Children’s Health: Access to Milk 11.00 am Mary
Glindon (North Tyneside) (Lab) I beg to move, That
this House has considered children’s health and access to milk in
educational settings. It is a great honour to speak under
your chairmanship, Mrs Gillan. School milk is an issue that
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Children’s Health: Access to Milk
11.00 am
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(North Tyneside)
(Lab)
I beg to move,
That this House has considered children’s health and access
to milk in educational settings.
It is a great honour to speak under your chairmanship, Mrs
Gillan. School milk is an issue that cuts across three
Departments—the Department of Health, the Department for
Environment, Food and Rural Affairs, and the Department for
Education—but I am glad that the Minister for Vulnerable
Children and Families is here today to respond to the
debate.
I want to highlight the importance of school milk because
it is fundamental to children’s health and is a nutritious
source of energy during the school day. I thank the School
and Nursery Milk Alliance for all its good work and for the
information it has supplied for the debate. I am also
grateful to Tetra Pak for sharing with me a copy of its
forthcoming report, “Making More of Milk”, which will be
formally launched on 5 April and which contains information
particularly pertinent to the debate.
Milk has been an important part of our diet for hundreds of
years. It is a natural healthy option for children that
contains vitamins and minerals vital for good dental health
and bone development. It also plays a key role in a healthy
diet, helping efforts against childhood obesity and dental
decay.
The Health Secretary has identified childhood obesity as a
public health priority. It is estimated that 29.2% of
children between the ages of two and 10 in England are
either overweight or obese. Excess weight during childhood
often precedes the development of cardiovascular disease,
hypertension, insulin resistance and other diseases.
Overweight and obese children are more prone to become
obese adults.
The latest data from the Health and Social Care Information
Centre show that 34% of 12-year-olds and 46% of
15-year-olds exhibit tooth decay. As well as being
unpleasant for children, treating tooth decay is a
significant cost to the NHS. Cow’s milk contains
micronutrients, such as calcium and vitamins B3, B12 and
B2, that reduce the risk of tooth decay, bleeding gums and
mouth sores.
Statistics released only last week by the faculty of dental
surgery at the Royal College of Surgeons showed that more
than 9,000 tooth extractions were performed on young
children last year, including 47 extractions performed on
babies under one year old. The dean of the faculty,
Professor Hunt, described the figures as “shocking” and as
attributable to the amount of sugar that children consume.
Sadly, although the figures were widely reported in the
media and although the new soft drinks levy will exclude
milk products that contain at least 75% milk, there was no
mention of the fact that drinking milk as a healthy
alternative to sugary drinks can help children to develop
strong teeth.
In 2016, Northumbria University published a review of the
available research on the impact of milk on children’s
development. The evidence reviewed by the researchers
suggested that milk consumption greatly improves children’s
nutritional status. The review, which was drawn primarily
from cross-sectional studies, reported that children who
regularly drink milk have lower body mass indices, lower
body fat percentages and lower waist circumferences than
children who rarely drink it. That is probably due to the
unique combination of essential nutrients that it contains.
In particular, the evidence suggests that milk contributes
to body mass control and body composition in
children—possibly because of the high satiety effect, which
makes it an ideal mid-morning snack—and contains multiple
nutritional properties that protect against dental decay
and promote good dental health.
The nursery milk scheme was subject to a lengthy
consultation during the last Parliament about whether it
could be made more cost-effective, possibly by giving a
single large company the contract to provide milk to all
settings across the country. The scheme was left in place
untouched, but the problem with it is that children are no
longer entitled to milk once they turn five, whenever in
their reception year that happens. This confusing system
not only creates extra work for teachers but seems very
unfair on little children. Tetra Pak’s “Making More of
Milk” report has found that 89% of parents and 93% of
teachers think that school milk should be made available to
all reception children, regardless of when they turn five.
Will the Minister commit to changing the scheme and making
free school milk available for all reception children?
The Government have given assurances that until we leave
the EU we will continue to participate in the European
school milk scheme, through which over-fives can receive a
subsidised portion of milk, but schools and parents need to
know the Government’s plans for the future. Can the
Minister offer us any further information or assurances
about the future of subsidised school milk for children
over five?
Another worrying factor is that Public Health England’s
“Eatwell Guide”, which was published in March 2016, reduced
the content of milk and dairy products in the recommended
daily diet from 15% to 8%. Although the guidance includes
recommendations of healthier drinks for the first time, the
reduced role of milk and dairy products could limit
alternatives for children and young people who are
unwilling to drink water or unsweetened beverages.
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(Wells) (Con)
I congratulate the hon. Lady on securing this debate and on
highlighting the many health benefits of drinking milk. I
represent a constituency that produces a great deal of
milk. It is fantastic to see her advocating those health
benefits; I hope that the Government will listen and, more
generally, that people around the country will realise that
the more milk they drink, the healthier they will be.
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I thank the hon. Gentleman for his intervention. He
expresses a sentiment that will be shared by many people
around the country.
Milk can play a role in keeping children hydrated. The
British Nutrition Foundation’s healthy hydration advice for
children puts milk second only to water as a drink that
they should consume. Although greens are important in
everyone’s diet, it is worth knowing that a 200 ml glass of
milk provides the same calcium as 63 Brussels sprouts or 11
servings of broccoli—quite a thought.
The “Eatwell Guide” caused great concern among stakeholders
in the dairy industry, who did not feel that they had been
properly consulted during its development. Although Public
Health England published information last December on the
process of developing the guide, it did not make it clear
why the recommendations to reduce the level of dairy were
introduced. Can the Minister offer reassurances that the
new guide will not discourage children from drinking milk?
Will he commit to involving the full range of stakeholders
next time any important public health guidance is being
revised?
Finally, I would like to raise the issue of school food
standards. The school milk sector was broadly positive
about their introduction in January 2015, but the School
and Nursery Milk Alliance has highlighted the fact that
there is no clear evaluation or monitoring of them. To
ensure that we make the most of the standards, schools not
only need to provide milk, they need to provide it in a way
that is appealing to children and that encourages them to
drink it. Does the Department for Education have any plans
to evaluate the implementation and impact of the standards?
Today, school milk tends to be chilled and served in
individual cartons—a big contrast to the warm milk that
some MPs may remember from their childhood—but there are
other factors that affect whether children want to drink
it. For example, milk is more appealing at the mid-morning
break than at lunchtime, because its high satiety effect
means that it does not make a good accompaniment to a meal.
A mid-morning break is also a good time to have a healthy
snack, to help children to get through until lunch,
particularly if they did not eat a proper breakfast.
Evidence shows that many children drink only skimmed or
semi-skimmed milk at home, so if they are given full-fat
milk at school, they tend not to like the taste. The school
food standards will be revised as part of the childhood
obesity plan and it is important that the requirement to
provide milk is retained. Can the Minister provide any
details about the plans to update the standards as part of
the childhood obesity plan? As part of the childhood
obesity plan, a new health rating scheme for primary
schools will be introduced in September this year. It would
be helpful if it covered access to milk in schools,
including how it is offered to children. Will milk be
included at least once a day?
Ofsted is also planning to produce guidance for schools
following its thematic review of obesity, healthy eating
and physical activity in schools. It would be helpful for
this guidance to include information on milk, including
best practice on how to serve it. Academies established
between June 2010 and September 2014 are not required to
implement the school food standards, although we understand
that many of them do so voluntarily. Are there are any
plans to make compliance compulsory for all schools?
There are a wide range of issues impacting on school milk
today. I look forward to hearing the Minister’s response to
this debate. As these issues cut across a number of
Departments, I hope he will be able to tell us how they are
working together to ensure that children are able to access
milk in schools for the benefit of their health, for now
and for their lifetime.
11.11 am
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The Minister for Vulnerable Children and Families (Edward
Timpson)
As ever, Mrs Gillan, it is an absolute pleasure to serve
under your chairmanship.
I begin, in the customary way, by congratulating the hon.
Member for North Tyneside (Mary Glindon) on securing this
debate. It goes without saying that, like her, we want to
ensure that all pupils are healthy and well-nourished. To
that end, we promote and encourage a healthy, balanced diet
and healthy life choices, through school funding,
legislation and guidance—the tools at our disposal. We use
our legislative frameworks, such as the school food
standards, to ensure that children receive a healthy,
balanced diet within all educational settings.
We know, of course, that most adults and children in the
United Kingdom eat too much sugar. That is why the
Government recommend that we reduce our intake by eating
fewer sugary foods and drinks, such as sweets, cakes and
biscuits. We also know that the earlier that eating and
drinking habits are ingrained, the harder it is to disrupt
them and put people on a different dietary path in the
future.
It is in such a context that this debate is timely, as it
gives me the opportunity to explain how we are promoting a
healthy, balanced diet and milk consumption within
educational settings, particularly among those children who
are most in need. For example, children under the age of
five who attend a day care or early years setting receive
milk via the nursery milk scheme, which the hon. Lady
referred to. That scheme is funded by the Department of
Health, so it is a cross-Government scheme, but we work
together to ensure that it reaches the children who need it
most. It has actually been in existence since the 1940s, so
it is a very well-established route to ensure that those
children who perhaps would not enjoy that level of milk
consumption at the early age they need it are able to do
so.
Indeed, I suspect that I was a beneficiary of that scheme
in the 1970s, believe it or not, when I was at Mrs Batsen’s
nursery in Wilmslow, where—from memory—I was first faced
with the reality of needing to learn to share with others
and not just think about myself. I was very excited on the
day I was asked to be the milk monitor. The job was to go
downstairs with another child—my fellow milk monitor—to
collect a crate of small milk bottles for distribution
upstairs among our peers. Now, we knew that there were two
children absent that day, so we concocted a plan to drink
two of the bottles downstairs and then bring the remaining
bottles upstairs, where we would then be able to consume
another bottle, knowing that there should be two bottles
spare. Unfortunately, the plan did not turn out to be the
grand plan that we had hoped it would be, as a number of
bottles had already been taken out of the crate by the
staff, who recognised that they needed to reduce the number
of bottles to reflect the level of attendance. So we were
caught red-handed and I was never made milk monitor again.
Consequently, when I visited Beechwood school in my
constituency in 2011, on what was World School Milk Day, it
was something of a surprise to be made an honorary milk
monitor. That gave me an opportunity to reflect on the role
that milk has played in my life, both in learning life
lessons and in being able to access what is an important
part of a healthy diet in those formative years as we grow
up.
That is why the Government promote a healthy, balanced diet
to children, using legislative frameworks such as the
school food standards. Those standards, which apply to the
overwhelming majority of maintained schools as well as to
maintained nurseries, restrict the amount of fat, sugar and
salt that can be served during the day. I heard what the
hon. Lady said about the fact that there are some academies
formed between September 2010 and 2014 to which those
school food standards do not apply. We encourage those
schools to follow the standards, but of course we keep this
matter under review and in the future we will look to see
how we can ensure a greater level of engagement with those
standards, as they reflect exactly what we want to see
happen in schools for the good of children.
The benefits of providing a healthy school meal and milk to
the most disadvantaged children are well-recognised.
Currently, around 1.15 million of the most disadvantaged
children are eligible for and claim a free and nutritious
meal. As for milk specifically, we promote its consumption
as part of a healthy, balanced diet through funding,
legislation and guidance.
Why do we do that? As the hon. Lady rightly highlighted, we
know that milk is excellent for children’s growth and
development, which is why the school food standards require
lower-fat or lactose-reduced milk to be available for
children who want it during school hours, and it is offered
free to disadvantaged pupils. We also provide significant
funding to schools to support the provision of milk,
through the European Union, which I will move on to in a
moment, as well as through top-up and nursery milk schemes,
as part of free school meals, and more recently through
universal infant free school meals, which benefit 1.4
million infants.
The hon. Lady made it clear that we have continued our
commitments to the European Union scheme during our period
of membership of the EU. Of course, like all areas of
policy that will be moving into a domestic arena, we will
carefully consider how we will continue to support schools,
so that we can fulfil our obligation to provide children
with a healthy and balanced diet. I cannot say at this
stage where that consideration will lead us, but the fact
that we can go back to the 1940s to see how Governments
have provided help and support in this area is an
indication of where we may want to take the evidence in
future, when we come to make those decisions in a few
years’ time.
Notably, we provide around £60 million each year, outside
the EU arrangement, to reimburse costs for the nursery milk
scheme, which is targeted at children under the age of
five, to ensure that they get the important nutrients they
need in those important years of development.
The hon. Lady asked about the over-fives who are still at
nursery school. I will look carefully at what she said and
discuss it with my ministerial colleagues. However, it is
worth pointing out that over-fives who are entitled to
receive a free school meal do so, and where they are
entitled to a free meal they also receive free milk. Also,
under the universal infant free school meals scheme that I
referred to a few moments ago, free milk is available to
infants if it is served as part of their lunch. We will
look at the impact that is having as part of our
consideration of where we go next with our commitment in
this area.
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I thank the Minister for giving way, and it was very
entertaining to hear about his time as a milk monitor. I just
wanted to emphasise the issue of children having free milk
throughout reception, rather than the current situation,
where a child stops getting free milk the moment they are
five, even though they will obviously be in a class with
other children who are younger than they are. That is the
point I want to emphasise. If free milk could be guaranteed
to children while they are in a reception class, it would
make life a lot easier for the teachers and it would seem
fairer to the little children themselves.
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As I have said, I will look carefully at what the hon. Lady
has said, but there are a number of routes that I have
described whereby children over the age of five in a nursery
setting are able to access free milk, whether that is through
free school meals or universal infant free school meals.
There will be a continuation of the policy in the
deliberations by different Government Departments about where
it goes next, and clearly that issue will be part of future
discussions.
The scheme we support—the nursery milk scheme—has extensive
reach, providing milk to 1.5 million children, and it should
not be forgotten that it saves families about £400 a year and
ensures regular milk consumption. Because milk is a valuable
source of a range of nutrients, including calcium, protein
and B vitamins, the Government recommend the consumption of
lower-fat milks for the general population aged over five
years, and promotes that through the Eatwell guide, the
nation’s food model and the Change4Life social marketing
campaign, which recommends swapping sugary drinks for water,
lower-fat milks, and diet, sugar-free or no-added-sugar
drinks. The Eatwell guide has been distributed to all
primary, secondary and independent schools in England. I hear
what the hon. Lady says about the guide and the advice, but
the advice was set after a review of all the evidence,
including the recommendations of the Scientific Advisory
Committee on Nutrition on the basis of a full public
consultation. The intention is absolutely not to discourage
children from drinking milk but to encourage them to do so as
part of a healthy, balanced diet. That important message
should be taken away from the debate.
I turn to the early years foundation stage framework, which
sets out the regulatory standards for all early years
providers. The framework requires early years settings to
“promote the good health of children attending the setting”,
and to provide meals, snacks and drinks that are “healthy,
balanced and nutritious”. About 40,000 childcare settings are
currently registered with the nursery milk scheme in their
fulfilment of that responsibility. Such settings much also
help children to make healthy food and drink choices, so that
they can formulate healthy lifestyle habits early on. In line
with our commitment in the childhood obesity plan, we will
publish and promote example menus for early years settings in
England, to help them meet the latest Government dietary
recommendations. I am sure that the hon. Lady will be
interested in looking at those.
We are also committed to improving young children’s oral
health. That is a Public Health England priority, and it has
established a child oral health improvement programme board,
with a substantial programme of work and a wide range of
partners, to improve the oral health of children under the
age of five. In fact, only a few months ago, in December,
Public Health England and the Department for
Education—another example of cross-Government
working—published a toolkit for early years providers, to
support those considering setting up a supervised
teeth-brushing scheme. In addition, Government measures to
reduce sugar consumption, as set out in the childhood obesity
plan, are designed to have a positive effect, and they
include the soft drinks industry levy announced last year and
wider measures to reduce sugar in food and drink products.
Although it is encouraging that the data published by Public
Health England show that over the past two years the number
of tooth extractions for children in hospital has reduced,
there is no let-up in doing all we can to improve children’s
oral health. Public Health England and the National Institute
for Health and Care Excellence have published evidence-based
guidance and toolkits to support local authorities, and NHS
England is also working up plans to test, in 10 high-need
areas, more creative ways of using commissioning expenditure
to improve children’s oral health. I understand that those
areas will be announced shortly. The Department of Health is
working with NHS England to test the NHS dental contract
focus on improving oral health, particularly in children.
This is about promoting not just milk but other physical
activity that can be undertaken by children, at home or at
school, to support a healthy, balanced diet. As part of the
work to tackle childhood obesity, we are also committed to
updating the school food standards, to align them with the
latest scientific advice on sugar. We are in the process of
scoping out the timeliness of that work, and I hope further
information will be available later in the year. We will take
into account the hon. Lady’s points about who the standards
apply to and will ensure that the standards best reflect what
we know works for children in instilling good, healthy
lifestyle choices, including the regular consumption of milk
as they grow up.
Sugar consumption is a major factor in childhood obesity, and
sugar-sweetened soft drinks are now one of the biggest
sources of dietary sugar for children and teenagers. The
introduction of the soft drinks industry levy is a clear
indication of our determination to address that vital issue.
The levy will generate significant funding for a variety of
initiatives announced in the childhood obesity plan,
including the doubling, from September 2017, of the primary
physical education and sport premium from £160 million to
£320 million a year, the provision of £10 million a year to
fund breakfast clubs in up to 1,600 schools, targeting pupils
most in need—milk could play a part in those clubs—as well as
£415 million towards the creation of a new healthy pupils
capital programme, supporting schools to pay for facilities
for PE, after-school activities and healthy eating. There is
an opportunity there to use significant new money to promote
the cause that the hon. Lady has articulated so well.
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On the levy, I asked the Minister whether the Government
would consider it a good idea to promote drinking milk as
opposed to sugary drinks, since not all children like water
or unsweetened beverages. That is my key point on the issue;
the Government should say, “Milk is good for you. Drink it”
instead of a glass of sugary pop.
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At the risk of harking back to the halcyon days of the 1970s
and 1980s, I remember the adverts, “Gotta lotta bottle” and
“Nice cold, ice cold, milk”, which did a lot to promote milk
consumption, not just within educational settings but in the
wider community. I think I have given a strong message today
about the Government’s support for the continuation of milk
as a central tenet of a child’s dietary upbringing. Through
the various schemes that we still support and also the new
money that we have announced, there is an opportunity to help
that to infiltrate even further into our education system.
However, we still have a lot of educating of parents to do.
Last year a survey in Scotland showed that a third of parents
still did not think it an issue if their child had tooth
decay by the time they were a teenager. There are some
perceptions and societal norms that we would not want to
support, and there is work to do to bust them as we strive to
improve the health of our nation. The Government want to help
children to achieve a healthy, balanced diet and to encourage
them to make the right food choices, and I want to reassure
the hon. Lady that we will continue to encourage the
consumption of dairy products, including milk.
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It is useful to hear about the role the Minister sees for his
Department in promoting the drinking of milk. Does he see a
wider role in promoting an affinity with farming, to
encourage children to have a greater interest in the
provenance of their food? That might be a catalyst for
healthier eating and for support for the UK’s agricultural
industries.
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As a Member of Parliament with a strong dairy industry in his
constituency, I am always keen to find ways of bringing
children closer to the land and helping them to understand
the importance of the industry and its produce to them and
their health as they grow up. My hon. Friend’s suggestion is
helpful. The more we can do to bind those things together,
the better.
Through the likes of the nursery milk scheme, we can ensure
that children under the age of five receive free milk every
day. In addition, through the early years foundation stage,
we are ensuring that early years settings are promoting good
health choices and providing meals, drinks and snacks that
are healthy, balanced and nutritious. We are always open to
suggestions and evidence that point towards other approaches
to help us tackle what is, as the hon. Lady said, and as the
Secretary of State for Health has said on many occasions, a
public health issue. I thank the hon. Lady for using the
debate to do just that, and I hope that she has been
reassured by the Government’s continued commitment to
ensuring that children can grow up and have a healthy and
fulfilling life, in which milk plays a prominent part.
Question put and agreed to.
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