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16 Jan 2008 : Column 282WH—continued

UNICEF says that two main loopholes in the current law allow such advertising to happen. The first loophole is that advertising formula for babies under six months is banned, but advertising it for babies over six months is allowed. By ensuring that their milks for younger and older babies are almost identical, manufacturers also ensure that an advert for one automatically promotes the other. Secondly, to prevent information materials for parents from being used to promote specific products, the current law prohibits companies from putting formula milk brand names on information that they give to mothers. However, they are allowed to put their company logo on it. By changing their logos and milk brand names to be near-identical, companies have ensured that their information materials can continue to promote their milks. As names and logos on information materials
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have therefore become both legal and illegal at the same time, it has become impossible for trading standards to enforce the current law.

Those weaknesses have been recognised at European Union level and in 2006 a directive was passed—directive 2006/141/EC—to tighten European-wide law. Of course, the Minister’s new regulations will transpose that tightening of the law into our domestic law. The regulations, along with new guidance that she proposes to publish, aim to tighten our law in respect of the labelling and advertising of infant formula. In addition to those regulations and the guidance, the Minister promises a review of how the changes are operating 12 months later. It is in respect of that review that the point raised by the hon. Member for Mid-Dorset and North Poole becomes relevant.

Before I explain why I am arguing that the Minister is not going far enough, let me acknowledge and welcome all that is being done in other ways to improve our country’s breastfeeding rates. For example, the Department of Health is demonstrating a good, strong commitment to delivering widely education and information that is necessary to help parents make an informed choice in favour of breastfeeding their children. Examples include greater engagement with the relevant stakeholders, support for the national breastfeeding week in May and the Department’s stated intention of making its national breastfeeding week promotions year-round. Another example is the new National Institute for Health and Clinical Excellence guidance on antenatal and post-natal care, which is very positive about the role of breastfeeding. That is underpinned by the national service framework for children and maternity services and aided by the UNICEF baby friendly initiative.

The Government have given the Department of Health a public service agreement target for improving child health and well-being, which is very welcome, and there is now an indicator regarding the prevalence of breastfeeding at six to eight weeks. Also, regarding the wider Government position, consultation on the single equality law has shown a welcome determination to protect parents who feed their babies in public places from discrimination.

With that background of good work, it is a pity that the new regulations fall short of implementing the World Health Organisation code. Many argue that failing to do so will mean that mothers’ and children’s health will continue to be put at risk. I ask Members to consider this: follow-on formula is suitable only for babies over the age of six months, say the manufacturers and distributors, but the confusion caused by the marketing ploys that I have described creates the risk of babies under six months being inappropriately fed follow-on milk. Fourteen per cent. of parents say that they have given babies under six months of age follow-on formula, which is dangerous and can cause serious infections.

It is for those reasons that the Minister recently received an open letter from the relevant royal colleges describing “serious shortcomings” in her proposed approach. I believe that her own scientific advice, from the Scientific Advisory Committee on Nutrition, and advice from local authorities, which are responsible for
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upholding and enforcing the law through trading standards, is calling for stronger and more straightforward measures. For those reasons, I urge the Minister to go further than the regulations currently propose and implement in full the WHO code.

I gather that the trade body representing some of the manufacturers and distributors has sought to challenge the new regulations by way of a judicial review application. I believe that I am right in saying that the introduction of the proposed regulations has been suspended. Naturally, we cannot discuss the court case, because the matter is sub judice, but does the Minister accept that this new development would give her time to consider the arguments that I and many others are putting forward for an altogether more robust change in the law? Furthermore, will she agree to meet me and representatives of the Breastfeeding Manifesto Coalition to discuss the case for a tougher approach?

It is trite for politicians to claim that it is the measure of a society’s compassion, reasonableness or good sense that it treats one particular group of society better; Winston Churchill said that the measure of our society is how we treat prisoners, for example. However, there is no stronger test of a Government’s mettle than how we as a society take care of the well-being of our children—youngsters who, because of their age and lack of maturity, are unable to speak up for themselves and defend their own interests. They are the people we need to invest in as tomorrow’s generation of decision makers, wealth creators, upholders of the law and so on. It is, therefore, a good test of the Government’s resolve that we do all we can to ensure that children are safe and protected at the most vulnerable time of their lives, when they have just been born and are gaining weight and the knowledge and health that will secure their development throughout their childhood and probably influence the whole of their lives.

I hope that those points are well made to the Minister, and I look forward to hearing her response to them.

11.18 am

The Minister of State, Department of Health (Dawn Primarolo): . May I congratulate my hon. Friend the Member for Stafford (Mr. Kidney) on securing this important debate, thus giving me an opportunity to clarify the Government’s position and explain why I do not agree with the points that he made about a lack of resolve on the Government’s part? I absolutely congratulate him on his fantastic work in Parliament as a champion of the breastfeeding manifesto coalition, and I concur entirely with the points that he made about the importance of supporting, encouraging, protecting and promoting breastfeeding, in the interests of giving all infants the very best start in life. I will not go over the many eloquent points that he made about the important contribution that that makes to children’s development.

My hon. Friend acknowledged that not all mothers choose to, or are able to, breastfeed and that it is vital both that bottle-fed babies are protected and that mothers are in the best possible position to make informed decisions about feeding choices for their babies. The Government are developing an agenda on two fronts. Our central policy is to encourage, promote,
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protect and support breastfeeding mothers. We want to ensure that mothers who choose not to breastfeed or who cannot do so, receive the best advice so they can choose what is best for their babies without other people interfering in those decisions or causing confusion. For those reasons, we have placed stricter controls on the promotion, labelling and composition of infant and follow-on formula.

The main points made by my hon. Friend and the coalition concerned follow-on formula, and I concur entirely, because parents tell us that the available information is confusing. We recognise that advertisements for follow-on and infant formula may provide confusing advice about what is appropriate for infants and can be misinterpreted by parents. The hon. Member for Mid-Dorset and North Poole (Annette Brooke), who has been very active in this campaign, touched on that point. Let me make the position absolutely clear: the Government are determined to take tough action to stamp out those practices and to prevent marketing activity that directly or indirectly undermines breastfeeding. We are acting on evidence suggesting that consumers in the UK cannot clearly differentiate between infant and follow-on formula when purchasing those products.

As my hon. Friend pointed out, maternal and infant support groups have brought the issue to our attention. I have had many meetings with different organisations about press and TV adverts on follow-on formula which, they believe, undermine breastfeeding. In the guidance issued alongside the regulations, we have explicitly taken up every example that was put to us and said, “This is not acceptable, and action will be taken.” There have been complaints about the industry seeking to bypass restrictions on the direct advertising of infant formula by the way in which it labels infant and follow-on formula, and advertising follow-on formula in such a way that it is difficult to distinguish between the two. I absolutely agree. On that basis, following extensive consultation with stakeholders, I have agreed a package of measures that will strengthen controls in this area. The package is made up of effective, proportionate and evidence-based controls, and I am confident it will improve consumer protection and give us a robust system that can withstand challenges, should they be made.

I gave a further commitment, after looking at everything that I received in representations about advertising, to provide guidance. That guidance is now operational, and it shows how the regulations should be interpreted. I have made a commitment, too, to provide an independently chaired review of the new controls after their first year of operation. As I made absolutely clear to the relevant organisations in our private meetings, the review will play an important role in policy making and in assessing whether the new controls work as expected. It will assess whether people have found new ways of getting around the rules or whether they are simply not complying with the rules. If the new arrangements are found not to be working, because they have been circumvented or because new methods emerge, the Government will respond proportionately and take the next step of considering further legislative action. We have therefore put robust measures in place.

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Mr. Kidney: I accept my right hon. Friend’s determination that the combination of regulations and guidance should present a tough position, but I would prefer more emphasis on the regulations and less on the guidance. I have seen the first draft of the Food Standards Agency’s suggestions for the review, and they seemed to be limited to the issue of whether the new position will reduce confusion between formula and follow-on. That remit seems far too narrow. Will the final review be every bit as broad as the Minister has just described?

Dawn Primarolo: I can assure my hon. Friend that the review will be every bit as broad as I have suggested. I am sure that he will recognise, both from his parliamentary experience and from the work that he did before he was elected, that Governments must always proceed in a proportionate way. Stepping outside that process can bring other complications that slow down progress.

I am convinced that, with the new regulations, we have put in place a response that is proportionate and will deliver the objectives which were eloquently described by my hon. Friend and with which I agree. I am determined to work with the industry and non-governmental organisations to ensure that that is the outcome, given the need for clear imperatives that he set out. We all want—it seems like a no-brainer—the best advice on providing a healthy start for our newborn babies and children in the earliest months and years of their lives, and I am determined to ensure that we provide that advice.

We support the international code of marketing of breast milk substitutes, and the subsequent amendments made by the World Health Assembly resolutions. My hon. Friend knows that the code makes a broad set of recommendations on labelling, the functioning of health care systems and the corporate responsibility of formula companies, and I can assure him that I am taking all those matters forward. The directive provides increased consumer protection in comparison with previous legislation, but we must ensure that it works, and I shall do so.

My hon. Friend touched on the Department’s present and planned initiatives further to improve breastfeeding rates across England. I have met and corresponded with the relevant non-governmental organisations. Clearly, I would like to be where they are and not where I am, but I am where I am. I have an opportunity to do what I can, and I am doing it as fast as I can. I am trying to deliver all our objectives in a reasonable way, but I am happy to meet them and others to take that work forward. My hon. Friend will be aware that a High Court order has been made, and that there has been a disagreement over the timetable for the provisions to come into force in England and Wales. The order has been suspended until a hearing of the substantive application for judicial review, which is due to take place at the end of February. I am disappointed about that: we will fight the case, because the Government’s priority is to ensure that infant and follow-on formula are clearly labelled, so that parents and carers who wish to use those products do so correctly. I am more than happy to continue my meetings with my hon. Friend and others when I know the outcome of the case to discuss the review and the future of the regulations.

11.29 am

Sitting suspended until half-past Two o’clock.

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Pakistan (Terrorism)

2.30 pm

Mr. Tobias Ellwood (Bournemouth, East) (Con): It is a pleasure to begin this important and topical debate on Pakistani-based terrorism. Indeed, considering recent events, there is terrorism not only in Pakistan but in the United Kingdom, as well as in other recent attacks across the globe. Unfortunately, we can now see a common denominator in the attacks of 9/11 and 7/7, and those in Madrid and Bali, not to mention the frequent insurgency operations in Afghanistan—the training camps based in the remote mountains on the border between Afghanistan and Pakistan. Sadly, we must now add the dreadful assassination of Benazir Bhutto this Christmas, with 20 others, in Rawalpindi on 27 December.

How did things come to this? Why, six years after the so-called global war on terror, do those camps still exist? What impact does Pakistani-based terrorism have in the UK? Finally, what are we, the Government and the nation, doing about it? Those are the questions that I pose today.

For clarity, I declare a personal interest—I think that the Minister is aware of it—in that I lost my brother in the explosion that took place in Bali on 12 October. It is because I see so little advance in the war on terrorism, if we can call it that, that I am pleased that this subject has been selected for debate.

It is worth reminding ourselves of the background in Pakistan. As countries go, it is a fascinating cocktail of people, religions, languages and customs. If one throws into that a serious boundary dispute with its neighbour, India, a security service—the ISI—that is a power unto itself, a military six times the size of ours, a nuclear arsenal, 70 political parties and the fact that for many years it was on the front line of the cold war, it is easy to see why governance has been such a challenge. Pakistan has 161 million people; it is the sixth most populous country in the world, and it has the second largest Muslim population.

Since independence from British India in 1947, Pakistan has been characterised by periods of instability and dispute. Civilian politics during the past few years have been tarnished by corruption and inefficiency. That has been compounded by alternating periods of civilian and military rule, which have not helped the country’s stability or long-term prospects.

More recently, in October 1999, Pakistan came under military rule once again, when General Musharraf, as he was then, led a bloodless coup to oust the civilian Government. That was widely condemned not only by Britain; it led to Pakistan’s suspension from the Commonwealth. Musharraf inherited many of the problems and challenges that have been besetting the country for years. The biggest problem is the increasing polarisation between Islamist militancy and the modernising secular wing of Pakistani politics.

The challenge is made all the greater given the mountainous area, 200 miles wide and 1,600 miles long, that contains the Durand line. That poorly marked Afghan-Pakistan border—named after Sir Mortimer Durand in the late 19th century by the Foreign Secretary of the British Indian Government—was a way of
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concluding what was called the great game—the conflict between the British and the Russian empires for supremacy in central Asia.

It is important to put things into context. Pakistan is four times the area of the UK, but I should point out the extent—or perhaps the limits—of Pakistani leaders’ influence. State control over a sizeable section of the north-west is, I believe, tenuous, and there are many areas—for example, in Belucistan and Waziristan—that are completely autonomous, in which any rule or recognised authority is absent. Indeed, the North-West Frontier Province is known as the Federally Administered Tribal Areas. They are now the playground for terrorism, and no-go areas for official authorities. In those remote areas, it is easy to take full advantage of the absence of civilised rule with the dominance of tribal power.

Until 11 September 2001, General Musharraf ignored much of what was happening in the mountains. He turned a blind eye to what was going on, hoping that it would not cause problems. After the 9/11 attacks, however, he clearly had to revisit the situation. He made a quick assessment—I believe he was influenced by the amount of military hardware promised to him—deciding that he should change sides and call those people his enemy. He supported the Taliban prior to 2001; only after 9/11 did he join the rest of the world in condemning what they stood for, becoming a key ally of the west.

Unfortunately, the fight continues six years on. The assassination of Benazir Bhutto is a potentially crippling blow to Pakistan’s hopes of emerging in a state of stability. Placed in context, it is easy to see that such high tensions could bring Pakistan to the verge of imploding, unless action is taken. Certainly that is the case now.

However, the seeds of the terrorism were not sown during Musharraf’s time but in the wake of the Soviet invasion of Afghanistan, when religious institutions mushroomed under General Zia’s rule. His idea was to encourage the funding of madrassas, religious seminaries, to create ideological nurseries to motivate people into joining the jihadis and the holy warriors to battle against the Soviets. Of course, once created, they could not be closed, particularly because of their location. That led to a multitude of religious scholars. Today, any radicalised youngster who wants to know more about his religion and who is still asking questions about 9/11 will turn to them. It is estimated that there are 13,000 madrassas in the north-west of Pakistan, and more than 1.7 million people have enrolled in them.

Tony Baldry (Banbury) (Con): Part of the problem in Pakistan is that a pathetically small amount of the national budget is spent on education because so much of it is being spent on defence. With the Government school system collapsing, many parents in the North-West Frontier Province and other parts of the country have no opportunity but to send their children to a madrassa. Until Pakistan gets its basic education system sorted out, it will, sadly, be a country of increasing illiteracy.

Mr. Ellwood: My hon. Friend makes a powerful point. The problem is exacerbated by the fact that Pakistan has a very nervous leader, who has chosen to invest in the military. Pakistan has 700,000 soldiers;
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that is seven times the size of the British Army. That is where the money is going, and it is denying the youth of the country the chance of a proper education. That is where the seeds of the future should be sown. My hon. Friend makes a good point.

Mr. Brooks Newmark (Braintree) (Con): If I may, I return to an earlier point about madrassas. General Musharraf said that he wants to bring about reform. I was in Pakistan last year, and I saw evidence of that. However, the reality is very different. The International Crisis Group said that the reform of the 13,000 madrassas—the number that my hon. Friend mentioned—is now a shambles. Notwithstanding the excellent point made on education, reforming madrassas will not cost money. However, it needs the will to do so, and that will needs to be enforced. That is where the weakness lies.

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