Cost of Living: Healthy Start Scheme — [Derek Twigg in the Chair]

– in Westminster Hall at 11:19 am on 23rd May 2023.

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[Derek Twigg in the Chair]

Photo of Andrew Western Andrew Western Labour, Stretford and Urmston 2:30 pm, 23rd May 2023

I beg to move,

That this House
has considered the Healthy Start scheme and increases in the cost of living.

It is a pleasure to serve under your chairship, Mr Twigg. I am pleased I have been successful in securing a debate on this issue at such a timely and critical moment.

Hon. Members will be aware of the shocking revelations from Sky News last week that parents are being forced to steal baby formula to feed their infant children. Other parents revealed that they are watering down formula or mixing it with other ingredients, such as flour, in a desperate attempt to make it last longer. One parent in that situation, who was quoted in Sky’s report, talked about his baby’s “hungry scream” and how he has heard it so often that he knows it now.

It has also been reported that an unregulated black market has sprung up with second-hand baby formula, which is often less safe than formula found in supermarkets, being sold online at a cheaper price, to which parents are now turning in their panic. The British Pregnancy Advisory Service has warned that parents being forced to make such decisions is putting the UK on the brink of a public health crisis.

Let me be clear from the start: the fact that parents are in such a situation in 21st century Britain is utterly shameful. Although I do not want the debate to turn into a political slanging match, last week’s reporting from Sky should make the Government reflect on their record on the cost of living crisis. Not just baby formula is proving out of reach for struggling young families. Food banks are reporting steep increases in the number of parents with infant children coming to them for support. When asked what his Government were doing in the face of this cost of living catastrophe, the Prime Minister said:

“We have particular support for young families, something called Healthy Start vouchers, which provide money to young families” to help

“with the costs of fresh food.”

I am sorry to say that the Prime Minister is living in a different world if he thinks the current rate of Healthy Start, which has been frozen by Conservative Governments in each of the past two years, is sufficient for struggling families who are living through the worst cost of living crisis on record. That is the reason I have secured the debate today. Healthy Start is simply not living up to its stated purpose. It does not cover the cost of healthy food, it does not cover the cost of baby formula and it is no longer acting as the nutritional safety net for families that it was originally intended to be.

Although many much-needed reforms could be made to Healthy Start to make it more effective, including auto-enrolment, on which my hon. Friend Mrs Lewell-Buck is doing great work, fundamentally, as is so often the case, this is a question of money. The money being provided by Healthy Start is simply not enough for struggling parents. The solution must, therefore, be to uplift the value of Healthy Start so that payments reflect inflation and so that children, regardless of background, are given the best possible nutritional start in life. That is what I am calling for today.

To set out the context: Healthy Start was introduced by the previous Labour Government in 2006. It provides payments to people who qualify to help buy milk, baby formula, fresh fruit and vegetables, and pulses. Eligible families receive £4.25 a week from the 10th week of pregnancy, then £8.50 a week while the baby is from nought to one year old and £4.25 per week thereafter, until the child is four. As of April 2023, there were 336,468 beneficiaries of Healthy Start payments, although my understanding is that there is a lack of transparency on the number of Healthy Start recipients as data is published only on the number of beneficiaries, as opposed to the number of actual children the claims relate to. I would be grateful if the Minister could set out why that data is not published, and commit to sharing that information as soon as possible, given the seriousness of the issue.

Healthy Start payments have been uplifted only once under the Conservative Government—once in 13 years. That was in April 2021 and was in response to a recommendation from the National Food Strategy. That date is important because, since the last increase, inflation has torn into the budgets of the poorest families hardest. The cumulative change in UK consumer prices from April 2021 to March 2023 was 17%. Looked at in isolation, food inflation was much higher than that and was running at 17.2% in the last year alone.

New data from First Steps Nutrition Trust shows that the cost of the cheapest brand of formula milk has risen by 45% in the past two years. Other brands have risen by between 17% and 31% in the same period. Currently, Healthy Start payments do not cover the full cost of any baby formula on the market in the UK. What might have been affordable when the last increase was announced is now out of reach for many of those in most need.

The Government talk about halving inflation, but I am sure that even the Minister would agree with me that that cannot be achieved overnight. In the meantime, families have to make ends meet, but at the moment they simply cannot. Increasing Healthy Start payments to reflect the 17% rise in costs that families have endured in the last two years would make a real difference. That is being called for by the national charities working in this area, as well as my local Labour-run Trafford Council, which I must credit with first raising this matter with me and highlighting the impact that freezing the allowance is having on families in my constituency and across Trafford.

I understand that money is tight, and 17% might sound like a big increase, but we are talking in real terms about less than £1 per child per week for those on the lower rate of Healthy Start, which is the vast majority of recipients. If the £4.25 voucher were uprated to reflect inflation, it would rise to around £4.97—72p more than current levels. For context, the Best Start Foods scheme in Scotland is currently £4.95 per child aged between one and three years old, so the uplift would effectively bring parity. I do not believe that in 21st century Britain, which, despite all our many issues, remains one of the wealthiest countries in the world, a 72p increase to help the poorest children is beyond us. Not only is there a strong moral case for it; there is also a compelling economic case. We know the impact that child poverty and the poor nutrition that comes with it have on a child’s health and wellbeing, with a knock-on effect on their future life chances.

Loughborough University has estimated that the costs of child poverty on future lost earnings retained by individuals were £11.6 billion in 2021. Not only is that terrible for the individual, but it represents billions in lost tax revenue for the Treasury. That is before we get to the fact that people on the lowest incomes are more than twice as likely to say that they have poor health than people on the highest incomes, meaning that they are more likely to be reliant on an NHS that is now at breaking point.

I am pleased that yesterday the Labour party put prevention at the heart of our mission for the national health service. I am sure that when the shadow Minister, my hon. Friend Andrew Gwynne, responds—[Interruption.] He says “Hear, hear” from a sedentary position, but he might not when I finish. I hope that he will agree on the importance of tackling health inequalities and on why it is such an important issue. An improved Healthy Start scheme can be a part of the journey, given we know that it is effective in improving childhood nutrition and leads to greater consumption of healthy foods.

I will not pretend that increasing the value of Healthy Start is a silver bullet. The increases that I am calling for are modest, but they must form part of a much wider national effort to tackle child poverty, which has now reached such a level that more than 4,000 children in my constituency of Stretford and Urmston are growing up under the yoke of poverty. Labour has a record to be proud of here: the last Labour Government lifted more than a million children out of poverty, largely through fairly redistributing the proceeds of sustained economic growth, which this Government is failing to achieve. Alongside that, they prioritised tackling child poverty and implementing the measures in the Child Poverty Act 2010. Those measures were scrapped by this Government several years ago, leaving us in the mire we now find ourselves in.

The debate is about calling on the Government to take action now. They are the ones with the power to make a difference. A modest increase to Healthy Start could have a significant impact on the poorest families. When considering the issue, I urge the Minister to think of last week’s reports, the indignity that poverty brings and the stigma, shame and anxiety felt by families who are forced to steal or risk their child’s health. Think of what it must be like to feel helpless, hearing again your child’s hungry scream, which many parents now know so well. With all that in mind, if the Minister does not support uplifting the value of Healthy Start in the face of such powerful testimony, I ask him, why not?

Photo of Jim Shannon Jim Shannon Shadow DUP Spokesperson (Human Rights), Shadow DUP Spokesperson (Health) 2:41 pm, 23rd May 2023

We had a similar debate yesterday about poverty, the cost of living and disabled people. It was a heartfelt debate because everyone brought examples from their constituents. I congratulate Andrew Western on bringing forward today’s debate. It is always a pleasure to add a contribution in support of the hon. Gentleman, but I also support the thrust of what he has asked for.

I always like to give credit where credit is due. The Government and the Minister have genuinely made many efforts to address this issue. The hon. Member for Stretford and Urmston is asking for more consideration. I reiterate that, and do what I always try to do, which is to provide a Northern Ireland perspective. Yesterday’s Westminster Hall debate on the impact of the cost of living on disabled people across the UK was important, but it is also good to discuss the detrimental impact of the cost of living on families. The hon. Gentleman outlined some examples from his own constituents and the people he meets every day. I would like to do the same.

In the UK, we are very fortunate to have the Healthy Start scheme. I can very seldom stand here as a Northern Irish MP and talk about a scheme that applies to the whole United Kingdom, but that one does. It provides huge help to many lower-income families, especially at the peak of the cost of living crisis. The Healthy Start scheme, for which the Minister has responsibility and which the Government have made available, provides a pre-paid card for eligible applicants that allows them to purchase frozen fruit and veg, liquid cow’s milk, vitamins or infant milk-based formula. Some 13,500 households in Northern Ireland avail themselves of the scheme and it has been a Godsend—I use that word on purpose—for those families. It has been instrumental for many people in providing the key nutrition they need at the time they need it. I put my thanks for that on record. The scheme is not only for young children, but for expectant mothers and for new mothers who are breastfeeding.

I want to commend Alison Thewliss, who has been a great leader on this issue through the all-party parliamentary group on infant feeding and inequalities. I am a member of that group because I support what the hon. Lady is trying to put forward. It is a very active APPG. I have spoken at a number of events in Northern Ireland and the hon. Lady has always ensured that breastfeeding is central to the debate. I have no doubt that when she speaks shortly that she will add some of the thoughts that she has expressed in APPG meetings.

In Northern Ireland, the scheme has been good for expectant mothers and new mothers who are breastfeeding. I would like to say how important it is to receive the right support at the right time. In Northern Ireland, eligibility for free school meals does not start until primary 1, the equivalent of year 1 here in England, so before children start primary school, the responsibility to provide them with nutrition is solely on mothers and families. I did not see the story on the news about people hearing their children crying for food, but the hon. Member for Stretford and Urmston told it well. I am well past the baby stage now, but I had my grandchildren at our house at the weekend. Whenever they want to be fed, they want to be fed right then, so when the hon. Gentleman tells a story about a child crying because they are hungry, I understand how important it is that we can respond.

Unfortunately, some people struggle to afford food, and the additional pressure of the cost of living has made things considerably harder for mothers and families, which highlights the importance of the wonderful Healthy Start scheme and why it is so crucial for so many parents across the whole of the United Kingdom of Great Britain and Northern Ireland. Northern Ireland statistics show that 330,000 people in Northern Ireland live in poverty. That is a massive figure out of a population of 1.95 million—almost one in five people. Sadly, it includes 110,000 children, which means that the poverty rate is highest among children. This is an issue that I deal with every day in my office, and—the hon. Member for Stretford and Urmston referred to food banks—my staff try to help people through the food bank in Newtownards, which has been used 50% more than it was last year. That gives Members an idea of what is happening. Food banks have a role to play, and they bring good people together. They bring together churches, charities and people in order to reach out and help, and they do that with a kindness and generosity that always amazes me.

The figure of 110,000 equates to one child in four—24%—living in poverty. I ask the Minister to consider extending the eligibility criteria for the Health Start scheme so that more people are included. If I had one request to the Minister, that is what I would ask for. I know the hon. Member for Stretford and Urmston referred to the issue, and I think we are all united on that. So many working individuals are already on the breadline and are unable to support their families because of the cost of living, which is something that we deal with every day in our offices and advice centres. Working families who are struggling to cope should be able, at least temporarily, to avail themselves of the perks of the Healthy Start scheme while the rise in the cost of living is proving so prevalent.

There are so many factors that sew into why so many people and their families are struggling. We are not blaming anybody, because there are circumstances beyond our control. The Ukraine war is one example, as is the cost of energy. They are the fault of nobody in this room, but they are among the factors. What we get from our Government and the Minister is compassion and understanding, and increasing or reviewing the eligibility for the Healthy Start scheme would be a massive step in the right direction. Other factors include the cost of living, the removal of the uplift in universal credit, and the basic rates of maternity and paternity pay for certain forms of employment.

My benefit adviser, who works from both of my offices in Strangford, in Newtownards and Ballynahinch, is a very busy lady and spends five days a week doing nothing but benefits, which are complex. The wonderful thing about her—I say this to her face, so I am not saying anything that I have not said before—is that she understands the benefit system. It can be complex for people to take on board, but she understands it and can offer help through it to address the cost of living, which is impacting on all sorts of people from all kinds of communities.

I have spoken numerous times in the House about the increase in food bank referrals from my office. The food bank in my town is run by the Trussell Trust and was the first one in Northern Ireland. It tells me that my office refers the most people for food bank packages. I probably see more than most people what it means to be desperate, with some being too embarrassed to ask for the help they need. I have also spoken before about the need for universal free school meals. I am not sure whether it is the Minister’s responsibility, but perhaps he could indicate whether it is possible to provide support for children, who are the future—we must not let them down. I love children; we all do. We have our own families, children and grandchildren, and we want to see them do well. However, we also see the children of people who come to see us, and the desperation in their eyes as they try to reach out and seek help. That is what we desperately want as well—to be able to respond in a positive fashion.

I ask the same for the Healthy Start scheme; we should do more to assist expectant mothers and children up to four, who also need help. It should not depend on what parents earn or how much they are struggling, there should be an acceptance that this is a hard time for everyone. We can do more to provide that extra bit of support. The hon. Member for Stretford and Urmston has asked for that. I endorse it; I support it, and I know others will as well. I also encourage greater discussion between the devolved Administrations to keep a constant eye on the situation, and to assess what more we can do in this place to support people who are struggling daily to make ends meet.

I look forward to hearing from the two shadow Ministers—Andrew Gwynne. The three of us are always together in the same debates, and more often than not with the same Minister to respond. I look forward to hearing from him as well.

Photo of Alison Thewliss Alison Thewliss Shadow SNP Spokesperson (Home Affairs) 2:51 pm, 23rd May 2023

It is a pleasure to see you in the Chair, Mr Twigg. I thank Andrew Western for bringing this important debate to Westminster Hall. As the chair of the all-party parliamentary group on infant feeding and inequalities, I have worked on this issue for many years. The cost of formula is not a new problem; it is a continual problem, and one that the UK Government have completely ignored for many years.

A number of years ago, the all-party group did some research on the cost of formula. Even at that time, it was already a struggle for many families. Despite all the evidence, the Government did nothing about it. I have asked questions about inflation and the cost of infant formula, and the Government have said that they are monitoring it. Monitoring is one thing, but actually doing something about it is quite another.

I was glad to see the hon. Member for Stretford and Urmston introduce the debate. I am also grateful to Sky News, which has done stellar work in exposing the many, multifaceted impacts that the cost of infant formula is having on families up and down these islands. Sky News has been out there listening to people’s heartbreaking stories, and telling them. In 2023, we should not have people foraging on Facebook or stealing from shops to feed their babies. It is absolutely desperate.

As hon. Members have said, there is nothing more distressing than a hungry baby. The Minister needs to be dealing with this issue as a matter of urgency. Quite frankly, the Prime Minister is living in a different world if he suggests that the Healthy Start vouchers are sufficient to meet the needs of families. Not enough people are eligible, not enough people are claiming and the vouchers do not meet the cost of a tub of infant formula. Suggesting that people should somehow fall back on discretionary payments from local councils is not much help to a family with a screaming baby at 3 o’clock in the morning. The Prime Minister does not have a clue.

This issue is vital to the development of babies. Babies’ brain development is crucial to their future health and wellbeing, and not being fed properly at this very young stage can have a significant impact on their development. Families are watering down formula beyond the composition it is supposed to be. If they are adding things to formula, such as flour, rusk or other things, children are not getting the nutrition that they need. If people are buying it on the black market, or buying half tubs off Facebook or from friends, the quality of the milk is not guaranteed. Formula in itself is not sterile and it has to be made up properly. If it has been lying open for a while, it could be unsafe for the baby and cause them health problems.

In addition to that, people are struggling to pay their electricity bills. I am grateful to Mumsnet for providing a briefing for this debate. A person on that website said:

“I used to have a client family, a young couple with a newborn, who were really struggling financially...The poor mum just couldn’t breastfeed her newborn, despite the health visitor’s best efforts...The cost of formula was crippling, even with the healthy start vouchers. To make matters worse, they were being really ripped off for electricity through a coin meter and it cost them about 20p to boil a kettle to make up the formula.”

Families are being hit at all angles.

There is also a risk with bottles of formula that are made up. They should be discarded after a period because they do not remain safe and sterile, but if a family cannot afford the next bottle, they will just keep it and feed it to the baby regardless. In those circumstances, parents will likely feel that some formula is better than no formula at all, despite the risk to the child’s health.

Food price inflation is at 19.2% and general inflation is at 10.4%. I pay tribute to First Steps Nutrition Trust for its long-standing research that tracks the price of formula. It has found that the cheapest own brand, and the only own brand of formula on the market in the UK, has gone up by 45% in the last two years. Other formulas went up by between 17% and 31% in the same period. The market is out of control, and the Government have done nothing to address it.

First Steps Nutrition Trust has pointed out that the situation is much the same for other items people may buy with Healthy Start vouchers, such as fruit, fresh vegetables, bread or milk. The trust says that in 2006 someone could get seven pints of milk with Healthy Start vouchers, whereas in 2023 they can get only 4.7 pints. The money is being stretched in all kinds of ways—not just for babies but for older children too.

Part of the issue is the unregulated nature of the formula market in the UK. According to recent research in The Lancet, formula companies bring in £55 billion annually. They spend £3 billion at least on marketing. That amount adds to the price people pay when they buy a tub at the till. The companies are also spending significant money on developing new products, apparently for specialist needs, but these products can be bought over the counter uniquely in the UK. In many cases, they are not necessarily products the Government have failed to regulate, but desperate families are choosing them as an option.

There are also follow-on milks, which are completely unnecessary. I would say to any families out there spending their precious money on follow-on formulas: do not spend that money. They are simply a tool to market formula. They are not required for children. First-stage formula is perfectly adequate for the first year. Do not waste money. If all first-stage formulas are exactly the same—which they are by regulation—why does one cost £9.39 when a different tub costs £19? The Government have very little curiosity about why there is a variation in these prices if all compositions are essentially the same.

The Government should do an awful lot more to interrogate this industry and make sure there is provision for parents out there. It could be like something of the past—perhaps a plain-labelled Government-branded formula that is accessible to people. The Government should be looking at what they can do. It is very clear that the market left to itself is not able to control the prices. The Government should be stepping in to regulate the price of formula. Formula is unique. Unlike all other food products, it is required by babies; they cannot get nourishment any other way. It is a very different type of food product to everything else.

Jim Shannon mentioned breastfeeding. As chair of the all-party parliamentary group on infant feeding and inequalities, I am a massive supporter of breastfeeding. It is the best way to feed a baby. For many families, breastfeeding can be very challenging and formula is necessary—if, for instance, the mother has an HIV diagnosis and breastfeeding is contraindicated, they require infant formula. In other families, children may be adopted or there may be childcare issues, so breastfeeding can be difficult. I would always encourage the Government to invest more in infant feeding support, because inconsistency in support, alongside a very rapacious infant formula industry, is undermining breastfeeding in this country. I would like to see full implementation of the international code of marketing of breastmilk substitutes, because that would also help to support families.

I also want to talk about the holes within the system. The Healthy Start vouchers are not keeping up with the pace of things. Families cannot simply rely on food banks or baby banks to provide something as a fall-back option, because, as I have said, infant formula is incredibly expensive and if food banks are trying to feed the most people they can, do they buy a whole load of tins of beans or do they buy one can of infant formula? That is a very difficult position to put food banks in and they should not be the emergency service to make up for where the Government have failed.

I will finish with a point of contrast. As has been mentioned, the Best Start Foods scheme in Scotland, which is a devolved benefit that the Scottish Government have set up, is—importantly—more generous than the Healthy Start scheme. It stands at £9.90 per week in the first year. The Scottish Government have increased that, with inflation, and the UK Government should do likewise with their schemes.

In addition, in Scotland there is the Scottish Child Payment of £25 a week, which makes a massive difference to families; whether they have babies or older children, that is £25 per child per week. And from speaking to people at food banks in my constituency, I know that that is making the difference between families coming in desperate for food or not. That £25 payment is paid up to the age of 16. As I say, it makes a massive difference for families in Scotland and provides a clear contrast with what the UK Government are providing.

In Scotland, we have also looked at increasing the eligibility for that benefit. We are trying to make sure that those who have no recourse to public funds and who would not be eligible ordinarily for Healthy Start vouchers can get the Best Start grant in some circumstances. Of course, if the UK Government would abolish no recourse to public funds, we could give the Best Start grant out to far more people and make sure that all babies are fed, regardless of their parents’ immigration status.

In Scotland, there is also a range of other grants, in addition to Best Start Foods. So, there is a Best Start Pregnancy Payment of £707.25 for someone’s first child and of £353.65 for subsequent children, with no limit on the number of children, unlike the two-child limit for some other schemes. There is also the Best Start Grant Early Learning Payment between the ages of two and three and a half, and a School Age Payment for when a child is old enough to start school.

Those grants are incredibly important in the landscape of benefits available to parents, because families are pressed from all different directions at the moment, whether that is buying school uniforms or putting food on the table. The Scottish Government are making a real difference in this way, by making sure that children are fed and that families are not on the absolute brink of survival. I believe that it is up to the UK Government to meet that challenge, to regulate the infant formula sector and to uprate the payments under the Healthy Start scheme to match—or exceed if possible, which would be nice—what is available in Scotland, because we are doing everything we can.

I thank First Steps Nutrition Trust, Leicester Mammas, Feed UK, the British Pregnancy Advisory Service and the Food Foundation for their work, and I thank the hon. Member for Stretford and Urmston for securing this debate today. There is a lot of work going on and the Government need to meet the challenge that they have been set.

Photo of Andrew Gwynne Andrew Gwynne Shadow Minister (Health and Social Care) 3:02 pm, 23rd May 2023

As ever, it is a pleasure, Mr Twigg, to serve under your chairmanship.

I begin by thanking my hon. Friend Andrew Western for securing this debate and for the fantastic work that he is doing in raising awareness of this issue.

It has been a small but perfectly formed debate, with Jim Shannon contributing to it. He always comes to Westminster Hall full of knowledge and willing to share the Northern Ireland perspective. We are always grateful for that, because we can learn a lot from different parts of the United Kingdom and it is really important that voices from different parts of the United Kingdom are raised in these debates, even though primarily these debates, when they relate to health, relate to health issues in England only. Nevertheless, we are the United Kingdom Parliament and it is really important to know what is happening in other parts of the country where there are devolved Governments.

Alison Thewliss speaks so well on these issues. She obviously has her role as the chair of the all-party parliamentary group on infant feeding and inequalities, and with the work that she does with that APPG she has got really stuck into the matters that we are considering today in real depth and detail. But she also brings a fresh perspective to these debates, as does the hon. Member for Strangford. We learn more from her about what is happening within Scotland through the Scottish Government, and it is important that across the United Kingdom Parliament we hear such examples and that we learn from best practice in different parts of the United Kingdom, so as to make better policy here in Westminster.

My hon. Friend the Member for Stretford and Urmston was absolutely right to raise the issues that he did in this debate, because Healthy Start is an essential scheme that ensures that there is a nutritional safety net for pregnant women, parents and children under the age of four in low-income families. It allows parents—in theory —to buy healthy foods such as fruit and milk, as well as to access free vitamins. However, in the context of the cost of living crisis—so eloquently set out by my hon. Friend—families are undoubtedly finding it increasingly difficult to get what they need. Analysis from the British Pregnancy Advisory Service shows that, although the benefit itself has not changed since 2021, the price of infant formula—as we have heard from the hon. Member for Glasgow Central and from my hon. Friend the Member for Stretford and Urmston—has increased substantially since then. The cheapest brands have increased in price by a phenomenal 22%, which is just unfathomable, in that short space of time.

As we have also heard, huge concerns have been raised about the uptake of the vouchers themselves, particularly following the switch from paper vouchers to a prepaid card system. Healthy Start scheme data for January 2023 shows that up to 37% of eligible families with young children are currently missing out on the scheme. That cannot be acceptable, either. A huge proportion of the people who desperately need that support—or they would not be eligible for it—are missing out.

In an answer on 13 February to a written question tabled by my hon. Friend the Member for Stretford and Urmston, the Minister responded:

“While there are no current plans to increase the value of Healthy Start, this is kept under continuous review.”

With that in mind, I would be grateful if the Minister could update us on whether there have been any recent discussions regarding the value of the scheme and whether it is still his Department’s position that no increase in value is forthcoming. If that is the case, can the Minister set out what assessment his Department has made of the impact of inflationary price rises on low-income households, and what reassurances he can provide to all Members here today that families are not being priced out of essential goods on this Government’s watch?

Similarly, I will press the Minister on the uptake of the scheme. The Government’s target for uptake is 75%, but as I mentioned earlier, we are currently sitting at about 63%. A quick trawl of written questions shows that the Minister has been responding to concerns raised by Members on this issue with a boilerplate response—namely, that the NHS Business Services Authority promotes the Healthy Start scheme through its digital channels and has created free tools to help stakeholders to promote the scheme locally. That answer suggests to me that the Government are not particularly concerned about missing their own target. That is not acceptable. I remind the Minister that there is very little point in setting a target if they are not going to do their utmost to meet it. We all know that the NHSBSA promotes this scheme, but something is clearly not working if uptake is as low as it is. What additional action is the Minister planning to take to increase uptake so that all families who are eligible are not just able to access the scheme but do access it?

It would be remiss of me if I did not raise the problem of child health inequalities, which are widening at an alarming rate. At our mission launch on Monday, Labour committed to a children’s health plan that would give every child a healthy start in life. That includes our pledge to establish fully-funded healthy breakfast clubs across England and restrict adverts for foods high in fat, sugar and salt. We would oversee the retrofitting of 19 million homes in England, to keep families warm. We would reform universal credit. And we would pass a clean air Act, to protect our children from the serious respiratory illnesses caused by pollution. It is an ambitious agenda that would proactively tackle child poverty and ensure families could afford to feed their children and keep them well. Over the last 13 years, the UK’s progress on infant and child mortality has stalled, and we now have much worse rates compared with other developed countries. We must see a concerted effort from the Minister to tackle that. More of the same will just not cut it. What exactly is the Government’s plan to meet the scale of the crisis in child poverty and ill health?

All children deserve to lead long, happy and healthy lives, irrespective of where they grow up and which part of the United Kingdom they live in. That means ensuring that in England the Healthy Start scheme works, and that we do everything we can to tackle child poverty across the country. I strongly urge the Minister to better engage with campaigners on the issue and work proactively with Members on all sides of the House to ensure that the Healthy Start scheme is fit for purpose.

Photo of Neil O'Brien Neil O'Brien The Parliamentary Under-Secretary for Health and Social Care 3:11 pm, 23rd May 2023

It is a pleasure to serve under your chairmanship, Mr Twigg. I am grateful to Andrew Western for securing this debate and to the other Members who have participated. Jim Shannon made a typically compassionate speech.

The Russian invasion of Ukraine has had a global impact. We have seen a rise in inflation, with increased food costs and higher energy prices, and that has impacted on the cost of living. The challenge of the increase in the cost of living is felt by everyone across the country. The Government understand and recognise the challenges that many face as a result of the huge increase in inflation.

The Government have taken, and will continue to take, decisive action to support people with the cost of living. In response to higher food costs, the Department for Environment, Food and Rural Affairs continues to work with food retailers and producers on ways to ensure the availability of affordable food—for example, by maintaining value ranges, price matching and price freezing measures.

In response to higher energy prices, the Department for Business, Energy and Industrial Strategy put in place the energy price guarantee to shield households from the unprecedented rises in energy prices. The guarantee will run until April 2024, and the Government are working with consumer groups and industry to explore the best approach to consumer protections from April 2024 onwards, as part of wider retail market reforms. As set out in the energy security plan, we intend to consult on those options this summer.

In response to the higher cost of living more generally, the Department for Work and Pensions is providing up to £900 in three lump sums for households on eligible means-tested benefits, a separate £300 payment for pensioner households and a £150 payment for individuals in receipt of eligible disability benefits. From this April, the Government have uprated benefit rates and state pensions by 10.1%. In order to increase the number of households who can benefit from those uprating decisions, the benefit cap levels were also increased by the same amount.

Also from this April, the national living wage that this Government introduced increased by 9.7% to £10.42 an hour for workers aged 23 and over. That is the largest ever cash increase for the national living wage. For those who require extra support, the Government are providing an additional £1 billion of funding, including Barnett impact, to enable the extension of the household support fund in England this financial year. That is on top of what we have provided since October 2021, bringing the total funding up to £2.6 billion. This is used by local authorities to help households with the cost of essentials.

Photo of Alison Thewliss Alison Thewliss Shadow SNP Spokesperson (Home Affairs)

It is interesting to hear about all the things that were uprated with inflation. Will the Minister explain why Healthy Start was excluded from that?

Photo of Neil O'Brien Neil O'Brien The Parliamentary Under-Secretary for Health and Social Care

If I can just complete the thought, the total cost of living support that the Government have provided is worth more than £94 billion across 2022-23 and 2023-24. That is, on average, more than £3,300 per UK household. It is one of the most generous support packages for the cost of living anywhere in Europe.

I turn to the critical role that the Healthy Start scheme plays in supporting hundreds of thousands of lower-income families across the country. Eating a healthy, balanced diet, in line with “The Eatwell Guide”, can help to prevent diet-related disease. It ensures that we get the right energy and nutrients needed for good health and to maintain a healthy weight throughout life. The Healthy Start scheme is one way that the Government continue to target nutritional support at the families who need it most, which is increasingly important in view of the cost of living.

Healthy Start is a passported benefit, one of a range of additional sources of help and support that the Government provide to families on benefits and tax credits. It is a statutory scheme that helps to encourage a healthy diet for pregnant women, babies and young children under four from lower-income households. Women who are at least 10 weeks pregnant and families with a child under four years old are eligible for the scheme if they claim: income support; income-based jobseeker’s allowance; child tax credit, if they have an annual family income of £16,190 or less; universal credit, if they have a family take-home pay of £408 or less a month; or pension credit. Pregnant women on income-related employment and support allowance are also eligible for the scheme.

Anyone under 18 who is pregnant is eligible for Healthy Start, regardless of whether they receive benefits. Following the birth of their child, they must meet the benefit criteria to continue receiving Healthy Start. The scheme offers financial support towards buying fresh, frozen or tinned fruit and vegetables, fresh, dried and tinned pulses, plain cow’s milk and infant formula. Beneficiaries are also eligible for free Healthy Start vitamins.

In April 2021, as has been mentioned, we increased the value of Healthy Start by 37%, from £3.10 per week to £4.25 per week. Unlike the Scottish Government’s scheme, which is for the under-threes, Healthy Start is for the under-fours. Pregnant women and children aged over one and under four each receive £4.25 a week, and children aged under one each receive £8.50 a week—twice as much. For a family with a six-month-old and a three-year-old, that is £12.75 a week to help towards buying nutritious foods. That comes on top of the benefits and all the other measures, such as the increase in the national living wage, that I mentioned.

Photo of Andrew Gwynne Andrew Gwynne Shadow Minister (Health and Social Care)

I am grateful to the Minister for rattling off the sums. To go back to the point that Alison Thewliss made about the Healthy Start grant and why the Government chose not to uprate it, will he share with the House what the cost to the Exchequer would have been to uprate it? That must have been part of their deliberations as to why not to do it. What is the cost?

Photo of Neil O'Brien Neil O'Brien The Parliamentary Under-Secretary for Health and Social Care

We have chosen to spend over £3,300 per UK household, on average, on the cost of living support. Putting that into the schemes that are available and targeted at people with low incomes, and indeed at the entire population, is the choice that we have made. To reiterate my earlier point, and since the hon. Member says that I am rattling off the figures, it is worth stressing that we have invested £3,300 per household—a colossal sum of money. That is unprecedented. There has never been a cost of living intervention anywhere of that magnitude, so that must be an important part of the discussion about Healthy Start.

Photo of Neil O'Brien Neil O'Brien The Parliamentary Under-Secretary for Health and Social Care

I will continue with my points and perhaps come back to the hon. Lady in a moment.

Healthy Start is delivered by the NHS Business Services Authority on behalf of the Department. Following user research and testing by the Department and NHSBSA, the scheme, as various Members have mentioned, was switched from being paper-based to a digitised service to increase uptake and usability. We have introduced an online application to replace the previous paper-based application form and a prepaid card to replace paper vouchers. The digitised scheme opened to the public for the first time in September 2021. The online application provides an instant decision for many families. The prepaid card can be used in any retailer that sells Healthy Start foods and accepts Mastercard.

I am pleased to see that the number of new families joining the scheme continues to grow following the introduction of the prepaid card. Since September 2021, there have been more than 500,000 successful applications, with 48% coming from new families. The scheme now supports more than 375,000 families on lower incomes, and that continues to grow month on month. The current uptake is 64.6%, which is higher than the paper scheme, which had a 59.9% uptake in August 2021.

The hon. Member for Stretford and Urmston asked whether we published the figures on eligibility. Yes, the total number of eligible and entitled beneficiaries are published on the NHS Healthy Start website and are broken down by local authority.

Photo of Alison Thewliss Alison Thewliss Shadow SNP Spokesperson (Home Affairs)

The Minister is making an interesting point about the uptake, but can he account for why things are so much better in Scotland, where the uptake of Best Start Foods sits at 88%?

Photo of Neil O'Brien Neil O'Brien The Parliamentary Under-Secretary for Health and Social Care

The schemes are not completely comparable because the Healthy Start scheme covers a wider base of people, as I mentioned. It goes up to age four rather than age three, so it has a wider field of benefit than the Scottish scheme. That may be part of the story, but there could be other reasons, and there may be important things that we can learn from the Scottish scheme. I am always keen to have those discussions.

To increase take-up, NHSBSA actively promotes Healthy Start through its digital channels and has created free toolkits to support stakeholders to do so. NHSBSA uses a range of communications activities to engage parents, pregnant women and healthcare professionals to help to raise awareness of the scheme. NHSBSA has attended Maternity & Midwifery Forum events and placed advertisements in the Bounty packs, which many people receive when they have children, and the “You and your pregnancy” magazine, which is given to pregnant women in the first trimester.

We constantly review the materials produced for the Healthy Start scheme to ensure that communications reach those who need support the most. That is why, following user research by NHSBSA, promotional material was translated into the top five languages spoken by Healthy Start families, to reach a wider demographic. NHSBSA continues to engage with national and local stakeholders to improve the delivery of the scheme and increase the uptake.

Healthy Start is an important part of the support provided by the Government, but it is only one aspect of the support available for families. We are funding 75 English local authorities with high levels of deprivation to ensure that parents and carers can access Start for Life services locally. The healthy child programme is a universal offer across all 150 local authority areas—led by health visitors and school nurses—that supports families from the antenatal period up to school entry. The nursery milk scheme provides reimbursement to childcare providers for a daily third of a pint portion of milk to children and babies. The school fruit and vegetable scheme provides around 2.2 million children in key stage 1 with a portion of fresh fruit or vegetables each day at school, and 419 million pieces of fruit and vegetables were distributed to children in 2022-23.

The Government have extended free school meals eligibility several times and to more groups of children than any other Government over the past half a century, including the introduction of universal infant free school meals and further education free meals. Under the benefits-based criteria, 1.9 million of the most disadvantaged pupils are eligible for and are claiming a free school meal. That saves families around £400 per year. To make it easier for families to find support, the Government also created an online resource so that families can easily check what help is available to them.

At a time when families need support, and with the cost of living increasing, the Government are committed to helping as many families as possible to access the Healthy Start scheme, as well as all those other schemes, to help those most in need.

Photo of Andrew Western Andrew Western Labour, Stretford and Urmston 3:22 pm, 23rd May 2023

I thank everybody who has taken the time to participate in the debate. This matter is incredibly important to me, my constituents and so many people up and down the country in the midst of this cost of living crisis.

I will comment on some contributions from hon. Members, beginning with Jim Shannon. I am very grateful for his support for uprating the Healthy Start allowance. He is right to highlight the scheme’s importance to the people of Northern Ireland; it is also important to people across the whole UK, as he rightly said. He was also right to mention free school meals, because that is a major problem with the scheme as it stands. The Healthy Start allowance finishes on a child’s fourth birthday, after which the children of some of the very poorest families do not receive that support. We are talking about children and the food they eat, rather than about the families. At a crucial time in any child’s development, those children do not receive that support until they are at school and in receipt of free school meals. I thank him for making that point.

I also agree with the hon. Gentleman’s point about the potential extension of eligibility. I very deliberately sought to put forward a reasonable ask of Government today. Based on the Minister’s response, I need not have bothered to do so; I could have asked for all the issues with the scheme to be addressed. I made a minimal request in the hope that there might be a positive offer in response. The extension of the eligibility criteria would be particularly welcome not just to those with children over the age of four, but to everybody in receipt of universal credit. The current level of eligibility is set at any family earning up to £408 a week from employment, which is not a significant sum when there are little mouths to feed.

I very much associate myself with the comments from the hon. Member for Strangford about the complexity of the application process. I hear what the Minister said about the move online and the digitisation of the scheme, but there have been significant problems, not least with the availability of reporting and data as a result of the shift to digitisation. The hon. Member for Strangford made a point about his dear friend who spends so much time advising on benefits that it is a full-time job. He is absolutely right: it would need to be, because the scheme is so complex that many families are simply not taking it up. The shadow Minister, my hon. Friend Andrew Gwynne, pointed out that we are missing the Government’s target, and I will return to that serious issue momentarily.

I turn to the comments of Alison Thewliss, whose expertise in this matter—not least that garnered as chair of the all-party group on infant feeding and inequalities—is second to none. I stress that I am not here speaking specifically about baby formula. She says that that is not a new issue, and I absolutely appreciate that. However, on this issue, we have an acute and current problem that is relatively new across the piece, because Healthy Start is used for things other than baby formula, including milk, pulses, fruit and vegetables, and so on. I know she understands that, but I am trying to continue making the case for why this is important in and of itself. There is a broader remit up to the age of four, and it is incredibly important to note that, but I endorse everything that she says about milk formula, and the challenges for the lowest-income families as a result of the current system and the current pricing regime.

The hon. Lady’s comments about the value of the voucher, in terms of the loss of milk, are really pertinent. For the value of the voucher to be down by the cost of more than two pints of milk over a relatively short period shows the impact on families. I am incredibly fortunate to do this job. I do not know what it is like to have to sit there and work out, “Can I buy an additional pint or two of milk this week?” For families in that situation, it must be absolutely devastating when they have a hungry child crying for food as they make that calculation.

I also associate myself with the hon. Lady’s comments about individuals with no recourse to public funds. That is really important, and I firmly agree that that should not be a barrier to receiving the Healthy Start allowance. In particular, the Government have moved on that specifically in relation to free school meals. When one considers a child’s journey through the early years and on to education, I can see no difference that would excuse these two alternating and contradictory positions. If nothing else, I hope that the Minister will take that away and endeavour to look at it.

The shadow Minister, my hon. Friend the Member for Denton and Reddish, made some really important points about uptake, building on the comments of the hon. Member for Strangford. We have up to 200,000 beneficiaries of the allowance not currently taking it up. We have a Government target of 75% against a national average of 64%, so that is a significant failing. Having said that I would restrict my requests to one particular area, I place on record that I support the Food Foundation’s request for a £5 million investment campaign spent on promoting the scheme to drive up the uptake.

My hon. Friend’s broader list of points, in setting out Labour’s agenda, shows the breadth and scale of change that is needed to genuinely tackle the cost of living crisis. I said in my opening speech that this change alone would not be a silver bullet. It is one of myriad interventions that are needed, given the scale of the crisis that young families and people up and down the country face, whether they have young children or not. That sort of visionary and transformational agenda will be required to tackle child poverty. I know that my hon. Friend will agree that the last Labour Government did that, and I hope that the day when we can do so again comes very soon.

To turn to the Minister’s contribution, it has probably come across that I am relatively disappointed by the response. He refused to say, and presumably has not even looked at, what the cost of this intervention would be. He mentioned that the data—which I pointed out was troublesome—made this complicated. I am happy to give way if he wants to provide clarification on this point. There is an awful lot of talk about “beneficiaries”—he used that term—but that does not make it clear to me whether we are talking about one parent in a family, two parents in a family, one family, one child or two children in the same family. It is not clear, so I have had to make these calculations based on 336,000 current recipients of Healthy Start, assuming that around 30% of those fall into the category of children between nought and one. An inflation-level uplift of 72p a week for those on the lower rate and therefore £1.44 for those on the higher rate would add up to a whopping £16.3 million. That is nothing when one considers the grotesque scale of waste that the Government incur through failing to intervene early enough in children’s lives, before they face deeper problems further down the line. That is nothing against what I set out in my opening speech in relation to the lost revenue to the Treasury when one considers the lost potential over the course of a lifetime.

These are tiny sums in reality, but they would make an enormous difference to people on the lowest salaries and incomes. When the Minister lists the litany of interventions from the Government and says, for instance, that the living wage has been increased to £10.42, it is important to recognise that that can be a problem for previous recipients of Healthy Start, because not uprating the Healthy Start allowance means that some people may roll off it and be worse off. There is no taper and no support for those just over the limit. Forgive me, I had not considered this in advance, or I would have made this point in my opening speech: I think I am correct in saying that the decision not to uprate Healthy Start will lead to fewer people being eligible. That is shameful, given the crisis that we face in this country, and given that we have families stealing to feed their babies. It terrifies me that the Minister hides behind an increase in the national living wage, when that leaves people potentially worse off in this instance.

We have to be honest: this invest-to-save measure would have been particularly cheap for the Government to enact. The greatest impact that we can have on anybody’s development is in those first few years. That is why we have policies such as Sure Start and why we have the Government’s albeit limited family hubs policy. No child can reach their potential if they grow up without the food and nutrition that we all need, particularly in our youngest years.

There are many issues. As I said, I began in a rather restrained way, but we received such a disappointing response from the Minister. He did not even consider this proposal and pointed to broader lists, seemingly not having looked at what the negligible costs would be, so I will briefly set those issues out. I would have liked to say more about auto-enrolment and take-up; expansion of the scheme to all children under free school meals age; and widening the eligibility criteria to all families on universal credit and those with no recourse to public funds, who can now get free school meals.

Fundamentally, however, I came here with a reasonable ask today, at a time when we know that families are so desperate that they are stealing to feed their children and are listening to hungry cries because of the empty bellies of the very youngest people in our society. We are talking necessarily about the most vulnerable young people in our society, in families on the lowest incomes. This proposal would have cost next to nothing, but I fear that the price for those individuals will be grave indeed. I am grateful to everybody who has participated today, but I have to say, I remain deeply disappointed by the Minister’s response.

Question put and agreed to.


That this House
has considered the Healthy Start scheme and increases in the cost of living.

Sitting suspended.