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Health and Social Care (Community Health and Standards) Bill

Health and Social Care (Community Health and Standards) Bill

Column Number: 753

Standing Committee E

Thursday 12 June 2003


[Mr. Win Griffiths in the Chair]

Health and Social Care (Community Health and Standards) Bill

Clause 167

Replacement of the Welfare Food Schemes

2.30 pm

Mrs. Patsy Calton (Cheadle): I beg to move amendment No. 597, in

    clause 167, page 84, line 19, leave out

    'food of a prescribed description'

    and insert

    'milk or appropriate alternative and other foods of a beneficial nature.'.

The Chairman: With this it will be convenient to discuss the following amendments: No. 596, in

    clause 167, page 84, line 42, after 'scheme', insert

    'must include provision for a benefit to consist of a minimum of one pint of milk per day or the equivalent of formula milk, or the financial equivalent made available through a voucher system, or similar arrangements, and'.

No. 600, in

    clause 167, page 85, line 10, at end insert

    'to include the provision of 7 pints of whole or semi skimmed milk or appropriate alternative per week to beneficiaries and the provision of a third of a pint of whole or semi skimmed milk or appropriate alternative a day to children under 8 years of age in day or nursing care'.

Mrs. Calton: In tabling the amendment I have more than one purpose. First, my aim is to explore the meaning of the phrase ''food of a prescribed description''. Secondly, I seek to ensure that the value of milk as a food is not downgraded, although I recognise that substitutes may well be necessary and that additional foods are, as healthy start showed, obviously desirable, if not essential.

The historic aim behind the welfare food scheme was to provide a universal benefit that would protect expectant and nursing mothers and their children from food shortages and escalating food costs. It was an important protection for mothers and their children. Over the years, the reasoning behind the scheme has gradually been eroded. However, I should like to hear some recognition from the Minister that there is a group of mothers and children that nevertheless still requires support beyond benefits that are already available.

The aims behind healthy start are laudable. However, I have a difference with the Government over the means to achieve those aims. I am concerned that the values of the scheme as it is currently constituted may not be completely maintained. Amendment No. 598 would remove the proposed new section 13(4) of the Social Security Act 1988 and I will explore some aspects of that, although I shall leave

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my comments about that until we debate that amendment.

The Liberal Democrats support the wish to produce a shift to breastfeeding of infants. There is no argument about that: every study by medical and health professionals has shown that breastfeeding is best for babies and their mothers, wherever it is possible. However, although the aims are, as I said, laudable, the means by which the Government intend to effect the shift to breastfeeding will be somewhat problematic. I should like the Minister to examine what the effect of removing formula milk from clinics will be, for example. I completely agree with that proposal. As a prospective mother many years ago, I was absolutely appalled at the way in which we were almost pushed down a sausage tube towards taking up formula milk instead of breastfeeding our children. I remember a film that we were shown that depicted examples of women breastfeeding in just about every place in which it would be embarrassing or difficult for some women to do so. In the end we found out that a certain formula milk distributor made that film. I was very annoyed at the time that women were, in a way, being coerced into taking up formula milk.

However, there will be some difficulties. I understand that the voucher will buy only a third or half a tin in a supermarket. Several groups have expressed concerns about the value of the voucher and what it will enable people to buy. The Maternity Alliance has voiced its total support for the proposal to increase the value of the vouchers for those up to the age of six months. It would be unfair if healthy start effectively cut the amount of support. That argument might also apply to babies in the six to 12-month age group. At all stages, there should be a rounding up to at least the cost of formula milk. The Royal College of Paediatrics and Child Health said that the value of the vouchers would need to be considerably higher than the value of seven pints of milk in the first year of life to allow the purchase of sufficient formula milk for those children who had never beenóor were no longeróbreast-fed. The Royal College of Midwives said that the Department of Health should ensure that

    ''the new scheme does not create a potential risk to the health of those infants whose mothers, for whatever reasons, are unable to breast-feed.''

The Community Practitioners' and Health Visitors' Association recommended that the minimum face value of vouchers should be the equivalent of the cost of a 900 g tin of formula milk, not 7 pints of liquid milk. All of those organisations are concerned about the value of the vouchers, and what they will buy. Liberal Democrats support that view. The hon. Member for West Chelmsford (Mr. Burns) will pick up on the point about the value of the vouchers in his contribution on amendment No. 596.

A major concern is that we may well encourage use of cow's milk too early, before 12 months. Access in rural areas to formula milk may well be a problem. There are better ways of encouraging breastfeeding than the methods that the Government seek to introduce. There must be support for women. I recently visited a group in the north of Manchester

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which had carried out a pilot study in which women were encouraged before they gave birth, with support from specialist breastfeeding advisers, to breastfeed. The rates of uptake and continuance of breastfeeding was considerably higher in that group of women than the norm. That is better than effectively making it difficult for women to obtain formula milk.

Mr. Stephen Pound (Ealing, North): Like everyone else, I have followed the hon. Lady's arguments with great interest. Is she not being overly prescriptive? Things change. When I was born, my mother was prescribed a bottle of Guinness a day, or two bottles of Mackeson milk stout. I was weaned on those substances, which may explain a great deal.

Surely the Bill already provides the flexibility for changes in dietary and medical analysis to be incorporated, whereas the amendments that she proposes are extraordinarily prescriptive, and almost reminiscent of the Stalinist health service of the USSR.

Mrs. Calton: I have the greatest respect for the prowess with which the hon. Gentleman approaches his task. However, if he reads amendment No. 597 carefully, he will see that it is rather wide-ranging. It mentions milk or an appropriate alternative, and other foods of a beneficial nature. I will return to the matter of an appropriate alternative. No one is suggesting that one should force children or their mothers to drink milk stout. I remember that I was advised to drink a pint of Guinness each night, and I wondered why I had a colicky baby for the whole of the first year. It dawned on me after I had my second child that the Guinness might be the problem. I thank the hon. Gentleman for his intervention, but I do not intend to be prescriptive.

I am sure that the Under-Secretary will agree that it is important that mothers should receive support in breastfeeding. I am sure that she is aware of the pilot studies and will mention them later. Undoubtedly, she would want to be an adjunct to the sort of advice that was given to mothers. There are ways and means of doing that, and what I want to say on that is best dealt with under amendment No. 598. Early education has been missed out, and that is one of the problems that occurs because Departments are still acting in the sort of silos that we have complained about in local government, but which we have not yet got away from in central Government. Young people should receive education while they are still at school about their own future diets and those of infants. That would be a much better method than those about which I shall speak later.

There needs, also, to be a change in society's attitude to breastfeeding, not least in this place, which finds it extremely difficult to accept that women might need to work and breastfeed. This place should provide a lead in viewing breastfeeding as being a normal part of life.

The Chairman: Order. I have allowed the debate to be fairly wide ranging, but I do not think that arrangements for breastfeeding, in this place of work or any other, form part of the amendment.

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Mrs. Calton: I do, of course, apologise, and will restrict myself to the importance of milk in the diet. In tabling the amendment, my intention was to ensure that we do not lose sight of the importance of milk in the diet of expectant or nursing mothers or of their young children. Most of us are aware that milk is important for dental health. It provides a range of nutrients, especially B vitamins, and, in whole milk, vitamin A, and calciumóit is the largest source of calcium in the dietózinc and magnesium. It is needed for bone development as well. It would be a great pity if milk were effectively lost, as it could be in the Bill as drafted.

There is an indication that alternatives to milk, such as fizzy drinks, are linked to obesity and dental cavities. My reference in the amendment to appropriate alternatives recognises the fact that the biggest single set of allergies in young children is milk allergies. As the responses to the healthy start consultation paper show, there would be a need for soya milk and other substitutes where milk was not an appropriate food. It is not necessarily a reference to formula milk. I hope that the Under-Secretary will answer all our points and will explain how the new system can possibly meet all the aims of the Department of Health within the current budget.


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