Summary

The UK’s food system—the production, manufacture, retail and consumption of food—is failing. Food should be a source of enjoyment, good health and cultural expression, but there are stark contrasts in the way that people experience the food system in this country. For many people, food is the source of considerable anxiety. Significant numbers of people are unable to access the food they need, let alone access a healthy diet. Billions of pounds are spent each year by the National Health Service (NHS) treating significant, but avoidable, levels of diet-related obesity and non-communicable disease. Although diet-related ill health affects all sectors of the population, its effects are felt more acutely in deprived areas, and considerable health inequalities persist. The food industries, manufacturers, retailers and the food services sector, perpetuate the demand for less healthy, highly processed products. This not only impacts on public health, but also inhibits efforts to produce food in an environmentally sustainable way. The health of the population, and the health of the planet, is at risk. This report makes clear how this situation might be reversed.

The devastating impact of the COVID-19 crisis is likely to have lasting consequences for the economy and for public health. The crisis has exposed the fragility of many people’s economic situation and exacerbated many of the problems relating to poverty, food insecurity and health inequalities that our inquiry examined. The crisis should serve as an urgent wake up call to the Government. People should be able to access not only enough food, but also the food that they need to stay healthy; the food system, and action in related policy areas such as health, welfare and food production, should guarantee this.

The Committee was set up to “consider the links between inequality, public health and food sustainability.” We found barriers at all levels of the food system that make it harder for people, particularly those living in poverty, to access a healthy and sustainable diet. The lack of a unifying Government ambition or strategy on food has prevented interrelated issues such as hunger, health and sustainability from being considered in parallel, meaning that opportunities have been missed to develop coherent policies that could effect widespread change. Our recommendations are built around the central aim of ensuring that everyone, regardless of income, has access to a healthy and sustainable diet.

Key recommendations

The Food and Agriculture Organization of the UN estimated that around 2.2 million people in the UK are severely food insecure (i.e. with limited access to food, due to a lack of money or other resources).1 Until recently, however, the Government has not collected data on this and so does not have an accurate picture of the prevalence of food insecurity. Without a comprehensive understanding of the scale of the problem, neither the root causes of food insecurity, nor the detrimental impact it has on public health and wellbeing can be fully evaluated or addressed. We have asked that the Government commits to detailed and routine monitoring of the levels of food insecurity. That data should be published transparently and be subject to scrutiny to ensure that trends in food insecurity can be linked to wider socioeconomic reforms, and can inform policy in other areas such as public health and welfare so that efforts to tackle food insecurity can be targeted effectively.

The welfare system is failing to prevent situations where people find themselves without the resources to access food. Food insecurity is a consequence of poverty. An estimated 11 million people, including around 2.8 million children, are living in poverty2 in the UK.3 Poverty is characterised by a lack of resources, and for many people, their food budget is the only budget that can be reduced. Although the Government has not, until recently, collected routine data on food insecurity, the existence, and rising use of food banks provides a clear indication of the severity of the problem. Food aid organisations told us that reliance on food banks is increasing. In 2019, the Trussell Trust reported that it had seen a 73% increase in the number of emergency food parcels it has delivered over the past 5 years4. Following the outbreak of the COVID-19 pandemic, the Trussell Trust reported an 81% increase for emergency food parcels from food banks during the last two weeks of March 2020, compared to the same period in 2019.5 The Trussell Trust, and others, have suggested that problems with Universal Credit are one factor in the increased use of food banks.6 Specifically, we were told that many people lack the financial resilience to cope with the five-week wait between making a claim and receiving the first payment of Universal Credit. As a result, some people struggle to afford food, with many going hungry. We are not the first to urge the Government to rethink and replace the current system of the five-week wait but we have added our support to calls to urgently address the long-standing problems with Universal Credit, problems that place people in the vulnerable situation of not being able to afford enough food. The charitable sector is shouldering this burden and although it is providing vital support, the Government should not be relying on food aid to fill the gaps in the welfare system.

People with limited resources to access food often find it hard to access healthy food. Less healthy diets and their adverse consequences are not limited to those in the lowest income groups, but affect these groups disproportionately. Adults and children in deprived areas are significantly more likely to become obese or suffer with diet-related ill health7, a disadvantage that is contributing to widening health inequalities in this country.8 The Government has introduced guidance on what constitutes a healthy diet through Public Health England’s Eatwell Guide but it has not fully evaluated whether the diet it recommends is affordable to everyone. We were referred to a Food Foundation report which estimated that: “the poorest decile of UK households would need to spend 74% of their after-housing disposable income on food to meet the cost of the Eatwell Guide compared to just 6% in the richest decile.”9 The Government should know whether or not people can afford to adhere to its own dietary guidance. We have therefore recommended that a fuller understanding of the cost of a healthy diet should be reached, and factored into the calculation of benefit rates. This cost should also act as a reference point to inform other policy interventions, including those relating to welfare and public food provision.

Highly processed foods—those that contain high levels of energy, unhealthy types of fat, salt or highly refined carbohydrates such as sugar10—are produced in abundance in this country. These products are then aggressively marketed and promoted to the consumer. Highly processed food products are also more likely to be on promotion, making them appealing to those on a tight budget.11 Manufacturing, retail and the food service sector, has a central role in this. As a consequence, a high proportion of both adults and children’s dietary energy comes from processed food12 with the UK consuming more processed products than any other European country.13 The less healthy choice has become the easier, cheaper choice for the consumer but this is inflicting profound costs on public health and the NHS.

The Government is fully aware of the need to reduce the prevalence and consumption of less healthy food and has, to date, introduced a range of policies and proposals aimed at improving the food environment, including numerous measures outlined in the three chapters of the Childhood Obesity Plan. Despite this, obesity rates continue to rise.14 There is no excuse for the Government not to re-double its efforts in these areas. Many Government proposals to impose restrictions on the marketing, advertising and price promotion of less healthy foods have so far failed to progress beyond consultation stage. We have urged the Government to publish the results of these consultations so that policies can finally be developed and enacted to conclusively tackle the factors in the food environment that make the less healthy choice so readily available.

We also have recommended that the Government step up its efforts to encourage the food industry to reformulate its products to reduce harmful levels of salt, sugar and unhealthy types of fats. Both the salt and sugar reduction programmes are likely to fail to achieve their stated targets so the Government must increase and maintain the pressure on industry to act. Industry progress against voluntary reformulation targets should be subject to transparent and regular monitoring, to highlight where successes and failures occur. Crucially, the Government should make clear what regulatory action will follow if the industry does not respond comprehensively and swiftly to voluntary targets. Mandatory (fiscal) approaches can work, as evidenced by the Soft Drinks Industry Levy. As there is a proven mechanism for delivering successful reductions in ingredients that may be associated with poor health outcomes in a way which has not had a detrimental impact on the industry, the Government must not delay in exploring the application of fiscal measures (such as further levies or changes to VAT) to other product categories where reformulation is not in line with Government targets. Food manufacturers and retailers have been reluctant and slow to act, but Government regulation can and must compel them to do so now.

In all sectors of society, a shift in consumption is required. Clear public health messaging is an important start, but the extension and reform of three public food measures—Healthy Start vouchers, free school meals and holiday hunger programmes—is absolutely necessary too. If properly funded, properly implemented, and extended to all who need them, these programmes could help to prevent the poorest children from going hungry and could enable a shift in consumption that would make a healthy diet more accessible for children and families. Combined with a renewed and more targeted effort to communicate public health messages, these programmes could help make healthy food an easier and more accessible choice. Schools and local authorities have an important role in increasing knowledge and skills on nutrition, and supporting people to make healthier choices, but the Government must ensure that they are adequately resourced to do so.

Current patterns of consumption are not only impacting adversely on the population’s health, but also on the environment. Our evidence indicated that economic forces, including the demands of supermarkets, food manufacturers, the food services sector, and the large food commodity companies, requiring farmers to produce food as cheaply as possible can act as an inhibitor to producing food in an environmentally sustainable way. This can increase the negative impacts of agriculture on the natural environment, threatening biodiversity and the quality of farmland. Future agricultural policy should aim to balance food production with the protection of health and the environment. We welcome the general direction of the Agriculture Bill, but we have highlighted where we think there are limitations in its proposals that must be addressed. The Bill proposes to reward farmers for producing environmental benefits, but we have warned that without a consistent, reliable system for determining, measuring and reporting these impacts, the Bill will not fulfil its potential. We have therefore recommended that every public good outlined in the Agriculture Bill is accompanied by a standardised framework to allow measurements and targets to be clear, consistent and easy to use. Farmers should be supported to achieve the public goods outlined in the Bill, and financial rewards should be conditional upon action and progress.

The Agriculture Bill must also help to support wider improvements to public health. There are convincing arguments for a fundamental shift in consumption towards a more plant-based, balanced diet: current patterns not only have an adverse impact on the population’s health, but also on the environment. The Government must clarify the vision for a healthy, sustainable diet, and set out a clear path towards achieving this. We have recommended that the Agriculture Bill should recognise, support and reward farmers for measures that promote improved public health.

In addition, if trade agreements allow for the import of cheap food, produced according to lower environmental and animal welfare standards, this could put UK producers, and even consumers’ health, at a disadvantage. In a joint letter to MPs and Peers, dated June 5 2020, the Secretary of State for International Trade, the Rt. Hon. Elizabeth Truss MP, and Secretary of State for the Department for Environment, Food and Rural Affairs, the Rt. Hon. George Eustice MP, stated that in all of its trade negotiations, the Government “will not compromise on our high environmental protection, animal welfare and food standards.”15 We have called on the Government to stand by this commitment and set out what safeguards it will provide.

Substantive change is required throughout the whole food system—from plough to plate—to ensure that everyone has access to a healthy, sustainable diet. Rising levels of obesity, food insecurity and health inequalities, and the damage caused to the environment by the current system of food production demonstrates that further action is needed now. In light of these persistent problems many of our witnesses advocated for ‘whole system change’. In this report we have identified the points in the food system where changes can and should be made. We have made recommendations that aim to address issues relating to: people’s ability to access food and the impact on diet of living in poverty; the efficacy of existing Government food programmes; the factors that influence consumer behaviour; the availability of less healthy foods; and food production and the natural environment. We are clear, however, that to ensure long-term, sustainable progress can be realised, a clear, overarching vision for what the food system should achieve is also required, underpinned by robust governance and accountability. The Government’s National Food Strategy is a positive and universally welcomed step in the right direction. The Government has committed to publishing a White Paper in response to the forthcoming recommendations of the National Food Strategy review, led by Henry Dimbleby. These recommendations are likely to require cross-departmental co-ordination and a dedicated system of oversight to bring about a tangible change to the way we produce, purchase and consume food. We have, therefore, recommended the establishment of an independent body, responsible for strategic oversight of the implementation of the National Food Strategy. This independent body should have the power to advise the Government and report to Parliament on progress.

At a time of crisis, when Government spending has necessarily and dramatically risen in response to the impact of the COVID-19 outbreak, we were conscious of the difficulty of making recommendations which require further demands on the public purse. With this in mind, we have been selective. The recommendations we have made would, if implemented, reduce the many burdens that poor diets place upon the environment, the NHS, and the wider economy.

Food policy has an impact on all sectors of our economy, environment, and society, and the ability to access a healthy diet has a profound impact on people’s health and wellbeing. Before the COVID-19 pandemic, the burden placed on the environment, economy and the NHS by the nation’s diet was already unsustainable. The unacceptable inequality in people’s ability to access healthy food also predates the current crisis. The COVID-19 outbreak has pushed more people into economic difficulty, and has had, and will continue to have, a serious negative impact on the nation’s health and economy, an impact that is being felt more acutely by those in deprived areas. It is now, therefore, more important than ever to ensure that everyone can access a healthy, sustainable diet. Jo Churchill MP, the Minister for Prevention, Public Health and Primary Care at the Department for Health and Social Care, appeared to share that view, and told us:

“We have a teachable moment, and we should seize it.”16

The COVID-19 pandemic has reinforced the need, and provided the opportunity, for the Government to act now with commitment and focus to deliver the improvements to the food system, public health and environmental sustainability that are so urgently required.

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