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Chamber and committees

Health and Community Care Committee,

Meeting date: Wednesday, May 15, 2002


Contents


School Meals (Scotland) Bill: Stage 1

The Convener:

We will take further evidence on the bill. Our first witness is Professor Phil Hanlon, whom we all know, from the Public Health Institute of Scotland. Welcome to the meeting, Phil. You can make a short statement, if you wish, after which we will have questions.

Professor Phil Hanlon (Public Health Institute of Scotland):

Members either have received or will soon receive our submission. For the sake of clarity, I might as well repeat the submission's main headings, because we tried to organise our evidence as succinctly as we could around those headings.

The propositions that we put to you are that nutrition is clearly a health issue in Scotland, that child nutrition is particularly problematical and that the growing numbers of obese and overweight children is a problem for which there are currently no effective strategies. I stress that latter point. We have a problem that is growing and for which we do not currently have an effective response. That is a key point.

Poverty is a key determinant of health and poverty and diet are inexorably linked. Simply giving advice and education is not sufficient. There is clear evidence that changing the cost and availability of food has an impact on consumption. It is clear that school meals fit within that body of evidence and that their cost, acceptability and availability are important. However, there is other evidence—which I will not repeat as the committee has probably heard it—that shows that the uptake of school meals is influenced by a wide variety of factors other than cost and availability.

We tried to consider the matter as honestly as we could and the conclusion that we had to come to is that we cannot present to the committee clear evidence that free school meals will have a positive health impact. However, we can present evidence to show that there are profound health issues around the question of free school meals. That evidence might influence the committee's eventual decision.

We conclude by saying that the decision must be primarily a political decision rather than a public health science one. As a public health science body, we have to declare ourselves as agnostic. However, we also make the point that the majority of the public health advances in the past have been made as much on political grounds as on public health science grounds. I am not dodging the issue. That is simply the evidence that we lay before you.

Thank you for that.

Mary Scanlon (Highlands and Islands) (Con):

I think that you possibly answered my first question. However, I will go a step further. Do you believe that the provision of free school meals will have a measurable or positive impact on schoolchildren's health? In answering, can you refer to any research that is evaluating the health outcomes of free school meals?

Professor Hanlon:

We did not have much time to research the issue, so the short answer to your second question is no. There is no equivalent to the drug-based, randomised, controlled trial that we can point to and say, "There is the evidence. That is the size of the effect." A decision will have to be made in the absence of such evidence. However, I point you to another kind of evidence.

California, Massachusetts and Florida have achieved lower smoking rates than other parts of North America. They have done so by introducing a host of anti-smoking legislation and activities for which there is no evidence base. I cannot point you to the randomised controlled trial that shows that taking away smoking in workplaces and public places reduces smoking prevalence. There are no trials to show that. Those American states made an act of faith or a political commitment. Their political commitment across a range of areas has resulted in lower levels of smoking.

That is why I say to the committee that the issue is whether members can convince themselves that the symbolism and the potential benefit that might be measurable in time is sufficiently great to justify the proposals. As our submission points out, the proposals would come at an opportunity cost—other things could be done with the same money. We are circumspect about the strength of evidence that can be brought to bear.

I know from experience that although California has a no-smoking policy, one cannot breathe the air there. My asthma is testament to that.

Professor Hanlon:

You win some, you lose some.

Mary Scanlon:

You certainly lose, because the air is so polluted. Point 9 of your submission states:

"Whether school meals should be provided free on a target or a universal basis is a decision for the political rather than public health science arena."

I am looking for a steer from you that free school meals will benefit health. I know that you think that the decision should be a political one.

Finally, the conclusion of your submission states:

"There is no scientific evidence that universal free school meals will improve child health."

Professor Hanlon:

Do not get me wrong. I am not trying to obfuscate the matter. If I put my trained scientist's hat on, I must adopt scientific vocabulary. That is what you get from scientists when you prompt us with such questions. If the introduction of universal free school meals of the suggested nutritional standards resulted in widespread uptake of nutritionally satisfactory meals on a near to full scale, particularly in primary schools, that would have a beneficial effect. That statement is unproblematic. Of course, the effect would be contingent on the rest of the diet because children consume only 12 per cent of their food in school time.

There is some observational data on the uptake of free school meals, but the problem is that there is no prospective work that allows me to prove or show the benefits in the way that I can say that a beta-blocker is beneficial for hypertension. I cannot do that, but I am not trying to pour cold water on the proposals by saying that the lack of evidence means that there is nothing more to be said.

Mary Scanlon:

The One Plus submission is interesting. According to the pie chart that shows the reasons why children do not take school meals, only 16 per cent of children cannot afford them, whereas 33 per cent dislike them and 30 per cent prefer packed lunches. Does that evidence show that only 16 per cent of children might benefit from free school meals?

Professor Hanlon:

That is one interpretation of the results. I am trying to be as positive as I can, because I do not want to be negatively scientific. To use a piece of jargon, my point is that there are normative benefits. If we made a healthy meal in the middle of the day normative—what kids do as a matter of routine—that would have some kind of general effect. That might be an argument for universal free school meals. There is also an argument against, which is that because the cost of meals is a barrier to only 16 per cent of children, free school meals might not be taken up. Those arguments have been well rehearsed before the committee.

After discussing the issue, we felt that there is not sufficient evidence to say that free school meals are the right course of action. Neither is there a lack of evidence to suggest that we do not have to do something. In considering that something that needs to be done, the proposals warrant serious thought, albeit that, to give my personal opinion, the £240 million has other potential demands on it in terms of the health of the people of Scotland.

Dorothy-Grace Elder (Glasgow) (Ind):

As you said, the decision is political. The nub of the matter is what proportion any positive improvement in health from the bill would have to the amount that the bill would cost to implement. Would the bill be the most effective use of money?

Professor Hanlon:

That is a big question. My submission sets out the position of the Public Health Institute of Scotland, but I can offer a personal opinion, if the committee would like me to. My best guess is that the biochemical and nutritional benefit of introducing universal provision of free school meals would be small, for the reasons that have already been rehearsed.

The only argument for such a measure—I am repeating myself, but the committee needs to hear this—relates to its symbolism. It would indicate that we had recognised a problem that needed to be reversed and that we were committed to doing that. The symbolic act of introducing universal provision of free school meals might have knock-on effects. However, we would need to know that that was the reason for the measure and to follow it up with a host of other practical and nutritional steps. The problem that we are discussing will not be solved unless many different things are done. I am not sure that the symbolism of introducing universal provision of free school meals is worth more than £200 million.

It would cost about £74 million more than £200 million.

Professor Hanlon:

Yes.

We have talked about the need for hard evidence. Do you support the introduction of a year-long pilot scheme in a particularly deprived area in order to gather such evidence?

Professor Hanlon:

That would be the most rational approach to take. We could conduct a randomised trial of universal free school meal provision. That would require attendant support, involving the examination of kids' behaviour and nutritional status, and other food-diary-type approaches. It would not take too long to conduct such a trial. It could be done easily and would provide the answers to some of the questions that you are asking.

Within what period would it be possible to discern whether universal provision of free school meals had made a difference? Would we need a year or longer than that?

Professor Hanlon:

Within a year, one could draw conclusions about the effect that the measure had had on uptake of meals. I must warn members that the likelihood of its impacting on body mass index, weight and obesity is small. The world literature is full of people who have tried—and failed—to combat the problem of obesity.

Many of them are sitting around this table.

Professor Hanlon:

We all live in a society that struggles with the issue of weight. We know how hard it is to combat obesity. Let us not pretend that the problem is easy to solve.

The only evidence that we could find of an approach that had worked was one letter to the "British Medical Journal" from a school in Singapore that had run a successful whole school programme to combat obesity. However, Singapore is a famously compliant society, and I am not sure that we would have the same success here. The most rational approach would be to conduct a trial.

If this symbolic step were taken and universal provision of free school meals were introduced, would it be possible or practical to monitor school meals to ensure that they complied with nutritional standards?

Professor Hanlon:

Yes. That is not beyond the wit of man.

So there would be no problem doing that.

Professor Hanlon:

I would not say that, although it is not hard to measure food content against nutrition. However, there is no guarantee that the 12 per cent of children's food that is consumed at school will be reflected in their overall nutrition. That is why simply introducing universal provision of free school meals would not deal adequately with the problem that we face.

Would it be worth our while introducing universal provision of free school meals alongside other measures?

Professor Hanlon:

We are now talking again about my personal opinion. As has been said, the cost of extending free school meals to all children is more than £200 million. I would prefer to target that resource more, because there is a gradation of need. Other symbolic measures could be introduced. For example, primary schools are probably more amenable than others to intervention of the sort that we are discussing. As a halfway house, I would suggest that universal free school meals be introduced first in primary schools.

The fruit in schools programme has been very successful, particularly where teachers have incorporated fruit eating and preparation into lessons. It is has been found that if fruit is peeled and cut up, kids will eat it, when they will not eat it unprepared. That is an imaginative approach. The communities school programme is also very exciting and has much potential. The teenage transition years demand much more resource and attention. I can think of many competing symbolic steps that the Parliament could take.

Would the approaches that you have outlined have a more positive effect than the introduction of universal free school meals?

Professor Hanlon:

They would have a stronger evidence base and be less problematic, although they would have less media impact. We have been doing the things that I have described, which usually receive no more than a few column inches here or there.

Are you saying that such measures would have a greater impact on the children?

Professor Hanlon:

Yes. The fruit in schools and the community school programmes can be shown to have increased the amount of fruit that children eat. They have stronger evidence bases because people have done the sorts of trials that we are discussing for free school meals. In that sense we have more confidence in such programmes. They are much less expensive and much more amenable to targeting.

Are you saying that they are more cost-effective?

Professor Hanlon:

Yes, but we have to be careful. Given that we do not know the effect of universal free school meals, we cannot comment. We have said that because there is a lack of evidence, it is inappropriate for us to comment. I have been forced back into scientific mode now. I cannot say that universal school meals are more or less cost-effective, because I do not have a cost-effective figure for universal free school meals.

Would a pilot project provide the scientific data that you could analyse in that respect?

Professor Hanlon:

Yes.

On the evidence base, what is the best example that you can give us of the fruit initiatives that you have talked about assisting the increased consumption of fruit among children?

Professor Hanlon:

The evidence is not at the trial level. The work that has been done in Glasgow has a captive audience for the fruit prepared and consumed in class. The number of pieces of fruit provided and consumed for a given target population can be shown.

Tommy Sheridan:

Would you accept that, inadvertently—I am not suggesting that you did this deliberately—your evidence on the success of the fruit schemes was slightly misleading? You mentioned that Glasgow was the best example of such a scheme, yet you also mentioned targeting. However, the fruit in Glasgow is free and there is no targeting.

Professor Hanlon:

That is right. I am sorry, I did not mean to be misleading. My point about targeting is that, for example, the new community schools initiative can target those areas that have lost out socially and economically in the past. I agree that every child in Scotland needs more fresh fruit and vegetables than they get and therefore the fruit programme is a good universal measure.

Let me be clear. Every child in Scotland, including my affluent children, could do with having less fat and processed food in their diet. I do not have a difficulty with the argument for universality in that respect. However, I have been asked whether there is an evidence base for the universal introduction of free school meals as a public health benefit. All I am saying is that, at the moment, I cannot lay my hand on the study that will show what that health benefit will be.

Tommy Sheridan:

Thank you. I appreciate what you are saying, but on the issue of what you call targeting and what I see as means testing, the evidence that you have given about the success of a particular programme relates to an area where there was no targeting.

Professor Hanlon:

I agree with that observation.

Tommy Sheridan:

Do you accept that the work that was done by Nordlund and Jacobson in 1997 on free school meals provision in Sweden showed that universal free school meals increased uptake, appreciation of food and the quality of food? The study also found improvements in physical fitness, well-being and alertness. Do you accept that the latest study from Nordlund and Jacobson in 1999 shows that in the local authorities in Sweden that have begun to introduce charging for meals, all the health benefits have declined and there is less take-up? Do you think that that is good evidence that could be reasonably used by the supporters of the bill to argue that universal and healthy free school meals could improve the health of the population?

Professor Hanlon:

I am trying to distinguish between my scientific answers and my answers based on opinion. With my scientific hat on, I would say that such studies are observational. For example, if I were trying to get a drug introduced on the basis of an observational study, it would not be allowed. The evidence from Sweden is helpful and is the sort of evidence that would convince a scientific committee to fund a trial. It is at that level. It is supported evidence and it is helpful and I have tried to be fair to that when saying that there is evidence that cost and availability influence food consumption. To that extent, it is kosher—that may be a politically incorrect usage of the word and I apologise if it is—but it is not proof in the scientific sense.

I would not suggest for a moment that it is proof. I was suggesting only that it is reasonable for the proponents of the bill to draw on this evidence to support their arguments.

Professor Hanlon:

Absolutely. There is a great deal of evidence that cost, availability, presentation and other related factors influence uptake. There is no doubt that your bill would have an impact on what Scots kids eat. It is just that, at the moment, the impact would be unpredictable and the debate is around whether the impact would be worth the money.

Tommy Sheridan:

You have sort of pre-empted my final question, but I will ask it anyway. Last week, the Health and Community Care Committee was told by Ian Young of the Health Education Board Scotland that, although there was no evidence, he confidently predicted that the bill would result in an increase in the intake of healthy food. We heard similar evidence from Dr Wrieden from Dundee University.

I will make available to the committee the article by Professor Mike Lean that says:

"The call for universal free school meals is certainly not something which should be dismissed out of hand.

Those advocating it have taken into consideration the dietary factors and while I'm not too concerned about the politics of this move to get a bill passed in the Scottish Parliament, I do see it as an ideal vehicle for promoting nutrition amongst the young."

Do you think that the bill could be an ideal vehicle for promoting nutrition amongst the young?

Professor Hanlon:

You are trying to put words in my mouth, so I will be careful. I am happy to go on the record as saying that I think that there is good evidence to suggest that what we eat is to some extent a habit. If we could make the consumption of healthy foods a habit right from primary 1—because primary school is a different proposition from secondary school and I wonder whether you have considered that distinction—we can be educative about it. If the meals reach a certain nutritional standard and the fast food culture that has infected our dining halls is to some extent overcome, there is something to be said for that argument.

Is the bill an ideal vehicle for promoting nutrition among the young? The strongest that I would put it is that the idea merits serious consideration as long as it is part of a much wider approach to confronting this serious problem.

Mr John McAllion (Dundee East) (Lab):

You have mentioned several times this morning that your only concern about the universal free school meals proposal is its opportunity cost because the money might be better spent in other ways. However, the figure that you mentioned is inaccurate. According to Jack McConnell, who, as I am sure you would accept, is an unimpeachable source, the net cost would be £174 million. That assumes no other action on the part of the Executive. However, the expert panel will produce a series of recommendations for changes in the school meals service that will have a cost effect. That means that the net cost of £174 million will come down still further. Would a reduction in the net cost to less than, say, £100 million change your views?

Professor Hanlon:

Again, I do not want to seem to be dodging your questions, but I can speak with some confidence only about what I have written in my submission. With confidence, I can say that the opportunity cost is a key issue. The question is not whether the cost is £174 million or less than that—I am sure that some people will claim that the capital costs will be greater than you imagine—because we do not have the data that would enable us to work out the cost per life saved or heart improved or whatever.

The Scottish diet action plan budget is tiny compared with the proposed cost of £174 million. Which budgets would be raided to achieve the aim of the bill? That is the dimension that I am concerned about. All I am doing today is raising concerns. I am not pretending to any special expertise about expenditure cost and relativity.

Mr McAllion:

I accept that. However, you mentioned the importance of universal access to fresh fruit and vegetables for children, no matter whether they are from poor or well-off families. Many of the initiatives that have been recommended by the Executive are not like that. For example, the Executive intends to set up a breakfast club challenge fund, which means that schools throughout Scotland will have to submit bids. Although some schools will be successful and will receive funding, many will not. That diminishes the scheme's effect.

Professor Hanlon:

I agree.

Is it not also the case that a targeting approach to diet, nutrition and health will have a limited effect and that it would be much better to ensure a universal approach to diet for all children in Scotland?

Professor Hanlon:

Just to ensure that my evidence on that is clear, I should point out that I happily subscribe to the view that we have a universal problem with respect to the diet of Scottish children. However, I am not fully convinced that the universal provision of school meals will solve that problem, although I am interested in the debate.

No one is saying that the provision of school meals will solve the problem on its own, but it could form part of a wider package to address the problem.

Professor Hanlon:

Yes.

Would the introduction of free school meals for everyone overcome the alleged stigma that prevents many children from taking up free meals under the present system?

Professor Hanlon:

I do not know. The evidence that we were able to find suggests that quite a long list of factors determine why kids do not take up school meals, no matter whether they pay for them or not. The cultural issue of escaping the school at lunchtime seems to play a large part in it.

We have all contributed to that at some time.

Professor Hanlon:

Indeed. Last year's conference on food and schools highlighted the stigma problem. Whatever happens to the bill, that problem needs to be solved. Again, it is not beyond the wit of man to deal with it, and I believe that there are proposals in the pipeline to do so.

My key informants—in other words, my children and their friends—tell me that everyone knows which children take free meals anyway. For example, if those kids go on a school trip, they receive free packed lunches and so on. Removing the stigma entirely will be difficult.

That said, my key informants also tell me that not much stigma attaches to free school meals. Kids do not feel that badly towards each other about these things. The issue is complex, and I do not think that one simple solution will remove the stigma—although free school meals for all would help. That is simply common sense.

Margaret Jamieson:

You have mentioned the likely impact on health if we were to tackle the problem of diet in primary schools. However, what about introducing young pupils, particularly those in nursery schools, to fruit and various vegetables that they might well never have tasted before? Could we take a targeted approach to that that would be beneficial and would produce measurable outcomes?

Professor Hanlon:

The answer to your specific question is probably yes. We must introduce some form of targeted pre-school approach that would be beneficial.

I have said a lot this morning, but perhaps I should emphasise that the incidence of childhood obesity has doubled in the past 10 years and will double again in the next seven to 10 years. As that is the trajectory, we need action. The "steady as she goes" approach will not be sufficient.

That said, this highly complex problem will not be solved by a single solution. I feel that the mood around the table is that the bill is not being proposed as a single solution; it will act as a lead solution with a lot of other measures falling in behind it. Somehow or other, we need to change the norm and expectation of what children eat as they grow up. Clearly, the pre-school and school arena is vital to achieving that aim. If the free school meals proposition does not fly, something else will need to be done. I want the committee to feel the force of my evidence in that respect.

However, committee members have asked me specific scientific questions. I represent PHIS with all its scientific credentials, and have tried to be true to the evidence.

Would it be a fair reflection of what you have said to say that even if we do not go ahead with the bill, the concept of piloting free school meals, particularly in primary schools, would be a useful contribution in itself?

Professor Hanlon:

Absolutely. The committee should hang on like a terrier to the issue. We must hang on to the fact that there is a profound problem with Scottish children's diets, including issues such as obesity and micronutrient deficiency.

The Convener:

In respect of that we can say, perhaps, that there are two issues about universality. People have focused so far on the financial one, which is that a bill that proposed universal free school meals would obviously help children, such as yours and mine, whose parents can afford to pay for school meals. However, you outlined a universality argument around the fact that there is obesity or lack of nutrition in all our children and that those are issues for every family with children.

Professor Hanlon:

There are two dimensions to that. First, there is evidence to show that there is a problem across the whole population. Secondly, what we eat is a socially determined phenomenon. Why do our kids wander off to McDonalds at lunch time? It is because that is socially determined. It is cool to do it and the other kids do it. If you change what is cool and normative, you will make a difference. That is the dimension of the bill. That is why I have tried to be balanced in my comments this morning, because the bill is a bold attempt to change the norm, particularly in primary schools, because most of the kids in the early years of primary school stay in school at lunch time. If the committee really went at the bill, if you were imaginative and promoted it, you could change the norm.

If you say, however, that the bill would be too expensive to implement and that you wanted to pilot universal free school meals in, perhaps, the first four or five years of primary school, when most kids stay in school at lunch time under supervision, you could also change the norm and up the standards. I am trying to say that there is something in the argument about trying to change the norm. I do not want the committee to get from my evidence that I am just pouring cold water on the bill. I hope that that is not what has come across.

The Convener:

No. You expand on social culture and changing the norms in paragraph 8, page 4 of your submission in terms of what we can do to increase the uptake of school meals. Paragraph 8 refers to such things as queuing and the ambience of school eating areas. You indicated that in some cases such aspects obviously have a big capital cost attached to them. However, that evidence shows the committee that the issue is not only about universal free school meals. The issue is much more complicated.

Professor Hanlon:

It is the whole-school approach. For example, let us consider your or my relatively affluent kids—although I hate that distinction, because each of our kids is needy in their own way. It is—careful with one's words here—not right that they should go to a school eating environment that is just not up to it, is it? Not only is there a nutritional issue, there is also an educational and social issue about being in a bad environment over lunch time. We must consider that in and of itself, irrespective of the nutritional argument.

Absolutely. Dorothy-Grace Elder will ask the final question.

Dorothy-Grace Elder:

You referred to kids wandering off to McDonalds at lunch time. However, you might agree that the situation is worse than that sometimes, because school environments have vending machines that sell confectionery and soft drinks. Schools are trying to encourage the eating of fruit, but they are also making money from selling children sugar. What do you think of that?

Professor Hanlon:

I think that that is a scandal. How did we get to the circumstance in which a school needs to flog its conscience for a few hundred quid by vending teeth-rotting soft drinks? That is product placement, is it not? It is awful.

It often happens in the poorest areas.

Professor Hanlon:

Yes.

Okay. That has covered all our questions. Thank you for coming along and for your written evidence.

Professor Hanlon:

Thank you.

Good morning to Bill Gray, our next witness, who is the national project officer for the Scottish Community Diet Project. I invite Mr Gray to make a short statement before members ask questions.

Bill Gray (Scottish Community Diet Project):

I want to make a brief statement relating to the written evidence that I submitted. As I represent the Scottish Community Diet Project, it is important to make clear the nature of the project. We are not a lobbying or a campaigning project; we are a networking project that works with hundreds of community initiatives throughout the country. We work on poverty and diet and health inequality.

I also stress that my background is in community development, rather than research or nutrition. The evidence that I will give is based on 20 years' experience in the field, including five years of working with the Scottish Community Diet Project and eight years of helping a local community run its health project. I have experience, but my perspective is perhaps different from that of some of the committee's other witnesses. My experience relates to a lot of the complementary activity that has been referred to around school meals, such as breakfast clubs, fruit-in-schools schemes and fruit tuck shops. All those schemes have their roots in activities that communities have established over a number of years.

One theme that I have tried to touch on relates to evidence and evaluation. How on earth do we put a value on the fact that in a school meals set-up a child who previously ate alone now eats with company? How do we quantify the contribution that catering staff make when the systems in which they operate allow them to engage with the children rather than simply handing over a tray? Communities and families know well that the eat-up-and-shut-up approach does not work and that it is often counterproductive. We have to learn from that experience.

Some of my colleagues run the healthy choices award scheme. The schools and local authorities that win those awards for their school-meals service invariably work in a partnership. They involve teachers, caterers, janitors, cleaners, health promotion staff, pupils and parents. It is important to note that that good practice is invariably accompanied by a participatory approach.

Although these are buzzwords in Government circles, best practice is related to joined-up thinking. I visited a school in Midlothian the other week and although I was there to see the school meals set-up, I found myself outside, seeing the school garden. I met a local parent who ran a fruit-in-schools scheme in the school, which the local food co-operative supported. It is important to acknowledge that there is a lot of good practice on the ground and that a lot of joined-up thinking is applied.

I also have experience of the social aspects of food. There has to be a clear acknowledgement that school meals are more than just a delivery system. I was in Dumfries and Galloway the other week to visit a primary school that had a learning centre attached for children with special educational needs. It was incredible to hear how the school used the meal in an educational manner. The staff used every scrap of the 45 minutes for lunch to benefit the children in their charge. The staff's use of the shape and colour of the food and the benefits that it brought to the co-ordination of the children's movements helped the children to appreciate their meal. Although I have a lot of experience, it was quite an experience in itself to see how the learning centre used the school meal.

The Scottish Executive gave us the role of working with low-income communities. We constantly come across issues around diet being related to income. Communities do not constantly raise the issue of universal free school meals. They are more likely to raise issues that will affect them more immediately. For many years, the impact of school holidays on family budgets has come up—particularly summer holidays and particularly on those whose children receive free school meals.

The second issue, which has come up several times over the years, is about those on the wrong side of the margin of provision, who fail to qualify for free school meals, but are clearly in great need. If they have several children at school, those families often ration their children's ability to take up free school meals.

I was asked to concentrate on whether there would be a positive health impact. I hold up my hands and say that I am not a researcher and I am a bit overawed at following Professor Hanlon. However, common sense tells me that of course universal free school meal provision would have a positive health impact. The difficulty is quantifying the extent of that impact and whether it is proportionate to the proposed investment.

Mary Scanlon:

My question relates to points that you have already raised. We all agree that nutritious meals would benefit health outcomes and the health of children in the long run. In your submission you say that the impact on health is "difficult to gauge" and that establishing the effect of the school meals system and what health impact that has

"merit greater consideration than they have so far received."

Is there any evidence base to suggest that free school meals would have a measurable impact?

Bill Gray:

I think I have answered that by saying that common sense says yes. I have no doubt that those who are more knowledgeable on the subject would be able to measure that impact. It is the scale of the impact that I have not heard any evidence about.

I was trying to emphasise that we also need evidence on the processes—the contribution that is made by giving children attractive meals in an attractive setting. We need to understand what that contributes to the health gain from school meal provision.

Mary Scanlon:

Could you elaborate on the point that you make in your submission under the heading "Diet and Income" that, although you have been working closely with communities in the different ways that you have outlined, you have not

"come across universal free school meals as a priority for action by low income communities."

That seems amazing, given that you work so closely with communities. The submission goes on to say:

"evidence suggests a desire to buy into a service rather than remain solely a recipient of that service."

That seems to fly in the face of the bill.

I will lump all my questions together. The submission from One Plus says that 33 per cent of children dislike school meals, 30 per cent like packed lunches, 14 per cent go home, 5 per cent go to the shops and 16 per cent cannot afford school meals. Do you think that any nutritional benefit would affect 16 per cent of children or less?

My first question is about why free school meals have not been a priority for communities, my second question is about why people prefer to pay and my third question is whether it would benefit only 16 per cent of children.

Bill Gray:

On the first point, I would say that it is not at all amazing that communities have not prioritised universal free school meal provision. That is a social policy response. The communities have identified several problems and universal free school meal provision could be the response that they require. People respond to their immediate needs and try to tackle them. That is why there are food co-operatives and all sorts of other community initiatives that will not provide an answer to the big picture, but will address immediate need.

Are you saying that communities do not see universal free school meals as the answer to the bigger picture?

Bill Gray:

No. I am saying that until now communities have not raised that. That issue has been raised very successfully with communities by the people giving evidence today and by the Child Poverty Action Group, which has done a lot to raise free school meals as a social policy option in our low income communities. It has become much more of an issue for people to consider.

But low income communities have not raised it as a priority at Scottish Community Diet Project events?

Bill Gray:

Not at any of our events. We have done the reverse and ensured that everyone on our mailing list has had the bill brought to their attention and has been encouraged to think carefully and get involved in the debate.

Will you spell out the evidence behind the desire to buy into a service instead of simply remaining a recipient of that service?

Bill Gray:

I am not claiming that this evidence is particularly strong, but we have a lot of experience with breakfast clubs, which is a slightly different kind of initiative. That said, when establishing breakfast clubs, local groups have carried out many surveys and have fed back that people seem willing to pay a relatively low, affordable price to feed into the schemes. I was simply giving an opinion based on anecdotal evidence about why people have chosen to respond in that way to those surveys.

I should add that breakfast clubs are very aware of the pressure on larger and low-income families and have responded with more imaginative approaches than the school meals system. Such approaches have included high-usage discounts and schemes in which families do not pay for any further children after their first two. It is worth looking at breakfast clubs and other community initiatives to find imaginative ways of identifying and tackling priorities.

The One Plus submission mentions that, in a survey that it carried out, 16 per cent of children said that they could not afford school meals. Have you come across the same evidence on your travels?

Bill Gray:

As evidence from my own project, from the Scottish Consumer Council conference and from the research that the SCC conducted with the Health Education Board for Scotland shows, cost is a major factor. No one has ever questioned that. However, quality of food and the environment that a child eats in are also major factors.

How many groups have fed into your consultation to enable you to arrive at the evidence that you have submitted today? In other words, what is your evidence based on?

Bill Gray:

My evidence is largely based on five and a half years of constant networking with low-income families, arranging conferences and seminars, attending other events, commissioning articles for the newsletter, organising study tours and all the other activities that we have undertaken. As I said, I worked with a community health project for eight years before that.

Tommy Sheridan:

With respect, I am trying to get you to home in on how your evidence applies to the bill, which was not around five and a half years ago and indeed has only existed in written form for the best part of six months. Are you suggesting that your evidence is based on your own experience rather than on the consultation with various groups involved in the Scottish Community Diet Project?

Bill Gray:

The evidence is based on our contact with people and groups in the field. In four out of the last five editions of our newsletter, we have gone out of our way to promote the bill and to encourage local communities to do the same. We have never tried to act as a representative for the hundreds of local community groups that exist; that is not within our remit and we are not seeking to do that today.

Tommy Sheridan:

It is important that that statement should be on the record. I do not know whether you heard our earlier discussion on this point. We are hearing a lot of evidence in relation to the bill. When anecdotal evidence is used to argue against it—which is what happened at yesterday's Education, Culture and Sport Committee meeting—it can be quite powerful; however, the anecdotal evidence used to support the bill has not been as powerful. I am sure that you will understand now why I have raised the matter.

As for the evidence that Mary Scanlon highlighted on page 3 of your submission, I found it a bit contradictory. You say, understandably, that you have

"not come across universal free school meals as a priority for action by low income communities".

However, the final sentence in that paragraph says:

"Another issue raised is the financial pressure on low paid non-recipients of free meals, particularly when several children are school age."

I might be misreading your submission. Are you saying that universal free school meals are not an issue for those who are already receiving free school meals, but for those who are in poverty and are not receiving free school meals?

Bill Gray:

School meals are the issue and access to school meals has always been an issue. We have to relate the problems that communities identify to the scale of the solution that they come up with. Communities that have identified school meals as a problem with regard to those who miss out and those who have problems over the summer have come up with responses to those problems.

It is understandable that no emphasis has been put on calling for a change in policy. The natural instinct is to respond to the immediate need, although that does not rule out social policy changes as undesirable. The instinct to respond to need applies to a range of initiatives, such as food co-operatives and community cafes. Those are not necessarily the complete answer, but communities take the actions that it is in their power to take to approach a problem that they have identified.

It would not be unreasonable to discern from your evidence that exclusion from entitlement to free school meals is an issue for low-income families.

Bill Gray:

It is definitely an issue.

The issue seems to boil down to cost. Are you saying that an improvement in health, possibly through free school meals, would not be proportionate to the cost of implementing the bill?

Bill Gray:

No. I could not say that. I could no more say that the improvement in health would be proportionate to the cost than I could say that it would not be proportionate to the cost. I do not think that the evidence exists to support either position, which is why I am suggesting a pilot.

Dorothy-Grace Elder:

We keep coming back to evidence. You will perhaps agree that during the war the Government had no evidence that providing free orange juice and milk for all children would help them. That was perhaps just common sense and the Government went ahead without evidence.

I am interested in the pilot idea that you mentioned. When we discussed that earlier with Professor Hanlon, I thought that it might be an idea to have a long pilot project—for a year or so—in one of the more deprived areas, such as the whole of Glasgow or Dundee. The last line of your written submission states that a pilot might be useful "in varied settings". Does that link with a concern that you feel for children who might be a bit better off, but are extremely badly nourished?

Bill Gray:

I would always bow to the Public Health Institute of Scotland or the Health Education Board for Scotland when it comes to the best research methodology. I was trying to reflect the diversity of Scotland's schools. In rural areas there are small schools and schools with large catchment areas, into which children are bussed. There are a lot of factors. I am suggesting that that diversity needs to be reflected, but I would be happy if organisations with research experience thought otherwise.

You seem to support a pilot scheme of a length that is sensible enough to show results. Is that correct?

Bill Gray:

I do not think that anyone who claims that there is inadequate evidence could argue against trying to get the evidence; that would be hypocritical.

Would the evidence be taken from a large area with a large number of children—say a whole city such as Glasgow or Dundee?

Bill Gray:

Again, I would take the lead from those that are more knowledgeable about creating a decent research proposal.

Do you believe that free school meals for all children would help to overcome the current stigma and improve uptake among children who are not claiming their entitlement?

Bill Gray:

I believe that universal free school meals are very likely to have an impact on both those areas.

Do you have any evidence for that?

Bill Gray:

Again, it is a matter of common sense. Universal free school meals are not likely to create a bigger stigma and they are not likely to reduce uptake. It is a question of quantifying the degree of improvement in those areas in proportion to the degree of investment.

Again, the only way of getting scientific evidence that is hard to refute is by carrying out a pilot project of some kind.

Bill Gray:

I think so, although, coming from a community development perspective, I would want to ensure that any pilot also took account of the range of factors involved, including the processes that are involved in the delivery of a school meal system. A pilot should not focus only on the fact that the meals are free—one could run a free school meal system that was bad and unpopular. We need to examine the other factors at the same time.

The pilot would need to be properly run.

Bill Gray:

I work a lot with local communities and they always argue that they have had so many pilots that they should have their own airports. On this occasion, I might go against my experience of local communities, which are sick of pilots. The pilot would have to be adequately researched. The important thing for local communities is that pilots are acted upon if they prove to be successful.

So it would need to be something that would fly and have a destination?

Bill Gray:

That is a good pun.

Thanks. It was not that good.

Mr McAllion:

I want to ask about a reply that you gave earlier. You said that your experience of breakfast clubs was that many parents preferred to buy into a service, rather than get it free. Was any work done on finding out why that was the case? It strikes me that the stigma that is attached to getting something for free is a big factor for many parents. Is it the humiliation of the means test that means that parents would prefer to pay some small contribution to show that they are not a burden on the state, as is often alleged?

Bill Gray:

That needs to be examined. I hope that that will be considered, either as part of or beyond the breakfast club review that is taking place. Your point is common sense and matches my experience.

Mr McAllion:

Your submission warns against imposing dietary initiatives on communities. Do you accept the argument of others that universal provision of a free school meal would increase ownership for communities, because it would tie all parents into the school meal service?

Bill Gray:

Steps would need to be taken to ensure that all parents were tied in. We could not presume that that would be automatic.

Mr McAllion:

Is it not the case that a universal free school meal would not impose anything on anyone, but would confer eligibility on everyone, just like the national health service? Surely that cannot be regarded as imposing something? We can give people eligibility and then negotiate how the free school meal service should be delivered.

Bill Gray:

You referred to breakfast clubs and I was basing those comments on my experience with breakfast clubs. It was mentioned earlier that there was some enthusiasm for having breakfast clubs in all schools. However, my experience and the research show that breakfast clubs work best where they are wanted. I was reflecting on the experience of imposing breakfast clubs on a school where the teaching staff, janitor, parents or anyone else is less than keen. Breakfast clubs in such schools are much more likely to be unsuccessful or unsustainable.

I just want to clarify that that argument does not apply to universal eligibility for free school meals in all schools.

Bill Gray:

That is right. However, work would still need to be done to involve parents and engage everyone else as much as possible. Ownership would not be created automatically, but would need to be worked on.

That specific criticism was about breakfast clubs, rather than the proposal for universal free school meals.

Bill Gray:

The criticism was based on the experience of breakfast clubs.

Mr McAllion:

You also said that the school meal service has obtained the Scottish healthy choices award because there is wide and effective consultation on best practice. In the event of a school meal service being universally free, would it be possible to conduct such wide and effective consultation before the service was implemented?

Bill Gray:

Yes; that would be essential.

And practical?

Bill Gray:

Yes, and not just before the service was implemented, but on an on-going basis. It is important to have consultation not just prior to setting up a system, but while the service is provided. When we visit a primary or secondary school where there is good provision, it is clear that that is because there is on-going participation by all the relevant parties.

Thank you for your evidence. We will now take evidence from the witnesses from One Plus.

Marion Davis (One Plus):

I thank the committee for inviting One Plus to give evidence and for enabling lone parents to make their voice heard on this important issue. My colleagues are Rose Wilmot, who was involved in the research on children's views; Deborah Doyle from Easterhouse, who will say something about the poverty trap; and Teresa McCormack from Pollokshaws, who will touch on issues around stigma.

Poverty is a key determinant of ill health. In a nutshell, poverty kills. People who are poor suffer more illnesses and die younger. Lone parents now make up one in four of all families in Scotland. Lone parents and their children tend to suffer from poor health. More than one in three children in lone parent households suffer long-term illness or disability. The latest Government research, which was published a couple of months ago, shows that 55 per cent of children in one parent families live in poverty. The link between poor health and the long-term effects of poverty and a life on benefits is clear.

The School Meals (Scotland) Bill is a historic opportunity for the Scottish Parliament to put money in the pockets of some of the poorest families in our community. We can make a contribution to children's health by reducing the poverty trap that faces parents who are in work and lone parents who want to go out to work. The bill would eradicate the stigma surrounding free school meals. We need to address the situation that is detailed in the Scottish Parliament information centre briefing, which highlights the fact that 5,000 children in Glasgow who are entitled to free school meals do not take them up. A survey by One Plus, which we have included in our written submission, pointed out that 83 per cent of the kids who were asked supported free school meals for all children. I suspect that one of the reasons for that support is the stigma and the fact that kids do not want to feel different—they want to feel equal to their fellow students.

The School Meals (Scotland) Bill would offer the opportunity to increase take-up of school meals, which we are conspicuously failing to do at the moment. The SPICe briefing note highlights the fact that 15.5 per cent of school pupils claim free school meals, yet recent research shows that 30 per cent of children in Scotland are in poverty. That means that almost 50 per cent of children in poverty in Scotland do not access free school meals.

The Scottish Parliament, along with Westminster, has a long-term goal of eradicating child poverty, which is a key determinant of poor health. Along with many other organisations, such as the British Medical Association, the Scottish Trades Union Congress, the Educational Institute of Scotland, One Parent Families Scotland, Unison and the Scottish Out of School Care Network, we hope that the Scottish Parliament will support universal access to a healthy, nutritious meal as a fundamental right for all children in Scotland.

Janis Hughes (Glasgow Rutherglen) (Lab):

You mentioned stigma as a main issue. The evidence that we have taken on that issue seems to differ. Can you give me practical examples of stigma? Why would removing stigma be such a big part of the benefit of providing universal free school meals?

Theresa McCormack (One Plus):

I have a younger sister who is about to go to secondary school. She is embarrassed about taking free school meals, because some of her friends pay for their lunch. There are two canteens. One is a cash cafeteria for pupils who pay for lunches. The other is for those who get free school meals. Taking free school meals stigmatises a lot of children because everybody knows who takes free school meals and who pays for their lunch.

Janis Hughes:

I do not think that anyone would doubt that some schools' systems are unsatisfactory and lead to children being stigmatised. However, I know that there are initiatives such as swipe cards. With a bit of creative thinking, we might be able to come up with other initiatives that could overcome stigma without making free school meals universal. Do you have views on such systems?

Theresa McCormack:

Even with swipe cards, there is a cash limit for those who receive free school meals compared with those who pay for their lunch. If a young person who received free school meals went over their limit on the swipe card, they would have to return something. The other children would then know that they were still on free school meals.

Janis Hughes:

It is obvious that providing universal free school meals would have a huge cost impact. Marion Davis mentioned that the School Meals (Scotland) Bill was an opportunity for the Parliament to put money into the pockets of those in poverty. However, as this is a health committee, we are primarily interested in whether there would be health benefits from providing universal free school meals. Instead of large sums of money being put into providing universal free school meals, could that money not be better used to improve the education system? Such an improvement would have a knock-on benefit for those in poverty and would assist in the longer term in removing people from the poverty trap.

Marion Davis:

Recent statistics have demonstrated the horrendous problems of ill health and poverty in Glasgow. Universal free school meals would contribute to improving Glasgow's situation and so should be a top expenditure priority. There is a close link between being in poverty, being on income support over a long period and struggling on a low income, and both the parent and the children in one parent families being in poor health. If we can contribute towards improving the standard of living of not only lone parents who want to go out to work, but lone parents who are in work, that would be good.

A problem for many women who come off income support and go into employment—we come across the situation daily at One Plus—is that when they are working they are just as poor as when they were on income support. Those women tend to move into low-paid employment, and they must pay for school meals for their children and 30 per cent of their child care or travel costs. As a result, the increase in income from working is not that much and there is still pressure on the family income. The money that is available for food tends to increase and decrease because rent and other things must be paid. If the children of such working lone parents were having a hot, nutritious meal at lunch time, that would benefit the well-being of both the parents and the children.

Nicola Sturgeon (Glasgow) (SNP):

You mentioned the number of children who are eligible for free school meals but who do not take up their entitlement. I agree that the stigma that is attached to free school meals is one of the main reasons for that; indeed, eradicating such stigma is one of the reasons for supporting the bill. Do any other factors influence the low uptake of free school meals? If so, what are they and how would the bill tackle them?

Deborah Doyle (One Plus):

I am a lone parent from Easterhouse with five sons; my middle three boys are triplets. I hope to be ready for employment in a year's time—I passed my Scottish vocational qualification in community work last year, and this year I am going to college and doing various things in between. I was told by the new deal adviser that I would need to earn a minimum wage of about £16,000 to £18,000 a year so that I could afford to go to work. Once I start work, I will need to pay about £200 a month to ensure that my kids get school meals. Over the next nine years, four of my kids will go to school, and that will work out at about £16,000 for school meals without taking interest rates and other factors into consideration. Getting this bill through would be a major benefit, as it would mean that my kids could have a hot meal in the afternoon.

Marion Davis:

In our survey, we found that many children who took school meals did not get their first choice. That is off-putting, because it means that they might be getting food that they are not keen on. The next time, they might refuse school dinners and ask their parents for a packed lunch instead.

One of the witnesses last week said that a child who takes free school meals is more likely not to get their first choice—even if they have a swipe card—because of the limit that you mentioned. Is that an issue?

Marion Davis:

I think that different schools have different arrangements for free school meals.

Deborah Doyle:

If my kids are among the last in the queue, they might get only one sausage and a spoonful of beans for their lunch.

Is that because of bad management in the dinner hall? Is not enough food being ordered?

Deborah Doyle:

The kids have to stand in another queue to get their ticket while the other kids who pay go and get their lunch. That means that the kids who pay for their meals get first choice.

Shona Robison (North-East Scotland) (SNP):

Marion Davis mentioned that paying for school meals creates a barrier to work, and Deborah Doyle outlined a very good example of that. Would you go so far as to say that there would be a cost saving if such a barrier were removed, because more people could start work and come off benefit?

Secondly, what is your response to the suggestion that we have heard in evidence that the problem could be dealt with by extending the eligibility of free school meals to children from families on low pay?

Marion Davis:

Offering free school meals to all children will not of itself enable more lone parents to start work. However, if it formed part of a comprehensive package, it would boost the in-work income of lone parents who come off income support and move into employment. Other policies would have to fit into place beside that. However, someone on a low income with two children might have to pay up to £20 a week for school meals; if the service was free, they would be able to spend £20 on something else. For example, they could use that money to pay their council tax.

Anther issue is that lone parents get into debt when they go out to work. The Government is keen for lone parents to go back to work. Gordon Brown set a target of 70 per cent of lone parents being in employment because the Government regards employment as the main route for one parent families to improve their standard of living and, of course, their health—which is today's topic of discussion. Universal free school meals are an important element in achieving those improvements.

One Plus has argued for universal benefits, including free school meals for all children, for years. I have worked for One Plus for 18 years and since my first day we have been arguing for universality. The issue is not particularly new for us. We think that the bill is a fantastic opportunity for arguing the case for universality.

What was your other question?

It was about whether extending eligibility would be enough.

Marion Davis:

Right—extending eligibility to the low paid. I assume that you mean people who claim working families tax credit.

Yes.

Marion Davis:

Universal free school meals would improve the end-mark income of those people, but it still would not address the stigma. What child wants to be labelled as a second-class citizen and set apart from their peers? No matter how sophisticated the technology that is put in place to address stigma, children still know who in their class is getting a free school meal. They know that their friend who has a swipe card for a free school meal can afford to spend only £1.10, or whatever it is in Glasgow. However, the other child, whose credit limit is higher, can also buy a bottle of water that can cost up to 60p. Irrespective of the technology that is put in place, that problem will not be resolved. The case for universality is sound.

Mary Scanlon:

Will the provision of free school meals to all Scottish school children have a measurable impact on health, given that many of those on low incomes already receive free school meals and universal provision would generally benefit more wealthy children? Do you have specific research that has evaluated the health outcomes of free school meals?

Marion Davis:

We accept that children from wealthier families would benefit from universal provision. However, children from better income families do not necessarily have a nutritious lunch or a nutritious meal at home in the evening. I highlighted earlier that almost half the children in Scotland who are defined as poor by the Government do not take up their entitlement to a free school meal. Universality is a way of reaching the people whom we want to target. That is why child benefit and other universal benefits are so successful. That is also why there are problems with benefits such as working families tax credit, whose major shortcoming is that eligible people do not claim because the benefit is means tested. Universality is at the core of our argument and that of other organisations that want to tackle child poverty.

On research, I can say only that we had a seminar last Friday and a chap—who has given evidence to the Health and Community Care Committee—spoke about the implementation of policies in Finland and Sweden that have improved the health statistics for children and adults and the death rates. Those countries' health statistics are better than Scotland's. That is part of a wider package and is not just because the children all have access to free school meals.

A brilliant feature of the bill is that it is about not only free school meals, but the wider picture. We should put school meals at the centre of a policy that promotes family health, links that with education and connects that with the wider policy forum.

Mary Scanlon:

Page 8 of your submission contains a pie chart on why children do not take school meals, which says that 33 per cent of children dislike them, 30 per cent like packed lunches, 14 per cent go home and 5 per cent go to the shops. Two per cent made no response and only 16 per cent said that they could not afford school meals. We have received submissions from various councils; last week I was surprised by a submission from Glasgow City Council, which said that it was not favourably disposed toward free school meals, despite the levels of poverty and deprivation in Glasgow. Angus Council said that free school meals would

"result in a monolithic national facility completely unresponsive to the wishes or aspirations of pupils or parents."

Would the eventual outcome be less than nutritious meals, because of a lack of freedom of choice? Were you shocked by the fact that only 16 per cent of children who participated in your extensive survey throughout Glasgow, Renfrewshire and Ayrshire said that they could not afford school meals? Does that mean that only 16 per cent of children, or less, are likely to benefit?

Marion Davis:

That direct connection cannot be made. It is bad that 16 per cent of children of primary age feel that they cannot have a school meal because their parents cannot afford it. In general, children of that age do not put finance at the top of their school meals priority list.

My point is that 33 per cent—twice as many as cannot afford school meals—dislike school meals.

Rose Wilmot (One Plus):

The children were given a free choice with the question—there were no boxes to tick. They were given the chance to write what they felt, so they did not prioritise by a list. They did not have to say whether they disliked school meals—that just came out. The question was not multiple choice. The answers reflect the children's priorities.

Marion Davis:

Some children who dislike school meals might also be unable to afford them. As Rose Wilmot said, the answers were in response to an open question.

The point is that only one segment of the pie chart—16 per cent—says that the problem is financial.

I would like to move on.

I thank Theresa McCormack for attending. You talked about your sister's humiliation, which made her dread going to secondary school. I presume that you had the same experience at the same school.

Theresa McCormack:

I did.

Will you describe that and go into a bit more detail about the two cafeterias? Was the standard of food lower in the cafeteria that served children who took free school meals?

Theresa McCormack:

The two cafeterias are a new development in the school. When I was there, the school had a healthy option bar, which was called the milk bar, and a big canteen, which served chips and so on. There were two lines. As has been said, kids with dinner tickets had to line up first and show their tickets to enter the cafeteria. Now, kids who pay enter the cash cafeteria, which sells fast food and has no healthy option. That cafeteria sells food such as burgers and pizzas. I am not too sure about the canteen, because my sister does not start secondary school until summer.

Did you sometimes not take up a free school meal out of humiliation and embarrassment?

Theresa McCormack:

Yes.

Tell me a bit more about that, please.

Theresa McCormack:

A lot of the time we would just go out and walk about down at the shops instead of going into the canteen. A lot of people would sell their dinner tickets because they did not like the idea of having to stand in a big queue—the school was massive—and show their dinner ticket with all the other people looking on. It was really quite embarrassing sometimes.

Did that cloud your school days? Are you still at school, Theresa?

Theresa McCormack:

No, I am not.

You just look very young.

Tommy Sheridan:

For the record, convener, although Mary Scanlon has referred a couple of times to Glasgow City Council's evidence, we should make it clear that the evidence was not from Glasgow City Council. The beginning of the submission makes it clear that it is not from Glasgow City Council. I have also had a letter from the chief executive of Glasgow City Council to say that the submission's conclusion should have made it clearer that it was not Glasgow City Council's evidence.

The evidence was written by the chief executive of Glasgow City Council.

That is what I have tried to explain to you, Mary.

We shall seek clarification for members.

Tommy Sheridan:

Please do so because I know that tomorrow's Education, Culture and Sport Committee meeting will discuss that evidence. There has been some disquiet over it.

It is unfortunate that Marion Davis referred to the written submission of someone who offered to give oral evidence on the experience of Sweden in particular, and also of Finland. As that person has not been called, that evidence has not been heard.

Janis Hughes referred to the different evidence on stigma that we have heard. I want to clarify that that evidence has not questioned the existence of stigma as a factor. On Tuesday, I visited my 15th school, which was Alva Academy in Clackmannanshire. The school was friendly and welcoming, but gives out a metal token that people who are on free school meals must queue for before they go into the dining hall. Stigma is very much alive. The only difference—

I can hear your speech in the chamber any time I like. Can I have a question, please?

Sure. I will come to that.

No. You will come to the question now, please. Everybody else asks questions without making speeches. Ask the question.

I will come to the question, but your invitations to witnesses have been balanced against the bill. That is the problem.

I do not accept that. The calling of witnesses has been totally balanced. In fact, you and I had a private conversation about the fact that we felt that the evidence taking was balanced. Ask the question.

Tommy Sheridan:

I think that you will find that we disagreed during that conversation. I said that I thought that there was an imbalance.

My question to Marion Davis concerns whether she believes that stigma is still attached to claiming free school meals. Given the number of children whom the Scottish Executive accepts are from poor families because they qualify for other means-tested benefits, how many children do you believe are excluded from free school meals?

Marion Davis:

The issue of stigma is alive and well and comes up regularly within our organisation. When we did the survey of children, we also had a focus group of parents. The parents talked about the stigma that was involved in free school dinners when they were younger. The parents were really keen that their children should not have to go through that.

You asked about the numbers of children in poverty who do not have access to free school meals. There are about 170,000 children in one-parent families in Scotland, of whom half are of school age. A percentage of them will not take up their free school meal option, which is the issue for us. We want all those children to have access to a free school meal at lunchtime to improve their health. We can start to change the behaviour of children of primary school age in particular, and we can encourage them to eat healthy and nutritious food.

Can you explain to the committee who One Plus represents? On whose behalf are you speaking today?

Marion Davis:

One Plus is the United Kingdom's largest lone-parent organisation. We work with lone parents in a range of ways. We offer advice and information, we work with lone parents based in local communities, and we deliver training and employment. We are a representative organisation and most members of our management committee are lone parents. We try to act on behalf of lone parents.

How did you arrive at your policy on the bill? Are you speaking on your own behalf or on behalf or your organisation?

Marion Davis:

I am speaking on behalf of the organisation. The One Plus committee discussed the School Meals (Scotland) Bill and agreed to support it.

I will have to bring this part of this evidence-taking session to a conclusion, as we have another set of witnesses to hear. Thank you very much for attending and for your written submission, including the pie chart.

Marion Davis:

Thank you very much for inviting us.

The Convener:

We will now hear from our last witnesses today, who represent the Food Standards Agency Scotland.

Dr George Paterson and Lydia Wilkie are no strangers to the committee—but it will be unusual to hear them talking about something other than shellfish. You may make a brief statement, and we will then move to questions.

Dr George Paterson (Food Standards Agency Scotland):

Thank you for the invitation. The committee has received our submission, so I will not discuss that; instead, I will tell the committee a little bit about the Food Standards Agency. The agency was created in April 2000 as a non-ministerial UK Government department—which is quite a mouthful. We have an independent board consisting of lay people, who provide the agency's strategic direction, but the agency itself is accountable to health ministers. Food safety matters are devolved, so a distinct arm of the agency—the Food Standards Agency Scotland—is based in Aberdeen. I, as director, am accountable to the Minister for Health and Community Care and the Scottish Parliament.

The agency has two primary functions. First, it has a regulatory function in food safety and food standards. As members will be aware, much food law and many food regulations and directives now come via Brussels.

The other part of our mandate is what I would call information and advice, which might be the area that the committee will probe more today. Specifically, we provide information and advice on healthy or better eating and on nutrition and diet. We are very much an evidence-based organisation, and we commission research. In the two years of our existence, we have conducted a fundamental review of our research and surveillance programme and we are now putting more money and more resources into commissioning research on nutrition and diet. This year and next year, we will commission a UK-wide nutrition survey of four-year-olds to 18-year-olds.

The Food Standards Agency Scotland supports a partnership approach to addressing diet and nutrition issues. Much of our first two years of activity has involved bedding down and building relationships with the key players: the Scottish Executive health department, the Scottish Executive education department, the Scottish Community Diet Project, the Scottish Consumer Council, local authorities and HEBS.

We support a whole-school approach. In particular, we very much support nutritional standards, reinforced by nutrition education. I will leave it at that and invite members' questions.

In your written submission you agree that nutritious school meals would improve the health of pupils. Do you agree that providing free school meals to all pupils would maximise the potential health impact?

Dr Paterson:

That is a difficult question. I return to the fact that the views we take are evidence-based. I am not trying to skirt the issue, but I do not think that evidence on that exists. I emphasise that the agency's priority is to ensure that there are high standards of nutrition throughout Scotland's school meals system. Whether that would be maximised through universal provision of free school meals, I cannot say.

Mary Scanlon:

Let us assume that all school meals are nutritious. In paragraph 7 of your evidence you state:

"There is no evidence that providing free school meals to all … children would improve uptake."

What would improve uptake? What is the basis of that assertion?

Dr Paterson:

I will start to answer that question, then hand over to Lydia Wilkie for more detail. Many factors influence the situation, such as nutrition, the appeal of the food, where the food is served, and the number of alternative sources of food. There is a multiplicity of factors. Lydia Wilkie will address the question in more detail.

Lydia Wilkie (Food Standards Agency Scotland):

We are actively involved in the expert panel on school meals, on which we have a representative. One issue that has been identified is uptake. We have carried out research that links to that. We performed a focus-group study to examine why the messages that people know about—for example, many children know about the message to eat five portions of fruit and vegetables a day, because that is being taught in the curriculum—are not being put into practice. We want to see whether the information that we gain can be used to address school canteen issues. One of the messages that came out of the research is that the term "healthy eating" is a turn-off. People feel that they can more easily buy into a message about better eating and its positive effects. The research has been fed into the expert panel, and may contribute to chipping away at the poor uptake of school meals.

Mary Scanlon:

Are you really saying that improving the uptake of what we assume will be nutritional meals has more to do with schools' and education authorities' management, the presentation of the food and the provision of the service? Are you saying that those are more important in increasing uptake than giving everyone a free school meal?

Dr Paterson:

I am not saying that those are the most important factors, but they must be considered. We cannot just look at—

What is the most important factor?

Dr Paterson:

On our evidence so far, good nutrition and accessibility are as important.

How, in that case, do we improve accessibility?

Lydia Wilkie:

The expert panel is trying to find out what is best practice throughout Scotland. There have, under the Scottish diet action plan, been a tremendous number of initiatives. It is important to review those to determine best practice. I am sure that the committee has done that to a certain extent. The expert panel is bringing together its expert knowledge to determine definitive best practice. That does not naturally go as far as considering whether universal provision of free school meals is the way to implement best practice.

We believe that, once the whole-school approach is developed, it will have to be kept under review. That is where we stand at the moment—[Interruption.]

If any one in the public gallery has a mobile phone switched on, they should switch it off, because it interferes with the sound system.

I thought that that was Bill Butler thinking.

Bill Butler:

I think that Tommy Sheridan is listening to himself again.

I want to continue the line of questioning that Mary Scanlon opened up, as I am troubled by the definite views that have been expressed. The Food Standards Agency submission states:

"There is no evidence that providing free school meals to all school children would improve uptake."

Why is it so certain that such provision would play no part whatever in improving uptake? Other witnesses do not seem to be so certain.

Lydia Wilkie:

There is no scientific evidence—

Bill Butler:

With respect, that is not what the submission says. It says that there "is no evidence" that such provision would do anything at all. Why are you so certain that free school meals would not play even the smallest part in improving uptake? Such provision might not be a worthwhile addition, but you say that it would play no part whatever in improving uptake. What is your evidence for that?

Lydia Wilkie:

We have no negative evidence, either. The statement was meant to be a bald statement of fact. We have no scientific evidence to show—

Bill Butler:

With respect, is it not a bald statement of opinion rather than fact? I have a problem with it. Professor Hanlon was careful to be even-handed and objective. The question is not easy, but you seem to have gone at it pell-mell, given an opinion and dressed it up as a fact. How do you know that?

Dr Paterson:

I accept your point—perhaps our wording could have been better couched.

How would you restate what you said?

Dr Paterson:

I would restate it in the way that you stated it. With the evidence that is available, it is difficult to reach a firm conclusion.

So what I have said has led you to reappraise that part of the submission. Are you now saying that that is not 100 per cent certain?

Dr Paterson:

Yes.

Bill Butler:

Good. Other witnesses have suggested that, as the question cannot be proved conclusively one way or the other, a way of progressing the matter and obtaining objective scientific data would be to have a pilot project. What do you think of that suggestion?

Dr Paterson:

In general, the Food Standards Agency is comfortable with that suggestion. As I said in my preamble, the agency has been very much an evidence-based organisation in respect of the hard sciences such as chemistry and biology. We are putting much more emphasis on social science research and research on nutrition and diet. In doing so, we are supporting some pilot projects—Professor Anderson has a couple in the Dundee area. We favour pilots to advance knowledge.

Do you mean the sort of pilots that other members of the committee proposed to witnesses? Do you think that such pilots would be a positive way of trying to answer a question that cannot absolutely be answered at this stage?

Dr Paterson:

In science, pilots are used all the time to test theories.

Do you favour a pilot of the sort that has been suggested?

Dr Paterson:

I apologise for the fact that I was not here when the details of such a pilot were discussed, but in principle I would support one.

I do not expect you to respond to this, but a couple of witnesses mentioned that it might be easier to achieve the ends of the bill by restricting universal free school meals to primary school children.

Dorothy-Grace Elder:

Do you accept that, for a pilot to be effective, it would have to be run in a large area, such as a whole city or education authority? It would also have to be conducted in an area that was home to a considerable number of children from deprived backgrounds, as well as children from families that are not so deprived. You referred to an area of Dundee in which some sort of pilot was under way—although I do not think that it was a pilot for universal free school meals. Do you accept that any pilot for universal free schools meals could not be restricted to a district, and that it would have to be substantial and serious?

Dr Paterson:

I do not accept that any pilot scheme would have to cover a whole area. How a pilot is run depends on what one is trying to prove, on the methodology that is being followed and on the statistical base that is required. The study might be stratified to focus on children between five and 11 in urban centres. It could cover a representative sample of primary schools in a local authority.

The FSA Scotland is an agency of the Scottish Executive. In fact, in your submission you refer to the Executive four times. Does that make your evidence biased against the universal provision of free school meals?

Dr Paterson:

The FSA Scotland is not an agency of the Scottish Executive. We are a UK body.

You are funded by the Scottish Executive.

Dr Paterson:

Yes, and we are accountable politically to the Scottish Parliament. You asked whether we were too cosy with the Scottish Executive.

Is your opposition to the universal provision of free school meals influenced in any way by your relationship with the Scottish Executive?

Dr Paterson:

I do not think so. My point applies to pilots as well as to the general statement that we made—and have since modified—regarding the impact on uptake of making free school meals available to all. In different ways, we are all seeking new knowledge and evidence that will enable us to make sensible policy. The Scottish Executive, the UK Government and everyone else subscribe to the principles of joined-up government and partnership.

However, your submission seems to focus on whether the universal provision of free school meals would be cost-effective. We all agree that better nutrition in schools is a necessity.

Dr Paterson:

Yes.

Mr McAllion:

I refer you to the evidence that you have given regarding stigma and how that can be ended. You mention smart cards as one way of overcoming the stigma that is associated with means testing. However, we have heard evidence from other witnesses—including, this morning, from people who are at the receiving end of means testing—that smart cards would not work. For a free school meals smart card there would be a credit limit of £1.10, but for every other kind of smart card there would be no credit limit. As soon as children went to get their food, it would become obvious that one person was receiving a free school meal and another was not. Do you accept that?

Lydia Wilkie:

We recognise the problem that the member describes as a barrier. That is why we are working with members of the expert panel to identify best practice in this area. A variety of options and methodologies are being introduced in schools throughout Scotland.

Mr McAllion:

Can you comment specifically on the smart cards? They are the only suggestion to end stigma, other than universal free school meals, that has come forward during the discussion on the bill. How do you stop comparisons being made between the cards, when a free school meal smart card is limited to £1.10 and the other cards have no such limit? How can you overcome that? Would everybody who pays for a meal have to be limited to spending £1.10?

Lydia Wilkie:

That is outwith the remit of our Government departments. What we are trying to do is within our remit.

I thought that the remit of the expert panel was to address stigma.

Lydia Wilkie is saying that the Food Standards Agency does not have a position on smart cards.

Lydia Wilkie:

Our position is that we recognise that we need to break down barriers. We will work with people to do that as far as possible so that our aim, which is general nutrition improvement, can be met.

Mr McAllion:

You have mentioned the whole-school approach several times this morning. We have heard from the evidence given to us by the previous witnesses, who are means tested, that they are excluded from the school meal service because of embarrassment about being means tested. Does that not make nonsense of your arguments for a whole-school approach? If you allow means testing in a school, you immediately exclude children from the school lunch in the middle of the day, which is a major part of the school experience. They cannot go because they cannot afford it, or they are too embarrassed to go because they get a free school meal. Does that not make nonsense of the whole-school approach?

Dr Paterson:

Not necessarily.

So people can be excluded and there can still be a whole-school approach.

Dr Paterson:

It depends on whether stigma is the total reason. I accept the evidence that was presented by the previous witnesses, but I think that other factors influence the pupil's decision. I do not think that we know—I certainly do not know and, if evidence has been presented, I would be pleased to see it—how strongly those factors weigh in the decisions of the pupil. I accept that stigmatisation has been presented as being the critical factor, but I think that there is evidence to show that there are other factors; I do not know whether they are critical factors or minor influencing factors.

Are you saying that if stigma remains inside the system there cannot be a whole-school approach?

Dr Paterson:

I agree that stigmatisation would have to be addressed for a whole-school approach to work effectively.

It would have to be removed, not addressed.

Dr Paterson:

Yes.

Janis Hughes:

Notwithstanding John McAllion's comments on the whole-school approach, your submission states that there is overwhelming evidence that a whole-school approach is the most effective way to ensure a healthy eating strategy in schools. Are you saying that that is more effective than providing universal free school meals? If so, on what evidence do you base that statement?

Lydia Wilkie:

We are talking about two different evidence bases. The problem is that we do not have the evidence base to say that the provision of free school meals will, per se, change the nutrition that a child is taking in. Our view is that there is evidence to suggest that the priority is to marry what is being taught about healthy eating in the school curriculum to availability of healthy options and an appealing set-up of the dining area so that children are actively encouraged to use it. We must also find ways to remove stigmas and other barriers. That is the positive way to move forward. The expert panel that has been examining that matter is due to pull its conclusions together towards the end of the month. Its specific aim is to consider best practice and see how to take that forward. It will be important to review how effective that is. Our view is that, if we were to consider taking it to the next step, which is universal free school meals, we should first develop the whole-school approach and review its effectiveness.

Janis Hughes:

Would you say that the whole-school approach—breakfast clubs, fruit in schools, the curriculum and so on—and providing meals that are attractive and healthy, although not necessarily free, would be a better use of resources in improving the health and nutrition of our children?

Lydia Wilkie:

The finer resource issues are a matter for ministers rather than the agency. Our focus is to consider children and school meals in the context of our wider aim, which is to improve the diet of people in Scotland and the rest of the UK.

The next question is from Nicola Sturgeon. It will have to be the final question because we have run out of time. We have to curtail the meeting because our report to the Finance Committee on the budget is due tomorrow.

If the introducer of the bill wants to take the final question, I am happy to defer to him.

Tommy Sheridan:

Thank you, Nicola.

The Food Standards Agency has come here today and talked about evidence, but has not presented any evidence whatsoever. You have given us a biased political report against the bill. You have not provided any evidence that suggests that if healthy meals were provided free of charge to all school pupils it would not improve the health of the children of Scotland. Do you accept that?

Dr Paterson:

I would not accept that we were being completely biased. I hope that that is not the view of the committee. We have tried to convey to the committee—

I am sorry, but your submission says:

"There is no evidence that providing free school meals to all school children would improve uptake."

Dr Paterson:

We retracted that statement.

We covered that at length earlier.

Tommy Sheridan:

What about your statement that

"there is no evidence to suggest that free school meals for all school children is necessarily the most effective, or most cost-effective, method"?

What do you base that statement on if you have no evidence as to whether the provision would improve the future health of the nation and save on the country's health budget in the long term?

Dr Paterson:

Without getting into a long answer—

If you have the answer you should give it to us.

Dr Paterson:

There is no evidence on that—not even from Finland, which first introduced free school meals in the early 1900s and then more seriously after the war. There is no concrete evidence from Finland that that has been successful. In fact, one could say that Finland is experiencing similar problems to those of Scotland and other developed countries, such as obesity and cardiovascular problems.

I stand by that statement, although you may see that as sitting on the fence. However, there is no evidence that free school meals per se will be the magic bullet. In our view, based on some of the evidence that is emerging, a whole-school approach is conceptually superior and would overall produce better results in the long term. We hope that the expert panel will advance that at the end of May.

Thank you for giving evidence and for your written submission. That brings the public part of this morning's meeting to a close. We will continue in private to discuss items on the MMR report and our budget report.

Meeting continued in private until 12:24.