Meeting of the Parliament

Meeting date: Tuesday, May 30, 2023

Official Report 990KB pdf

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Diet and Healthy Weight Consultations

The next item of business is a statement by Jenni Minto on diet and healthy weight consultations. The minister will take questions at the end of her statement, so there should be no interventions or interruptions. You have up to 10 minutes, minister.

14:19  

Thank you, Presiding Officer. As the new Minister for Public Health and Women’s Health, I welcome this opportunity to reaffirm the Scottish Government’s vision of a Scotland where everyone eats well and has a healthy weight.

In 2018, we published our diet and healthy weight delivery plan, which detailed how we would seek to improve the health of our nation and which had preventative action at its heart.

It makes clear that to achieve Scotland’s dietary goals and to realise our aim to halve the childhood obesity rate by 2030 and reduce diet-related health inequalities requires action to support healthier options. That focus on improving health and reducing health inequalities was reiterated by the First Minister in the new policy prospectus “Equality, opportunity, community: New leadership—A fresh start”.

Today, I will provide updates on the outcome of three consultations, which are on ending the sale of energy drinks to children and young people; mandating calorie labelling in the out-of-home sector; and restricting promotions of food and drink that are high in fat, sugar or salt where they are sold to the public.

The views that were gathered in the consultations have helped us to ensure that our policies are evidence based, proportionate and designed to deliver positive outcomes for public health. The independent analysis reports for the three consultations were published today on the Scottish Government’s website.

I will first provide an update on our consultation on ending the sale of energy drinks to children and young people. The aim of the consultation was to inform our consideration of whether there is sufficient cause and evidence to mandate restrictions on their sale. An evidence-based approach is central to the development of our policy. We have carefully considered the received responses in conjunction with the current evidence base and, today, we have published an evidence brief on energy drinks alongside the consultation analysis report.

Based on our considerations, we do not think that the evidence base is sufficiently developed to pursue mandatory measures at this time. I recognise that consumption of energy drinks is a significant concern to parents, teachers and young people. We will therefore continue to support voluntary measures to restrict the sale of energy drinks to children and will keep under review how those could be strengthened.

We will also consider what additional evidence gathering and analysis could be undertaken, including on the impacts of current voluntary actions and understanding young people’s consumption of energy drinks and the contribution that that makes to their total caffeine intake. That will help to inform consideration of possible mandatory measures in the future.

I turn next to our consultation on mandating calorie information in the out-of-home sector, fulfilling a commitment in our 2021 out-of-home action plan. The consultation was accompanied by a rapid evidence review that was carried out by Food Standards Scotland, which found that mandating calorie labelling would likely lead to a reduction of calorie intake when eating out or ordering in.

In January this year, Nesta—the United Kingdom’s innovation agency for social good—published research confirming that calorie labelling in an online environment leads to calorie reduction, which is potentially a substantial reduction depending on how calorie information is presented. Out-of-home calorie labelling has been mandated for large businesses in England since April 2022, which has resulted in many UK-wide high street chains now including such information on their menus in outlets in Scotland.

I am grateful to all 660 respondents to our consultation and to the wide range of business, health, charity and consumer organisations that engaged with my officials. A strong case has been made by many respondents that requiring calorie information at the point of choice where people eat out or order in will help them to make more informed and healthier choices and that it will encourage reformulation and allow us to better monitor population calorie intakes in the out-of-home sector.

I thank the eating disorders charity Beat for the constructive way in which it has engaged with our consultation. Beat has helped us to hear from people affected by eating disorders who are concerned that mandatory calorie labelling will make their illness worse. Those accounts are powerful. They are real and we cannot ignore them. We need a better understanding of the lived experiences of those with an eating disorder. I welcome the fact that Public Health Scotland has commissioned research on the issue, which is due in the autumn.

We are committed to assessing the impact of our policies and are reflecting on all the responses that have been gathered, including the views of people who are affected by eating disorders. We wish to have further discussions with the hospitality sector before taking a decision to proceed with the measure. Therefore, I believe that we should pause before making a final decision on the next steps in relation to mandating calorie labelling.

I turn to the third consultation, which is on restricting the promotion of less healthy food and drink where they are sold to the public. We know that promotions such as multibuy offers or placement at checkouts can directly influence what people buy—that is what they are designed to do. Promotions can encourage us to buy things that we do not need and to overlook cheaper, healthier alternatives. Restricting the promotion of less healthy food and drink is an important step in encouraging healthier options and making it easier for people to spend less and make healthier choices.

Work on the policy was paused in 2020, as we sought to ascertain the impact of the Covid-19 pandemic on both consumers and businesses. We have used the time since then to gather and consider additional evidence on our proposals and to take into account the pandemic, action in other parts of the UK, Britain’s exit from the European Union and cost of living pressures. Last summer, building on consultation carried out before the Covid-19 pandemic, we consulted on our proposals, including consulting on opportunities to be consistent with promotion restrictions in England when it is in Scotland’s best interest to do so. We keep our policies and the plans for their delivery under regular review, and evaluation is firmly embedded into the policy-making, implementation and delivery cycle.

Having done that important work, we have reviewed whether primary legislation is necessary and have concluded that there is a more direct and efficient route to deliver our policy aims. Therefore, rather than introduce the public health (restriction of promotions) bill, I plan to consult on the detail of proposed regulations this autumn. That will include proposals to restrict the promotion of less healthy food and drinks in prominent in-store locations, such as at the end of aisles or beside checkouts. We also propose to target certain price promotions, such as multibuys and unlimited refills, that encourage people to buy more than they actually need.

I recognise that businesses, as well as individuals, have experienced a number of significant challenges in the past few years. Our forthcoming consultation will provide an opportunity for them to comment on the detail of the proposed regulations, including on the timescales for implementation. In line with the principles of the new deal for business, that will be done in parallel with an extensive engagement programme to ensure that everyone has the opportunity to be heard. My officials and I look forward to engaging with our stakeholders, including businesses, as our policy develops. Furthermore, we will continue working with the joint regulatory task force and the Convention of Scottish Local Authorities to consider the differing impacts of regulation on business and to improve the process of developing, implementing and reviewing regulations to meet our long-term economic and societal aims.

I have focused today on the outcomes of three diet-related consultations and on our planned next steps. We will continue our support for voluntary measures to restrict the sale of energy drinks to children, while keeping under review how those measures could be strengthened. That will include the consideration of additional evidence and analysis to inform further consideration of possible mandatory measures in future. On the question of mandatory calorie labelling, there will be more time to consider the potential impact of such labelling on those with eating disorders, ensuring that we have a robust evidence base to further inform any steps that we might take in due course. Regarding the restriction of promotions, I will be taking forward a more focused consultation in the autumn on the detail of proposed regulations to restrict the promotion of less healthy food and drink where those are sold to the public.

Clearly, no policy in isolation can achieve our vision of a Scotland where everyone eats well and has a healthy weight. Our diet and healthy weight delivery plan sets out a challenging package of actions that will have a greater impact collectively. As I take stock of progress, I commend the work to date, while noting that there is still more to do.

I remain committed to the key outcomes of the delivery plan and am confident that, together with our public, private and third sector partners and by progressing the commitments set out today, we can meet those challenges and can encourage people to make healthier choices about food.

The minister will now take questions on the issues raised in her statement. I intend to allow around 20 minutes for questions, after which we will move on to the next item of business. Members who wish to ask a question should press their request-to-speak button now.

As a practising general practitioner, I am all too familiar with the obesity crisis that has developed in Scotland. Our country has one of the world’s worst records on obesity, with two thirds of all adults in Scotland being overweight. Make no mistake—obesity is one of the biggest issues that affects our health service. It is estimated to cost up to £600 million a year. The Scottish National Party has declined to take action on the issue for the past 16 years. The prevalence of overweight people has increased over the past 10 years, and the percentage of children who are a healthy weight is at its lowest-ever level.

The minister’s statement does little to address the obesity epidemic that is sweeping across Scotland. It amounts to, on energy drinks, “We won’t do this”; on mandatory calorie labelling, “We’re not sure”; and on restrictions on promotions, “Let’s do some more thinking.” What was the point of the statement?

How much money has been spent to date on the consultations? What concrete work and action is the minister taking?

I refute the suggestion that the Scottish Government has been doing nothing. Over the past five years, a lot of evidence has been gathered to ensure that we introduce the right policies for the right people in Scotland.

We have a suite of policies, not just those that I discussed at the end of my statement. The Scottish child payment gives people in poverty money in their pockets to purchase the right foods. A number of voluntary regulations have also been introduced, and the Scottish Government supports the work that voluntary groups are doing. We are moving forward in ensuring that we introduce the right policies for the right people. We are listening to groups such as Beat, which I mentioned, and to people with food crisis illnesses to ensure that the policies that we introduce on calorie labelling for out-of-home eating are correct, proportionate and proper.

The importance of getting this right cannot be overstated. Delivering positive and tangible actions to improve diet and tackle obesity is crucial to improving the health of the nation and eradicating health inequalities.

However, we have yet another ministerial statement that shows little to no progress. The Government is no stranger to a strategy, but it has a terrible relationship with delivery. The minister should be here to explain why the SNP Scottish Government has made so little progress in the area since the plan was established five years ago. Please explain why so little progress has been made.

I disagree that little progress has been made. We have been working hard with healthy eating stakeholders, including businesses, to ensure that we introduce the right policies. As I said in my statement, we need to have robust evidence and support to ensure that we introduce the right policies that will impact the right people.

What steps is the Scottish Government taking to support community kitchen initiatives that support people on low incomes to access the right tools and resources to help them to eat a healthy diet?

I thank Evelyn Tweed for that important question. Community food networks promote healthier diets among groups that are disadvantaged, whether that is due to lack of income, cultural barriers or poor skills. They provide a broad range of activities, including cooking classes, benefit checks, grow-your-own groups, cafes and food pantries. We have also provided an online resource—Eat Well, Your Way—which was launched last year by Food Standards Scotland. It gives easy access to evidence-based advice on how to eat well based on the “Eatwell Guide”.

The minister said that she will have further discussions with the hospitality sector before taking a decision on mandatory calorie labelling in the out-of-home sector. Our struggling hospitality sector has been ignored all too often in the past by the Government, and that cannot be allowed to happen again. Will the minister outline the form in which those conversations will take place and when they will start?

In my statement, I was clear that we need to involve business in these decisions, but we have to get the balance right between public health and business. When it comes to the new deal, the Government operates on a wish to speak more directly with business and to understand its concerns, because I recognise the points that Craig Hoy has raised about the level of regulation that is coming through. However, we will get the best solutions through working with business to ensure that we bring in things in a timely manner that allows it to work with us to ensure that the public health benefits are met.

Significant evidence shows that ultra-processed foods link directly to obesity, poor diet, malnourishment and negative health implications. Will the minister describe some of the specific policy work that is being carried out to use the evidence that relates to ultra-processed food—which impacts on low-income families in particular—to improve diet and health outcomes?

The scientific advisory committee on nutrition considered ultra-processed foods in June last year and is now carrying out a scoping review of the evidence on ultra-processed foods and health, with a view to publishing a position paper on processed foods and health this summer. Ministers and Food Standards Scotland remain committed to using the latest scientific consensus of established evidence to inform our consideration of ultra-processed foods and will consider the findings of the review once those are available.

Although there is no universally agreed definition of ultra-processed foods, we know that many processed foods are high in fat, sugar or salt, which can contribute to diet-related conditions. Those HFSS foods in targeted food and drink categories would be subject to the proposed restrictions on promotion.

Organisations of professionals who have argued for action will be bitterly disappointed by the statement. Earlier this month, Obesity Action Scotland asked itself:

“So, can Scotland halve childhood obesity by 2030? Based on the current direction of travel, the answer is almost certainly no.”

How much more evidence gathering is there going to be, given that the results of inaction are staring us in the face? For example, too often, in the out-of-home sector, kids’ food is unhealthy food. What action will the Government take to tackle children’s poor choices in the out-of-home sector?

As I said earlier, I believe that it is important to ensure that we get the right, robust evidence to ensure that we bring in the right policies.

As I have also said, we have brought in a number of policies to support the reduction of obesity in children. As we took evidence for the Good Food Nation (Scotland) Bill, we learned that, in local authority areas in which the provision of 1,140 hours of childcare allowed more time to be spent with children and ensure that they got nutritious healthy food, that had a knock-on effect on the food choices that they made later, in primary school. In primary schools, we have really improved the choice of food.

It is not a one-stop shop. A lot of different things can be changed to bring obesity levels down.

Work has been done on a voluntary basis to discuss what is in menus for out-of-home eating. That is an improvement. My officials and I are working on that to make sure that we get the right information to enable us to make the right policy decisions to ensure that we meet the ambition of halving childhood obesity by 2030.

Will the minister provide more detail about how the Scottish Government will ensure that businesses have sufficient time to prepare for the implementation of restrictions on promotions of unhealthy food and drinks?

We plan to consult on the detail of proposed regulations this autumn, in order to lay regulations before the Parliament next year, subject to the outcome of the consultation. There will be a period between regulations been laid and their coming into force, to enable the industry to fully prepare.

Our consultation this autumn will include consulting on an appropriate lead-in time for businesses ahead of regulations coming into force. Our prior engagement with stakeholders has been on the basis that the restrictions would not come into force before 2025 at the earliest. That remains the case.

We recognise the challenges that businesses are experiencing in the current economic climate. We have engaged and will continue to engage widely with business stakeholders on business impacts, and are developing a suite of impact assessments for the policy, including a business and regulatory impact assessment.

We have just heard that there will be a pause to the introduction of mandatory calorie counting on menus, which is very welcome. The evidence of harm to people with or at risk of eating disorders is widespread, which is why Scottish Liberal Democrats have opposed such plans from the outset. It is not only Lib Dems who oppose them; stakeholders named in the statement do, too, as do 80 per cent of respondents to the Government’s own consultation.

What does the minister expect the pause to tell her that she does not already know? Why does she not just answer the calls of campaigners by acting and scrapping the plans entirely?

It is important to review the population as a whole and not to make decisions that are based on only one element of it. We have taken cognisance of the decisions that have been made in England and we are looking to gather further information. We will be speaking to Beat and looking to see how we can work with it to provide the right information, whether that is online, which allows people to make a decision about the out-of-home food that they purchase, or on restaurant menus, including fast-food restaurant menus, such as has been brought in in England.

Will the minister outline what the Scottish Government considers to be the broad benefits of restricting promotions on unhealthy food and drink and how those benefits fit in with the Scottish Government’s focus on improving health and reducing health inequalities?

I am clear that I want to reduce the public health harms that are associated with the excess consumption of calories, fat, sugar and salt, including the risks of developing type 2 diabetes, various types of cancer and other conditions, such as cardiovascular disease. I also want to reduce diet-related health inequalities, including in relation to socioeconomic disadvantage.

The food environment is often skewed towards the promotion of less healthy food and drink, encouraging extra spend and higher calorie intake, as I referenced in my statement. Promotions do not necessarily represent good value. They can encourage us to buy things that we do not need and lead us to overlook cheaper, healthier alternatives. By restricting the promotion of less healthy food and drink, we will make it easier for people to spend less and make healthier food choices. Changes to the food environment, such as restricting promotions, are likely to be more effective in reducing health inequalities.

It is often easier to ban things and demonise people who are overweight than it is to encourage and empower people to make positive lifestyle choices. With only one in five adults in Scotland eating the recommended five portions of fruit and veg a day—a figure that has remained unchanged since this Parliament was created—what practical steps is the Scottish Government taking to ensure that people who live in Scotland, a food-rich nation, can benefit from affordable local produce, which promotes good health and supports our farmers?

I agree that we need to take a holistic approach to the issue, and that we need to support people to make the right lifestyle choices. One of the ways that the Scottish Government is moving in that direction is with the Good Food Nation (Scotland) Act 2022, which will ensure that the Scottish Government, local authorities and health boards provide good food nation plans. That is incredibly important.

The member is right that local food is a great way to do that, and not only from a food miles perspective. It adds an economic benefit for our farmers and food growers. Across Scotland, there are fantastic opportunities for local organisations, which I referenced in response to Evelyn Tweed. Communities have community gardens, which allow them to grow food. People who do that get not only healthy food but exercise, which improves general wellbeing.

The point that I have been trying to make is that we need a holistic solution to solve the problem. I am very supportive of local food initiatives, as well as what is happening with the 2022 act.

The consultation analysis report on energy drinks highlights that respondents suggested that there was a need to focus on education about energy drinks, on the labelling of energy drinks and on providing an easily understood and straightforward definition of energy drinks and the drinks that that definition would capture. What action is being taken to address those concerns?

I agree that we must have clear labelling. A code of practice ensures that that level of labelling on energy drinks is provided. Energy drinks are defined as ones that contain more than 150mg of caffeine per litre. It is important that that signage is very clear on those drinks.

It is also important to point out that, in primary schools, energy drinks are not allowed to be provided in the school estate, and that, in secondary schools, as part of the curriculum for excellence, pupils are taught about energy drinks and that they are only given them at a time that allows them to be recognised almost as a treat. That is certainly the way that I grew up. Normally, I would drink water. Energy drinks should be seen as a treat.

We are acting in a number of ways. A key aspect is ensuring that the right information is on the cans.

Will the minister expand on how the Scottish Government has engaged with people with lived experience in relation to calorie labelling? Will the Government commit to continuing to listen to their views?

The Scottish Government engaged extensively with Beat, which is the largest charity for people with an eating disorder, throughout the consultation process.

I am also grateful for the large number of responses to our consultation from people with eating disorders and their family members, friends and carers. We will continue to engage with Beat once Public Health Scotland has completed its research into the impact of calorie labelling on the lived experience of people with an eating disorder. We are committed to taking into account how calorie labelling might affect those individuals.

The recent health inequalities in Scotland report cited a 24-year gap in the time spent in good health between people living in the most and least deprived 10 per cent areas. The reality is that making healthier choices is a privilege for many people in Scotland. Does the minister accept that the Government must address the root cause of health inequalities to improve health outcomes?

As I said in previous answers, I believe that we need to take a holistic approach—and yes, we need to work very closely with people who are suffering health inequalities. The Scottish child payment, which I referenced earlier, is one such measure. It puts money directly into people’s hands to allow them to make such decisions, which is incredibly important.

In the wider public health sphere, we work closely with third sector colleagues and partners to ensure that the support that communities across Scotland get is really helpful with regard to healthy eating, as well as for wellbeing and exercise, which tie in with and are important aspects of that approach.

That concludes the ministerial statement on diet and healthy weight consultations.