Memorandum by Barnardo's (WP 67)
INTRODUCTION
Barnardo's works with more than 100,000 children,
young people and their families in 361 services across the UK.
These services are located in some of the most disadvantaged neighbourhoods
where child poverty and social exclusion are common features.
We work with children affected by today's most urgent issues:
poverty, homelessness, disability, bereavement and abuse. Many
of our services have a specific health focus and we have strong
working relationships with local health agencies.
Our response to the questions set out in the
memorandum is set out below.
Question 1. Whether the proposals will enable
the Government to achieve its public health goals?
1.1 Tackling childhood obesity by improving
school meals
For the purposes of this evidence we will focus
on one of the key aims of the White Paper—to tackle childhood
obesity. Within that this submission examines the specific proposals
aimed at improving school meals to tackle obesity as well as health
inequalities.
We will be drawing primarily on the findings
in our report "Burger boy and sporty girl—children
and young people's attitudes towards food in schools". (November
2004) This report was based on interviews with 174 children in
nine schools across Great Britain: three nurseries, three primaries
and three secondary schools. These interviews investigated the
views of children and young people about their food preferences
and choices in school. A qualified nutritionist from The Food
Commission analysed the nutritional content of school meals and
packed lunches in three schools: a nursery, a primary and a secondary
school.
1.2 The White Paper: tackling childhood obesity
The White Paper sets a national target:
"to halt, by 2010, the year-on-year
increase in obesity among children under 11 in the context of
a broader strategy to tackle obesity in the population as a whole."
The following strategy for improving school
meals is set out:
— revising both primary and secondary
school meal standards to reduce the consumption of fat, salt and
sugar and to increase the consumption of fruit and vegetables
and other essential nutrients. We will strongly consider introducing
nutrient-based standards. Ofsted inspectors will be looking at
healthy eating in schools and will take account of any school
meals provided in doing so;
— subject to legislation, extending
the new standards to cover food across the school day, including
vending machines and tuck shops; and
— supporting schools to provide the
best meal service possible—for example through new guidance
on food procurement for heads and governors, and improving training
and support or school meal providers and catering staff.
The White Paper sets a target for half of all
schools to be healthy schools by 2006 and for the rest to be working
towards that status by 2009.
Most importantly, one of the key principles
of the White Paper is to reduce inequalities in health.
1.3 Response to the strategy for improving school
meals
Our response to the points in the strategy is
as follows:
Revising primary and secondary school nutritional
standards
We welcome the proposal to revise the nutritional
standards for school meals. However, it is disappointing that
they fall short of a commitment to introducing nutrient based
standards. The research findings from our report "Burger
boy and sporty girl" showed that none of the school meals
or packed lunches analysed met the Caroline Walker Trust guidelines.
For example in the primary school researched,
it was possible for children to make healthy choices from the
food provided. However, as older children served themselves with
side dishes, none of their meals included significant portions
of vegetables or salad and only one of the four recorded school
meals included fruit. Estimated values for energy, fat, saturated
fat, carbohydrate and fibre failed to meet the Caroline Walker
Trust guidelines. Estimated micronutrients were low for iron,
calcium, vitamin A and folate.
The estimated nutritional values for lunchboxes
were too high in saturated fat and too low in fibre. Most of the
lunchboxes contained crisps, chocolate and almost all sandwiches
were made with white bread.
In the secondary school researched, all the
school meals analysed consisted of a cheeseburger, and/or chips
and/or a fizzy drink. The energy contents of these meals failed
to meet one-third of the young people's daily requirement and
none included any fruit or vegetables. None of the school meals
or packed lunches analysed met the Caroline Walker Trust guidelines.
Just within the canteen area pupils had 27 opportunities
to choose different brands of sugary soft drinks and 21 opportunities
to buy low-sugar artificially, sweetened soft drinks. In comparison
there were four opportunities to choose water and five to choose
pure fruit juice. In total there were 28 opportunities for pupils
to purchase different brands of chocolate and confectionery compared
to 5 to purchase fruit or fruit salad. There were 18 options to
buy different brands and flavours of crisps. Our research indicated
clearly that when presented with a range of choice young people
usually made unhealthy choices. A number of social and environmental
factors played a key role—especially peer pressure, and
the desire to "conform". Additionally, branding and
advertising was significant in guiding food choices.
In both the primary and secondary school children
were also influenced in their food choices by cost. In the secondary
school a two course meal cost about £2.00 compared to about
£1.45 in a primary school—on top of this the young
people had to purchase a drink. The option of a burger/chips/fizzy
drink was much cheaper at between £1.00 and £1.50. However,
despite the costs incurred by children only between 31-35 pence
is spent on school meals by caterers compared to £1.74 spent
per prisoner per day on food ingredients (Soil Association 2003).
1.4 Our recommendations for improving nutritional
standards
Our research indicates very strongly that any
improvement in the nutritional content of school meals can only
be achieved by:
— Revising school meals standards in
line with the Caroline Walker Trust Guidelines—the current
National Nutritional Standards go some way towards promoting healthy
food choices but these need to be improved. Choice must be restricted
to a range of healthier options based on menus balanced over one
week, and the provision of fizzy drinks as a part of a school
meal should be phased out as is the case in Scotland.
— The government should ensure that
the Food Standards Agency's recommendations on the balance of
less healthy food are properly implemented. These include setting
criteria for levels of salt, sugar and fat in schools promoted
to children and introducing point-of-sale information and clear
labelling for salt, sugar and fat.
— The improved nutritional standards
must be compulsory and monitored on a regular basis and cover
all food provided on school premises, including vending machines.
— Setting guidelines for packed lunches
which head teachers together with school governors and parents
can ensure are followed
1.5 The role of Ofsted inspectors
We welcome the proposal for Ofsted inspectors
to take account of school meals. This should be linked to the
overall performance of schools and included in the school's Ofsted
report . We would strongly recommend that when Ofsted inspections
take place a qualified nutritional analyses the nutritional content
of both the school meals and packed lunches and advises the inspectors
of the findings.
1.6 Improving the quality of food throughout
the school day, including vending machines
The proposals in the White Paper to improve
the quality of food provided throughout the school day, including
vending machines need strengthening if they are to have an impact.
This is especially important as schools become extended schools
and it is likely that many children, especially those from the
most disadvantaged families consume a significant proportion of
their meals at school. Our research found that the obesity-causing
environment has infiltrated schools, especially secondary schools,
through vending machines, and the promotion of energy-dense foods.
1.7 Our recommendations for improving the quality
of food throughout the school day
We would recommend that:
— Branding on school vending machines
should be banned in England as is the case in Scotland and Wales.
— School vending machines should only
offer healthy food and drink choice.
1.8 Healthy Schools
The Government's vision is that half of all
schools should be healthy schools by 2006 with the rest working
towards healthy schools status by 2009. Local Healthy Schools
will be encouraged to target deprived areas. These timescales
are very long and it is difficult to see how levels of obesity
will start to decrease by 2010 even if all schools become "healthy"
by 2009. Furthermore, reaching this target will require legislation
and tighter guidelines. It is doubtful that it can be reached
by relying on individual schools to participate in the Healthy
Schools Programme on a voluntary basis. This will result in differing
standards between schools with a mixture of both good and poor
practice.
1.9 Tackling inequalities in health —our
recommendations
Schools have a pivotal role to play in ensuring
that all children, regardless of parental income, eat a healthy
diet when they are school. If the White Paper is to tackle health
then it is imperative that school meals are affordable for all
children. As we pointed out earlier in this submission, our research
showed cost was a determining factor in the food choices children
and young people made.
Our recommendations for tackling health inequalities
are:
— The government should set up a committee
to review school catering arrangements with the aim of implementing
a policy which enables all children, including those on free school
meals, to purchase a healthy two-course meal.
— Funding for school meal provision
must be ring-fenced so that a minimum amount is spent per child
per meal.
Question 2. Whether the proposals are appropriate,
will be effective and whether they represent value for money
2.1 The proposals in the White Paper are
appropriate and provide an adequate framework within which to
improve the quality of the food provided in schools. However,
it is unlikely that they will be effective unless they are strengthened
to reflect the recommendations set out above. In particular, the
Government has the opportunity to ensure that primary and secondary
school meals are revised so that they are nutrient-based. Nutrient-based
standards are the key to ensuring that the diet and health of
children when they are at school is improved. These nutrient-based
standards will then apply to all food provided across the school
day, including vending machines. We would urge very strongly that
primary and secondary school meals are revised in line with the
Caroline Walker Trust guidelines.
2.2 The proposals represent value for money.
The costs of not investing in improving the quality of food in
schools is much higher—especially in terms of dealing with
a growing population that has health problems associated with
inadequate diets. However, we feel that the £1m that the
Government has allocated is insufficient. In contrast the Scottish
Executive has earmarked £63m to improve school meals over
the next three years.
2.3 Extra resources also need to be earmarked
to support schools in becoming "healthy schools". The
funding of schools should be reviewed so that schools do not find
themselves in the position of having to rely on income from vending
machines and promotions to fund core teaching activities. All
schools should have sufficient funding without recourse to sources
of funding which are detrimental to the health of children and
young people.
Question 3. Whether the necessary public
health infrastructure and mechanisms exist to ensure that proposals
will be implemented and goals achieved
3.1 There is no clear strategy in the White
Paper on the structures and mechanisms that will support schools
to improve school meals. There will be a school nurse for every
PCT who work with a cluster of primary and related secondary schools.
However, roll-out will not start until 2006-07. This resource
is far from adequate and school nurses will not have the skills
necessarily to advice on the nutritional content of school meals
and packed lunches.
3.2 We would recommend that each school
is allocated sufficient resources to employ the services of a
qualified dietician/nutritionist who can in the first instance
analyse the nutritional content of school meals, food in vending
machines, and packed lunches and who can work with the school
on drawing up their nutritional plans. Ofsted inspectors should
also be advised by a qualified nutritionist when inspecting the
provision of food in schools.
3.3 The White Paper acknowledges that catering
staff need training. We support this and recommend that specific
monies from the Healthy living blueprint for schools is ring-fenced
for this.
CONCLUSION
The proposals in the White Paper provide an
appropriate framework. However, we do not feel that they will
meet the Government's own targets unless the following key steps
are taken:
— Nutritional standards become nutrient-based,
are compulsory, and subject to inspection and reporting by Ofsted.
— The promotion of foods high in fat,
salt and sugar and branding on vending machines is banned and
that schools are required to offer only healthy choices in vending
machines.
— There is sufficient funding for schools
so that they are not put in a position of relying on income from
vending machines, and food promotions.
— All children and young people can
afford to purchase a healthy two course school meal.
— There is adequate funding for schools
to buy in the resources, such as training for catering staff and
the expertise of dieticians as they become healthy schools.
February 2005
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