MOANA MACKEY (Labour) Link to this
I move, That this House disallow the New Zealand (Mandatory Fortification of Bread with Folic Acid) Amendment Food Standard 2009. It was after a lot of soul-searching and consultation with my colleagues that we decided to take the unusual step of bringing a Regulations Review Committee report to this House and using a motion to disallow a mandatory standard.
I would like to give a brief background. In May 2004 the Australia and New Zealand Food Regulation Ministerial Council asked Food Standards Australia New Zealand to investigate the mandatory folic acid fortification of bread to prevent neural tube defects. Under a Labour Government it took 3 years to complete consultation, including two rounds of extensive public consultation. On 18 September 2007—as I said, 3 years later—the Hon Annette King, the Minister for Food Safety, issued the 2007 food standard.
In 2008 there was a change of Government, and the Hon Kate Wilkinson was appointed as the Minister for Food Safety. She made public statements that she did not support mandatory fortification but that due to trans-Tasman food standards her hands were tied and she was unable to make any changes. Following a discussion with her Australian counterpart the Minister was advised that Australia was comfortable with New Zealand taking its own course on the matter, so on 22 July 2009 the New Zealand Food Safety Authority issued a paper under the Minister’s direction. Submissions responding to that discussion paper were due back a mere 3 weeks later.
One week after that, the Minister was briefed on the outcome of the consultation period, and I add here that the overview of the submissions noted that 61 preferred the status quo option, 42 preferred the option the Minister went with, which was revocation, and 19 preferred an option of delaying the commencement of mandatory fortification. Six days later Minister Wilkinson issued the 2009 amendment food standard. Members will note that the process took just over 1 month from start to finish.
On 11 February 2010 the Regulations Review Committee received a complaint from the New Zealand Organisation for Rare Disorders. In August of the same year the Regulations Review Committee reported back to this House. Labour members on that committee took the unusual step of putting in a minority report, marking and recording our concerns about the consultation process followed by the Minister for Food Safety. Submitters to the Regulations Review Committee made the point that that select committee is the last bastion of protection for groups who want to challenge a regulation made by a Government.
I firmly believe that genuine consultation should be just that, and on an issue as serious and important as this, I do not see how it is appropriate to follow a process that took merely 1 month, during which time submitters were forced to rush. Officials told the Regulations Review Committee that they were under enormous pressure, that they could have done a better job if they had had more time, and that they had to take extreme measures in order to report back within the Minister’s time frame. I do not believe that any member of this House should say that that is an adequate process to be followed, or that it represents genuine consultation.
I acknowledge the officials because they did the best they could in extremely difficult circumstances. We have taken the unusual step of bringing this issue to the House because we believe that a line has been stepped over, and that the concept of genuine consultation is under threat in this House.
There are many reasons why this regulation should be disallowed, and I say up front that I have always been naturally wary of issues such as mandatory fortification. It is not something that I am particularly comfortable with off the bat, but I strongly believe that these decisions should be evidence-based. After being challenged to review the research on folate fortification by someone who had had a stillborn child due to folate deficiency, I became convinced that it is the right thing to do.
I know that this issue inflames passions and opinions, and I respect everyone’s views, but I was disappointed at the one-sided nature of the debate. Medical professionals, including the Paediatric Society, and families living with the reality of neural tube defects tried to inject some balance, but they were drowned out by those with more political clout and more money. Folate is a naturally occurring B vitamin, also known as folic acid or vitamin B9. It helps our bodies make new cells and it helps prevent anaemia. Although it is particularly important for pregnant women, in fact everyone needs it. This is not something that men should be scared about having in their diet—well, not if they want their cells to divide.
The campaign to fortify bread has been going for more than 20 years, and it has significant research evidence backing it, with 57 countries already having mandatory folate fortification. Wheat naturally contains folate, but it is stripped out when we unnaturally process it into flour. Rather than mass medication, as it has been labelled by opponents, fortification merely replenishes a natural nutrient that has been lost during processing. In that respect this debate is different from other arguments about mandatory fortification, and I ask members to remember that consumers would still have been able to purchase non-fortified organic bread.
A diet low in folate during conception and early pregnancy means an unborn child’s nervous system may not develop, the most common outcome being spina bifida. Opponents argue that pregnant women can simply be educated to take supplements, but most pregnancies are not planned, and many women do not realise they are pregnant until the crucial period of organ development has already taken place. That explains why research shows educational campaigns have little effect.
Statistics have shown a drop in the number of infants born with spina bifida, but the reason for that drop is that almost all women now have mid-pregnancy ultrasounds, which can diagnose spina bifida, and the majority of those women choose termination of pregnancy.
Opponents mischievously claim that women must eat 11 slices of bread a day to get any benefit. That would be true only if we ate nothing but bread. Folate is found in breakfast cereals, orange juice, green vegetables, eggs, fruit, and yoghurt, yet most women still consume only about 200 micrograms of folate a day, well below the recommended minimum 400 micrograms. Folic acid fortification of bread would likely add a maximum 140 micrograms, which is still below recommendations for some, but enough to minimise the likelihood of a baby being born with a congenital abnormality.
Concerns about the health impacts of folate are not borne out by the evidence. The World Health Organization said our planned levels of fortification had shown no evidence of negative health effects, and all recent studies regarding cancer risks did not look at flour fortification but at high-dose folate supplements, which is what the Minister is telling women they should take instead of mandatory fortification.
Even the Prime Minister’s much touted Chief Science Adviser—who was appointed, apparently, to ensure that good science is paramount in Government decisions—said there would be about a two-third reduction in neural tube defects without significantly elevating folate levels beyond the norm in anybody. He condemned the scaremongering by various interest groups and the media, saying that there was no risk to human health, and that “there is some laboratory evidence that chronic use in doses 20 to 50 times what we’re talking about might do harm.”
The latest UK research has also shown no risk to health, with any delays in legislation occurring because of decisions about whether to fortify just bread or all flour. Claims that studies show that folic acid causes prostate cancer in humans are also not true. The study referred to involved dosing rats with extreme levels of folic acid—levels humans would never consume.
In terms of cost, fortification in the United States added 25c to the cost of bread per person per year, which is minimal when we consider the enormous lifetime cost of care for children with these conditions—$400,000 per child per year. But the most compelling arguments come from the Coalition of Parents of Children with Spina Bifida. It has long been my experience that parents of children with any kind of medical condition quickly become some of the most informed and up-to-date experts on the topic. The coalition points out that opposition to fortification in New Zealand is about money, not food safety. It says that the bakers’ association, which led the opposition, has agreed to fortification many times during face-to-face meetings over 10 years, as has the National Party. The coalition’s plea to Government is this: “We don’t have the Bakers budget of thousands of dollars to fight this. We do know this programme is soundly based on quality research, full consultation, international support and many hours of taxpayer and volunteer dollars over the past 20 years.”
The Labour members of the Regulations Review Committee believe that the coalition’s voice deserves to be heard. We believe that the coalition deserved a genuine process, not a rubber-stamping exercise at the select committee. I see Minister Wilkinson frowning at me; she could have turned up to the select committee to defend the decision that she made, but she chose not to. This is one of the reasons that we have had to bring this issue to the House. We did not want to do that; this is an unusual step.
The Regulations Review Committee members work very well together. It is a consensus committee, and it is unfortunate that on this one issue we were unable to come to an agreement that the process followed here was horribly inadequate. It was insulting—the Minister can laugh, but it was insulting to all those who live with this issue every single day of their lives. The Minister could have done better; she could simply have extended the consultation period, and had proper consultation. She had a number of possibilities available to her, but she chose none of those possibilities. It is a shameful and sorry day for this House.
Hon KATE WILKINSON (Minister for Food Safety) Link to this
I first thank the member for providing a timely reminder as to why New Zealanders kicked the previous administration off the Treasury benches. New Zealanders overwhelmingly opposed Labour’s plan to force them to eat bread fortified with folic acid. They simply did not want it. Mandatory fortification would completely remove consumer choice. It was abundantly clear that this issue was of significant concern to the public. There had been no attempt to forge a voluntary system or focus a campaign on getting young women to eat a healthier diet. We know that folate is important for pregnancy, but rather than look at a targeted method, Labour wanted to blanket the entire population, the vast majority of which does not need it.
Responding to the public outcry, this Government decided to reopen the issue for debate. Numerous issues needed to be worked through, including ensuring that our obligations and responsibilities under the food treaty with Australia were met. We met those obligations and then called for public submissions on the matter. The process was completely transparent, fair, and correct. In fact, the process was endorsed by the Hon Phil Goff when he said: “The public is rightly concerned. … Let’s get a review, let’s get the information out into the public, let’s make an informed decision about it and let’s do it without waiting till they bring it in. … It needs action now. You know, if I didn’t know any better I’d say ‘Well, what the hell are we doing?’ ”. That was from the Hon Phil Goff.
The evidence concerning health and safety is well known, and the material was freely available. Officials personally contacted a number of key stakeholders to ensure that they were all well aware of the consultation and the associated time frames. The consultation was also advertised in the major daily newspapers. The nature and quality of the submissions is evidence that submitters had every opportunity to make a submission. The New Zealand Food Safety Authority received roughly three times the number of submissions usually received for a routine consultation. A longer consultation period would not have resulted in a different response.
After carefully considering the submissions, it was decided—and the public agreed—that the best way forward was to defer the implementation date to May 2012. In the meantime, work on a voluntary standard that would allow some bread to be fortified was instigated. Voluntary fortification has proved successful overseas, including in Ireland, and should always have been the first step in this debate.
Progress has been made on voluntary fortification, with the establishment of a working group made up of representatives of the baking and retail industries, health professionals, and academics. At a meeting last month, the three main bread manufacturers noted that they are now fortifying a range of both premium and budget brand breads.
Market research shows that women predominantly eat grain breads, and it is those breads that are largely being fortified. The Baking Industry Association has also been encouraging 2,000 small bakeries around the country to add folic acid to their breads. The information it sent out has been translated into different languages such as Cambodian and Mandarin, to ensure that the message can be received by bakers who speak English as a second language.
Promoting and implementing voluntary fortification is a pragmatic and sensible approach. It allows for consumer choice, while also targeting the folic acid supplement section of the population who most needs it.
The New Zealand Food Safety Authority has commissioned two pieces of research to help inform the decision on the future of the folic acid standard before the amendment expires in May 2012. This research includes work to be undertaken by Otago University to provide a comparison of the concentration of folate in red blood cells before and after the voluntary fortification initiative started. The second piece of research will be undertaken by Research New Zealand. It will look at women’s awareness and understanding of folic acid in food and its relationship to health.
Hon Steve Chadwick Link to this
This has all been done. This is just delay tactics, like blood alcohol.
Hon KATE WILKINSON Link to this
Actually, we are doing what Mr Goff recommended. A disallowance of the 2009 amendment standard would render all the work being undertaken redundant and is in direct contrast to the wishes of New Zealanders, creating more frustration and uncertainty. We do not support the motion to disallow this standard.
SUE KEDGLEY (Green) Link to this
The Green Party will not be supporting the motion to disallow the standard. We were not part of the Regulations Review Committee, and we share the concern that the Labour Party mentioned that there was a very short 1-month consultation period. Nevertheless, we think that the Government acted wisely when it followed Ireland and the United Kingdom, who put on hold their mandatory folate fortification plans. Instead, the Government has initiated a two-year review before moving to mandatory fortification. We think that that was a very wise decision, and we wholeheartedly support the Government in it.
The reason for this is that in our view, if we are to think about introducing mandatory fortification—a compulsory measure that would affect virtually every New Zealander—rather than a voluntary measure, which would allow consumers to have a choice, a much higher test would need to be met. The Government would need to be absolutely certain that requiring a synthetic additive to be added to almost every loaf of bread in New Zealand would be effective, that nobody would get too high a dose of folic acid, that there would not be any harmful side effects in the long term, and that there is no better way to achieve the desired outcome. In our view, the mandatory fortification of virtually all bread with folic acid would fail to meet all of those criteria. Namely, it is unlikely to be effective; it would result in some sectors of the population receiving too high a dose; there is—and I will expand on this—significant scientific concern about the long-term effects of mandatory fortification, and as well as Moana Mackey I have also done an examination of the scientific research; and there are better ways of achieving the desired outcome.
I look first at whether mandatory fortification would be effective. Would adding folic acid to bread achieve the objective of reducing the incidence of spina bifida in the population? The Government’s own advice, from the New Zealand Food Safety Authority and from the Minister for Food Safety, estimates that in order for that to be effective, women would need to eat approximately 11 slices of bread every day to get the necessary supplementation if they were not eating a diet rich in folate. The problem is that the people whom we are targeting are the very people who do not eat a diet rich in folate. The advice went on to say—
It is interesting that the member said she wanted to have a reasoned debate and she understood that there are different points of view on this issue, yet here she is shouting about it. Let us just have a reasonable debate, because there are very different points of view. The Food Safety Authority went on to say that as well as consuming up to 11 slices of bread, women would also need to take folic acid supplementation at the same time. This begs the question of how many young women, particularly the young women whom we would be targeting, are likely to consume approximately 11 slices of bread every day. I would suggest few, if any. The other question is why a Government would want to encourage women, or anyone, to eat 11 slices of bread a day, since this would contribute to obesity rates and consequent health problems such as type 2 diabetes. Why would the Government propose a public health measure that would contribute to significant public health problems, especially when it is allegedly committed to reducing the incidence of obesity and type 2 diabetes?
The second issue is whether the Government could be certain that nobody would get too high a dose of folic acid if there was mandatory fortification. The answer is that it could not be certain, because the Government has been given advice by the Food Safety Authority that some children will regularly consume excessive amounts of folic acid if we go ahead with mandatory fortification. It said: “We continue to have concerns that 13.8% of New Zealand males aged 5-8 years and 8.2% of New Zealand females aged 5-8 years are going to exceed the upper level of intake …”. It points out that mandatory fortification with folic acid in America resulted in 43 percent of children under 5 years of age having too much folic acid. We know that our young children would have too high a dose of folic acid, according to the Food Safety Authority. Should this matter? Does this matter? Many will say: “So what?”. Well, it matters a lot, because we have considerable conflicting research about the benefits and harms of folic acid. Sure, there is evidence—and we do not dispute it—that folic acid can protect against some cancers and against spina bifida. But at the same time it can accelerate the risk of developing cancers—in particular, colon cancer—and the growth of pre-cancerous tumours and cells, which are, of course, common in our population. In other words, high intakes of folic acid can be beneficial to some and detrimental to others at the same time.
I can recite many professors if the member would like me to do that, but I will quote just one, Professor Joel Mason. He said folic acid is a two-edged sword, and that “… We’re presented with this horrible dilemma that on the one hand, taking ample quantities of folic in the diet is helpful. On the other hand, it might be accelerating the risk of developing certain cancers in certain people.” It is because of this that Professor David Smith said, as a high folic acid intake may be harmful to some people and cause the growth of pre-cancerous tumours and cells, “Nations considering fortification should be cautious”—I repeat: “Nations considering fortification should be cautious”—and they should undertake further research before developing strategies for the population as a whole. In fact, he is also quoted as saying “Fortifying all flour with folic acid is potentially a national health disaster”, and he has argued that if the Americans had known in 1996 what we know now, then they would never have introduced it.
We cannot dispute this. There is evidence that folic acid can cause pre-cancerous tumours to grow, and there is also evidence that it can be beneficial to some people. So I ask why a responsible Government, faced with evidence that high intakes of folic acid can cause pre-cancerous tumours to grow, would introduce it on a mandatory basis in all breads, so that every New Zealander would be consuming it and some would be consuming potentially dangerously high levels of it. Some researchers are worried about epidemiological research that shows that at the same time as Canada and America introduced mandatory fortification, there was also an increase in the rates of colon cancer. Everyone acknowledges that this does not prove a link, but it does invite caution. That is one of the reasons why both Ireland and the United Kingdom have put mandatory fortification on hold while they look at the emerging issues of cancer risk. These are conservative bodies. Similarly, a group of Irish experts said we should defer making a decision on mandatory fortification because they are aware of new studies that suggest a link between high intakes of folic acid and the risk of cancer.
Ireland found that voluntary fortification there increased folate levels in its population by 30 percent, and that there is no need for mandatory fortification if there is a successful roll-out of voluntary fortification. I am aware that 34 brands of bread have been fortified with folic acid. Other researchers say that if half of all women who are planning a pregnancy took folic acid supplements at the correct time, then the reduction in the incidence of neural tube defects would be equivalent to that achieved by mandatory fortification. But I think there was concern about whether bakers would follow through on their promise to introduce the voluntary fortification of bread. They have introduced it to 34 breads. Frankly, I am concerned that many of the breads they are introducing it to are wholemeal breads, when its introduction should be focused on white breads. The member for Labour pointed out that one of the problems is that wholemeal breads have folic acid in them naturally, but it is stripped out of white flour during processing. Surely, then, that is the problem. We should try to stop the processing that strips out folic acid, and give people wholemeal bread.
RAHUI KATENE (Māori Party—Te Tai Tonga) Link to this
Today our caucus held a baby shower for one of our staff members who is expecting her first baby in less than a month’s time. We have another staff member due to give birth to her second child in February, and we have another staff member who delights us all by occasionally bringing her 5-month-old wonder, Kori-Lee, into our offices. I am not laying down these facts as a parliamentary challenge to see which party has the most fertile office, but more to remind ourselves how absolutely blessed we are with the arrival of any new baby, when that baby comes into our lives. I hasten to suggest that if one were to ask any of the members of our party what featured amongst their most significant moments in life, it would be the birth of their children. So we come to this debate absolutely clear about the wonder of whakapapa, the miracle of conception, and the joy of welcoming a newborn into our midst.
We understand that the proposal to establish mandatory fortification of bread with folic acid comes from much the same thinking as investing in folate as an incentive to protect and preserve the health and well-being of women who are in their early stages of pregnancy and their developing babies. We recognise the motivation in the motion put forward by Moana Mackey to disallow the New Zealand (Mandatory Fortification of Bread with Folic Acid) Amendment Food Standard 2009. I place on record the complexity associated with this issue and the considerable thought it has provoked. The Māori Party supports any move that can be taken to encourage pregnant women to either take or abstain from whatever substances will assist in protecting the unborn child, whether that be folic acid—the synthetic form of folate—natural folate, as in leafy vegetables, citrus fruits, wholegrain bread or yeast, or indeed being smoke-free or alcohol-free. But we note the view of Consumer New Zealand that mandatory fortification would not fully address the health issue, as there would still be the need to promote a diet high in folate-rich foods. Women planning a pregnancy would still need to take a folic acid supplement. Consumer New Zealand suggested, and it was reiterated by the New Zealand Food Safety Authority, that pregnant women should increase the folate in their diet by eating fruit and vegetables, and wholegrain breads and cereals. The authority also confirmed that folic acid as a supplement is readily available and affordable, and sold over the counter as a medicine at pharmacies.
But another statement from Consumer New Zealand raised the antenna for us, and that was its concern at the move to mandatory fortification because it might result in limited consumer choice and nutrient imbalances and excesses in children and the elderly. Consumer New Zealand supported the suspension of plans to compel bakers to add folic acid to bread, but emphasised instead that the Government should publicly fund an awareness campaign stressing the importance of folate supplements. This is where the Māori Party states our preference. There appear to be a number of issues that our members have found hard to resolve. I want to share some of the questions with the House to explain our discussions on this issue. If the target is pregnant women and unborn babies, then what will be the impacts for all other sectors of the population from increased levels of folate? What is the reliability of the information that suggests that folic acid fortification is associated, in time, with an additional risk of colon cancer?
We have come across some studies in the US and Canada and Chile that suggest there is a causal relationship, albeit a weak one, between folate enrichment and colorectal cancer. However, the point for us is that it raises the question. As lawmakers we must debate the ethics and morality behind every issue that comes before this House. We cannot afford to look at the issue without considering all the impacts and implications for people.
We appreciate the views of Dietitians New Zealand, which does not support mandatory fortification with folic acid until more research is done. It recommended that further good-quality baseline data should be collected prior to major fortification to determine the benefits or potential harm for a population-wide intervention. It also argued that the mandatory fortification programme in America has actually reduced the amount of pregnant women taking the folic acid supplements, which are still needed to ensure sufficient amounts are reached during pregnancy. We have heard very clearly that folate has been proven to prevent neural tube defects and that as a consequence the Ministry of Health has recommended that extra folate is crucial a month before conception and 12 weeks after conception. We have also heard that approximately one-third of women do consume the recommended amount.
There are some real concerns for us around unplanned pregnancies, or women who simply do not realise they are pregnant until well after the time they have started taking the supplement. As New Zealand has high rates of youth pregnancies this group is at high risk, as they may be low in both iron and folate. During the course of our research we contacted Te Hotu Manawa Māori, which raised some of the issues specific to Māori in relation to this issue. The fact is that so many of our women may have low iron, low baseline folate intake, and potentially low vitamin C intake, and if that is associated with oral contraceptives, all of those will increase the risk of low serum folate levels and neural tube defects.
So the overriding question for us is how we can assure this group that it will be aware and able to access the foods that are fortified. What sort of information do we need to promote to this group the value of consuming green, leafy vegetables such as asparagus, broccoli, and spinach, or to increase their intake of mushrooms, potatoes, legumes, and seeds? How do we encourage this group to eat breads, cereals and, in some cases, pasta or dairy products, which will increase their folate intake? We absolutely agree with Te Hotu Manawa Māori that gaining knowledge of, and education on, the importance of folate for everyone, and specifically for women of childbearing age, is something that all of us can do, and we would particularly encourage the Minister of Health to look further at promoting this possibility.
Finally, I raise a question about the way in which this debate has been discussed, with particular reference to the focus on the risk of having a child with spina bifida. I will share the views of Ruth Jones, from Kanohi ki te Kanohi Ltd, who has issued the challenge that an assumption is made by those without disabilities that people with spina bifida and related conditions are seriously disabled. I will share some of her statements with the House, as I believe they remind us of some of the issues we should consider. She said: “I am aware that when we talk about ‘reducing these birth defects’ we are actually talking about a distinct population group within the disability community and the assumption is made by those without disabilities that people with spina bifida and related conditions are ‘seriously disabling’. … The conditions that are disabling are not the impairment but society’s response to us. Therefore mandatory fortification of bread for me means that again, a whole population group gets ignored, misrepresented and marginalised.”
There are so many issues associated with the proposal to introduce a synthetic form of folate into bread as a universal intervention to prevent folate deficiency. For a start, it would be great to hear that the Government is reviewing my bill to take GST off healthy foods, which would support a move to increase the consumption of folate, an essential B vitamin found naturally in leafy vegetables and citrus fruits. We believe that the vitamins and supplements that help to make pregnant women ready for baby should be freely available for whānau in order for them to make good choices. If we are serious about building capacity and caring for future generations, then we need an approach that combines the provision of these supplements with an effective education campaign. We do not support the member’s motion.
CHARLES CHAUVEL (Labour) Link to this
I will begin by associating myself with what has been said already by Moana Mackey on the merits of the issue. New Zealand tried the voluntary fortification of commercially produced bread. It was a failure. Bread producers just ignored the voluntary standard, and nothing happened. It was right to do what Annette King did in September 2007, which was to join the Australians and move towards mandatory fortification.
The decision of the Minister for Food Safety, Kate Wilkinson, to delay mandatory fortification will lead to the birth of many more children with birth defects in this country. Bowing to the commercial interests of big producers will have that cost in human terms. For that reason, it was a cruel decision, and certainly one that is not consistent with the Minister’s statutory duty to uphold and protect the public health.
It was also a flawed decision, as the view of Labour members recorded in the report of the Regulations Review Committee on the amendment to food standards shows. In particular, the consultation process adopted by the Minister was seriously flawed. It was far too short, and its results were treated without any real regard. The facts are these. A discussion paper was issued on 22 July 2009. Submissions were required some 3 weeks later, on 12 August 2009. It has been suggested that the consultation period was limited by the looming deadline for mandatory fortification, which was September 2009, but there is simply no reason that the Minister could not have just extended that deadline to allow for a more realistic time frame for submissions to be made. But she did not, so submitters had just 3 weeks to respond to the discussion paper. Worse than that was the way in which submissions were treated, so much so that the inevitable conclusion must be, on an objective review of the evidence, that the outcome of the entire exercise was predetermined.
The discussion paper set out three options regarding the 2007 food standard: maintain it, revoke it, or delay its implementation. Of the 123 submissions received after the 3-week consultation period, fully 61 sought to retain the status quo, but those submissions were simply disregarded by the Minister.
If we look objectively at the process that I have just described, we see that no scrutiny committee doing its job properly could uphold it. But the Regulations Review Committee, dividing between its National and its Labour members, unusually, on this occasion, did uphold that process, and the majority—the four members of the committee who appeared at the time of the vote from National—voted to uphold the process. This goes to the nub of the issue that I will deal with in my speech, as chair of the Regulations Review Committee. The issue is the effectiveness of the committee as it is currently constituted.
Originally, when the committee was set up at the beginning of this Parliament, it had three National members, three Labour members, and one Māori Party member. The seventh member of the committee was Rahui Katene, from whom we have just heard. That is the right way to constitute a scrutiny committee under an MMP Parliament. There ought to be an equal number of members from the two major parties, and then there ought to be a third party member, who can bring some independence to the process of the deliberations of the committee. It also helps that by convention we have an Opposition chair of the Regulations Review Committee. This means that the committee can work in a non-partisan way. It can look at the questions of procedure before it and try to bring some independence to the scrutiny with which the committee is charged. But earlier this year Rahui Katene announced that she was too busy to continue to attend meetings of the committee. That is fair enough—
Hon Rodney HideI am not trying to make a partisan point here, I say to Mr Hide. I understand that it is hard for smaller parties to stretch their resources across the committee commitments that are expected of them. So it is not a problem in itself that the member announced she was too busy to keep coming to the committee; the problem is that she did not resign.
I raise a point of order, Mr Speaker. I am sorry to interrupt the member on his feet. I accept the point he is making, but I ask you this. We are not allowed to refer to a member’s presence in the House or, more particularly, the member’s absence from the House. I believe that the same rule applies to a select committee.
Speaking to the point of order, I am not in any way referring to the absence or presence of a member in the House or at a committee meeting. I am describing objective facts about the decision of the member to no longer come to the committee. I am sure that it is not an announcement that member would dispute.
The ASSISTANT SPEAKER (Hon Rick Barker) Link to this
I would like to say that I am entirely fresh with all the Speakers’ rulings on this matter, but I will say this. It is not always an absolute rule that one must not refer to the absence of a member. It is an open rule and a general one, but I took it from the member’s speech that it was in no particular way a direct criticism of the member concerned. People in this job are very busy, and everyone here in this House knows that members cannot do every job that is before them. For someone to say that he or she is too busy to do that is, in my opinion, perfectly acceptable. It is much better than the alternative, which is for a member to continue to say he or she will do the job, but not do it because of a shortage of time. I did not see it as being a personal reflection on Rahui Katene. It certainly was not the tenor of the speech. From that point of view, I have no objection to the member continuing.
After Rahui Katene announced she was to withdraw from the business of the committee, she did not resign from the committee, but instead arranged with the National whip to be permanently replaced by a National member, a different member on different occasions, on the committee. The problem from the point of view of the independence of the scrutiny committee is that it now has a permanent majority of National members. For that reason, the laughable consultation process to which I have referred was approved by the Regulations Review Committee, with Labour members dissenting, as I say, in a very unusual move. The decision of Ms Katene to withdraw from the committee and allow herself to be permanently replaced has ramifications beyond this debate today, beyond the issue of whether the Minister and her consultation process should have passed muster in the committee.
We undertake routine scrutiny of every regulation that is promulgated by the Government. Every piece of delegated legislation that becomes part of the law of this land comes before the Regulations Review Committee for scrutiny. The Canterbury emergency orders are all coming to the committee for scrutiny, by special arrangement of this House, so that the public can be assured that the House will give proper scrutiny to those extraordinary orders.
My plea to the Māori Party is to take responsibility for membership of the Regulations Review Committee seriously. I would love to see—
I raise a point of order, Mr Speaker. I fail to see how this line fits with the debate. I think the member is straying too far away from the subject of the debate, and he needs to bring his remarks back to the debate.
The ASSISTANT SPEAKER (Hon Rick Barker) Link to this
I will allow the member to continue because he is describing, for me, anyway, the process by which the committee came to its decision and the workings of the committee, which is part of the reason why we are today having a debate on a disallowance motion. I will allow the member to continue.
Paul QuinnI raise a point of order, Mr Speaker. The speaker said, quite correctly, in his last statement that the Māori Party did not take its responsibilities in this House seriously. I think that reflects badly on the workings of this House and that party.
The ASSISTANT SPEAKER (Hon Rick Barker) Link to this
I say to the member that his point of order fails on two counts. Firstly, a member cannot take offence on behalf of another member, just as a member cannot take offence on behalf of another party, and, secondly, taking something seriously or not seriously is, I would suggest, an entirely debatable point. If the member feels offended by that, I look forward to him not making similar allegations himself in the future.
I am not sure whether that was Amy Adams or another member asking me to get out of the gutter, but I hope that she and other members of the Regulations Review Committee would acknowledge my attempts to chair that committee in an objective fashion. If not, then I will redouble my efforts.
The speech we heard from Rahui Katene today was superb. It dealt with the issues that ought to have been dealt with in the committee. If the member had been present in the committee for the hearing, the debate, and the discussion, the committee would have benefited greatly from her presence. But, unfortunately, she abrogated her responsibility as a member of the committee and gave to the National whip the right to appoint her replacement on every occasion. That means that we do not have an independent scrutiny committee in this Parliament. The Regulations Review Committee plays an important role in our constitutional arrangements, and its members, some of whom are present in the House, generally do an incredibly diligent job in trying to exercise seriously the responsibilities that they have.
The fact remains that it is hard for a Government backbencher to resist the will of the executive. That is why the committee was set up in the way it was at the beginning of this Parliament, with no Government majority and with an independent chair. Only by restoring the independence of the committee can the House be truly assured that the committee will do its job properly, particularly with the pressing public importance of the Canterbury orders coming before it.
I will conclude on this note: if we do not see that proper balance in the committee restored, by either the Māori Party doing the right thing or the Business Committee taking charge of the issue, then I certainly cannot guarantee that this will be the last debate of its kind during the life of this Parliament.
TIM MACINDOE (National—Hamilton West) Link to this
In light of the discussion about the points of order, I too will return to a discussion of the process that the Regulations Review Committee, of which I am the deputy chair, undertook when considering this complaint. A few months ago the committee considered the complaint that had been lodged by the New Zealand Organisation for Rare Disorders about the New Zealand (Mandatory Fortification of Bread with Folic Acid) Amendment Food Standard 2009. We heard evidence relating to the complaint from members of the organisation and from the New Zealand Food Safety Authority. All submitters were well prepared and presented their evidence and appeals with clarity and conviction. I acknowledge them all, and thank them for the care and sincerity they demonstrated.
There is no question that the fortification of bread with folic acid has some health benefits for some women of childbearing age and their progeny, who may be at risk of being born with a rare genetic disorder. That is why many countries have successfully introduced voluntary fortification of bread, and it is why the New Zealand Government indicated last year that work would be undertaken on a voluntary standard that would allow some bread to be fortified.
It was important for members of the Regulations Review Committee to restrict their focus during the hearing of the complaint and consideration of evidence to matters of process, and not to stray into matters of policy, in accordance with the purpose of our committee. The focus of the Regulations Review Committee is technical scrutiny, not scrutiny of policy. Our role was therefore to consider the complaint against the grounds set out in the Standing Orders, focusing on the technical aspects of the delegated legislation that were pertinent to the complaint.
As a result of consideration of the issues raised in the complaint, we concluded and reported to the House in August of this year that the 2009 amendment food standard is in accordance with the general objects and intentions of the Food Act 1981, does not appear to make unusual or unexpected use of the powers conferred by the Food Act, and, most important in the context of this debate, was made in compliance with particular notice and consultation procedures prescribed by the Food Act. I provide those details to the House because they underline the point made earlier by the Minister for Food Safety, that the consultation process that was undertaken in New Zealand, leading to the adoption of the New Zealand (Mandatory Fortification of Bread with Folic Acid) Amendment Food Standard 2009 was comprehensive and robust.
In seeking to have the standard disallowed by way of the motion that we are debating this afternoon, Moana Mackey is urging the House to revert to a position adopted by the previous Labour Government that attracted widespread opposition throughout New Zealand. Notwithstanding the earnest representations of the New Zealand Organisation for Rare Disorders, which we all understand and respect, when the previous Government announced its plans for mandatory fortification of bread with folic acid there was strong evidence of stern resistance to the measure from New Zealanders. Labour intended to remove consumer choice.
There was significant media coverage of the issue then, and again when the new Government responded to that widespread public opposition by commencing an investigation of this country’s options, given that the standard was a feature of our joint food treaty with Australia. The Government made a decision to ask New Zealanders whether they wanted mandatory fortification of their bread with folic acid. That was done by way of a discussion document being issued and public submissions being invited. Thanks to significant media interest and coverage, members of the public were well aware of the issues under consideration, and of their opportunity to influence the Government’s response. And they did so.
Contrary to what members opposite are asserting, we were told at our inquiry that the level of responses at that time was entirely normal and as would be expected in the circumstances.
We were told that fact, I say to Ms Mackey, during the inquiry. It was a thorough and appropriate process.
Those submissions resulted in an overwhelming indication from the public of New Zealand that they wanted to be able to choose whether they eat bread that is fortified with folic acid. Men, in particular, were concerned about some significant adverse health effects that they could experience from being subjected to the additive. Sue Kedgley earlier referred to those issues. Elderly New Zealanders were also strongly opposed to the measure. There is no evidence that anything has changed since they made their submissions.
Although consumer choice was an important aspect, it should be noted that it was not the only factor that the Government took into account. The Government’s statement on regulation sets out the expectation that voluntary measures should be used, in preference to regulatory measures, where possible. The Regulations Review Committee—far from being a rubber stamp and an insulting process, as Moana Mackey suggested when she concluded her speech earlier—undertook its work thoroughly, and the chairperson, Mr Chauvel, indicated earlier that we always do so. I acknowledge that he is a fair, even-handed chairman and he does the job extraordinarily well.
The committee undertook its work thoroughly and, on the evidence, found that the process followed was not only adequate but also thorough. It is for that reason that this resolution will, and should, be voted down this afternoon.
Hon RUTH DYSON (Labour—Port Hills) Link to this
I begin by commending the Labour members on the Regulations Review Committee—Charles Chauvel, Moana Mackey, and Jacinda Ardern—and thanking them for the way they have considered the complaints that came before them a little while ago. I also commend the New Zealand Organisation for Rare Disorders, and particularly John Forman, who brought the complaint to the attention of the Regulations Review Committee. I understand that Mr Forman is listening to the debate, and I think he should give himself a big pat on the back for the work that he did in ensuring that this very important issue received some attention from Parliament, even though the issue will be unable to be progressed. Mr Forman has done his work on behalf of other people. Too few New Zealanders do that, so he should be commended by the whole of Parliament. I also acknowledge and thank Moana Mackey for moving this motion to disallow the food standard.
We have heard from numerous members of the House already. Members of the National Party, a member of the Green Party, and, in fact, a member of the Māori Party repeated the basis of the campaign in opposition to the addition of folate to our bread, but unfortunately the information that they have given to the House is incorrect. The campaign in opposition to the addition of folate was based on lies. It was a deliberate campaign; it was an orchestrated campaign; it was a totally unscientific campaign. It was a campaign driven by a small number of people in New Zealand, but because an orchestration of lies was conducted as part of the campaign, a number of the public were understandably disturbed by it. In that situation it seems to me that politicians of courage, principle, and integrity would stand up to people who were lying, would stand up on behalf of the truth, and would make some effort to explain it. That is not what is happening, because the Minister for Food Safety is a weak Minister. She was prepared to do as she was told by the Prime Minister, and to make an untidy situation just go away, rather than stand up for truth and for healthier babies being born in New Zealand. To me, doing that would not have been a big ask; any politician of courage and integrity would do that. The Minister proved that she had neither courage nor integrity. I think what has occurred represents a great loss of opportunity for our country.
I want to get to the nub of the issue of why it was proposed to put folate back into bread. Actually, it is already in there, but during the manufacture of bread it is lost as part of the processing. So if we want to get to a wholly natural state, as Sue Kedgley indicated, then we would take this measure, because we would be putting folate back that is taken out during the process of making bread. What happens if a pregnant woman does not have enough vitamin B9 in her diet during the term of her pregnancy? One of the things that happens is that the foetus might not be carried to full term, and often quite late in the pregnancy the woman miscarries. It is a pretty hard thing for a woman and her partner to go through a miscarriage at any time in a pregnancy, but that is particularly so in the case of a late one resulting from neural tube defects caused by the lack of folate in a woman’s diet. There is one cause, with one remedy, but the National Government said no. So National says it does not matter whether a pregnant woman has a miscarriage of a baby that she wanted to have. It is not worried about trying to prevent that. I think that is wrong; it is the wrong decision to make.
The parents may choose to have a pregnancy terminated because of the impairment of a baby—and that is not an easy decision for them to make, either—or the baby could be born with spina bifida. I make it crystal clear that this debate is not about reducing the value of the citizenship and worth of any person in New Zealand who has spina bifida. That is not what this debate is about. This debate is about ensuring that when we, as a Parliament, have an opportunity to reduce impairment, reduce ill health, then we should take it. It does not mean that anyone who has spina bifida is any less worthy a person than anyone without it. In the same way, we would no longer encourage women to take thalidomide; we would not do that any more. That says nothing to reduce the value of people who were born impaired as a result of their mothers taking thalidomide. We just would not continue to take it in pregnancy, knowing the effect that it has.
I referred, earlier on, to the misinformation that drove the orchestrated campaign on behalf of the bakers against the addition of vitamin B to our bread. The United States, the land of the free, the land of consumer choice, and the leading light for non-intervention, has had mandatory folate addition to bread for years, because it knows health outcomes are better as a result of doing that. But let me get back to the misinformation. The member from Hamilton, and also some other members, referred to consumer choice. They said consumers need to have the ability to choose whether they want to eat bread with folate added, in case they might not like it, or something—
They do not want their cells to divide! For some reason, we are suddenly obsessed with consumer choice. I tell Mr Macindoe that some women do not know they are pregnant. This will be gobsmacking news to the member, I am sure. If women do not know they are pregnant for a month, or two months, or three months, it is too late for them to take up their consumer choice option of adding folate to their diet. It is too late by then. Hundreds of women in New Zealand do not know they are pregnant until it is too late for that additional folate to make a difference to the neural tube situation of the foetus they are carrying. That is why consumer choice is a load of hogwash in this debate. The member should know better than to say what he did.
The other term that we heard was “mass medication”; “mass medication” is giving a vitamin to people who might not need it. What a terrible thing it is to consider doing that, when the reason for it concerns the health and well-being of unborn babies. I personally think it is worth taking the risk of possibly having a little too much vitamin B9 in one’s diet, for the sake of the health of babies who have no choice at all about what their mother eats, when we have the ability to change their future.
Some members repeated the absolute nonsense that women would have to eat 11 slices of bread every day for the whole of their pregnancy in order for the added folate to make a difference. For that rubbish to be perpetuated in a grown-up, adult Parliament is a disgrace. They would need to eat 11 slices of bread only if they ate nothing else. That might be the case for some people. I personally do not know anyone who eats only bread, but that might be the situation for some people. It is rubbish to say that that would have to be the case in order to meet the level of vitamin B9 required to make a difference to the health of a woman’s unborn child—it is just rubbish.
A previous speaker also talked about the United Kingdom, and said we should follow its example by introducing the voluntary addition of folate to bread. Our bakers refused to do that; they said they wanted it to be mandatory. They did not want to go along with a voluntary code because they were nervous about the nonsense that was spoken on their behalf during the debate on this issue. They thought then that people would not buy bread with added folate, so the whole purpose of adding it would be defeated. But in the United Kingdom that was not the subject of the debate; the debate there was about the point in the processing of food at which to add the folate: to flour, or to bread.
This motion should be supported. It should be supported on behalf of the hundreds and hundreds of unborn children for whom we have the ability to make a difference to the quality of their health and their lives.
Hon STEVE CHADWICK (Labour) Link to this
I congratulate the previous speaker and previous Minister of Health, the Hon Ruth Dyson, on bringing such a reasoned approach and sensible and empirically driven points to the House today. I also congratulate my Labour colleagues who made one more attempt to bring this disallowance motion to the House, and Moana Mackay on moving the motion in the House today.
This is a very, very sad day and many parents of New Zealand are very, very saddened by the National Government’s political decision on this disallowance motion.
I congratulate the New Zealand Organisation for Rare Disorders, which is concerned with children born with terrible disorders—sometimes overwhelming disorders—with which they have to live their lives. That organisation brings to the House and to members of Parliament research that develops methods of prevention, treatment, and cure for those families who are living with genetic and other rare disorders. I congratulate the organisation on taking this issue of folate to the Regulations Review Committee and making another attempt to convince the National-led Government that its process here is having an impact on up to 30 babies every year who are born with neural tube defects. Government members over there do not care and I am amazed, because Professor Fiona Stanley, the Australian of the Year, said that this is the one preventable rare disorder where we do not have to resort to termination of pregnancy, and which we can prevent by simply adding back to bread folate that has been milled out in the manufacturing process.
Annette King picked up this issue when she was the Minister of Health. At that time we had cross-party support. The Greens had a reserved position because they wanted the option of non-fortified bread, but it was actually Dr Paul Hutchison of National who wrote several opinion pieces and convinced the then Opposition spokesperson for health that fortification of bread with folate was something that National should support. But since agreeing to the food standard promulgated by Minister Annette King in 2007, the current Minister for Food Safety in New Zealand, Minister Kate Wilkinson, has changed her mind. She instructed the select committee that was set up to act against the Labour members to get this issue off the Order Paper quickly and get it out of the way quickly, as it was an embarrassment to the New Zealand Government.
We are the one country that has reneged on our international agreement; even Iraq, Iran, and Yemen last year fortified bread. Look at New Zealand. We are still delaying the fortification of bread with folate and have, as the resulting impact, up to 30 babies every year born with neural tube defects. I was a midwife who assisted with over 5,000 deliveries. I think those in the House who are speaking after hearing evidence have no idea what it is like for sufferers of neural tube defects and their families.
If we apply a very pure economic model of avoided costs for urology, neurology, orthotics, and special education services—let alone taking into consideration the suffering of individuals with neural tube defects and their families who are responsible for raising those children in New Zealand today at a time of cost-cutting by the National Government of disability services—we see that the health costs alone are an argument for putting back the mandatory fortification of folate into our flour. This delay is unacceptable.
We certainly support this disallowance motion in the House today. I remind members who said that the Regulations Review Committee was purely about process that politicians were voted to come into the House to make bold decisions and not to hide behind process. Politicians on that select committee had yet another opportunity to make a brave decision to help up to 30 babies born in New Zealand every year with neural tube defects. Those in Government did not take that opportunity and they hide behind process today. I congratulate Labour members on their strong stance on this disallowance motion.
A party vote was called for on the question,
That the motion be agreed to.
Ayes 44
Noes 77
Motion not agreed to.