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Dr. Richard Taylor (Wyre Forest) (Ind): I have not read the report, and I regret that I am now rather more confused than I was. I still cannot see a fair way of allowing extra payments from those who can afford them. To avoid the need for that, will the Secretary of State revisit better care, better value indicators, which alone would save the NHS £2 billion per year? That could be added to the money available to NICE so that it could pass many more drugs.
Alan Johnson: I respect the hon. Gentleman’s judgment on this matter, and perhaps we should have a meeting with Mike Richards to talk this through. The primary point is not about what we will do—we will do many things, including make more drugs available—but about what we will not do: we will no longer withdraw that NHS treatment.
There is a second point: no party, not even the Conservative party, which has its weird and wonderful moments, is arguing that the NHS must pay for every drug that comes on the market. We could never do that. Despite making more drugs available, in some circumstances a few people—even fewer after we have implemented the proposal before us—will face the dilemma of having to pay for a drug that is not available on the NHS. We believe, therefore, that the principle of separate care, as proposed by Professor Richards, is the right way to proceed.
David Tredinnick (Bosworth) (Con): First, does this mean that a patient being successfully treated by a traditional Chinese medicine practitioner, using herbs and acupuncture, will have their costs paid by the NHS? Secondly—
Mr. Deputy Speaker: Order. I am trying to ration time, so hon. Members may ask one question only, I am afraid.
Alan Johnson: I am afraid not.
Andrew George (St. Ives) (LD): Can the Secretary of State reassure me that the NHS will use its procurement muscle when negotiating, especially in regard to what he described as the new and more flexible pricing arrangements, which will enable “drug companies to supply drugs to the NHS at lower initial prices, with the option of higher prices if value is proven at a later date?” Will that be a one-way street? In other words, if the value is not proven, or if more drugs are purchased than anticipated, will the price go down?
Alan Johnson: That is a question for NICE in deciding how to operate the system. Currently, drugs companies come in with a price at the beginning and cannot alter it, but under a value-based system they could come in with a lower price and then argue for a higher price later.
Andrew George: But can it go down?
Alan Johnson:
I shall take advice from NICE on that, but I doubt it. The whole point is to have a voluntary, rigorous agreement. Drug companies have agreed to a 5 per cent. reduction in drug prices with a further 2 per cent. reduction in prospect. It is a great tribute to them that they have entered negotiations and that they are
proceeding so successfully. I reassure the hon. Gentleman that a robust negotiating system will be put in place, but at the end of the day it is up to drugs companies to seek to make a drug available and to put it through the NICE process. It must be voluntary. We cannot proceed otherwise.
Dr. Julian Lewis (New Forest, East) (Con): The Secretary of State said in his statement that only a small number of people have had to pay privately for these top-end drugs. Will he indicate how many people have had the NHS entitlement withdrawn and can he think again—
Mr. Deputy Speaker: Order. I appeal to the House. We have other important business to reach. The Secretary of State’s answers are lengthy, in an attempt—I am sure—to help the House, but if I am to get everybody else in we must move more quickly.
Alan Johnson: Mike Richards says that not enough evidence or information is available—one of his recommendation is that my Department gets more. He quotes the Joint Collegiate Council on Clinical Oncology, which carried out an online assessment and concluded that about half of those patients refused a drug go on to pay for it. Incidentally, 15,000 people a year go through the process and two thirds have the drugs approved by their PCT. However, not even Professor Richards thinks that that is very robust. We need to do more work to get an accurate picture.
Greg Mulholland (Leeds, North-West) (LD): I commend this positive step and remind the House of the heroic Jane Tomlinson, who did so much for charity but could not access the drugs that she needed.
May I ask the Secretary of State a practical question about the ever-changing medicines available for people who are terminally ill? NICE often takes time to make decisions and decisions on what the NHS will fund often change, so will the Secretary of State say whether, if someone starts to pay for treatment straight away—clearly,
if they medically need to do so, they should—they will get their treatment refunded, if, at the end of the process, it is recommended that the NHS should fund it?
Alan Johnson: The decisions do not apply retrospectively. A NICE decision applies from the time at which it takes effect. In terms of the additional care that we are talking about, when NHS care is withdrawn from a patient in those circumstances that comes into effect immediately.
Mr. Graham Stuart (Beverley and Holderness) (Con): The Labour party of Nye Bevan is gone and there are few Labour MPs to mourn its passing. Why will my constituents have to pay thousands of pounds to receive cancer drugs that are routinely available elsewhere? Why will they be wheeled down the corridor to a designated private room in an NHS hospital? Is it because of the Labour Government’s failure to manage budgets properly?
Alan Johnson: I shall take that question as an audition for the Royal Shakespeare Company and treat it with the contempt it deserves.
Mr. Paul Burstow (Sutton and Cheam) (LD): Speedier NICE appraisal decisions are essential but they are not sufficient. We also need more transparency and accountability in NICE decisions. In the light of the Law Lords’ decision to refuse permission to NICE to go to appeal on the dementia drug case decision, will the Secretary of State now put it beyond doubt that he expects NICE to place all the models it uses in respect of decisions on appraisals into the public domain?
Alan Johnson: That is an issue for NICE. It needs to comply with the court judgment. This is not the end of the story about NICE, as I hope to make fresh announcements early in the new year. Perhaps we will return to the subject then.
Food Labelling (Nutrition and Health)
5.1 pm
Helen Southworth (Warrington, South) (Lab): I beg to move,
That leave be given to bring in a Bill to require simple, uniform nutritional labelling on the front of packaged foods; and for connected purposes.
In our busy lives, even with the huge improvements to the labelling of packaged food since I first tabled a food labelling Bill four years ago, we often shop in a hurry. We do not have time to stop and study labels in detail, or we might just not have very good eyesight. We need to be able to compare and choose healthy options easily and simply. Front-of-package labelling that gives at-a-glace information about how much fat, sugar and salt different foods contain is crucial for shoppers.
The Co-operative introduced front-of-pack labels 10 years ago and was one of the first retailers to sign up to the Food Standards Agency’s traffic lights scheme. Co-op customers say that they find front-of-pack traffic lights simple and straightforward and this year the Co-op decided to include them on all products, with a few exceptions. Fruit and vegetables will have nutritional information without colour coding, because the health message in their case is the importance of five-a-day.
Sainsbury’s uses multiple traffic lights on almost 5,000 of its own brand products and has found a strong recognition—93 per cent.—of the label among customers. Customers use the labels to choose sandwiches and healthy meals so that they can get healthy. The company is aiming for fewer red traffic lights by reducing salt, sugar, fat and saturated fats and removing all hydrogenated fats from its own brand products. Sainsbury’s is being led by its customers, as 63 per cent. of them said that multiple traffic light labels were helping them to eat more healthily.
Asda has a combination food labelling system. The traffic light approach was the option requested by customers and Asda has received hugely positive feedback since introducing it. The labels include guideline daily amounts and are designed to be read and understood in less than two seconds.
Many other retailers and manufacturers including Boots, Marks & Spencer, Waitrose, McCain, Virgin Trains, National Express and YO! Sushi are using the FSA’s multiple traffic light scheme. Other retailers have responded to customers’ desire for quick, easy-to-see information by designing other labelling schemes using guideline daily amounts.
Tesco’s label also includes a pastel colour code for each main ingredient. At Tesco, too, front-of-pack labelling has driven changes in product content. In the last 12 months, salt levels have been reduced in more than 200 products and fat has been cut in more than 150 products. The introduction of front-of-package labels by a wide range of retailers is giving people much more control over what they eat.
Why, therefore, do we need simple, uniform nutritional labelling on the front of food packaging? In the words of the Government Office for Science,
“Britain has become a nation where overweight is the norm”.
The office predicts that, on current trends, within 40 years half of adult women, two thirds of adult men and a
quarter of all children could be obese—and obesity increases the risk of a range of chronic diseases, especially type 2 diabetes, stroke and coronary heart disease, cancer and arthritis. Today, more than 2 million people over 18 are registered with their GPs as having diabetes, and nearly 2 million have coronary heart disease.
Back home in Warrington, more than 8,000 people are on the patient register with diabetes and nearly 8,000 with coronary heart disease. That means that there are 16,000 people and their families in my home town with a very urgent need to know how much salt, sugar and fat their food contains, but we all want to be able to take control of what we eat and to know what is inside the packaging, and everyone needs to be able to access that information. Those who cannot read too well or calculate percentages—or people who are in a hurry—also need to know that information, and not just people who can understand complex variants.
The Food Standards Agency has commissioned a major piece of work on comprehension and use of the UK’s nutrition signpost labelling schemes. The interim report published this September found that customers like front-of-package label schemes and use them to make choices, but that various issues were causing confusion for some customers.
The FSA report said that people were confused about what the colours in traffic light labels meant, and about whether there were different guideline daily amounts for different people according to gender, age and body type. It found that people were uncertain about how GDAs related to portion size and the mathematical calculations that were needed, as well as about the meaning of the GDA pastel colours and the percentages involved. They were even confused about what the acronym “GDA” meant.
Those confusions have to be resolved in a simple system that meets the need of all consumers. Which?—formerly known as the Consumers Association—is absolutely clear about what needs to be done:
“If consumers are going to improve their diets, they need to be provided with information that helps them to make healthier choices. The Food Standards Agency is carrying out extensive research to establish the best labelling approach for achieving this. The food industry needs to give their customers a helping hand by adopting the approach that works best”.
Over 14 million ready meals are eaten each week in Britain. Last summer, Which? bought all the cheese and tomato pizzas, beef lasagnes and chicken tikka masalas that it could find in the main supermarkets. For each type of meal, it compared the fat, saturated fat and salt content. It found that people could eat five times as much fat and more than three times the amount of salt, depending on which brand of lasagne they bought. Some pizzas had seven times as much salt as others, and five times as much fat. A curry could have three and a half times the amount of saturates or more than four times the amount of salt per 100 g, depending on which chicken tikka meal was chosen.
That may sound funny, but 30 per cent. of deaths from coronary heart disease and around one third of cancers are believed to be down to diet. When the FSA publishes the results of the full research project on UK nutrition signposting labelling schemes next year, the food industry must respond with simple, uniform nutritional labelling to enable people to choose healthy food.
This Bill has the support of the British Medical Association, which has stated:
“The British Medical Association has a long-term interest in the health of the public and believes that the increase in the frequency of obesity is a cause for great concern. While tackling obesity requires commitment to a multi-faceted approach, there is a particular need to change dietary behaviour. The BMA considers improved and consistent food labelling to be an important mechanism for enabling consumers to make informed dietary choices”,
and for that reason it welcomes this Bill.
The British Heart Foundation says:
“Poor diets are creating a massive burden of ill health in the UK, including by contributing to several key risk factors for the development of heart disease, such as obesity and high blood pressure. To help reverse this trend, we believe that people must be provided with clear information about the food which they eat in order to encourage them to make healthier choices.
BHF therefore strongly supports the principle behind this debate. It is essential that all members of the food industry agree to abide by the recommendations of the Food Standards Agency on which single form of front of pack labelling should be adopted”.
Diabetes UK supports the intention of this Bill, saying:
“We believe it is vital that a universal nutrition labelling scheme is introduced to enable consumers to make informed choices about their diet”.
“After not smoking, keeping a healthy weight is one of the best ways to reduce your risk of cancer.”
Researchers have estimated that more than 13,000 cases of cancer could be avoided every year if everyone maintained a healthy body weight. The plethora of signpost labelling schemes used by retailers and manufacturers inevitably results in consumer confusion. It is important that the labelling scheme that works best for consumers is adopted and championed across the food industry.
In just the past week, 100 MPs have supported my early-day motion, which calls on food retailers and manufacturers to end the confusion caused by the proliferation of different schemes, and to commit to
adopting whichever single labelling approach is found by the Food Standards Agency to perform best for consumers.
The last word goes to James, aged 63, via the Royal National Institute of Blind People:
“I've been trying to eat more healthily since my GP warned me about my high blood pressure. Even with my magnifier I find it difficult working out how much fat and sugar any product had. I wish they’d stop worrying about their branding and start worrying about me their customer.”
I ask the House to support the Bill.
Bill ordered to be brought in by Helen Southworth, Mr. Kevin Barron, Charlotte Atkins, Jim Dowd, Stephen Hesford, Christine Russell, David Taylor, Dr. Howard Stoate, Mrs. Janet Dean, Dr. Doug Naysmith, Mr. Paul Burstow and Mr. David Amess.
Food Labelling (Nutrition and Health)
Helen Southworth accordingly presented a Bill to require simple, uniform nutritional labelling on the front of packaged foods; and for connected purposes: And the same was read the First time; and ordered to be read a Second time on Friday 14 November, and to be printed [Bill 157].
DELEGATED LEGISLATION
Motion made, and Question put forthwith, pursuant to Standing Order No. 118(6) (Delegated Legislation Committees),
That the draft Local Elections (Ordinary Day of Elections in 2009) Order 2008, which was laid before this House on 7th October, be approved. —[Ms Butler.]
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