HC 1048-III Health CommitteeWritten evidence from Cool Milk (PH 137)

Introduction

1. Cool Milk welcomes the Health Select Committee Inquiry into the Public Health White Paper: Healthy Lives, Healthy People. We would be pleased to assist the Committee with any further information, as requested.

Summary

Milk is widely recognised by health professionals for its high nutritional value and ability to contribute to positive health outcomes.

The free nursery milk scheme currently applies universally to all children in child-care settings under the age of five. Subsidised milk is available to children aged 5–11 years old.

The provision of milk in nurseries and schools provides health and social benefits particularly for the youngest children.

Local authorities will play a crucial role in promoting healthy living amongst children as part of its new public health remit.

The Department’s proposed Public Health Outcomes Framework should be broadened to acknowledge the crucial role of milk in supporting public health which would help Directors of Public Health in measuring the proportion of children in nurseries and schools who are likely to receive their daily intake of a range of nutrients.

In line with the Marmot recommendation which states “that to reduce the steepness of the social gradient in health, actions must be universal”, the scheme would benefit from free nursery milk becoming universally available to all children up to the end of reception class—currently, classes are divided according to those children who have reached the age of five and are ineligible—and those children who are under five and are eligible.

Cool Milk

2. Established in 1998, Cool Milk is one of the UK’s leading school milk suppliers, working in partnership with local authorities and early years groups to supply free and subsidised school milk to children in pre-schools, nurseries and primary schools.

3. Cool Milk is dedicated to making free and subsidised milk easier for schools, nurseries, local authorities and parents, whilst promoting the important health benefits and learning opportunities that school and nursery milk offers.

4. Cool Milk relieves the administrative burden of school and nursery milk provision (including arranging deliveries, accountancy, reclaiming of subsidies and invoicing). In doing so, we ensure that milk reaches the classroom from local dairies whilst freeing up the educators to get on with educating. Cool Milk provides every school and many nurseries with a fridge to ensure that all milk is served at the correct temperature, as well as providing any other supporting materials to run the scheme in the nursery or school.

Provision of milk in nurseries and schools

5. Currently the Department of Health finances the universal provision of free school milk to children under five in childcare settings. It remains very popular with the public not only because of milk’s substantial nutritional value, but also because the universality principle ensures that it benefits both the socially disadvantaged and broader societal groups.

6. At present, children under five years of age are entitled to free milk, with a subsidy of three and a half pence for children over five years. Of this subsidy, two and half pence is funded by the European Union, with the remaining penny funded by the UK government.

7. Administration of supplying milk to young people, accountancy and invoicing has usually been undertaken by either individual schools or, in the case of larger local schemes, by the local authority. Such systems suffer from two immediate problems—firstly, the addition of substantial demands to existing workloads (or alternatively, the designation of staff for this purpose). Secondly, the subsidies can be difficult and time consuming to reclaim.

The Benefits of School Milk for Children

8. Milk is a naturally good provider of a whole range of nutrients essential to growth, development and maintenance of the human body and contains no artificial preservatives or colouring.

9. Relatively small quantities, (such as 189ml) can provide a significant proportion of daily nutrient requirements. In particular 189ml of milk provides a child with over half his daily calcium and phosphorous requirements. Both these minerals are essential for the healthy growth of bones and teeth. Milk is also a source of “high biological value” protein which means it provides us with all the essential amino acids that the body cannot make itself.

10. Among its many benefits, milk is known to support robust immune systems through its vitamin A content; and provide the recommended daily allowance of vitamin B12. Rehydration and re-energising are aided by the nutrient content of milk, supporting the improvement of concentration and memory function, to assist overall educational performance.

11. The National Advisory Panel for Food and Nutrition in the Early Years recommended that children consume three portions of milk a day. With many children only consuming milk at home during breakfast and dinner (and in many cases, no milk at all), the provision of milk in nurseries and schools is vital.

12. In addition, parents and teachers report a positive impact of “milk time” on young children, the positive peer influence on fussy eaters, and that there are many other social benefits, particularly for the youngest children, in terms of communal eating, sharing, pouring, table manners etc.

Public Health White Paper

13. Cool Milk supports the White Paper’s statement that taking better care of children’s health and development could improve educational attainment and reduce the risks of illness, tooth decay, unhealthy lifestyles and premature death.

14. The proposed Public Health Outcomes Framework which accompanied the publication of the White Paper aims to provide a tool which would allow an objective assessment of health issues and inequalities facing a local area.

15. This Framework could be strengthened through the inclusion of an indicator assessing the uptake of milk amongst young people within the classroom. Such an indicator would enable an appraisal of the effectiveness of the measures that have been employed to improve the health of young children. It would allow local Directors of Public Health to have an accurate measure of the proportion of children in their area who are receiving their daily intake of a range of nutrients through milk.

16. The Department of Health already collects data relating to the number of children and school in each local authority making use of the free nursery milk scheme, making the measurement of this proposed indicator easily achievable. Such an indicator would also be easily understandable by both public health professionals and the general public.

17. This data, coupled with information about rates of obesity, will enable public health professionals to identify particular areas within their community where children are at a particular risk of not receiving essential nutrients for their development. Most importantly, it will allow local health professionals to take action to ensure that the uptake of free nursery milk and subsidised milk in schools increases.

Universal Access to Free Nursery Milk and Improving Take-up

18. The Marmot review highlighted that focusing solely on the most disadvantaged children will not reduce health inequalities sufficiently. Whilst currently all children under the age of five in nursery settings (or reception class if they are under the age of five) are eligible for free nursery milk, the principle and practise of universality needs to be maintained.

19. Equally, the current cut-off point means that children in reception class stop receiving free nursery milk on the day of their fifth birthday. Our experience suggests that this is often very divisive within children’s settings and that nursery and reception class teachers are put off from using the free nursery milk scheme as a result. It is therefore clear that the uptake of free nursery milk schemes would be higher if the Government sought to expand it to cover ALL children up to the end of reception class.

20. In conclusion, Cool Milk would like the Committee to recognise the positive role milk can play in children’s development, which we believe is secured through the universal provision of milk to nursery school children. Cool Milk believes that in order to continue supporting children in this way, the Government’s Public Health structures must continue to support the free milk scheme. This can be facilitated through by including an indicator measuring consumption in the Public Health Outcomes Framework and by extending eligibility for free milk to all children in their reception year at school.

June 2011

Prepared 28th November 2011