Item 2 on our agenda is consideration of the School Meals (Scotland) Bill. We are the secondary committee on the bill. Our first witness is Ian Young from the Health Education Board for Scotland. Later we will hear from Gillian Kynoch, the Scottish Executive food and health co-ordinator.
My name is Maureen Bruce and I am here to support Ian Young and Gillian Kynoch.
We will put the same questions first to Ian Young from HEBS and then to Gillian Kynoch.
Do you believe that the provision of free school meals to all Scottish school children would have a measurable impact on health? If so, how great would that impact be? Are you aware of any research that has been evaluated regarding the effect of school meal provision on health outcomes?
Good morning, ladies and gentlemen.
I want to stick to the health issues. The paper that you have provided us with today states that
You must have quoted from Gillian Kynoch's paper, not mine.
It is from your department.
No, it is not from my department. I work with HEBS.
Do you disagree with Gillian Kynoch's statement then?
Sorry, will you repeat the statement?
The statement says:
The statement may be correct in that there may be no evidence. However, that does not mean that what is behind that statement is true.
That is what I am trying to get at. Do free school meals have a measurable impact on health? Has any research been done to prove that free school meals will be beneficial to the health of children and adults? Will you give me a clear answer?
We do not know the answer.
You do not know the answer?
No, we do not know the answer. There are many things for which we do not know the answer and for which we do not necessarily possess the absolute evidence from a study.
I am not getting far with that line of questioning, so I will try another.
I return to the basic point: we want better nutrition for all our young people. We have evidence that suggests that the young people for whom better nutrition is most important are those who are currently entitled to free school meals. That is the case because of a complex range of things. If we want better nutrition, we need better uptake of free school meals in our schools. I defend the basic premise that we need more young people to take a nutritious school meal—free or otherwise.
Are you saying that a free school meal would have added nutritional benefit? Are you in favour of free school meals?
You are asking me whether there is research that shows a clear benefit; I am saying that there is not. If, however, you were to ask me whether I believe that free school meals would benefit young people, the answer would be yes.
You think that free school meals would benefit, but the paper we have from Gillian Kynoch says that there is no evidence that universal provision has any benefit. Is yours a personal view?
No. Either I am not making myself clear or you do not understand what I am saying.
It is a bit of both, I think.
There are two separate issues. I have not read Gillian Kynoch's paper, but I know that it mentions evidence. I agree with her that evidence does not exist. There is plenty of associated knowledge and understanding that has not come from research studies and that shows that free schools meals for young people are more likely to be nutritious than what they would get elsewhere, although that is not true in every case. There is evidence to support that. If young people are not getting nutritious meals, there will be effects on their health.
We all agree that a meal in school is likely to be more nutritious than a pack of chips outside the school.
Right. That is what I am saying.
However, that is not the question I am asking.
Mr Young, I feel duty bound to say that I think that your attitude towards my committee colleague leaves a lot to be desired. I would like you to treat her with the respect that she deserves as a Parliamentarian.
I apologise if that is the case.
I believe that it is the case and I am in the chair, so please take that on board.
I am just trying to get a clear idea from you. Are you in favour of free school meals based on your knowledge and understanding rather than on scientific evidence? That is what I am trying to get at.
Yes, although I was not given a chance at the beginning of the meeting to say on what basis I am speaking. I thought I would have been entitled to make a short statement about that.
You are also entitled to supply members of the committee with a supporting statement in advance. The other two sets of witnesses this morning have done that and you have not. In a way, the committee is at an immediate disadvantage because you have not given us something from which to work.
That was not made clear.
If you could answer the questions that are put to you, we can move forward together.
It was not made clear that I was entitled to do that.
Every other set of witnesses that we have had before us has been very clear that that is an entitlement and both previous sets of witnesses today have given us written submissions.
I have concluded that Mr Young is in favour of universal free school meals because they are more nutritionally advantageous than what they get outside.
Correct.
I have concluded that he is in favour of free school meals because more people are likely to eat those meals. Is that right?
Correct.
Do you also agree that there is no evidence that the universal provision of free school meals has a benefit to health?
There is no clear evidence of that.
I have finished.
You say that there is no research to back that up. Are there any international comparisons? Do we have any evidence from some of the Scandinavian countries, for example, about the impact of free school meals?
Yes. The issue is complex. There is evidence from countries such as Finland and Sweden, which have high nutritional status and an excellent record in child and adult health. There is an interesting phenomenon; the Finns introduced free school meals just after the war in the late 1940s. As late as the 1970s, they still had major problems such as coronary heart disease. There is obviously a time lag. The Finns then responded more enthusiastically and whole-heartedly than any other country in Europe to the World Health Organisation's health for all targets when they came out in 1979. They turned their population's health status around from having the highest coronary heart disease figures in Europe to being well down the league table. The Finns are therefore a success story. We cannot attribute all of that to universal free school meals provision, but it is possible that it was a significant factor.
You indicated in your response to Mary Scanlon that there was sound evidence concerning nutrition during children's formative years. Can you tell us more about that evidence and when it became available?
There is evidence from the COMA report, which came out just over 10 years ago, that a lack of certain vitamins and minerals was a particular feature in teenage girls and that that was related to where and what they ate. The fact that many of those young girls during puberty and early teenage years were eating out of school was seen as an indicator that they were getting less of certain key minerals and vitamins. That had the effect of increasing the risk of conditions such as osteoporosis because insufficient calcium was being laid down. The policy memorandum recognises that point. The COMA research is a clear and important piece of work.
Was that the first time that such research was undertaken?
My understanding is that it was the biggest piece of research of its kind in the British isles at that time: it involved thousands of young people and was a major piece of UK work.
Is it true that nutritional values did not previously underpin the school meals service?
As some members know, the service dates back to about 1904 or 1906 when the first provision of school meals was introduced by the state as distinct from the parish. Nutritional standards were not laid down. One can read statements that said that the school meal should be hot and should be the main meal of the day, but those statements did not define specifically the vitamins, minerals, proteins, carbohydrates and fats that should be in the meal. In the 1930s, legislation was introduced in England that made more specific statements and provided guidelines, although I have never seen them. They were issued to local authorities in England and I think they were also issued in Scotland at that time.
Should not your department have advised previous Governments about the risk to the nation's young people?
It is something in which I have had a lifelong interest. In my masters dissertation 12 years ago I examined the effect of a healthy school meals policy and I made recommendations. I was not in a position to have those recommendations taken up. I have a career commitment to the issue.
Did those recommendations fall on deaf ears?
Yes they did.
I am glad that you made the point about nutritional standards because whatever view one takes of free school meals, making a meal free will not necessarily improve its nutritional quality. Laying down binding standards is important.
Nobody knows what the exact percentage increase in uptake would be if the bill were passed. However, I am confident that there would be an increase. About 19 per cent or 20 per cent of young people are entitled to free school meals and about 16 per cent take that up. There is therefore a shortfall of 3 per cent or 4 per cent among the overall total of young people, but that equates to a shortfall of about 20 per cent among those who are entitled to free school meals. Nobody can be certain by how much that gap will narrow. However, by making meals free for everybody, we can be confident that uptake would increase.
You appear to be saying that, because more people would be entitled to free school meals, uptake would inevitably increase, but that that would not necessarily happen among the group that, arguably, needs free nutritional school meals the most. What must be done to ensure that kids from the poorest and most deprived backgrounds get a free school meal every day? That is the crucial question.
Research in England is mentioned in the policy memorandum. I have circled a paragraph from that research that says:
I interpret that to mean two things: first, we need better information about what people are entitled to; and secondly, we need to improve the quality of the meals and to provide information on how we have done that. That is what the research in England concluded.
You and Nicola Sturgeon have spoken about nutritional standards. Everyone would agree that acceptable nutritional standards are important. If there were universal provision of free school meals, would it be possible or practical to monitor schools to ensure that they comply with acceptable nutritional standards? Is the Executive doing anything about that?
We will have to set up a fairly sophisticated monitoring procedure. I do not have first-hand knowledge, but I understand that in England no clear or rigorous monitoring system has been set up for nutritional standards. That is my understanding from speaking to colleagues in England; it is second-hand information.
Before I move on to the cost factor, I will take up the point that you made that children get worse food by going outside school. Many people would agree with that point. Do you agree that, nowadays, worse food is imposed inside schools through vending machines that sell sugary drinks and sweets, which means that children's mouths are bathed in sugar all day—a sort of "Coca-Cola high" syndrome? Unfortunately, that syndrome has come to Scotland and to some of the poorest parts of Glasgow. I have never heard HEBS speak out against that syndrome, although it is made out that all school dinners are simply terrible when not all of them are. Schools make money from vending machines. What is HEBS's view on allowing that to continue?
I have spoken out on that issue. I was mentioned in a leader in The Glaswegian newspaper—which was of interest to me as a Glaswegian—when I commented on what was happening in the fuel zones in Glasgow. HEBS withdrew the healthy choices award scheme—which we run jointly with the Scottish Consumer Council—where we saw sponsorship that had a negative effect on health choices. We closed the scheme and did not give the award in authorities where there was sponsorship. At a national conference that the previous Minister for Health and Community Care attended, I made a case against sponsorship.
Are you against children being fed all day on sweets courtesy of the school?
Absolutely.
That is worse than children going outside for food, because the school approves it and makes money from it. Are you against that?
Yes.
I want to move on to the cost factor. Do you think that any positive improvement in children's health from the bill will be proportional to the amount that it will cost to implement it? In other words, will the bill involve the most effective use of money? Will the bill help breakfast clubs or damage them in any way?
I will start with your second question. The breakfast club concept is a good one because we should not consider one meal in isolation. We must consider what young people eat over 24 hours and over the week, because we all know that our own pattern can vary and that what we eat over a time is more important than one meal.
Could that be disadvantaged by the bill, which concentrates on the main meal of the day?
That is a difficult question. It is a matter of balance. I have spoken to young people in schools about the range of what they do and what they eat, and we cannot get away from the fact that what they eat over 24 hours is more important than one meal. There is another way of considering that. If some of those young people do not receive a substantial meal at any time, the school meal becomes crucial. The issue can be considered in two ways and is complex.
You referred to bread and jam. I think that many children do not have even that during the school day. Are free school meals an effective use of money for children's health, their educational well-being, their alertness and generally preparing them for life?
The evidence on young people's alertness and efficiency—their ability to perform and to get the best out of their education—is surprisingly scanty. That does not mean that it is unimportant. Any teacher, anyone who has worked with young people or any parent will say that the issue is important and that what young people eat affects their concentration and blood sugar levels.
So the answer is yes.
Janis Hughes will expand on the stigma issue. I want an answer to the crux of Dorothy-Grace Elder's question. Will any positive improvement in health be proportional to the amount that it will cost to implement the bill? Could we use £170 million for other children's health initiatives that would have more impact proportionally?
That returns us to Gillian Kynoch's statement, which was quoted at the beginning of the meeting. I would love to say that we had clear evidence for a concrete answer to that question, but we do not. We do not have the information to compute the calculation to quantify an answer.
You speak for the Health Education Board for Scotland, so I will ask about research and medical back-up. Does any research evidence show that children who eat nutritious food more regularly than other children are healthier?
Yes. Absolutely.
So you do not think that it is an enormously dishonest leap of the imagination to argue that, if free, nutritious, healthy meals were available and children ate them more regularly, the health of those children would improve. You have suggested that uptake would increase if school meals were available free to all children.
That is not an enormous leap of the imagination. The difficulty is in quantifying the improvement.
I appreciate that it is very difficult to quantify it. I am concerned by the statement in Gillian Kynoch's submission—which you were accused of writing—that the universal free provision of school meals would have no benefits. Do you think that that is a rather sweeping statement to make?
The submission says that there is no evidence of benefit. It does not say that there may not be such benefit.
I want to press you on that. I asked you whether there was any research evidence to support the argument that improving the nutritional content of the food that a child receives regularly improves their health, and you replied that there was. You were asked whether the uptake of school meals would increase if they were available free to all children, and you said that it would. The logic of those answers is that, if school meals were free, more children would eat more healthily. Do you conclude from that that the universal provision of free school meals would be a health benefit for children?
Yes. The difficulty is in quantifying the health benefit for those concerned. We do not know what the increase in the uptake of free school meals and of school meals generally would be. A leap of faith would be required.
The policy memorandum does not argue that health would improve by a specified amount. It simply states that the introduction of free schools meals for all children could lead to an improvement in health. I would like you to confirm that educated and informed opinion in the health community regards that statement as supportable. You seem to be saying that, as an individual, you support the claim that the memorandum makes.
The claim is supportable. However, we need to consider whether universal provision of free school meals is the best value for money.
I will come on to that. The former Minister for Education, Europe and External Affairs, now the First Minister, suggested that the cost of implementing the bill would be £174 million per annum. Is it your position that there are tangible health benefits to be had from the bill but that you cannot quantify those benefits or say whether spending the £174 million per annum that is required would later produce equivalent savings in health spending on diabetes, coronary heart disease and various cancers? The supporters of the bill argue that the problem that we face is now so large that a radical response is needed. We think that the universal provision of free school meals would be a good radical response. Is there evidence that it could lead to a radical improvement in the health of our children?
Improvements in dental and oral health are easier to quantify than savings on dealing with complex conditions such as coronary heart disease. Consider how much we have to spend on correcting dental problems through fillings, extractions and so on. Those problems are caused by high sugar consumption in early life. With improved diet, significant amounts of money could be saved on dental treatment and people would have a better quality of life and reduced pain, through having a healthy mouth. What price do we put on quality of life? Attempts have been made in the health literature to do that, but it is a complex and difficult question. The universal provision of free school meals would have benefits, but it is tricky to quantify those against the expenditure that would be required.
As always, points have been made that other members would like to pursue. Because I would like to finish this evidence-taking session in the next three or four minutes, I ask Ian Young to deal with the final three questions from John McAllion, Margaret Jamieson and Mary Scanlon together.
I declare an interest as co-sponsor of the bill.
Yes. There is a restriction, but it works both ways. In the only complaint that I have heard, the discrimination was not to do with different coloured tickets. Such discrimination does not happen in schools any more—if there are examples of that, we should do something about it, but as far as I know it is not happening. If such discrimination is happening in this day and age, it is a scandal.
She could not get any drink with her meal. That is the point—she could not even get water if she wanted it.
There are some people who are not getting good quality water, but that is another issue that we will have to deal with when the European directive comes in. You are right to say that there is restriction on choice.
Just one final point—
No. I am sorry John, but I will have to stop you, because three other members want to ask questions.
How can you think that providing free school meals over 38 weeks will have an impact on the health of young people? What will you do about the remaining weeks of the year, when they are not at school? Bursts of nutrition—good, hot food—followed by periods without can have an adverse effect on children's bowels and so on. How will you ensure a steady input into young life?
Perhaps Ian Young can hold fire on that question until Mary Scanlon has asked her question.
I want to quote from two submissions that we received. The submission from Angus Council said:
Could you answer Margaret Jamieson's question, too?
On the last question, we live in a different society from the one in which many of us were brought up, where to get something cheaper or free was considered a great bonus—whether it was broken wafers from the ice cream van or whatever. Society is different now and image is top of the list for many young people.
The other point was about Angus Council, which said that provision of meals would lead to
I am not in the business of having a bash at councils; I work with all the councils. Angus Council's view is valid from its perspective but, from my perspective, the statement seems a bit extreme and dogmatic.
Could you answer Margaret Jamieson's question about the 38 weeks?
There is a body of evidence that suggests that if we build up the nutritional status of meals over a period, certain things will be improved. If children have nutritional meals for 38 weeks, that is a lot better than their not having such meals at all. As the nutritional status is built up, there will be 101 benefits, such as resistance to infection. Nutrition is an issue in our society. If we get school meal provision right but do not get right other issues of food provision or create a food-promoting environment, we will have completed only part of the picture. On balance, we want to get school meal provision right and build out from there to improve nutritional status. There will be benefits from the provision of nutritional school meals.
Thank you. The clerks assure me that we have asked for a written statement. If there is anything that you want to cover that has not been covered in the questioning, feel free to write to us to supplement your evidence.
I am the Scottish food and health co-ordinator, which means that I am employed by the Scottish Executive health department to advise the Minister for Health and Community Care on implementing food policy.
Do you believe that the provision of free school meals to all schoolchildren will have a measurable impact on health? If so, what will the extent of that impact be? Will you outline any research that has evaluated the effect of school meal provision on health outcomes?
The provision of good school meals would have a big effect on the health of Scottish children. We must consider the role that school meals can have in improving health. There are three core but interrelated functions. In Scotland, it is evident that there is a group of vulnerable children who have stunted growth and who are disadvantaged through poor nutrition. There is quite a large difference in height across the socioeconomic groups. It is important to understand why school meals were introduced: to protect and provide with food vulnerable children who might otherwise not get adequate nutrition.
You mentioned breakfast clubs, which we discussed with the previous witness. The bill refers to provision of a nutritious meal in the middle of the day. However, you spoke just about providing a nutritious meal. I am interested in the role that breakfast clubs are playing in community schools in the Glasgow City Council area. That initiative is now to be extended to every school in the authority. There is evidence that provision of a nutritious breakfast has an impact on attendance rates and attainment levels. Would it be better for authorities to fund breakfast club initiatives than for them to fund school meals at lunch time?
Because of the sheer number of children who take school lunches, we should concentrate on getting school meals provision right. Given that just under 50 per cent of Scottish children eat lunch at school, getting that cornerstone right should be our absolute priority. Breakfast provision is an important supplement to provision of school lunches, but it should never replace that. We do not want to transfer a family meal to a more institutional setting. It is important for children to eat meals with their families as well as at school.
Because of funding constraints, some authorities may not be able to provide breakfast clubs if they have to provide free school lunches. There is evidence that breakfast clubs work and that uptake is high. As we have heard, there is no concrete evidence that universal provision of free school meals would lead to a large increase in uptake. That would require a leap of faith. We can provide free meals and make them nutritious, but children will not necessarily eat them. At the moment, uptake of school meals generally is not high. Is it better to give children the option of breakfast, which they are likely to take up, than to make provision for free school meals that large numbers of children may not take up?
You are asking me to speculate about what would happen if the School Meals (Scotland) Bill were passed. How universal provision of free school meals would impact on services at other times of day is one of the great unknowns.
We are all agreed on the importance of the nutritional content of school meals, but I am looking for a clear line on whether free school meals will impact on health outcomes. Point 1 of the Scottish Executive submission says:
Angus Council says:
Glasgow City Council says:
That is rather a lot to remember.
Will you comment on the two quotes from the councils, which are not too helpful in the light of your statement that there is no evidence of a health benefit? Will you also comment on the work of the expert group?
I want to make it clear that there is a great deal of evidence that improving the quality of school meals will impact on children's health. It is important that we improve the provision of school meals. The statement in our submission says that we do not know what the extra dimension of universal provision of free meals will add to health benefits on top of the work that we have in hand. We have a solid package of work in hand to improve school meals.
The point that Janis Hughes made is the crux of the matter. No one disagrees that if kids eat more nutritious meals, more regularly, they will be healthier. The question is whether making school meals free universally will result in more kids eating more nutritious meals, more regularly. That is the case of which I must be persuaded. If school meals are free for all, are children who already qualify for free school meals more likely to take up their entitlement? Will the bill make kids from richer backgrounds, who are given money to spend as they wish, more likely to opt for school meals, rather than using their purchasing power to buy food elsewhere? I understand that we are asking you to hypothesise, but those questions are crucial in determining whether the bill will have the desired effect.
The desired outcome of the bill is something that the minister supports. The only point on which the Executive's aspirations and what the bill wants to achieve differ is the question of universal provision.
That difference does not seem to be based on evidence. The Executive and the minister have simply taken the view that the bill will not have the desired effect. They may be right—I do not know—but I would like to have something more concrete than the minister's view to go on.
One could say that the bill has come too soon. That is what the weight of evidence suggests. We intend to put in place a package of policy measures aimed at improving school meals and at achieving the outcomes that we all seek. How does the committee know that those measures will not work? From the evidence, we believe that they will. Our approach is based on current practice. We are examining what works. Across Scotland, there are many examples of good practice in the current system. Local authorities are investing in dining halls, kitchens and staff training. They are involving pupils and parents in school nutrition action groups and involving children in the redesign of school meals services. From the current pockets of good practice, we know that we can bring about a large increase in the uptake of school meals and a very high uptake of free school meals. We know that we can provide services that are valued by parents, pupils and teachers. We now seek to roll out that good practice throughout Scotland.
The key issue is evidence. Are you saying that you have produced evidence that you can, by a different route, achieve the same results that universal provision of free school meals would achieve?
Because we do not know what impact universal provision of free school meals would have, I cannot say that our approach would achieve the same outcomes.
However, you are saying that you know absolutely what impact the package of measures that you have described would have.
I am saying that I have seen good practice and achievement. I have seen local authorities investing and achieving results by working in partnership with schools, parents and pupils. In that way, they have brought about great improvements in school meals. The expert panel is capturing that good practice. We seek to understand better what makes the system work, so that we can deliver best practice to all children in Scotland.
So you are not saying that the Executive has disproved that universal provision of free school meals would be beneficial. You are saying that you do not have the evidence one way or the other and that you would prefer to take a different route.
Yes.
You and the Executive will agree that we are faced with a massive problem. The Child Poverty Action Group and others have stated that, officially, more than 300,000 Scots children live in poverty. Many more live on the margins of poverty. You have outlined many useful measures that the Executive is taking, but are you in danger of skirting round the issue and failing to tackle it at its core, as could be done by making universal provision for free school meals? Do you take on board the fact that it can cost a family that is on the margins of poverty and which does not quite qualify for free school meals about £25 a week to fund school meals for three children? Have you ever considered experimenting on a short-term basis—perhaps only for six months—with universal provision of free school meals, to see whether that would work? Such an experiment could be run in an area such as Glasgow, which has one of the highest child poverty rates in western Europe.
As food and health adviser to the Scottish Executive health department, I will not give evidence on increasing benefit entitlement. That is not my area of expertise. I know that parts of the Executive with policy leads in social justice and welfare entitlement are examining the issue that Dorothy-Grace Elder raises, but I am not aware that the Minister for Health and Community Care has made a policy decision on it.
I appreciate that. It is excellent work, but it does not tackle the massive core issue. We are talking not about a few hundred children, but about 300,000 or more children who live in poverty.
That is why we are setting national standards for school meals, so that we impact on all children.
But England is well ahead of us on that—it has been looking after child nutrition much better in schools for many years. Why are we behind when so much good work has been done with no real results?
I do not agree that a lot of work has been done south of the border. We are looking to improve on the work that has been done.
England has nutritional guidelines.
England has had food-based standards for school meals for a year and a half. It is well recognised that those are not monitored and that they have not delivered an improvement in the provision of school meals. What is important about the work on which we have embarked in Scotland is that we have strong nutrient standards and a robust system of monitoring. That means that we can measure improvements in the service. We are not about setting token national standards in Scotland.
We all agree that nutritious meals are important. If the bill were enacted, would it be possible or practical to monitor schools to ensure that they complied with acceptable nutritional standards and if so, how?
Whether we get the added element of universal provision of free school meals or not, the bill provides that food must be nutritious. I consider that my major task, which is to set nutritional standards for Scotland, would be achieved and that those standards would be monitored. The process would be the same either way. We are building in a strong monitoring system at various levels to check whether schools are delivering on the standards.
The school meals services provided little incentive to work with young people as valued customers. The attitude was very much: "Here is your free jelly and peanut butter sandwich—take it or leave it." The schools often hit their nutrient targets by adding in extra minerals or vitamins, but it was not the quality of school meals service that I would want for Scotland.
So we would not have to augment the monitoring system if the bill were enacted, as the previous witness suggested? Would the monitoring system and all its components be able to monitor nutrition regardless of whether the bill was passed?
The expert panel is taking advice on the monitoring system at the moment. It is one of the topics for the next meeting and I would not like to pre-empt that discussion.
What areas will the expert group be discussing?
We will need to monitor not only whether nutritional standards are met, but whether that is done in the context of an increased uptake of school meals. There is no point in having healthy dinners if no one eats them. We must monitor presentation, environment, uptake, popularity, choice, variety and so on.
Do we have sufficient resources to monitor all that, once we have decided which areas we want to monitor?
Yes. There is no point in having standards of any sort if they are not monitored.
Of course. I am just saying that there is no need to augment the process because we have the resources in place to monitor the areas.
No. The panel will be advising the minister on the level of monitoring.
It will require further funding.
There is no monitoring system in place for national standards at the moment because we do not have national standards.
So that would require more money.
The panel is taking advice. I am sure that the committee will consult representatives of the panel, but we have to come up with a fully costed implementation plan and a fully costed monitoring plan. That will be done by the end of May.
You mentioned the importance of the system containing no disincentives to children to have a school meal. Do you not accept that, for the working poor and for those on very low incomes who do not receive income support or jobseekers allowance, the cost of a school meal is a disincentive that prevents children from getting a school meal? Equally, even for those who are on income support or who do receive jobseekers allowance, do you accept that, even with card systems, the present means-tested system and the cash limit on the amount that is free set people apart, create a stigma and act as a disincentive, at least to some people?
There is always a grey area, and a number of people who are just outside the threshold of entitlement. For some families, the current cost of a school meal may be a disincentive.
Universal free school meals would specifically tackle such disincentives.
What we do not know is the impact on the uptake of meals that universal free provision—
There would not be a cost disincentive if there were universal free school meals.
What I was saying was—
Do you not agree with that?
We know that what influences whether children go for school meals—whether they are entitled to free meals or not—is largely their peer group. I have talked about this to a lot of children and they, their parents and their teachers continually reinforce the idea that children's eating habits are largely determined by what their friends are doing. There is a pattern: in first year, pupils tend to eat school meals; in second year, they eat fewer school meals; in third year, they all go down the town; and in fifth or sixth year, if they stay on, they come back to having school meals. The desire to eat with friends and follow what friends are doing, as well as the perception of the value for money and the quality provided by the school meal service, are what drive young people's habits and—
Can I be clear? Are you saying that there may be a cost disincentive but that it does not affect uptake at all?
I do not know.
Do you think that there is a cost disincentive for some families to participate—
I have certainly worked with families who found paying for school meals hard—yes.
Do you accept that a universal free school meal would get rid of that cost disincentive, if nothing else?
I think that there—
That seems logical, does it not?
It is not an all-or-nothing thing. We may need to consider the level of benefit provision—
Well, either there is a cost disincentive or there is not. If school meals are free, there is no cost disincentive. Do you not agree?
Yes, that makes logical sense—
Thank you very much.
But that is not the only way.
You have talked about what you found in America. What other international comparisons of nutritional standards have you made? We have heard that some Scandinavian countries have offered free school meals. What was the impact on uptake there? Our earlier discussion touched on the possible impact on health. It is perhaps difficult to isolate the impact, because we know, for example, that the Finns were doing lots of other things, such as encouraging people to eat berries. Do we have any evidence of the impact of a shift to free provision in other countries?
I do not have that information. I have not been out to look at the Finnish system but you may well be able to get that information from other experts you will be talking to. I have anecdotal evidence from a party that went out recently on a Scottish community diet project. They looked at the provision of school meals and were not impressed at all. However, I have not seen a written report.
The cost of the bill's proposals is estimated at £170 million. Can you give us ballpark figures for the cost of the work on nutritional standards and for the work that you have in hand?
No, you are a couple of weeks too early. The panel will report at the end of May.
Do you believe that the likely improvement in health will be proportionate to the cost of implementing the bill, or do you feel that it will be disproportionate and that the money could be better spent elsewhere?
There is no doubt that to improve school meal provision in the way that has been discussed this morning will take an increased level of investment.
Gillian, I am pleased at the way in which you have focused on school meals. The priority you have accorded school meals is laudable.
Are you saying that the work of the panel will not increase entitlement?
Yes.
The expert panel is not considering entitlement.
I wanted that to be clarified, as there was confusion over the expert group's publicity about improving school meal take-up, including free school meal take-up. As a supporter of the bill, I worry that we are missing out those 100,000 poor children who come from low-income families but who are excluded from free school meals. The expert group is not addressing that concern.
Within the task that I have been given, my major priority is to provide a school meals service that serves Scottish children as best we can. The task ahead of the expert panel is to provide a service that offers value for money and good food—a service that children and parents will value. We must ensure that the current service has no disincentives. However, extending entitlement is outwith the remit of the expert panel.
In response to John McAllion, you accepted that there was currently a cost disincentive. If you improve the standard of food, is that not likely to impact on the cost?
In my work across central Scotland, we were able to bring about large improvements without increasing the cost. There was a big capital expenditure in bringing services up to standard, but the on-going cost of providing healthier food was not a problem in our experience. We were able to keep food costs the same, but the service costs were high.
My final point relates to the importance that you have put on school meals as a vital contribution to children's health. Earlier, the representative of the Health Education Board for Scotland said that he confidently believed that, if school meals were universally free, uptake would increase. He could not quantify that, but he confidently believed it. Without quantifying your answer, do you similarly believe that, if school meals were made healthy and free, uptake would increase?
No, I do not, Tommy, and it is my biggest worry. I cannot feel confident about that. I cannot look ahead to a school meals service that is universally free and predict its impact from the evidence that I have, given that we have never tried such a system and that there have been no pilots. My concern is that the service would split and polarise. If the service were universally free, middle-class families might opt out and we would have an increased number of middle-class pupils taking packed lunches, as they largely do now. Because the service did not have to compete and to provide value, the level of service might decline, so we would end up with a poor provision of service—
I am sorry to interrupt you, but you have already accepted that we need strict nutritional standards. How could the service decline if we impose strict nutritional standards? You seem to be doing yourself out of a job.
There is a difference between the nutrient standard and providing a quality service. We can hit the nutrient standards by just providing someone with a vitamin pill. We must provide a quality, valued school meals service.
Do you think that you would not be able to provide that if school meals were free, as is the case in Sweden and Finland? You gave the bad example of America. There are healthy examples from Sweden and Finland. Those examples show clearly that the promotion of healthy food at school age is a contributory factor to public health. Do you not think that it would help?
I have confidence that we can build a good school meals service, given the expert panel's remit and the tasks that are ahead of it. My concern is that taking the extra step of making the service universally free would not necessarily impact well on the provision of the service. I would need to be shown that it would.
Just how joined up is the approach to ensuring that appropriate nutritional standards are met? What is envisaged for the future for health improvement and the programmes to which each NHS board has to sign up?
The strategy is joined up. The background to improving the diet of Scotland is "Eating for Health: a Diet Action Plan for Scotland", which is the strategic framework to which we are working. The work on school meals is part of that. The policy is fairly holistic, so it should be joined up. We are also joined up in other directions. The work that we are doing in nutrition in schools is part of a joint initiative with the Minister for Health and Community Care, the Minister for Social Justice and the Minister for Education and Young People to ensure that the right strands of policy come together.
How is that evaluated? We will take evidence on the budget from the Minister for Health and Community Care this morning. One of the areas in which the committee is interested is how NHS boards are answerable to the minister and the public. How do you measure what is happening in the school meals service?
I must excuse myself by saying that that question is outside my remit. I look after health education and diet policy. However, I know that colleagues of mine—
You are from the health improvement strategy division.
I am the head of the branch that looks after health education and diet policy. Colleagues within the health improvement strategy division are working with the NHS on performance assessment. They are examining closely and discussing with colleagues and experts how we assess performance in terms of health improvement. How do we assess something that happens in childhood and impacts on a person's health as an adult or in old age? Those challenging questions are being worked on. I am sure that the minister will give you the benefit of his advice.
Is that not currently part of the performance assessment tool?
I am not placed to give you correct evidence on that. I am sorry.
We will check it out.
I take issue with something that Gillian Kynoch said. You seemed to imply—correct me if I am wrong—that only competition would maintain the standards of school meals and that a free service would somehow be devalued in the public mind. You cited middle-class parents not taking up free school meals because they would perceive them as being of low quality. Is that what you were saying?
That is a danger.
Does that not raise the same question about any universal service, such as the NHS, which is free at the point of delivery? Are you saying that people do not value that service because it is free? I cannot see the logic in your argument.
I want to step back and focus on the catering provision in schools. It is a challenge to provide such a service in schools. In the case of large secondary schools, where the pupils are mobile, the school catering service has to compete with the high street and with the other food choices that children make. Across much of Scotland and especially in secondary schools, the catering service has lost its client base because of that competition—in effect, the kids have walked. Regardless of whether the children are entitled to free provision of food or whether they have to pay, they have chosen to go down the street.
It is possible to turn around that argument and say that, if the market forces argument that schools have to compete is to be applied, schools should sell burgers and chips and no nutritional standards would apply. If the baseline is that school meals services have to compete with the high street, how is the Executive to drive up nutritional standards? Surely it will be all burgers and chips if school meals services have to compete in that way.
Luckily, children are more discerning than that. I could take committee members to secondary schools—such as one that I visited last week in Dundee—where the school meals service has competed successfully with the high street. The people who work for the service are bringing pupils back in because they have a vision of good-quality food served in a nice environment. The children appreciate that; they see that the food that is provided in their school is every bit as good value for money and appealing to them as young customers as the food that they can buy in the high street is. That is what I mean by good practice. It is no longer enough for school meals services to compete in terms of burgers and chips; we are asking them to compete with the world outside. They have to keep their custom base, give children healthy food and monitor the service as it is delivered.
Are you saying that that can be achieved only by charging for the provision? Are you saying that the meals that you talked about in Dundee that were attractive to the pupils are attractive only if they are charged for? What disincentive would charging have for the children who are taking those school meals?
I have seen that system work, but I have not seen the system of giving all children free school meals.
Okay. We will bring that part of the evidence session to a close. I thank Gillian Kynoch for her written submission and for answering members' questions. Our next two witnesses are from the Child Poverty Action Group in Scotland.
Good morning. You have provided us with helpful information. Do you want to make an opening statement before we put questions to you?
We both want to make a quick opening statement. I will be as brief as possible.
Rather than having another statement, we will move on to questions. If there is anything that we have not covered by the end of the evidence session, I will give you a chance to say more.
The committee is particularly interested in the health aspects of the bill. Given your supporting statement and what you have said about the bill as a measure to eliminate poverty, do you think that money would be better spent on targeting children in families that live in poverty than on providing my child with free school meals when I can afford to pay for them?
The question is why the Child Poverty Action Group supports proposals that would also feed rich children. Perhaps that attitude comes from looking at the problem from the wrong direction.
Earlier, a witness denied that a ticketing or discriminatory system is used nowadays. However, in your submission, you say that, occasionally, children who might have got fish—a decent thing—are so far back in the queue that the canteen has run out of it by the time that they get to the front. Tell us about the practical effects of stigmatisation.
I often hear people say that we are moving towards new, cashless systems and swipe cards to tackle the stigma. People say that the stigma does not exist any more and that old-fashioned practices such as having separate queues are no longer in use. However, I visited a school—I would rather not name it, as the head teacher was extremely supportive of what we are trying to achieve—where the children lined up along the wall of the dining hall as soon as the bell rang. There was a burger bar arrangement, with 10 hatches and smaller queues at each hatch. A teacher stood at the front of the queue and let a few pupils through at a time.
You said that if all families have a stake in the system, they will feel responsible for it and standards will be less likely to fall. Who would monitor strict adherence to those nutritional standards in the long term?
Wendy Wrieden is a nutritionist and can probably explain that better than I can. I point out that the submission gives specific examples of current initiatives of which we might make use.
I am from the centre for public health nutrition research in Dundee and I contributed to the book in support of the bill. We were contracted to do some monitoring of school meals in Dundee because the council was considering introducing various systems. There are experts who can carry out such monitoring. I am sure that Gillian Kynoch will be looking into that with the expert panel on school meals.
If the bill is passed, what impact will the provision of free school meals have on the health of future generations of Scottish children?
I am sure that there is no need to tell the committee that a vast number of premature deaths result from diet-related diseases such as coronary heart disease—diet is not the only cause, but has been shown to be one of the related factors. We know that something like 9 per cent of teenage girls have an iron deficiency in their haemoglobin and tend to be anaemic. We also know that 50 per cent of teenage girls have a marginal intake of iron from food.
I am sympathetic to the bill and its aims, but I want to be convinced that it will have the desired effect. We have heard about cost disincentives in the system. That is an obvious point, in that there is bound to be a cost disincentive in any system involving charging.
You asked whether stigma is a major contributor to families' not taking up free school meals. I refer you to evidence taken in May 2001 by the Department for Education and Employment, as it was then, and the Child Poverty Action Group. The evidence is referred to in a Scottish Parliament information centre paper and I would be happy to supply it. It states that 30 per cent of the children consulted—this was the first time that they had been consulted about the matter—said that the stigma of claiming a free school meal put them off doing so. Interestingly, two fifths of parents also said that that was the reason why they did not take up free school meals. Therefore, I suggest that there is evidence that stigma is a factor. Indeed, in that case it was the biggest contributory factor.
I think that—
I am sorry, Nicola. We have to move on, because four other members wish to contribute and I want to conclude this evidence session in the next little while.
I want to get a quick response from you to Gillian Kynoch's comment that, if school meals were free, that would devalue them. She was hinting that uptake might fall because meals had been devalued.
I do not think that uptake would fall if the quality and standards of the meals were appropriate. One thing that perhaps discourages children from taking school meals is their quality. Some caterers are making good efforts in producing school meals, as Gillian Kynoch mentioned in relation to a school in Dundee. However, there is still a feeling that school meals are not particularly good. If they are good, children will take them, free or not.
Can I just—
No, sorry. I call John McAllion.
We have heard from several witnesses that there is no evidence to show that the bill will increase the uptake of school meals. We should be clear that the reason why there is no evidence is that no pilot studies have been done and there is no universal free school meals service.
In Scotland, at least.
Is there evidence from other parts of the world to show what patterns follow from free school meals?
Yes, there is evidence from Finland and Sweden. People have come to talk about that to our free school meals working group and to the Scottish community diet project. An academic has visited Sweden, which has a universal free meals system with a high uptake and high nutritional standards. Interestingly, those countries have a buffet system and kids help themselves. Such a system has worked in other places.
Tommy Sheridan can have a final question.
Is it just the one?
Yes.
I will ask it of Wendy Wrieden then. I ask her to explain what she does and for how long she has done it. In that context, will she, in her professional capacity, give an opinion on whether the £174 million investment is worth while.
I am a nutritionist and I have been a member of the centre for public health nutrition research for four or five years. I have lectured in nutrition and food science at the University of Dundee for 13 years. Most of my work has been on the relation between diet and health and on considering what people eat and why they eat it. What was the second part of the question?
If you had £174 million to spend, would you spend it on free school meals?
A lot of money is poured into dealing with health problems, but we have yet to pour a lot of money into preventing ill health. The provision of free school meals of a high nutritional standard and of a quality that makes children want to eat them—we cannot have free school meals without that—is a preventive method. In the long term, I would expect that method to prevent the burden of ill health in Scotland.
I am afraid that we must finish the questions sooner than we would have liked because we are about half an hour over the time that was allocated for the item and the Minister for Health and Community Care is waiting. I thank the witnesses for their evidence and for their written submission, which we found useful.
Meeting suspended.
On resuming—
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