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Supermarkets’ Role in Tackling Childhood Obesity

Volume 673: debated on Wednesday 18 March 2020

I beg to move,

That this House has considered the role of supermarkets in tackling childhood obesity.

It is a pleasure to serve under your chairmanship, Mr Robertson. Even as we struggle with the threat of covid-19, I want to stress the importance of this debate, because childhood obesity is a subject whose importance cannot be overestimated. It is without doubt the time bomb that will increasingly affect the lives and wellbeing of our society in the years ahead. We need clear steps to address it. The report, “Healthy Families: The present and future role of the supermarket”, from the all-party parliamentary group on a fit and healthy childhood, sets out to contribute to the debate. It does not seek to cast supermarkets as the villains of the piece; rather, it recognises the influence that they have and how that influence can be used positively to help tackle health issues.

Supermarkets have always occupied a special place in our psyche. It was J. K. Galbraith who told us:

“A person buying ordinary products in a supermarket is in touch with his deepest emotions”,

and Jonathan Sacks who suggested:

“A Martian would think that the English worship at supermarkets, not in churches.”

Supermarkets are now widespread in many countries. This country’s development trailed behind that of the USA. Indeed, by 1947 our self-service sector consisted of a mere 10 shops, but by 1969 supermarkets numbered about 3,500 and were well and truly established as part of our shopping experience. Store layout, daily promotions and sensory cues are all part of a formidable arsenal designed to encourage customer purchases, often regardless of the nutritional value of the product.

Price promotion is a key element in the strategy. A Cancer Research UK report in 2019 argued that three in 10 food and drink purchases are determined by price. The households making the greatest use of price promotion bought more products high in fat, salt and sugar. The upper quartile of promotional purchasers are 43% more likely to be overweight than the lower quartile, irrespective of income and age demographics.

I suspect that the hon. Gentleman shares my concern that supermarkets place chocolates just in front of the tills, so that there is almost a wish to buy them as people make their purchases. Does he feel that supermarkets should move them away from the tills, so that there is not that temptation for mothers and children as they come to pay for goods?

I certainly agree. There is quite a lot of research to show that children, almost irrespective of their age, are influenced by that, and that the placement of products influences purchases.

The Obesity Health Alliance’s 2018 report “Out of Place” focused on the prime locations in stores for selling particular goods—exactly the point that the hon. Member for Strangford (Jim Shannon) has just made. It found that 43% of all food and drink promotions situated in prominent places, such as entrances, checkouts, aisle ends and so on, were for sugary food and drink. Fruit and vegetables amounted to less than 1% of products promoted in high-profile locations.

Diabetes UK reports that one in three children in primary schools in England currently suffer from excess weight, increasing their risk of type 2 diabetes. Excess weight or obesity accounts for up to 85% of someone’s overall risk of developing the condition. The Obesity Health Alliance makes a similar point: as well as causing type 2 diabetes, obesity can lead to cancer, heart and liver disease, and associated mental health problems.

I think it is wise to reflect on diabetics. I declare an interest, as I have been a type 2 diabetic for almost 15 years. There are 5 million diabetics in the United Kingdom, and the number is rising. It is one of the greatest health problems for future generations. Does the hon. Gentleman agree that there should be a campaign to address the issue across the whole United Kingdom of Great Britain and Northern Ireland?

I do, because we have to educate people who could avoid this condition about to how to do so, not least because, as the Obesity Health Alliance points out, the annual cost of overweight and obesity-related ill health to the NHS is £6.1 billion.

Like other organisations, Diabetes UK acknowledges that products high in sugar are more likely to be promoted through price promotions. It argues that we must have a rebalancing of price promotions to favour healthier products, which would make healthier options cheaper and encourage people to buy such products. Polling conducted by Diabetes UK shows that 82% of adults favour front-of-pack traffic light labelling to help them make a more informed choice. As Britain negotiates new trade arrangements following our EU exit, there is an obvious opportunity to ensure that the UK can introduce legislation to mandate such labelling.

Supermarkets are showing that they have the capacity to reach out to different segments of our society and to play an important social role. In 2014 Sainsbury’s introduced a disability-friendly trolley, designed in conjunction with parents of disabled children. In 2018 Morrisons introduced a quiet hours scheme, with dim lighting and music switched off to help parents with autistic children. There is widespread agreement that the biggest driver of food poverty is lack of money, and that low-income families are therefore nudged by economic factors towards a diet characterised by highly processed, calorie-dependent foods with less fibre and less vitamin and mineral content. The consequent long-term health risks of such a diet can include heart disease, type 2 diabetes and cardiovascular illnesses.

Supermarkets are the sole largest food source for families in England and could support disadvantaged households in making healthy choices. There are good examples in other countries. Denmark, Norway and Sweden use a keyhole label to facilitate healthy choices. Since 2000 there has been a requirement in Finland for a “healthy heart choice” symbol to be displayed on over 11,000 products. In Israel, co-operatives sponsor community physical activity, as does Sainsbury’s in this country—it has helped raise over £186 million for sports equipment through its Active Kids scheme. In the United States, we have seen experiments with stocking healthier products at checkouts. In New York, 170 supermarkets participated in a study that found that displaying low-calorie drinks at eye level increased sales. In Australia, a study found that healthy signs on shopping baskets influence purchases. In New Zealand, supermarkets have co-operated on a health star rating and on programmes to encourage healthy eating.

Supermarkets have a major role to play in the drive to improve the nation’s health, but their potential is as yet untapped. In order to support families to make healthier choices, supermarkets must address the current retail environment by ensuring that healthy foods are available and conveniently located in stores. Snacks are popular across all income groups but tend to comprise a higher proportion of all food consumed by those on lower incomes. Major retailers could improve the availability of higher-quality snacks to low-income families by developing their own brand lines and diverting surplus waste food towards the production of affordable, healthy snacks. They could agree to place high-fat, salt and sugar products alongside like items, rather than supporting out-of-context promotions. Healthy products should be in prime locations, such as the end of aisles, at eye level on shelves and at checkouts.

I acknowledge the good that is done. Tesco’s free fruit for kids and “helpful little swaps” are welcome, as is Sainsbury’s investment in reducing the cost of fruit and vegetables and its measures to end multi-buy promotions. However, we need supermarkets to agree that all customers should have access to clear, accurate nutritional and value-for-money information on all products. Fruit, vegetables and other healthy foods should be positioned in prominent places. Price discounts and multi-buy promotions should be discouraged, or offered on healthy foods.

I do not want the Government to bludgeon supermarkets; I want supermarkets to be partners in this exercise. I want the Government to provide more information, in the context of health and education campaigns, about the psychology of shopping and the importance of lists and meal planning, but I also want the Government to consider legislative measures on price and multi-buy promotions. We can make a real difference here. I want supermarkets to use their influence to play their full part in helping us tackle the problem of childhood obesity.

It is a pleasure to serve under your chairmanship, Mr Robertson. I congratulate the hon. Member for Birmingham, Selly Oak (Steve McCabe) on securing this important debate, and on his work with the all-party parliamentary group on a fit and healthy childhood. I remember responding to him in one my first outings as a then Under-Secretary of State and finding myself, with a slight degree of nervousness for my ministerial career, agreeing with virtually everything he said. However, I am still here, and it has not done me any harm. I fear that I may be in agreement with a number of his points again today, but hopefully at no risk to my ministerial career.

Before turning to the detail of the hon. Gentleman’s points, I thank our supermarkets, particularly at this important time. They are very much in the frontline of our battle with covid-19, and I know that they, and particularly all their staff, in whatever capacity, are doing all they can to keep shelves stocked, deliveries going out and the nation fed. It is a complex job at any time, so I thank them. In parallel, I encourage customers and shoppers to be responsible, to purchase only what they need and to think of others. Working together, I am confident that the supermarkets will ensure that their supply chains remain robust and that shelves will continue to be full.

In its 15th report, “Healthy Families: The present and future role of the supermarket”, alongside the previous reports to which the hon. Gentleman referred, the APPG has provided a valuable contribution to the ongoing debate on improving children’s health and reducing childhood obesity—I have a copy here, and I very much enjoyed it as my bedtime reading last night. He is right; with more than one in five children entering primary school overweight or obese, rising to more than one in three by the time they leave, it is right that we take bold action to improve the nation’s diet. There can be no doubting the key role, as he has said, that supermarkets and other retailers play in helping consumers make healthier choices. I know that many supermarkets and businesses get this. They know that their customers want a healthier offer and that it makes business sense.

Although I am not familiar with the group that produced the report, I saw a recent report by ShareAction that highlighted the importance of investors’ decisions in the sector and factors such as those highlighted by the hon. Gentleman. With environmental, social and governance considerations playing an ever more important role in investment decisions by big investors more broadly, it is right that supermarkets recognise that this agenda is good not only for their customers, but for their business.

As the hon. Gentleman alluded to in various examples, many supermarkets have already taken the lead in the UK and feature the voluntary front-of-pack nutrition labelling on their pre-packaged foods, helping consumers make informed and healthier choices about the food they buy. The UK-wide voluntary front-of-pack traffic light labelling scheme introduced in the summer of 2013 is proving successful, but he makes a good point. It is important to ensure that UK labelling remains effective for UK consumers. We will always be willing to consider a range of measures to build on the success of the current traffic light system to ensure that it keeps up to date and continues to be successful. It is right that people are informed when choosing what they eat and what they buy.

As the hon. Gentleman mentioned, we have seen great work by supermarkets in a range of areas. I will add a few to the list. I hasten to add that if I miss any out, it is not because of any conscious decision; I have merely picked a few examples to illustrate the work that supermarkets do. For example, Aldi and Lidl—a point he touched on—were the first retailers to introduce healthier checkouts in 2015 when they removed all confectionery and sweets from checkouts and replaced them with healthier options, including dried fruit, nuts and water. I have seen that in Waitrose and other supermarket checkouts. It goes to the point made by the hon. Member for Strangford (Jim Shannon) about the importance of what is in the physical environment as we queue up at the checkout and the influence that can have at the last minute, with young children saying, “Mummy, Daddy, can I have that?” It is therefore important that supermarkets do their bit at least to gently steer people in the direction of healthier options.

Sainsbury’s has removed all multi-buy promotions on food and replaced them with lower regular prices on everyday items. Tesco has reformulated its entire soft drinks portfolio—the first supermarket to do so—to be below the level for the soft drinks industry levy, and has given away 100 million pieces of fruit to children in their free fruit for kids campaign. All supermarkets and many larger retailers have restricted the sale of energy drinks to children. In January, Aldi and Lidl announced that they will remove familiar figures from their own-label cereal boxes. All of that is important and positive and should be welcomed. However, as the report acknowledges, there are areas where supermarkets can go further, including doing more to promote and market a healthier food and drink offer more broadly.

As the hon. Gentleman pointed out, promotional marketing by price and store location can impact on the food purchases that we all make. Some can increase the amount of food and drink that people buy by around 20%, which can lead to overconsumption of less healthy products and can cost consumers more money in the long run. Obviously, parents want a healthier balance of offers and deals, but they are not helped by the fact that most deals and offers are currently for unhealthier products.

I am conscious that none of us wants to be hectored and lectured about what to eat. I feel strongly that people should have the right to choose freely for themselves and their families as they know best, but they need to do that on the basis of making an informed decision. People need information to make the choices about their and their children’s lives. It is not fair when all the promotions in store are mostly for unhealthy food, so the balance of the promotions needs to shift towards healthier options to make it easier to make healthier choices when shopping.

To respond to the point made by the hon. Member for Strangford (Jim Shannon), we hear the frustration of parents about what could be called pester power, particularly when queuing at checkouts. It can be hard to say no, so it is important that supermarkets do what they can to help parents in that situation. Again, rebalancing promotions in prominent locations such as tills and shop entrances towards healthier options can help reduce excess calorie consumption and contribute to reductions in childhood obesity in the long term. Many supermarkets are doing so, and I commend them for that, but there is more to do. I encourage supermarkets to continue down that path.

All of that is why in the second chapter of our childhood obesity plan we committed to consult on our intention to restrict promotions on products high in fat, sugar or salt by location and price in businesses that sell food and drink. The consultation closed last year and we will set out our response as soon as we can. I know that both hon. Members who spoke in the debate and the APPG will want to study the response carefully. They may well revert with their reflections on the adequacy of the Government response and whether it goes as far as they would wish. Indeed, I encourage that; it is part of what the House and debate are for.

We want a fairer deal for everyone wherever they live or shop, and whatever their background or financial situation. We want the healthy option to be an easier option for everyone so that we can help all our children grow up healthier. Indeed, as we look towards the future and the demands on our NHS and social care, we are always conscious of what changing demographic demands might do in the future and what children and young people may be letting themselves in for by virtue of their diet or lack of exercise, which in future may require longer-term care and have an impact not only on them but on the NHS and social care’s ability to meet those needs. It is right that, as well as ensuring that the social care and health system can meet those needs, we do everything we can to prevent long-term conditions coming about in the first place.

I have no desire to bludgeon supermarkets, and I understand the Government’s desire to work with them but, given the Minister’s point about long-term health conditions, I was struck that Public Health England’s report showed how some supermarket’s own food products—I will not name the supermarkets—showed increases in sugar content. An increase was found over the period of the report in sweet confectionary, chocolate spreads and morning goods. While the Government are trying to persuade supermarkets, should they also consider fiscal measures as an incentive to meet sugar reductions?

The hon. Gentleman gently tries to tempt me into an area that is perhaps more properly the remit of my right hon. Friend the Chancellor of the Exchequer. I do take the point behind what he says: we need to use multiple means to encourage supermarkets—perhaps that is the best way to phrase it. Again, I encourage him and the all-party parliamentary group to wait for the consultation response and beyond that to engage fully. I am sure that he will. We may well find ourselves here in a few months’ time—or when the report is published—for another debate in the light of the Government’s response.

I think the hon. Gentleman will agree that we will need supermarkets to continue their good work, alongside the out-of-home sector, health professionals, schools, local authorities, families and individuals, who all play an important role. We must also be willing to encourage supermarkets, building on their good work to date, to be ambitious and go that step further. We all have a role to play in what we eat, keeping ourselves healthy and doing the right thing by our long-term health. It is important that supermarkets play their role, and it is important that all of us do as well.

Question put and agreed to.

Sitting suspended.