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Folic Acid

Volume 813: debated on Tuesday 13 July 2021


Asked by

To ask Her Majesty’s Government, further to the reply by Lord Bethell on 3 September 2020 (HL Deb, cols 444–5), whether they have yet been able to form a conclusion on the outcome of their consultation on the proposal to add folic acid to flour which closed on 9 September 2019.

My Lords, I am pleased that substantial progress has been made on this work since I spoke to the House in June, including positive dialogue with all devolved Administrations. It is right that we remain committed to proceeding on a UK-wide basis and I am grateful to colleagues in the devolved Administrations for their energy and support. I assure the House that we are progressing this as a priority, and I look forward to updating the House after the Recess.

Can I assume that the Minister is aware of the statement from the Ministry for Primary Industries in New Zealand on 8 July, five days ago, that as a result of its consultation on folic fortification in 2019 it will fortify all non-organic wheat flour from mid-2023 and therefore join Australia and more than 80 other countries in mandatory fortification? Why are we so far behind New Zealand? The women of New Zealand had the vote 30 years before British women. Can I be assured that British women will not have to wait as long to have safer, healthier pregnancies and fewer babies with a lifelong disability?

My Lords, I pay tribute to the Government of New Zealand for focusing on this important issue and to the energy and passion of the noble Lord in his advocacy in this matter. I can give him the reassurance he asked for. This is a priority for the Government. We are taking it through the machinery of the British Government to ensure that it is rolled out safely, extensively and on a nationwide basis.

My Lords, assuming that the Minister is able to come back to the House after the Recess and give the green light, can he say when we could implement this policy? Does he agree that the recent report of the Health Select Committee on maternity services underlined the importance of making this decision soon?

My Lords, it is not only its importance for maternity services that is on my mind. It is also the recently announced office for health promotion, which will lead the national effort to improve and level up the health of the nation in the round by tackling obesity, improving mental health and promoting physical activity. This important initiative should be seen in the context of that important strategy. I completely endorse the ambition expressed by the noble Lord.

My Lords, why does the Minister tease the House? He says that fortification should happen, so there is no disagreement, but it does not happen. In June, just over two weeks ago, he said that

“we are committed to following the science and are totally persuaded by it … I reassure noble Lords that this remains a priority for the Government.”—[Official Report, 23/6/21; col. 221.]

Since that Question, 50 more babies will have been born with neural tube defects. This will not do. Has the Minister sought the view of the new Secretary of State? Could he share it with the House?

I look forward with great enthusiasm to my monthly updates to the House on this important initiative. We are moving as quickly as the machinery of government allows us to. Taking along all the nations is an important aspect, but, quite fairly, it requires consultation with and the engagement of the devolved assemblies, which is why we have written to them and are engaging with them accordingly. I am also pleased to share with the noble Baroness that we are actively engaged with Defra, which is undertaking a wider review of bread and flour regulations. We will be aligning its fortification plans with this measure in due course.

My Lords, I congratulate the noble Lord, Lord Rooker, on his campaign, which I strongly endorse. Further to the question from the noble Lord, Lord Hunt of Kings Heath, will my noble friend at least set out the draft timetable for the implementation of this measure before the House goes into recess?

My Lords, I am looking forward to outlining the draft timetable, but I will not be able to do so before the Recess.

My Lords, following on from the Minister’s answers, can he tell us whether a provisional target date has been set with the devolved nations for the implementation? Given that we know that 90% of women aged 16 to 49 currently have folate levels below that required to reduce the risk of neural tube defects and that 70% of adults—that includes men—have folate levels so low that they are at risk of anaemia, this is an urgent problem.

My Lords, I share the sense of urgency expressed by the noble Baroness in her articulation of those statistics. They are both worrying and entirely accurate. We very engaged with the devolved assemblies. Welsh and Scottish Ministers have expressed their support, but with Northern Ireland it is important that we consider all the implications of the Northern Ireland protocol. I am therefore not able to lay out the precise timetable now, but I reassure the noble Baroness that we are moving as quickly as we can.

My noble friend Lord Rooker continues to press to protect newborn babies while, sadly, the Government have over a number of years continued to drag their feet. In preparation for the Minister’s forthcoming update, which he has promised the House today, what assessment have the Government made of the impact of the Covid-19 pandemic on the financial and practical ability of women to access prenatal vitamins, including folic acid? How has the pandemic affected awareness-raising to ensure that women are not missing out on vital nutrients in the early stages of their pregnancy?

I am sorry, I cannot answer the noble Baroness’s question directly. I am not sure whether an assessment has been made of the impact of the pandemic on the consumption of folic acid, but it has undoubtedly raised the importance of these kinds of preventive measures. We have never been more acutely aware of the importance of improving the health of the nation, and this is an important step in that direction.

My Lords, one of the first to indicate that folic acid could prevent spina bifida was Professor Richard Smithells in 1980. That was accepted 11 years later, which is nothing compared with the present delay. Spina bifida is one of the commonest congenital defects and is easily prevented by adding folic acid to flour, which is what the Americans did 23 years ago, thus preventing 1,300 babies having that tragic condition every year. We keep hearing about consultations and meetings, which some of us regard more as group psychotherapy than as achieving anything. When will action be taken?

My Lords, I completely understand and appreciate the sense of frustration and urgency that my noble friend expressed, but I emphasise that this is a massive national measure. It has to be conducted in a way that takes the nations with us, that people feel confident that the right processes have been adhered to and that there is no doubt about the safety of the measure. This is not a question of foot dragging, quite the opposite. We are doing this in a thorough way that reflects the practicalities and realities of the machinery of the United Kingdom Government.

My Lords, I understand the frustration the Minister must feel being brought to the House again and again on this issue, but can he understand the frustration just expressed by the noble Lord, Lord McColl of Dulwich, that British science of 40 years ago has influenced the activities of countries across the world, New Zealand being the latest, and yet somehow in this country we have not managed to act on the science that was produced here and families have paid the price for that? Will the Minister understand the urgency and the frustration of those of us who have been raising this issue for years and will he look again at a timetable for implementation?

My Lords, I completely understand the frustration. I pay tribute to all noble Lords who have campaigned assiduously for this measure. It speaks extremely highly of this House that it is so focused on getting over the line an important and emblematic measure that puts preventive medicine at the heart of our healthcare system. Personally, I do not feel any disappointment or anger. I am completely committed to this measure, as are the British Government.

My Lords, I have been raising this matter since I became president of the British Dietetic Association, and my presidency ended a year ago. It seems that we go round and round in circles. Some 80 countries in the world have solved these questions. Why is it taking HMG so long? Can the Minister assure us that before we break up next week, he will have made a definitive statement on dates?

My Lords, I do not need to explain to a seasoned veteran such as my noble friend that the British Government have had a lot on their hands in the past 18 months and that getting right important measures such as this, that touch the lives of every single person in the country—at least, all those who have bred—is an extremely delicate matter. That is why we have to do it in a thoughtful, constructive way. There is no cutting corners on a measure such as this. I reassure my noble friend that we are going through it as quickly as we can. I am not able to give him the timetable that he asks for, but I would like to return in the new term with further details.