I welcome the Minister of State, Deputy Moffatt, to the House. It is nice to see a familiar face from the Department of Health and Children. I hope he will enjoy working with the new Minister who, I am sure, will be a splendid appointment.
I cannot remember if the Minister of State took this Adjournment Matter previously but on 22 October 1997 I asked the then Minister for Health and Children to consider the need for the fortification of flour with folic acid. As the Minister of State is well aware, we have one of the highest incidences of spina bifida and hydrocephalus in the world and the knowledge that this could be greatly reduced by a higher intake of folic acid in early pregnancy should have been addressed at that time. It is well known that this is an important way to address this problem.
The Minister said then that the fortification of flour with folic acid would "have to be considered in an EU context in view of the implications for the free movement of goods". In fact, I got the impression that the entire confectionery trade might collapse if I continued to pursue it. He said this was well outside the remit of the Department of Health and Children and that consultation would have to take place with some other Departments. As that was nearly two and a half years ago, I hope the Minister of State will be able to tell me the result of these consultations and his views on the fact the United Kingdom Government is considering supplementing flour with folic acid. The health benefits additional to that of preventing neural tube defects have now become obvious.
As the Minister of State knows, flour in the United States has been fortified with folic acid for many years. This was done on the recommendation of the Food and Drugs Administration which is a fairly conservative body when it comes to recommending anything such as that. This was done because it was recognised that the inference of folic acid on the synthesis of DNA in many cells was of great importance. It felt it was an important course of action for it to take.
Folic acid has been shown to be very helpful in the prevention of heart disease and bowel cancer. Some of the most important research in this area has been done in Ireland because we, unfortunately, have a very high level of heart disease, as can be seen around the periphery of the European continent. High levels of folic acid have been found to reduce the level of homocysteine in the blood. This is important in the prevention of heart disease because we have found that many of the population are short of an enzyme which is needed for the lowering of homocysteine in the blood. This is probably a genetic problem. Similarly, bowel cancer increases where there are high homocysteine levels. What is interesting is that we may have been blaming our diet for many years for problems we had which are due to in-built genetic problems.
There is only one satisfactory argument of which I have heard against the fortification of flour with folic acid and that is that it may mask B12 deficiency. The Minister of State and I know that B12 deficiency is fairly unusual and that we can also have B12 deficiencies without anaemia. The argument is that giving folic acid will improve the anaemia so it may mask the neurological signs which occur with B12 deficiency. In the overall health scene, we have to take that chance and hope people will carry out a better clinical examination of those expected to have B12 deficiency rather than use this as an excuse to persist in blocking the fortification of flour.
Professor John Scott of Trinity College, who is an expert in this area, has said there is a convincing argument to add folic acid to all flour. Surveys on the uptake of folic acid supplements have been very disappointing. Women of child bearing age have been advised that they should try to increase their intake of folic acid prior to conception. Clonmel Chemicals and other drug companies have been good at trying to promote the uptake of folic acid, as has the health promotion unit but, unfortunately, the uptake has been extremely poor and is worse among public patients than private patients. Public patients are quite likely to have a less nutritious diet so they may already have a diet which is low in folic acid.
It is sad that promoting additional folic acid in the diet will not totally eliminate cases of spina bifida. The Department of Heath and Children advisory group on this matter reckoned that it would cut the present rate which is about 70 to 80 per year by half. In other words, nearly 100 children are born with the serious defect of spina bifida who could have been saved from this problem if flour had been fortified when I suggested it in 1997. I hope the Minister will address this matter with a sense of urgency because it is one of the most distressing of the congenital defects and is one about which we are at liberty to do a great deal if we put our minds to it now.