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Column 353Willetts, David
Winterton, Mrs Ann (Congleton)
Winterton, Nicholas (Macc'f'ld)
Tellers for the Ayes :
Mr. Sydney Chapman and
Mr. Derek Conway.
Godman, Dr Norman A.
Grant, Bernie (Tottenham)
Tellers for the Noes :
Mr. Dennis Skinner and
Mr. Alan Simpson.
Question accordingly agreed to.
Bill read the Third time, and passed, with amendments.
Motion made, and Question proposed, That this House do now adjourn.-- [Mr. Wood.]
Mr. David Faber (Westbury) : I am most grateful for the opportunity to raise concerns about the Government's draft regulations implementing the EC directive on infant formula and follow-on formula--commonly known to most of us as baby milk. I hope that, in doing so, hon. Members will forgive me for not giving way, but I have some ground to cover in the time available.
I would particularly like to acknowledge my constituent, Cow and Gate Nutricia of Trowbridge--one of Europe's leading companies in infant feeding products and clinical nutrition, and a household name to millions of mothers over many years--for bringing the matter to my attention.
The EC directive on infant formula and follow-on formula contains much that should be welcomed by mothers and by the baby milk industry alike. The majority of the rules on marketing contained within it are already enshrined in a voluntary UK code of practice, which was agreed as long ago as 1983 between the Government, the industry and health care professionals.
That voluntary code of practice and the entire debate surrounding the advertising and marketing of baby milk starts with one basic presumption-- that breast is best. Mothers should be, and are, encouraged to breast-feed babies so long as it is physically and practically possible for them to do so.
However, in the real world, we all know that that is not always the case. For that reason, I believe that the draft UK regulations enforcing the EC directive go much too far. The code of practice was introduced with Government backing in 1983, since when it has been supported by a code monitoring committee of which the majority of members are completely independent of infant formula companies. The code bans advertising to the general public, except under the control of the health care system, and controls advertising to health professionals themselves.
The committee considers complaints against the code, which are rarely numerous and are often from pressure groups. Few of the complaints are upheld. Since the adoption of the code, baby milk manufacturers themselves have taken further steps to control their marketing by banning the free supply of infant formula and subsidised supplies to the health service from 1989 onwards. Much of what is contained in the EC directive merely goes to formalise what has been to date an informal voluntary code of practice.
It is particularly sad, therefore, that the draft UK regulations to implement this directive which come into force in June go beyond what is either necessary or desirable, and my concern is shared almost across the
Column 355board by the baby milk industry, health care professionals and, most importantly, by the consumers--that is to say, the mothers themselves.
In seeking to ban advertising both to mothers themselves in health journals and to the wholesale and retail trade, the draft regulations are an affront to free trade, anti-competitive and, above all, a denial of a mother's right to free choice and free information. The bottom line is that mothers need information to allow them to make informed choices about how to feed their infants.
Within the current UK code of practice, it is possible for manufacturers to advertise their formula brands to mothers, provided that such advertisements appear in specialist maternity and mothercraft publications which are already distributed within the health care system. Parents can obtain information about infant feeding from a number of different sources- -health professionals, the Government, specialist organisations and, of course, the manufacturers of baby milk themselves.
All those sources of information have an important role to play in providing suitable information to ensure an informed choice. Since the voluntary code was introduced in 1983, the Government have spent roughly £26,500 a year to promote breast-feeding through the national breast- feeding initiative. That total sum translates into a yearly figure of 33p per baby.
In contrast, baby milk manufacturers currently provide a service to health professionals and mothers by providing information about infant feeding, including both breast and bottle-feeding. They do so through leaflets, sponsorship, the training of health professionals, advertising, videos and customer health lines. It is said that the majority of the services they offer are currently offered under the control of the health care system. In all, it is estimated that the industry hands some 5 million educational leaflets a year to roughly 800,000 mothers.
The proposed legislation limits the provision of educational information material to parents and health professionals. Manufacturers will often find that they are no longer able to provide the variety and depth of information and material that can currently be found. Perhaps my hon. Friend the Minister can tell me what plans the Government have, given the mass exodus from the information and educational market that will probably take place if the regulations are enforced, to provide the additional information that will be necessary for mothers and health professionals in order to fulfil the obligations contained in the EC directive to
"provide objective and consistent information"
about infant feeding.
Mr. Morley : On a point of order, Mr. Deputy Speaker. I regret making a point of order, but I understand that it is a convention in the House that Members who have an interest declare that interest when they speak on a matter which relates directly to it. I have listened carefully to the hon. Gentleman, but I have not heard him declare his interest in Sterling Marketing, of which I understand that he is a director, and which is involved in advertising and
Column 356marketing. The debate has some relevance to advertising and marketing. I wonder whether you could give us some guidance on that point.
Mr. Faber : I am happy to put the hon. Gentleman's mind at rest. Sterling Marketing is not involved in advertising in any way. It produces mail order brochures and has absolutely nothing to do with either the infant formula market or the marketing of any good, let alone advertising. It produces mail order brochures for retail products. I have no connection with Sterling Marketing since I left it, except that I remain a shareholder.
What are the key factors that affect a mother's choice whether to breast- feed ? They are rooted in deep-seated personal preferences and advice from family, friends and health professionals, and social factors. Since 1983, when marketing controls were introduced, the proportion of mothers who breast-feed to mothers who bottle-feed has barely altered.
In 1980, before the introduction of the 1983 voluntary code of practice, the breast-feeding rate among the population was 65 per cent. According to a written reply by the Under-Secretary of State for Health, my hon. Friend the Member for Bolton, West (Mr. Sackville), to the hon. Member for Newcastle-under-Lyme (Mrs. Golding) on 3 February, the figure was again 65 per cent. in 1985. After the 1988 voluntary ban on free samples, the latest Government-reported breast-feeding rate in 1990 was 64 per cent.--a drop of just 1 per cent.
In a complex psychological process, in which rationality often conflicts with emotion, up to a third of mothers choose to bottle-feed from the outset, while many more make a token gesture to breast-feed before giving up. More than half of all mothers feel comfortable and confident about bottle-feeding their baby, but the irrefutable fact remains that breast- feeding is the best option to adopt.
The Government's report "Infant feeding 1990" gave the top seven reasons that mothers gave for bottle-feeding. They were : so that other people could feed the baby, the mother's previous experience, that the mother disliked the idea of breast-feeding, embarrassment, to see how much milk the infant had drunk, medical reasons and an expectation of a quick return to work. Advertising of infant formula was not given as a reason why mothers chose to bottle-feed rather than to breast-feed.
I am happy to say that fathers, too, are responsible for influencing the feeding method. In 1992, independent research showed that fathers were found to have a high level of interest and involvement in the feeding process. Their attitude was likely to be a major influence on the woman's choice of feeding method, second only to her personal inclinations and way above the role of advertising.
What is the role of advertising within the infant formula industry ? Infant formula advertising in this country does not promote bottle-feeding over breast-feeding. It provides information to allow mothers to make an informed choice
Column 357about what to feed their infant should they choose to bottle-feed. In all current advertising, manufacturers already stress the superiority of breast over bottle-feeding. That will be further strengthened by the requirements of the European Community directive.
It is clear that the key reasons why infant formula manufacturers advertise --operating under the code of practice--are to provide information and to compete against other brands of infant formula, but not to promote bottle- feeding over breast-feeding.
A survey undertaken by the independent research company Market Trends earlier this year showed that all groups of health professionals vigorously oppose the Government's proposed ban on consumer advertising--64 per cent. of health visitors, 68 per cent. of midwives, 61 per cent. of general practitioners and 60 per cent. of directors of midwifery all disagreed with an advertising ban. The same research overwhelmingly showed that parents want infant formula advertising, and most certainly do not want a ban on consumer advertising--88 per cent. of all mothers said that they did not want a ban, 74 per cent. of mothers who breast-feed only do not want a ban, and an astonishing 90 per cent. of mothers who both breast and bottle-feed did not support the proposed ban.
As well as depriving mothers of freedom of choice and free access to information, the draft regulations represent overpowering restrictions on free competition, and will discriminate against United Kingdom consumers and manufacturers by inhibiting free competition between companies and countries.
A ban on advertising will effectively freeze the present market situation in the UK, and manufacturers are likely to be faced with a static market, with roughly the proportions of market share that they currently hold.
Research and development in the field of infant nutrition is expensive and time-consuming, but leads to real and significant improvements in baby milk products, bringing them ever closer to breast milk. Unless manufacturers are able to make consumers aware of the differences and advantages of choosing one infant formula over another, there is little incentive for them to innovate and produce new products.
A ban on consumer advertising and the proposed restrictions on labelling information may mean that the rate of research and development slows down dramatically as manufacturers are simply unable to obtain any further benefits from it.
The proposed ban within the draft regulations on advertising to the grocery and drugstore trade will deny industry an important communication channel with its distributors. Trade advertising does not promote infant formula to consumers, but it serves to make retail outlets more aware of infant formula products that they may wish to stock. About 39 per cent. of all infant formula is sold through grocery outlets, and if a significant number of retailers are not permitted to have information about infant formula products, there is likely to be a reduction in the number of outlets that stock that formula.
Can my hon. Friend the Minister tell me of one other legal product that is freely and openly sold where such a ban on advertising is in effect ? At a time when the Government, whether rightly or wrongly, refuse to ban the advertising to consumers of tobacco products, does he not think it ironic that we should be discussing a much more restrictive type of ban on, of all things, baby milk ?
At a time when we are increasingly aware of the
Column 358so-called level playing field in Europe and progressive deregulation here at home, why do the Government seek once again to go beyond what is proposed by Brussels ? In January this year, my right hon. Friend the Minister of Agriculture, Fisheries and Food, in a consultation document on the deregulation of the food industry, outlined the criteria for introducing new legislation. Does the proposed legislation go further than is necessary ? What is likely to be its impact on business, has industry been adequately consulted, and what does it think ?
The legislation goes further than is necessary and will not achieve its stated aim of promoting and protecting breast-feeding. The regulations attempt to introduce extra rules and regulations that go way beyond the EC directive and will be of benefit to no one, least of all the mothers.
I think that I can anticipate one aspect of my hon. Friend's reply--that these are draft regulations and we are still in a period of consultation. I can only say that I hope that he will take this as one further submission, as part of that process, in addition to the many submissions opposing the regulations that he has already received. Perhaps my hon. Friend would also like to consider the words of my right hon. Friend the Prime Minister on "BBC News" on 3 December in Brussels, when he said :
"National Governments don't always translate Community Directives into plain rules that everyone can understand. We sometimes add extra rules simply because they seem a good idea to Departments, to advisers, or to pressure groups."
Mothers want information to help them make an informed choice about what to feed their babies should they choose to bottle feed. They should not be made to feel that they are in some way doing something wrong or nasty if they are unable or unwilling to breast feed. I believe that it is right to leave the last word to a mother who wrote to the Daily Mail just last month :
"When I became pregnant with my little boy . . . I intended from the start to breastfeed him. But when Jordan was born, much to my dismay I found it extremely difficult--and for him the whole experience was very distressing. After four days of unsuccessful attempts, I reluctantly agreed to put Jordan on bottled milk and the result was fantastic : a much happier baby and a more relaxed mum . . . but at the time I felt extremely guilty and a complete and utter failure as a mother.
Hundreds of women are faced with a similar problem. Like me, they start out with good intentions, but after the birth of their child they find breastfeeding impossible. They are getting very negative messages from the Government about their ability as mothers." I very much hope that my hon. Friend will take this opportunity tonight to send out a more positive message to all of those mothers.
The Parliamentary Secretary to the Ministry of Agriculture, Fisheries and Food (Mr. Nicholas Soames) : I am grateful to my hon. Friend the Member fo Westbury (Mr. Faber) for raising this subject. It is a tribute to my hon. Friend that he should be surrounded this evening by his supporters and friends who have come to hear him debate the matter in such a formidably well-informed manner. I congratulate him on the clear, sensible and entirely reasonable way in which he put forward his case. This matter raises the most extraordinary heat on both sides of the argument and I know that there is currently a great deal of interest in it.
We issued proposals for United Kingdom regulations implementing the directive in December 1993. Since then, I have received a large number of letters from hon. Members about our proposals. We have had a good
Column 359response to our consultation exercise and, far from being cynical, my hon. Friend was perfectly right when he said that we are still in a period of consultation. He may rest assured that what he has said tonight will be a very important part of that consultation, and we will certainly treat his speech as a submission.
I do not want to jump too far ahead, so I will return to consultation later. Before I deal with the points that my hon. Friend has raised, I am sure that it will be helpful to set out for the House the background to this issue.
As my hon. Friend is aware, the World Health Assembly has adopted an international code of marketing of breast milk substitutes drawn up by the World Health Organisation. The aim of this code is to contribute to the provision of safe and adequate nutrition for infants by the protection and promotion of breast feeding and by ensuring the proper use of breast milk substitutes.
The Government are fully committed to action to improve breast feeding rates ; it is one of our undertakings in relation to the "Health of the Nation" initiative. Individual countries were left to decide how best to implement the World Health Organisation's recommendations in their own territories. The United Kingdom Government decided that it could best be done through industry self-regulation and, following consultation with interested parties, a voluntary code of practice came into being in 1983 to give effect to the aim and principles of the World Health Organisation code. To complement this, the health departments in the United Kingdom provide guidance to health authorities and health professionals which draws attention to the aims and principles of the WHO code, the voluntary industry code of practice, the establishment of a code monitoring committee, and the responsibilities of health care professionals. That is the system that has operated in the United Kingdom for the past 10 years.
In the mid to late 1980s, the European Community started to interfere, frankly, and to consider the introduction of European Union legislation. In 1991, it adopted directives on the composition, marketing and export of infant formulae and follow-on formulae. I want to stress two points to my hon. Friend. First, although the EC directives are intended to implement the aims and the principles of the WHO code, they do not adopt its provisions in every detail. As with all EC measures, a consensus had to be reached to reflect the vastly differing views and practices of the various member states. The second and more important point is that the United Kingdom is required to implement the terms of the EC directive, not the WHO recommendations. In the usual way, therefore, the Government have considered the terms of the EC directives and have drafted regulations to give them effect in the United Kingdom. As I said earlier, those draft regulations were sent out to interested parties early in December 1993, and comments were invited on the proposals. I should like to make it absolutely clear to my hon. Friend that there has been overwhelming support for the majority of the provisions proposed in the draft regulations. There has been a unanimous welcome for compositional requirements--infant formula is the sole
Column 360source of nutrition for babies who are not breast-fed--and for labelling provisions that embody in statute that breast milk is without equal for infants in the first months of life.
Advertising is the one area on which opinion has been polarised. My hon. Friend has rightly identified that issue, and spoke about it sensibly. The manufacturers have complained that what the United Kingdom has proposed goes beyond the minimum requirements of the directive, is unnecessarily restrictive and does not conform with the Government's deregulation initiative.
I listened with great care to what my hon. Friend said about deregulation, the assurances given by the Prime Minister, and the entire thrust of my Ministry's legislative programme--to introduce regulation as a last resort. I must acknowledge that the latter point has struck a number of the hon. Members who have written to me, as it has struck me most formidably. I want to assure my hon. Friend that the decision will eventually be taken against that background as well as on all the other arguments.
I must also inform the House, however, that a large number of those who responded to the invitation to comment on the regulations were not only in support of the proposed advertising restrictions, but in some extraordinary way wanted them to be even more restrictive. They even went so far as requesting a total ban on advertising. They also want the advertising restriction to apply not only to infant formulae but to follow-on formulae. It is true to say that many of those letters were co-ordinated in a write- in.
It is right to consider what we are required to implement in the United Kingdom. Article 8 of the EC directive says :
"Advertising of infant formulae shall be restricted to publications specialising in baby care and scientific publications. Member states may further restrict or prohibit such advertising." The directive also adds :
"Such advertising shall contain only information of a scientific and factual nature."
Regulation 17 of the draft United Kingdom regulations says : " No person shall publish or display any advertisement for an infant formula except in a publication specialising in baby care or in a scientific publication of which, in either case, the intended readership is one of independent persons qualified in medicine, nutrition or pharmacy or having a professional qualification in maternal or child care."
As my hon. Friend has speculated, the wording of the United Kingdom regulations goes further than the minimum restriction in the directive, in that it restricts baby care publications to those with an intended readership of independent health care professionals. As I pointed out earlier, however, the directive allows member states to introduce further restrictions of their own.
Unequivocal medical advice has consistently supported breast feeding as the best way of feeding a baby. Restrictions on the advertising of infant formula have been developed to encourage mothers to give their children the best possible nutritional start in life. Given the health arguments in favour of breast feeding, we thought it right to explore the possibility of going further than the minimum required by the directive.
Other factors have to be taken into account when considering that possibility. Under the terms of the industry's voluntary code of practice, advertising in general baby care magazines read mainly by mothers and pregnant women is not permitted, although advertising is permitted if the magazines are distributed within the health care system. If we adopt the minimum laid down in the directive, it would appear to allow advertisements to be
Column 361placed in generally available baby care magazines. Should the UK regulations be less restrictive on advertising than those restrictions voluntarily adopted by the industry ?
I am aware of the survey carried out by Bounty earlier this year on the proposed advertising restrictions. It has been suggested that the United Kingdom is the only country which is being more restrictive than the directive requires. We have made inquiries about other member states' intentions, and we await replies from some of them. However, from the information that we have received, it would appear that some countries-- Italy, the Netherlands, Portugal and France--intend to use the option in the directive to introduce restrictions beyond the minimum laid down in the directive.
That is obviously something which the Government would wish to consider extremely carefully when finalising the regulations. My hon. Friend said, and it is correct to assume, that, were an advertising ban to go through, we would, in my view, be in the not entirely satisfactory position of needing to make available the information that mothers need, solely through the voluntary sector. That is not necessarily a position in which we would wish to find ourselves.
My hon. Friend made another argument in relation to the advertising restrictions. The restrictions currently adopted voluntarily by the industry apply only to advertising aimed at the purchasers of the products. That is mainly mothers and pregnant women. The restrictions do not apply to the manufacturers' advertising to wholesalers and retailers.
However, the industry believes, and I have to say that it is correct, that the draft regulations would prohibit manufacturers from advertising to the trade, and that the ban would include leaflets and circulars, conference displays and other forms of communication. I am well