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Baroness Howarth of Breckland: I was going to make various points, but the Olympian canter that the noble Lord, Lord Clement-Jones, made through the whole argument leaves me wanting to make just one strategic point. There may not be a need to support a pilot scheme, but there is a real need for research into the possible outcome of the changes. Having said that, I am very much in favour of modernising the welfare food scheme.
The replacement welfare food scheme will ensure the availability of a wider range of foods and will provide greater opportunities for families to receive expert advice on food for children. We shall debate some of the difficulties of registration. The replacement welfare food scheme will contribute to the wider task of the agencies in their strategic aim and give mothers in particular a new relationship with the health service. It is vital to know and understand how it works. I do not necessarily support pilot schemes as I believe that we need to change the whole scheme. However, it is utterly vital that we have something in place to measure the impact of what we are doing.
Baroness Finlay of Llandaff: I hesitate to join the debate having missed the marathon session. I am not sure whether my flu did me a favour or a disservice as that session appears to have been an entertaining night. I support the concept of a pilot scheme as proposed by the noble Lord, Lord Clement-Jones. As the noble Baroness, Lady Noakes, pointed out, the devil is in the detail. There is potential for abuse. Until a scheme is implemented and monitored on a day-to-day basis, and the results of that monitoring are available to the Government, the potential for abuse of a scheme, and its potential to educate the eating habits of the nation, will not become apparent.
The noble Baroness, Lady Howarth, referred to the debate on obesity. The appalling deteriorating nutritional state of children in this country is evident. There certainly is a need to do something in that regard, but without a careful weighing up of the pros and cons of any scheme we shall be unable to assess the complexities of implementation. Therefore, I strongly support the concept of a pilot to gain the evidence that we so badly need.
Baroness Andrews: I am very grateful to everyone who has spoken in the debate and for the warm welcome from noble Lords on all sides of the House. I understand the difficulties that the Committee has in debating a scheme which is in development, as it were. Many details are currently out for consultation. I hope that I can address most of the questions that have been raised and provide some background.
The Committee is aware that, since its inception, the welfare food scheme has been of tremendous value to millions of families. However, it was introduced in 194063 years agoand was designed to reflect the specific needs and expectations of families during wartime. The needs of families have changed, as have their expectations. Our knowledge of nutrition and child development has changed. We are in a very different situation now from that of 1940. The only thing that has not changed is the scheme itself. We have taken steps to ensure that we can effect
The noble Baroness, Lady Howarth, talked about the strategic importance of making the link between what we intend to put in place for young mothers and babies and the nutritional choices and issues facing the nation as a whole. That is indeed part of the context in which we are working to change eating and nutritional habits and to help people to build up a lifelong habit of healthy eating and good health. The second part of that strategy is to create better ways for young disadvantaged families in particular to link into the NHS itself so that they can get the added support, information and help that they need to make nutritional choices that will suit them and their families throughout their lives.
I have outlined the main aim of reforms but the Committee will want to know more about the regulations. I completely accept that consultation and debate are essential if we are to introduce reforms which low-income families want and which food suppliers can operate. In March this year we published our consultation document based on almost 500 responses, which demonstrated broad consensus across the spectrum on the need for reform as well as support for the principles of reform, and particularly the introduction of greater choice in the range of foods provided. Questions and concerns were raised on the detail. We are continuing that dialogue informally but consistently with key stakeholders, including beneficiaries and the dairy industry. Recently we produced a report with beneficiaries which contained germane questions about points of access and registration. To our pleasure, the overwhelming number of responses were positive. We shall let noble Lords have that information as soon as we can.
We do not want to lose out on opportunities to support new mothers in the pre- and post-natal stages. All we know about health inequalities indicates that they start at birth. I refer to low birth weight babies, higher mortality and higher morbidity for disadvantaged families throughout their lives, which result in the tragic statistics of shorter lives. It is extremely important to get young mothers into contact with the health service, to give them the information that they need and to expand the range of nutritional support through the scheme.
Officials have met representatives of the dairy industry, infant formula manufacturers, retailers and health professionals on a regular basis and their views are being, and will increasingly be, fully considered. As I said, feedback has been extremely important. We expect to publish the full details of our plans for reform later in the year. We shall obviously consult fully and publicly on the draft regulations for the scheme in 2004.
The noble Lord asked some very specific questions which I shall try to answer. The noble Lord asked about the value of the voucher regarding younger infants. We consulted on that matter. It was widely welcomed. We propose to give the parents of younger infants more help with the cost of infant formula. One of our main intentions is to increase the incidence of breastfeeding. We want to be certain that whatever we come up with will encourage young mothers to breastfeed. That is perfectly consistent with what the Government have said recently about breastfeeding.
At the moment the specific value of the voucher has not been set. We proposed in the consultation document that the value should be broadly equivalent to seven pints of liquid milk. We are taking all views fully into account and considering how best to assess the various options for the voucher value. Currently we spend £142 million on the scheme as a whole. We should like to keep the scheme within those bounds.
I shall now address the question of the number of beneficiaries. I was asked how many people would receive the benefit. Currently, 800,000 new mothers, pregnant women and those with children under the age of five get the voucher. We would expect that number to be sustained. The number of beneficiaries obviously varies according to the number of people on benefit.
At the moment one does not receive the voucher unless there is evidence of pregnancy, and the maternity benefit form is used as evidence of that, so many young mothers do not come into the scheme until quite late in the pregnancy. Through the registration system we are aiming to bring young mothers in earlier so that they have a better chance of being supported through the pregnancy by the health professionals. We believe that that could be a more successful way of dealing with the matter.
The noble Lord also asked about monitoring and evaluation, which is a very important element. As I have said, if we phase it in that will enable us to learn from experience. We are also very keen to get robust evaluation. We shall certainly discuss how best to do that, whether it will be academically-based or practitioner-based. We have no intention of proceeding without a very robust evaluation scheme.
The noble Lord also asked about healthy foods. We have talked about fruit and vegetables and cereal-based foods: that could be pasta or bread. We are still discussing with the nutritional experts the range that might be possible to achieve. As I shall argue in a little while, one of the arguments for flexibility is to have the ability to add different foods. For example, and speaking very personally, fish oil has been shown in recent years to have a significant impact on the brain development of young children. We are constantly faced with new information about nutrition.
I shall now move to some of the questions which the noble Baroness raised. She asked about milk in particular and the difficulty in exchanging its nutritional value for new food. The important thing is that milk is not going to be withdrawn. If families so choose, it will be possible for them to use their vouchers for a high proportion of milk. We are following the scientific advice of COMA in this matter. The scheme has, and will continue to have, a scientific base. We want to be certain about that.
As regards the impact on the dairy industry, the Government are certainly not unconcerned about it. We have consulted widely with the dairy industry. We know that there are a number of milk roundsmen who receive more than 7 per cent of their income from milk deliveries. We know that vulnerable people often depend on the milk round. We continue to consult with the retailers and the dairy industry on the matter. We have commissioned KPMGthe noble Baroness has an insidious influence on our tendering. I am not quite sure how to explain it. We are looking to that company to advise us on the specific area of milk delivery systems.
We are also looking at abuse. There is abuse of the system under the present scheme and most of it seems to derive from the suppliers and retailers charging over the odds, as it were. If we have a fixed rate voucher we believe it will remove that problem. We shall have four teams checking on the retailers to ensure that they sell the right range of foods. We shall require suppliers to sign up to a range of foods on registration. We are definitely not dropping milk. We shall be involving retailers in the decisions as they emerge. If I have not answered some questions I shall be happy to write to Members of the Committee.
I now turn to the affirmative resolution point and try to explain why we are convinced of the necessity for such regulations on this aspect. Affirmative regulations do have some disadvantages in the context of flexibility. The noble Baroness mentioned scientific evidence. Other potential changes are coming along in social security, tax benefits, and changes to health service delivery. The affirmative resolution procedure is more complicated. All the regulations covering the current scheme follow the negative procedure except for those describing the food to be provided. It is very interesting to note that the scheme has been changed over the past 63 years in every respect except this. This one area, which has been subject to the affirmative resolution, has not been changed since 1988. That of itself illustrates part of the problem we face.
In reviewing the existing scheme, the committee dealing with medical aspects of food and nutrition policy was clear that any scheme needed to offer a broader range of foods. So we believe that it is essential that the scheme is sufficiently responsive to the needs of the beneficiaries. As I have said, we propose to pilot, monitor and evaluate; we propose to build in as much flexibility as possible so that we can keep the scheme going. For example, it might be possible to phase in new foods. We need operational flexibility because of the major changes in tax credits and the changes in the way the food is supplied. We are very anxious indeed to avoid inflexibility, restrictiveness, and slowing down the necessity for change after all these years.
The Delegated Powers and Regulatory Reform Committee did not disagree with that proposal. It took the point that the negative resolution procedure served the scheme better. I urge Members of the Committee to think carefully about the implications of the affirmative resolution procedure for low-income beneficiaries who rely on the scheme to contribute 20 per cent of their weekly food budget. We want to move fast and to be flexible. On those grounds and in view of the explanations that I have given, I hope that the noble Lord will be able to withdraw his amendment.
Baroness Noakes: Before the noble Lord, Lord Clement-Jones, decides what to do about his amendment, perhaps I may return to a couple of points. The Minister said that she needs to move quickly. We cannot see the need for that. The current scheme is not failing. There may be some problems with it and issues of abuse at the margin. But the scheme is delivering milk, which has a known, life-time nutritional effect, particularly on young children. We are moving towards a scheme which has potential problems. I am not disputing that other foods have good nutritional value, but turning that into a food scheme is far from easy. The noble Baroness said that she is sympathetic towards pilot schemes, but she wants to move quickly. I believe that means the exclusion of pilot schemes, which are the subject matter of the amendment moved by the noble Lord, Lord Clement-Jones.
As regards my own amendment, I am far from convinced that the affirmative procedure, which merely adds another few weeks to making changes, is inappropriate. It is certainly appropriate for Parliament to have a really thorough look at the scheme when it is first introduced. I will not be pressing the amendment today, but I put the noble Baroness on notice that we are quite unmoved by her argument on not wanting affirmative regulations for this scheme.
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