measures have been put in place to,
This includes investment in healthy ingredients, training kitchens, the entitlement to learn to cook, a specific fund for building kitchens in addition to the £1 billion Building Schools for the Future programme, as well as increasing tendering opportunities for small and local producers. I pay tribute to the work of the trust and ask the Minister how he intends to deliver good health for the nation's children if the Government withdraw their support.
"The Food Standards Agency has revolutionised the way that food issues are handled in the UK, so we're pleased today's announcement ensures it can continue to independently monitor food safety. Unfortunately, some issues that would be best handled by the FSA have been moved to other departments. With these changes the government must ensure the interests of consumers remain at the heart of food policy".
"It had a hugely important role in improving the quality of foodstuffs in Britain and it was vital to have at the centre of government a body that championed healthy food. This appears just the old Conservative party being the political wing of business".
"The agency was set up to earn public trust after a succession of food scares. Its wobbles, like the latest row over GM foods, have come when that commitment has wavered. Any departments absorbing the FSA's role should heed that lesson carefully, doing even more to invite scrutiny and banish the slightest whiff of secrecy, or the new government could face another BSE".
"Many NGOs campaigning on food thought for a long time the food industry has an unhealthy degree of influence over the Department of Health, so the great risk is the corporate vested interests of the food industry will have too strong an influence on future policy".
How will the noble Earl respond to the fact that so many respected organisations are worried about what the future holds? Indeed, his noble friend Lady Miller believes that food regulation needs more teeth, so will his department be delivering on that?
I am grateful to the noble Baroness, Lady Finlay, for her wise words and for reminding the House about Every Child Matters. She underlined the importance of diet for pregnant women. I thank also my noble friend Lord Giddens for his analysis of the separation of food production and consumption. His words filled me with dread at the challenges ahead, and I cannot see how the Government's proposals will add to the solution. I enjoyed the speech of the noble Earl, Lord Erroll, but I wondered if he had been at the e-numbers recently. My noble friend Lord Rea was right to remind us of the roots of our public health regime, and of how hard vested interests work, but not only for consumers.
In conclusion, the FSA is neither overstaffed nor overresourced, and it has made significant economies over recent years. Will the Minister inform the House how his honourable friend has responded to the letters he received from my noble friend Lord Rooker, the current chair of the FSA, in June and July? The letters are on the public record and are available on the FSA website. My noble friend says:
"The core principles of the FSA are to put the consumer first; making policy in an open and transparent environment; operate independently; and be science and evidence-based. The FSA Board is concerned that these principles, which have served consumers well in the food policy environment since 2000, would be at risk by moving nutrition and dietary health work from a non-political to a political department".
The Parliamentary Under-Secretary of State, Department of Health (Earl Howe): My Lords, I thank the noble Lord, Lord Whitty, for calling this debate on food standards and the role of regulation and guidance in the food chain. As your Lordships may know, this is an area for which the noble Lord and I have, at one time or another, both been responsible in our previous roles as agriculture ministers, his experience being
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The food that we eat is fundamental to who we are. It is, of course, a source of essential sustenance necessary for basic survival. But food can also be much more. A meal made with the finest ingredients, prepared with skill and care and shared with loved ones can be one of life's great pleasures. Yet no matter what our culinary preference, we all expect our food to be safe. It is no longer enough that we do not expect to be taken ill with a mild dose of salmonella or to have our lives put at serious risk by botulism; we also need to pay attention to the less acute causes of harm which noble Lords have rightly highlighted-the high levels of salt, sugar and fat that can do so much harm over the course of our lives.
While I do not believe that the role of the Secretary of State is to tell people what they can and cannot eat, there is a role in making sure that the food we eat is safe; that we make people fully aware of any long-term risks from our diets; and that those risks are minimised as far as possible. The sensible use of appropriate regulation and guidance is essential to this. The warnings sounded by the noble Lord, Lord Patel, are well founded. Far too many people in this country eat far too much salt, saturated fat and sugar, and nowhere near enough fruit, vegetables and oily fish. The personal costs to our health and the high financial costs to business and, through the National Health Service, to the taxpayer are huge. If everyone ate a diet that matched national nutritional guidelines we could prevent around 70,000 deaths every year. The current cost to the NHS of those deaths is thought to be around £8 billion a year. This does not include the further costs to the wider economy in lost productivity.
As the noble Lord, Lord Giddens, for one, pointed out, obesity in particular is a serious and growing problem. Nearly three-quarters of a million people in the UK are classified as morbidly obese-overweight enough to cause real long-term damage to their health. As such, they increase their risk of being diagnosed with diabetes, some cancers and cardiovascular disease, as well as a wide range of conditions that have a significant negative impact on a person's quality of life.
The Government are committed to improving the health of the nation. We consider public health to be a high priority and to be everyone's business. Much has already been achieved-and here I pay tribute to a great deal of the work done by the previous Government: there is clearer and easier to understand information on the front of food packaging than ever before, helping people to make healthy choices at a glance; there are national guidelines to protect the most vulnerable and ensure high-quality food in places such as schools, hospitals, care homes and prisons; voluntary initiatives with the food industry have seen significant reductions in the amount of salt in our foods; we have put in place a new Change4Life strategy; we are working with industry on appropriate safeguards for marketing food and drink to children-I shall say more about that in a minute; and we will continue the national child measurement programme.
Something that many of these achievements have in common is that they stretch beyond the limitations of purely government actions. We recognise that public health is not a social good that can somehow be mandated from the centre. The way to make real progress is through a coalition of partners-government departments, private companies, charities and individuals all taking responsibility for their own actions. We want business to do more to help meet public health challenges. We want all partners to be joint owners of a long-term public health strategy and for each to play its part in improving people's health. This is the thinking behind the Responsibility Deal, our response to the challenges that cannot be resolved through legislation or regulation alone. The Responsibility Deal is a partnership between government and business that balances proportionate regulation with corporate responsibility to tackle the health problems associated with poor diet, alcohol abuse and a lack of exercise.
The noble Lord, Lord Whitty, raised the specific issue of nutrition. Providing clear, easy-to-understand nutritional information for consumers is essential if people are to make informed choices. This is also true when eating out. We have challenged the food industry to give its customers this information. From a traditional bag of fish and chips to a special treat for the whole family, eating out has become an important part of our culture and must be included in any serious attempt to influence it.
In this and in all areas of regulation, guidance and food standards, there is a balance to be found between the impact on health outcomes and the impact on business. We need always to take a proportionate approach and to try to get the balance right. Food is the UK's largest manufacturing sector. It is a real success story, bringing billions of pounds into the Exchequer and employing tens of thousands of people. We must be careful not to strangle this particular golden goose with excessive regulation. We want a light touch wherever possible. Where we can achieve our objectives through voluntary agreements, we should do so. We also need to be realistic about what is within our gift to do. Much food regulation is EU-wide, so we need to negotiate and agree certain changes at an EU level. I need hardly say that we should also avoid gold-plating any legislation when implementing it.
One other key plank of public health policy is informed consumer choice. The noble Lord, Lord Whitty, is a particularly strong advocate for consumers and their rights in his role as chair of Consumer Focus. Often, people's health and well-being are rooted in their daily lifestyle choices. To improve public health, we need to support people in changing their behaviour, making the healthy choice the easy choice. Public health must not be about nannying consumers or demonising particular foods. We need to find new approaches, founded in behavioural science, which nudge people in the right direction.
While we have made some progress, we have only really started to scratch the surface. Our average salt intake is down almost 10 per cent over the past decade, which will save the lives of 6,000 people each year as
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Early indications suggest that people are starting to reduce their intake of saturated fat, but we are still a very long way from the ideal level. Although levels have fallen substantially in young children, we are still eating far too much added sugar. Sadly, the consumption of fruit and vegetables remains poor, with only a third of people eating the recommended five a day. For all these reasons, we will publish later this year a public health White Paper. It will set out in detail our plans to transform public health: a good, balanced diet, more exercise, drinking responsibly and stopping smoking.
The noble Lord, Lord Whitty, and other noble Lords dwelt to a considerable extent on the decision by the Government to move nutrition policy to the Department of Health from the Food Standards Agency, a transfer which took effect from 1 October. The main reason for doing that is not only to ensure that nutrition policy is delivered coherently and consistently in relation to nutrition-although nutrition is certainly part of it-but also to recognise the direct interrelationship between nutrition policy and public health policy in areas such as obesity, diabetes and coronary heart disease. It is an early step towards realising the Government's vision of drawing together the diverse arrangements for delivering public health into an inclusive public health service. The transfer will mean that the Government can give the general public more consistent information. It will also mean, as I have indicated, a more co-ordinated and coherent policy-making process and a more effective partnership between Government and external stakeholders.
I agree with the noble Lord, Lord Whitty, that the creation of the Food Standards Agency was sensible and necessary in the context of public confidence at the time in the Government's advice on food safety. I am not so sure that I agree with him that there was any lack of consumer confidence in the Government's advice on nutrition. The main problem, I think, lay in issues around food safety.
I assure the noble Lord, Lord Rea, that the Food Standards Agency will continue to ensure the public's safety by maintaining its essential and robust regulatory role on food safety, covering all aspects of development, implementation and delivery. In the context of consumer confidence, what matters is surely transparency. The Government are committed to provide evidence-based advice to consumers in order for them to make healthier lifestyle choices. We understand the need for transparency in our policy-making and the need for independent advice and scientific accuracy. The Government will continue to be advised by independent experts to ensure high-quality, trustworthy advice to consumers.
The noble Lord, Lord Rea, mentioned the press report that appeared on 24 September that suggested that various public bodies would be axed, including the Government's independent Scientific Advisory Committee on Nutrition. In fact, discussions are still on-going and we will be in a position to make an announcement on the matter in due course. In the mean time, SACN will continue to provide expert advice on nutrition to the Government. Again let me
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The noble Baroness, Lady Thornton, questioned the evidence that food labelling belongs in Defra. She will recognise, I believe, that there was a division of responsibility for food labelling. We will now have a more consistent delivery of food labelling policy that will bring together general labelling and issues such as country-of-origin labelling.
The noble Lord, Lord Giddens, asked me to give the Government's view of the FSA in general. I hope that I have indicated that we think very highly of the FSA. We recognise the good work that it has achieved as well as the principles that it has established of openness, transparency and evidence-based policy. At the same time, it is important in delivering the Government's objectives on public health to draw together nutrition policy so that it can be delivered more coherently.
Much has been said this afternoon-not least by the noble Lord, Lord Patel-about saturated fat and salt and their connection with ill health. Two key dietary influences in the development of cardiovascular disease are the levels of saturated fat and salt in the diet. High intakes of saturated fat can cause increased cholesterol levels, which are a major risk factor for CVD. Similarly, high salt intake contributes to high blood pressure, which is also a risk factor. I say to the noble Earl, Lord Erroll, that there is strong international agreement with UK expert opinion on what constitutes a healthy balanced diet that is low in salt and saturated fat. The substantial body of scientific evidence supporting that view includes long-term epidemiological studies, which conclude that a healthy balanced diet has a positive effect on the prevention of diet-related chronic disease.
The noble Lords, Lord Patel and Lord Rea, suggested that there should be a stronger regulatory approach to such matters rather than simply a continuation of the voluntary approach. The UK is moving further and faster on salt, saturated fat and sugar reduction than most other countries, even those that have taken a regulatory approach. The responsibility deal aims to build on that and to challenge industry to play its part in improving people's health. Legislation would undoubtedly produce an additional burden, which could stifle industry innovation. Industry ought to have the flexibility to decide how it delivers public health benefits. Consumers also need to take responsibility. We need to find ways in which to support people in changing their behaviour and improving their diets. The Food Standards Agency is fully on board with this voluntary approach. It has worked with the food industry to deliver voluntary reductions and to secure public commitments to the reformulation of food.
The noble Lord, Lord Patel, spoke eloquently about trans fats. Action by the food industry in the UK has reduced average trans fatty acid intakes to less than half the maximum level set for public health. We
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Earl Howe: My Lords, the whole matter of trans fats is under review. I expect that we will be in a position to say something in the public health White Paper. In the context of the noble Lord's question, it is instructive to look at the experience of other countries. The United States took legislative action on trans fats only after voluntary measures had failed and because intakes by New York citizens in particular were much higher than those recommended and much, much higher than those in the UK. Denmark acted to ensure that individual food products did not contain high levels. We believe that much of this can be achieved by voluntary measures, which will be considered as part of the responsibility deal.
The noble Lord, Lord Giddens, suggested in his speech that the ban of trans fats in Denmark has directly reduced the incidence of chronic diseases. I would be interested to see the evidence that he has for that. We are not aware of published scientific evidence of a direct linkage between reducing trans fat intakes and changes in disease rates in the population in Denmark, so I should be glad to communicate with him on that topic.
The noble Lord, Lord Patel, questioned whether the voluntary approach would be enough. Voluntary action by industry so far has shown that it can be successful. As I indicated, we want to make industry joint owners of the long-term public health strategy. That includes our drive to reduce salt levels in food, about which the noble Baroness, Lady Thornton, asked.
The noble Baroness, Lady Hayter, asked for reassurance that protection of the consumer will be a watchword for the Government. I can tell her that the responsibility deal most certainly includes representation from consumer-focused organisations, to make sure that consumers' interests are protected. She also spoke about the impact of poverty on diet. We recognise the action that retailers have taken to ensure that the nutritional qualities of value food lines and premium food lines are comparable. The Government's responsibility deal can take into account these types of issue to help to promote good nutritional standards.
I say to the noble Lord, Lord Patel, that the Government are committed to working with the industry, as I indicated. We have seen a great deal of progress with children's diets, as he will know in relation to foods that are high in fat, salt and sugar.
The noble Baroness, Lady Finlay, asked what action the Government will take to help educate consumers, particularly about food labelling. The Government
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I shall write to noble Lords with answers to other points. Perhaps I may conclude by briefly emphasising that more than any other area of health, public health has the potential to change people's lives for the better. It cannot be seen as an add-on, or as somehow secondary to the important business of saving lives. It is saving lives and, at a time of tightening budgets, by preventing people from becoming ill in the first place it saves money as well.
Lord Whitty: My Lords, I welcome much of what the Minister has just said and I welcome very much the contributions of everybody in this debate. My noble friend Lord Giddens and the noble Baroness, Lady Miller of Chilthorne Domer, reminded us that this is only part of a huge issue about the world food industry and food chain, and its inter-relations with individuals, with society and with the environment. That might well be appropriate for a wider debate at some point in this House.
Almost everybody has accepted that we have a serious nutritional crisis on our hands; the Minister has just done so. The noble Lord, Lord Patel, the noble Baroness, Lady Finlay, and my noble friend Lord Rea have particular professional experience in these areas with the more vulnerable people. It was much welcomed that we drew attention to those things. The only points of contention around this House were, first, the role of regulation and, secondly, which part of government should be responsible. On regulation the noble Earl, Lord Erroll, played his part as the man in the street. He did it quite well and we do not think that he is mad-or, at least, not much madder than the rest of us-but the man in the street or, more particularly, the woman in the supermarket wants more understandable advice and more bad things banned. My noble friend Lord Rea and the noble Baroness, Lady Miller, made the point that, at times, we have to have a bit more regulation.
However, that was not actually my main point about the FSA, which has used softer but more effective means, some of which the Minister has just referred to, as well as regulation. Often, the threat of regulation, as my noble friend Lord Rea said, produces miracles to which otherwise industry would not respond. The FSA's record in the area of nutrition, as well as of food safety, is difficult to replicate in a government department. I wish the government department with that responsibility well, but-and this is where responsibility lies-the FSA has a reputation for independence, which is important and was the original concept behind it, and for its scientific base. It is also trusted by the public and nutritionists and, as my noble friend Lady Hayter said, trusted by consumers. I welcome the assurance
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I wonder sometimes why Ministers actually want that responsibility. I am not against Ministers taking some more general responsibility for the operation of agencies, as the noble Earl, Lord Erroll, suggested, but on actual advice to the public it is most difficult for Ministers to be taking responsibility. Indeed, history is littered with otherwise eminent, successful and distinguished Conservative politicians who have fallen foul of this: Edwina Currie for telling us what we could not eat-as the noble Baroness, Lady Finlay, reminded us-and John Gummer for telling us what we could eat. John Gummer has, of course, had to change his name to come into this House.
The Minister may object that that was food safety and not nutrition but, as somebody said to me, the only difference between interventions on nutrition and those on food safety are that the latter are to stop us eating things which will kill us quickly, while interventions on nutrition are to stop us eating things which will kill us slowly. My final contention is that both of those are better off in an independent agency, but for the moment I wish the noble Earl and his colleagues joy of them. I beg to withdraw the Motion.
Baroness Anelay of St Johns: My Lords, the business that follows is a Question for Short Debate in the name of my noble friend Lord Chidgey. It may be helpful if I indicate at this stage, as it is such a popular Question, that it has 19 speakers. As with the previous two debates, this is strictly time limited, on this occasion to 90 minutes. That means that if each person keeps precisely to the amount of time indicated on the speakers list, the House will just complete within the time limit. I appreciate that that is quite difficult today with only four minutes for most of the speeches permitted; therefore, the Whips on duty will assist Members to keep to the four minutes as they come up on the indicator. Today, because we appreciate that it is early days in this Parliament, I do not intend to invoke the rules in the Companion, so if there is by any remote chance a slight slippage, I assure the noble Baroness, Lady Thornton, on the opposition Front Bench that her time will remain protected. It is the Minister who will find his time reduced-but of course that means a reduction in the opportunity to respond to Members.
Baroness Anelay of St Johns: I beg your pardon, it is the noble Lord, Lord Brett, who is responding to the debate for the Opposition. The noble Baroness, Lady Thornton, has had her go and is giving way. The noble Lord will have his time protected.
It may be timely to remind the House that applying the Companion would mean, in practice, that if noble Lords were to overrun, the last Back-Bench speaker, the noble Lord, Lord Patel, might find himself without a slot at all. But today he will be guaranteed a voice.
Lord Chidgey: My Lords, after that I shall be as brief as I can. This is a serious matter. Each year, in the developing world, 9 million children under the age of five die. Four million people die from malaria, HIV/AIDS and other diseases. Maternal mortality continues to be at the rate of one death in every 200 births, and 1.4 billion people, one-quarter of the population of the developing world, continue to live below the international poverty line. These were the headline challenges on the MDG agenda facing the high-level plenary meeting of the General Assembly of the UN last month. Secretary-General Ban Ki-Moon, in calling on leaders from 140 Governments to redouble their efforts to achieve the goals, stressed how vital it was to keep our promise to the poor. He said:
"In the decade since the MDGs were first agreed, we have learnt a great deal about what works and where we need to focus our efforts. Evidence shows that the Goals can be achieved, even in the poorer countries. We can and must do more, especially given the impact of climate change, increasing global hunger, and fall-out from the economic crisis".
Since 2005, the 1.8 billion living below the poverty line has fallen to 1.4 billion, but only if you include China. Otherwise, the number has actually risen by 92 million, within a rising global population. Nevertheless, nine African countries are on track to halve poverty by 2015. Botswana is among the leaders, with 95 per cent enrolled in primary education, 90 per cent of HIV cases receiving healthcare, and robust programmes to reduce poverty in remote rural communities. Universally, net enrolment in primary education has risen to almost 90 per cent, but more than one in 10 primary school-age children are still out of school. Many countries are also facing severe shortages in teachers and teaching facilities.
The HIV infection rate in the developing world has decreased by almost a third to 2.7 million. Sub-Saharan Africa is still the most heavily affected, accounting for more than two-thirds of all those living with HIV. Yet, still nearly 1 million people a year die needlessly from malaria-a challenge that the UK has, to its credit, taken up.
The world is on track to achieve the safe water target, although close to 1 billion people worldwide still use unimproved water supplies. Over one-third of the world still does not have access to toilets or latrines and improvements are far too slow.
Women are still suffering disproportionately, with two-thirds of employed women having vulnerable jobs-part-time, seasonal or low-paid. The gender gap in secondary and third-level education in some countries continues to be unacceptably high. In spite of the steady decline in the deaths of children under five, the current figure of 9 million globally is still horrific. Every minute, somewhere in the world, 17 children under five die needlessly. Child mortality rates have been slashed in some 50 countries, but the decline of 28 per cent overall is not even close to the target of a two-thirds reduction.
The commitment to reduce by three-quarters the maternal mortality ratio and achieve universal access to reproductive health is where the least progress has been made. With maternal mortality declining only marginally over the last 15 years, with some 40 per cent of births still not attended by a skilled health worker and with only one in five sexually active women in sub-Saharan Africa thought to use contraception, the targets are being missed by a mile.
The response of the UN summit was to adopt a global action plan to achieve the MDGs by 2015. The Secretary-General secured more than $40 billion for women's and children's health. The World Bank doubled its support for agriculture, to up to $8 billion a year for the next three years. The Deputy Prime Minister emphasised the UK's overall leadership on international development issues. He reiterated our commitment to reaching 0.7 per cent of gross national income in aid by 2013. He challenged others to live up to their promises and to back Ban Ki-Moon's call to keep the promise to end world poverty.
While the ODA globally had reached some $120 billion in 2008, so far only four countries have reached the ODA target of 0.7 per cent of GNI. At the United Nations, major countries including Japan, Chile, France and China, together with global corporations, all committed to major increased support. To our Government's credit, they have pledged over the next five years to triple to some $750 million our contribution to fighting malaria, which needlessly kills 1 million people every year, and to prevent 50,000 maternal deaths and save the lives of 250,000 newborn babies.
Those commitments are welcome, but more detail is needed from the Government to deliver on their impact. For example, in tackling maternal mortality, what programmes are planned by the Government, and which countries and regions will they focus on? Do the Government share the concerns of Save the Children about the lack of an agreed accountability framework for achieving the goals on maternal and child health?
The increase in the proportion of hungry people, particularly in sub-Saharan Africa, underlines the importance of agriculture and food security and the impact of the dramatic 17 per cent rise in food prices in the past year. Will the Government be reconsidering their low-key approach to agricultural research and strengthening its ability to tackle a potential global crisis? The ongoing famine in Niger and the recent food riots in Mozambique are a clear warning of the threat.
At the UN, African leaders recognised that those in the developing world had to do more for themselves, to design programmes and strategies for their
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A major obstacle to achieving the MDGs and sustainable development beyond 2015 is insecurity and instability. Security, stability and development are interlinked. The UNDP in Afghanistan, for example, has added a ninth MDG to the list-to enhance security. The stark fact is that 22 of the 34 countries furthest from meeting the MDGs are in the midst of, or emerging from, violent conflict. More will need to be done to help states that are judged to be fragile or in conflict.
Increasing MDG investment alone will not be the solution. There needs to be an overarching consideration of political developments, not least if there is to be a results-based developmental return on the international development commitments that the Government are seeking. There needs to be established joint accountability between donors and recipients of ODA, introducing transparent audit and tackling corruption. This is essential to the long-term viability of international development.
We need legislation to allow us to play our part in tackling corruption. Tax evasion and bribery in developing countries is estimated by the OECD to cost their economies as much as $160 billion every year. We need to ensure that human and natural resources in developing countries are treated fairly and no longer exploited. Will the Government bring forward legislation to require UK companies, their subsidiaries and joint venture partners to disclose all payments made to recipient Governments for access to natural resources and details of the resources themselves? Will the Government bring forward legislation similar to the Dodd-Frank financial reform Act in the United States, requiring disclosure and due diligence transnationally?
Achieving the MDGs is not just about aid. Eradicating poverty is fundamentally a political challenge. Poverty reduction is hampered as much by political and social factors as by economic conditions. Poor communities need to be empowered at local and national level and to hold their Governments to account, in particular on progress with eliminating poverty and drastically reducing maternal and child mortality. Nothing demonstrates this more clearly than the knowledge that, at the end of the 90 minutes that are scheduled for this debate, another 1,500 children under the age of five will have died needlessly.
Lord Moynihan: My Lords, I declare an interest as chairman of the British Olympic Association and a member of the London Organising Committee of the Olympic Games. Today I will talk about the importance of sport as a key contributor to the progress needed to deliver the millennium development goals. Over the years the Olympic movement and its constituency
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Each of these programmes and activities offers a meaningful contribution to the achievement of the millennium development goals. For example, in community development we contribute to local socio-economic development through sport. In environmental protection we advocate environmentally sound sport practice and sustainable development. In HIV and AIDS prevention we promote healthy lifestyles through peer education. In humanitarian assistance we bring hope through recreation to people in need. In gender equality we ensure greater access to sport for girls and women, as well as leadership empowerment. In Olympic education and culture we promote Olympism and Olympic values throughout the world among youth. In peace and Olympic Truce promotion we work on conflict resolution and inter-community dialogue through sport-a subject close to the heart of my noble friend Lord Bates.
The International Olympic Committee and international sports associations co-operate with numerous United Nations agencies, programmes and funds, and with member states as well as non-governmental institutions, to develop and implement a range of initiatives, using sport as a tool for development. National Olympic committees and national sports federations play a critical role as they communicate with billions of young people throughout the world on a daily basis. They bring to the table specific organisational expertise that delivers a cadre of young, disciplined generations to be empowered and trained for the roles they will play as leaders of tomorrow. In this country my noble friend Lord Coe and we at the British Olympic Association do this through the programme International Inspiration. It is the main British project in this context. It is led by Sir Keith Mills and uses sport to touch the lives of more than 10 million people in developing countries as a result of our hosting the Olympic Games in London in 2012.
The decision by UN member states last October to invite the IOC to participate in the work of the UN General Assembly as permanent observer-a position strongly supported by the then Minister for Foreign Affairs, the noble Lord, Lord Malloch-Brown-has raised the level of partnership between sports organisations around the globe as a whole, and the political leadership of nations, to a whole new level that dictates that more resources should be provided to sport by Governments and by sport to deliver on its development commitments, so sport is an essential development tool and a key contributor towards ensuring progress towards the millennium development goals. We at the British Olympic Association are ready to assist government with a range of initiatives before and after 2012 so as to deliver a true and lasting legacy from London 2012.
Baroness Kinnock of Holyhead: My Lords, I thank the noble Lord, Lord Chidgey, for initiating this debate and, indeed, for giving us his usual wise and comprehensive account of the issues we are discussing. At the outset I pay tribute to the remarkable achievements of the Labour Government on all aspects of international development, including the millennium development goals. We trebled the aid budget, cancelled debt, established DfID and for the first time had a Secretary of State for International Development sitting in the Cabinet. Yet in spite of the efforts made by world leaders, many of the MDGs remain dangerously off track. We know that, according to the Institute of Development Studies, unless MDG progress accelerates more than 1 billion people will be living in dollar-a-day poverty in 2015. At current rates, we will not halve poverty in sub-Saharan Africa, which is the objective of MDG 1, before 2141.
Attention must be paid to achieving better accountability and to providing the predictable long-term funding which Governments in developing countries need if they are to plan a health infrastructure and get children into school. Critically, funds must be additional. This has to be new money. We do not want to see a rebadging and recycling of money that has already been pledged. I am afraid that we are seeing far too much of that in many countries. I very much hope that I can be given an assurance today that the funds that will be needed for resourcing adaptation to and mitigation of climate change will be new money and will not be transferred across from what is meant to be overseas development assistance. We also need to look at innovative sources of funding development. I am very much in favour of taxation on financial transactions-the so-called Robin Hood tax. France and Spain have already called for such a tax and I hope that the Government will support their position.
Critically, we need to invest in more and better opportunities for women and girls, as the noble Lord, Lord Chidgey, intimated. We need to invest very seriously and conscientiously in the economic, legal and political empowerment of women and girls. Gender equity has a multiplier effect on all the MDGs and arguably offers the most significant linkages between the millennium development goals. For instance, if we ensure that girls have increased and unfettered access to education, we will have more of a linkage to better health and nutrition. Enhancing access to reproductive and maternal health contributes to all the MDGs. Maternal mortality in sub-Saharan Africa has barely changed in two decades. Women also need to benefit from equitable land distribution, which increases output and provides better food security. Safe water and sources of energy reduce the burden of women's domestic activity. Discrimination is pervasive and ensures that women are more likely than men to be in low-paid jobs with no social protection. Violence against women was rightly described recently as a global pandemic.
On MDGs 4 and 5, which were a major focus in New York, I should be very interested in a response from the Minister to criticism that statements and announcements from DfID are focusing too much on newborn and one-month old babies rather than on children under five.
by providing contraception, safe abortion, maternity care and the prevention and treatment of sexually transmitted infections. As someone with a lifelong interest in women's health, and as the newly elected chair of the All-Party Parliamentary Group on Population, Development and Reproductive Health, I particularly welcomed this because, as the noble Baroness who spoke before me mentioned, healthy women with small families can access education for themselves and their children; and eventually not only they, but their communities and countries, will benefit economically-and also sustainably, if we can slow down population growth.
Two years ago and following extensive hearings, the all-party parliamentary group, chaired energetically by Richard Ottaway, produced an excellent report, The Return of the Population Factor. The conclusion was that it will be difficult or impossible to achieve the millennium development goals with current rates of population increase in the least developed countries and regions. World population is currently 6.5 billion. By 2050, if nothing else happens, it will be 8 billion to 10 billion, which will wipe out any advances we might have made towards the millennium development goals. Sadly, those who set them did not take account of this.
Why are we not making progress? I have always contended that family planning has long been the missing link. It has always been underfunded. Global funding for it has declined in absolute terms; it has been halved from its level a decade ago. We must get family-planning supplies to 215 million women who want them but cannot access them.
There is another problem apart from finance; distribution. We are always told that in Africa, two condoms are available per man per annum. This is not a very generous provision-for any age group, I may add. Why-I have asked this many times-is it possible to get Coca-Cola in whatever village you come to in Africa or Asia, but not to get condoms or pills? Will the Minister take up the challenge? It cannot be beyond the wit of our civil servants and business leaders to do a deal to ensure that the unmet need for family planning somehow is met through their networks. The distributors of anti-retrovirals missed an opportunity; they did not even send out condoms with the drugs because of George Bush's objection to contraception. That was a scandalous waste. I hope that the Minister will assure us of the Government's commitment to increase funding for sexual and reproductive health, especially family planning and safe abortion services. Women in developing countries depend on us to take the lead.
Lord Hannay of Chiswick: My Lords, last month's meeting in New York said most of the right things but it is legitimate to ask whether the right actions will follow, and that is why the debate introduced by the noble Lord, Lord Chidgey, is so timely. After all, those actions have not done so in the past, and the recession has taken its toll on the willingness of many countries to implement the commitments that they entered into, most importantly at Gleneagles and at the UN summit in 2005.
Some of those who endorsed the warm words agreed in New York last month are not fulfilling those commitments now and have shown no sign of doing so in the future. Russia, France and Italy are examples of that tendency. I should like to know what the Government are intending to do to make the monitoring of commitments in the EU and the G20 and at the UN more effective during the last one-third of the journey than it has been in the past two-thirds. It is good that we are sticking to our commitments, but the UK is only a modest part of a global jigsaw and, if we cannot carry others with us, progress towards achieving the millennium development goals will flag.
This issue of the consequences of the recession and of the current problems over government spending has to be confronted fair and square. It needs to be recalled that the global recession and the particularly sharp slowing of growth in the main developed countries-which are also, of course, the main aid donors-has already levied a substantial hidden tax on the resources being made available to the developing world, as many of the commitments entered into were expressed as percentages of donor countries' gross national income, and the growth of the GNI of those countries is markedly lower than was expected at the time the commitments were entered into.
A second consideration is that the 2008 financial and economic crisis was in no conceivable way attributable to the policies or actions of developing countries. Therefore, it would surely be aberrant and immoral if they were to be directly punished for events which are already taking a toll on their economies.
Thirdly, it is not in our own interest that developing countries' health, education, climate and other development policies should be hobbled, with the inevitable increase in global insecurity which would follow. Therefore, I strongly commend the coalition Government's decision to honour our commitments and to sustain the aid budget.
It is not too soon, I suggest, to be thinking now about the post-2015 scenario for the MDGs. The problems that they were established to address will not have disappeared by then, although one can hope that they will have been much reduced. An instrument a bit less blunt and all-embracing than the MDGs could serve better in the future. It is now widely recognised that global MDG achievement figures conceal as much as they reveal. Thanks to the rapid economic growth in Asia, the below-average performance of many weaker developing countries in other parts of the world is hidden and often not properly addressed. The problems of failed and failing states are simply not on the
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We also need to think hard about the role that can be played in the future by the most successful countries emerging from the developing world-countries such as China, India and Brazil. I do not believe that we should expect those countries to match the same degree of spending as the developed countries but they have gone through this experience themselves and pulled themselves up by their own bootstraps and they have a lot of lessons to teach us. Therefore, to ignore the contributions that these countries can make to shaping and participating in future development work would be foolish and entirely contrary to the rationale of establishing the G20 as the primary body for co-ordinating global economic policies. After all, these countries have shown how it can be done-how rapid progress to achieving the MDGs can be made. Therefore, I should like to suggest that in cases such as China, Brazil and India, the Government should be thinking of how we can work with them in the future and co-operate with them in seeking to achieve the goals. I hope that when he replies to this debate the noble Earl can say something on the Government's intentions in that respect. I heard the Secretary of State for DfID speak about that on television only two days ago and it would be very good if we could hear from him.
The Lord Bishop of London: My Lords, I am also very grateful to the noble Lord, Lord Chidgey, for introducing this timely debate. The previous Government gave a strong lead in addressing world poverty, and our present Prime Minister on the day he entered office declared that we should be "generous abroad" . The aid budget has been ring-fenced despite financial pressures, although one must take into account the reflection of the noble Lord, Lord Hannay. This issue has firmly joined the agenda of matters which, in this country at least, relate to the common good and occupy a sphere beyond party politics.
I wish to make one point and ask the Minister for one assurance. In a recent article, the Secretary of State for DfID said that the importance of faith groups in the global battle against poverty could not be overestimated. My experience comes from a 12-year partnership with the church in London and churches in Angola and Mozambique. We have been involved with local partners in building schools and medical facilities. We are also now raising money to float microfinance projects there.
It is very clear that those grass-roots networks involved have a high reputation for honesty and considerable reach. A recent World Health Organisation survey estimated that never less than 30 per cent, and in some cases as much as 70 per cent of the healthcare facilities in the countries of sub-Saharan Africa, are provided by faith-based groups. It is vital that the
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I am not, of course, making any exclusively Christian point. The reach and effectiveness of Islamic Relief agencies and other religious charities throughout the world contribute to an emerging-what shall we call it?-global society of great significance. Lambeth Palace was involved in meetings between the major faith groups in the UK with DfID in advance of the 2009 White Paper and in subsequent consultations. At that point a commitment was made to increase the use and the funding of faith-based networks in the distribution of aid but, in an internal DfID submission to the Secretary of State leaked to the Guardian, this commitment is cited as one of the 80 or so such commitments that could be abandoned. While others were considered to risk significant public outcry if they were jettisoned, this faith-based funding stream was thought to risk merely "individual vocal" criticism.
Can the Minister assure the House that there is no change to the commitment to an increased use of faith-based agencies in the distribution of aid? We do not want special treatment but fair treatment and recognition of the reach and effectiveness of distributing aid in this way.
Of course, I acknowledge that it is very difficult in a democracy to move too far ahead of public opinion. Here, churches, mosques, synagogues and temples have a responsibility to enlarge the room for manoeuvre so that sympathetic politicians can act. Make Poverty History and the Jubilee Debt Campaign on international debt showed what is possible. The Micah Challenge coalition is organising a global day of prayer on 10/10/2010-this coming Sunday. The plan is to match prayer with individual promises to contribute to bringing to an end disabling poverty in our generation. The focal event in the UK is, significantly, at Jesus House in north London. I do not have to declare an interest as it is not one of mine. It is home to one of the most vibrant black-led churches. Millions of people worldwide will participate in an effort to make sure that at a time of anxiety for the rich world, the vulnerable and the needy are not neglected.
Baroness Uddin: My Lords, I, too, thank the noble Lord, Lord Chidgey, for initiating this important discussion. In the UK we should be rightly proud of the British leadership in advancing the millennium development goals which represent a vision of a world transformed where equality and justice prevail.
However, while we are very pleased, one group of women remains outside the MDG effort. Until we address this failure, we cannot speak of real progress. Today I ask our Government to call explicitly for girls and women who are forcibly impregnated by the vicious use of rape in armed conflict to be included under MDG 5-reducing maternal mortality. "Rape as a weapon of war" is a phrase commonly used accurately to describe what is happening alongside today's armed conflicts, but we rarely speak about the consequences of this weapon. Thousands of girls and women impregnated by rape used as a weapon of war are routinely denied access to abortions. Girls and women
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We should do what no other country has done: to ensure that the humanitarian medical aid provided to girls and women in places such as Congo, Sudan and Burma-an endless list of countries-gives them choices and access to abortion when pregnancy is a direct result of rape as a weapon of war. This is a moral imperative and a legal obligation. The Geneva Convention requires that civilians and combatant victims receive non-discriminatory medical care, whether it is provided by the state in conflict or by others. Why, then, are pregnant rape victims given discriminatory medical care through the routine denial of access to abortion? The embedded inequality towards women in conflict settings has been recognised by the Security Council in such historic resolutions as 1325 and 1820. Equal justice for women is not limited to the courtroom, it must be extended to supporting those women who are victims of the inhuman practice of rape as a weapon of war.
I draw the attention of the House to the recent report of the Harvard Humanitarian Initiative and Oxfam, which details examples of the impact, stigma and suffering of raped children and women in Congo, Sudan and elsewhere, where no legal provision exists to support them. It also mentions that women should be given preventive care-that is, utilisation of contraception-as though women who are raped can be prepared for such horrors.
One of the solutions proposed by women's organisations, including the international human rights organisation the Global Justice Center, is that access to abortion must be a critical part of the support available to women. The centre filed a shadow report with the Human Rights Council asking it to recommend that the US remove the prohibitions put on humanitarian aid to rape victims in conflict, as it violates the US obligation under the Geneva Convention. The UK can and must support this issue by asking questions of the US during the council's review process due shortly.
I know that these are difficult matters for many individuals and countries to address, and international donor communities have thus far resisted pressurising countries to review their policies. Neither criminal abortion laws in the conflict state nor foreign aid contracts with the United States can serve as defence to a state provision of discriminatory medical care to all victims under international humanitarian law.
Time is short, and I should have liked to highlight many examples of countries such as Bangladesh where the suffering and humiliation of rape has left decades of suffering, ill health and stigma. The UK must take a lead to end that discrimination. This will mark real progress towards the millennium development goals and towards ensuring equal rights for women under international humanitarian law.
Lord Shipley: My Lords, we should be much reassured by the fact that, despite the difficult financial position faced by the Government, their commitment to raise spending on overseas aid from 0.5 per cent of our
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I shall talk specifically about the role and importance of women in reaching the challenging millennium goals that world leaders have set. A few years ago, I visited a housing project in Khayelitsha, one of Cape Town's townships. There, I realised that if you wanted homes built, it was the women's housing co-operative that would build them. If you wanted a crèche, it is women who would create it and run it. If you wanted bed-and-breakfasts, the businesses would be run by women; and if you wanted a self-help saving scheme to provide microfunding, it was women who would organise it.
That is why we need to concentrate far more on strategies which help the lives of women directly, particularly in health, maternity and schooling, which will in turn drive higher growth through greater equality. The millennium goal furthest away from being met relates to the mortality rates of women who die in pregnancy and childbirth. This impacts directly on the existing children of those mothers and their life chances. Half a million women die every year in this way, and half of them are in sub-Saharan Africa. The new strategies recently announced to increase substantially the number of lives saved are at the heart of what we need to do. For example, in under half of developing countries does a skilled health worker attend a birth. Addressing this specific issue could make such a difference. Two-thirds of the billion people who live on less than one dollar a day are women, and those women own only 1 per cent of the land they live on. Yet gender inequality discourages economic growth because when women earn money, they spend more of it on their families. Research by Goldman Sachs and by the World Bank has confirmed that if more women could earn their own income, the income per head in many developing countries could rise by a fifth.
I have two final points. Let us remember that economic growth requires clean water. As an example of what can be done if we concentrate aid, we should look to new technologies, such as encouraging the use of solar power to pump fresh water from deep underground wells. Finally, I congratulate the BBC World Service Trust on the excellence of its work in developing countries, to which it broadcasts information to help people in the face, for example, of natural disasters. I give a particular accolade to "Afghan Woman's Hour" to which six million Afghan women tune in every week. These women say that the stories they hear inspire them to take action to improve their own living conditions. At New York, Ban Ki-Moon reminded us that:
by 2015. This may be the most off-track of all the MDGs, as well as having the biggest beneficial multiplying effect on other MDGs. These benefits are also won through being connected with maternal health. The noble Lord, Lord Chidgey, said that this is the area of least progress and used the phrase "missed by a mile". The reason that the MDG I am referring to is called 5.B is that it was a very welcome additional afterthought, some years after the original 2000 framing of the MDGs. Hence there was a slow start in including reproductive health for the essential factor it is.
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