House of Commons - Public Accounts

Select Committee on Public Accounts Thirteenth Report

1 Serving healthy and appetising meals

1.The public sector in England spends around £2 billion annually on food and catering. The four largest areas of expenditure are schools, hospitals, Armed Forces bases—and prisons which the Committee examined separately in June 2006 (Figure 1).[3] Public food procurement encompasses not only the immediate purchasing of food but also how public bodies receive, store, prepare and serve it.

Figure 1: The four main areas of public sector expenditure on food and catering

Sector
Schools
NHS Trusts
Armed Forces
Prison Service
Annual expenditure
£1 billion on food and catering
£500 million (of which £300 million is on food)
£135 million on food
£94 million (of which £43 million is on food)

Source: National Audit Office

2. The quality, safety and value for money of food are of prime interest to the millions of adults and children who consume it (Figure 2). Healthy food also has an important role to play in the long term health of school children, including the need to reduce levels of childhood obesity[4], and can be an important factor in helping NHS patients to recover, and for maintaining the morale and operational effectiveness of the armed forces.

Figure 2: Key statistics on public food

617 million school meals are served each year (at an average daily cost of £1.50 of which between 37 and 85 pence is spent on ingredients)
300 million meals are served in the NHS each year (at an average daily cost for three meals of £2.60)
117 million meals were served by the MoD in 2004-05 (at an average daily cost for three meals of £2.10)
69 million meals are served each year to the inmates of public sector prisons (at an average daily cost for three meals of £1.87)

3. The quality of school food has received increased public and media attention in recent years with concern, in particular, about the unhealthy nature of many of the meals provided. The Department for Education and Skills has established new food-based standards that specify the types of food to be served for school lunches. For example, the standards include an outright ban on confectionery and savoury snacks, high in salt and fat, restrictions on deep fried food and manufactured meat products, and stipulation about the number of times that healthier food such as fruit, fresh vegetables and oily fish should be available over a given period. The standards became mandatory from September 2006, and will be extended to cover all food provided in schools (for example in vending machines and breakfast clubs) in September 2007. Additional nutrient-based standards will become mandatory for primary schools in September 2008 and secondary schools in September 2009.[5]

4. To support the drive for improved school food the Department for Education and Skills committed £220 million of transitional funding over three years (from September 2005 to October 2007) to all local authorities and schools, along with guidance on the types of items and activities the funding might be used to support.[6] The Department set minimum thresholds for expenditure on school meal ingredients of 50p for primary schools and 60p for secondary schools.[7] The Department's latest information on performance shows that spending in primary and secondary schools currently runs at 52p and 67p respectively.[8] Distribution of funding is on the simple basis of total numbers of pupils in each area and the numbers of those eligible for free school lunches.[9]

5. The Department for Education and Skills has only limited arrangements to assess how well this transitional money is being used by schools and local authorities to raise standards.[10] The Department recognises that balancing the need to secure value from the additional funding with a policy commitment to greater autonomy at the local level represents a significant challenge.[11] For example, schools and local authorities are able to exert discretion over how they procure food and catering, what they provide and what they charge parents.[12]

6. In September 2006, the Department announced an additional £240 million of transitional funding to further subsidise the costs of healthier ingredients in school lunches over the three years from 2008-09.[13] One of the aims of this funding is to help schools and local authorities keep down the prices charged for school meals, helping to maintain or increase levels of take-up.[14] The funding will be skewed towards the areas of greatest social need, although the department has not yet finally decided what criteria will be used to that end.[15]

7. The School Food Trust was established in May 2006 and became operational in September 2006. It has a £15 million core budget for three years to work with 7.6 million pupils (and their parents) to implement the Department for Education and Skills new food and nutritional standards in all in 21,000 schools in England, and promote the education and health of children by improving the quality of food consumed and supplied in schools.[16] The Trust has four published goals including one to ensure that all schools meet the food and nutritional standards for school food by September 2009. The Trust has 11 published targets including one to produce guidance for school staff, parents and children on the new Nutritional Standards for school food, and another to increase demand for school lunches by 4% by March 2008 and 10% by autumn 2009.[17]Since September 2005 the remit of Ofsted has been extended to cover the inspection of the quality of school meals services.

8. In March 2005 the Department announced that the School Food Trust would receive funding of £60 million, comprised of the £15 million of Departmental core funding plus a further £45 million from the Big Lottery Fund.[18] A further announcement from the Department in May 2005 stated that the Big Lottery Fund had decided to allocate up to £45 million to support healthy eating projects and initiatives for children, parents and their wider communities.[19] Organisations, including the Trust, were invited to bid for this funding. The Fund advised in December 2006 that the Trust had qualified for the second (and final) stage of the bid evaluation process in which they could bid for up to £20 million.[20] A final decision will be made in the summer of 2007.

9. The average level of school meal take up is 45%, and as low as 26% in some local authorities, putting the financial viability of school meals services at risk, and potentially reducing the number of children who eat at least one healthy meal per day.[21] One school, however, has been able to treble take up (from 30 to 90%), and quadruple revenue for reinvestment.[22] The Department for Education and Skills recognises that it needs to address low levels of take up by working closely with local authorities and schools in the worst performing areas to develop strategies to persuade children and their parents of the benefits of healthy eating and provide appetising and healthy meals. It also needs to tackle barriers to take up such as unattractive dining environments, restrictive opening hours and the potential stigma associated with free school meals.[23]

10. The Better Hospital Food Programme (established in 2001) was, until its closure in April 2006, the main Department of Health programme for improving the quality of meals served in hospitals. The Department planned to replace this with a new initiative, the "Eating Well in Hospital" programme, but has decided instead to distribute funding for improving hospital food direct to NHS trusts which it considers are better placed to decide how this funding should be spent. The Patient Environment Action Team (under the management of the National Patient Safety Agency) is responsible for assessing the quality of the meals provided. In 2005, 84% of hospitals were rated 'excellent' or 'good', compared to 58% in 2004.[24]

11. Alongside the drive for improved quality in public food and catering, whether health, education or the armed services, there is the need to encourage customers to eat better food as part of adopting a healthier lifestyle.[25] There are a range of good practices in marketing and education, as well as practical steps that can be used to influence eating habits, such as working closely with contract caterers to introduce healthier food combined with promotional and educational events that encourage healthy eating.[26] Departments recognise that they have to address the needs of all customers in their standards, guidance and promotional work on healthy eating, including those with special dietary requirements or taste preferences such as the elderly or ethnic and minority communities, and to raise awareness amongst food procurers, catering staff and contractors about what is expected of them.[27] Regular canvassing of customer feedback is needed as part of regular meal service quality audits (as used by Sheffield Teaching Hospitals NHS Foundation Trust).[28]