Healthy Start Scheme

Jim Shannon Excerpts

Wednesday 7th September 2022 Westminster Hall

[Kate Green]

It is a pleasure to respond to my hon. Friend’s question. He has done excellent work as part of his “Right to Food” campaign, and he raises a number of issues, including take-up, the generosity of the scheme and the importance of adequate nutrition, that I will come back to in my speech.

My hon. Friend will know that child food poverty continues to stunt children’s development as they grow up, and that overstretched family budgets, which mean that mothers go without in order to feed their children, are harmful to maternal health, increase maternal stress and are especially dangerous if women are breastfeeding—or, indeed, may prevent them from doing so. The Minister will share our concern that a new YouGov survey commissioned by Kellogg’s, which will be released next week—I appreciate that she has not had a chance to see it yet—has found that 66% of low-income families say that accessing Government benefits is complicated, and 53% are not confident that they are aware of all the benefits available to them. At the same time, 80% of parents on low incomes say that the rising cost of goods has impacted their ability to pay for essential items, and more than one in seven says that their children are worried about the situation.

[Jim Shannon (Strangford) (DUP)]

This is an incredibly important subject. I commend the hon. Lady on the way that she has introduced it. We are moving into what are perceived to be difficult times. Some of the figures for Northern Ireland show that poverty will probably double, which shows the importance of the scheme. Does she agree that the Government and the Minister must look once more at eligibility for the scheme, as working people who are already on the breadline will increasingly find themselves unable to support their family? If the scheme is not able to provide for a family as it did in years gone by, there will be a need to change the money available and the system.

[Kate Green]

The hon. Member draws attention to a very important point about the pressures faced by families—and not just those in which people are out of work, but those where they are working on low incomes. Healthy Start and other forms of social support can play an important part in enabling families to raise their children.

The removal some months ago of the £20 uplift in universal credit and the cost of living crisis will exacerbate the situation for families, as soaring energy, food and fuel bills lead to a further increase in maternal and child poverty. Last month, the Institute for Fiscal Studies reported that the cost of living is expected to be 11.3% higher in financial year 2022-23 than last year; inflation is expected to peak in the last quarter of this year at 13.1%. The impact will fall disproportionately on low-income families. The TUC has suggested that pay rises could fall behind inflation by almost 8% later this year, marking the biggest fall in real wages for 100 years.

The situation is especially acute for families with new babies and very young children. Maternity Action points out that the value of the basic rate of maternity, paternity and parental pay, relative to women’s median earnings, has declined from 42% in 2012 to 37% in April 2022. New mothers are expected to survive for up to 33 weeks on not much more than a third of women’s average earnings. That, of course, is at a time when they face the additional costs associated with parenthood.

Against that backdrop, Healthy Start will be more important than ever, but as my hon. Friend the Member for Liverpool, West Derby (Ian Byrne) and the hon. Member for Strangford (Jim Shannon) have pointed out, many mothers on low incomes will not even be eligible for support. To qualify, they have to be on an income of less than £408 per month, so a new mum receiving universal credit plus statutory maternity pay would not qualify for support.

Alongside concerns about the scale of support needed are concerns about the take-up of Healthy Start, as we have heard. In a written answer to the Bishop of Gloucester on 1 August, Lord Kamall stated that up-to-date figures are not held centrally. He promised that work to compile the data was taking place across Government, and that the data would be published as soon as possible, but I find it astonishing that the Government do not have those figures now.

As we have heard, there is widespread concern about low take-up. In Greater Manchester, the combined authority estimates that around 40%, or approximately £5 million-worth, of vouchers go unclaimed. That is borne out by Maternity Action’s survey; fewer than 1% of respondents on low incomes reported receiving Healthy Start, the Sure Start maternity grant, or the Scottish Best Start grant and food vouchers, yet more than half of those very same mothers reported difficulties in buying essentials at least some of the time, and 2% reported using food banks. It is pretty clear that the benefits are not proving effective at reaching all those most in need.

Concerns about take-up are compounded by the suspicion that digitalisation has not improved things; indeed, it may have made them worse. I am not at all against digitalisation—indeed, the National Institute for Health and Care Excellence recommended it back in 2014. There are a number of potential benefits to introducing a payment card system: cards can be used anywhere in the UK; unspent sums can be rolled over from week to week; administration should be simpler and potentially cheaper for retailers; and data collected from card use could be used to improve the supply chain and for system monitoring.

However, it appears that when prepaid cards were finally introduced last year—applications are made by telephone or online—the process had been piloted only on those who already had smartphones and monthly price plans. That may explain some of the problems being experienced, which may be inhibiting take-up. First, the issue of the cost of calls—55p a minute for those on a pay-as-you-go mobile—is compounded by long waiting times to get through on the helpline. Applicants have reported having to wait up to an hour to speak to an adviser, leading to call costs of as much as £33.

One reason for the delay in getting through seems to be that the same line is used for both inquiries and application. A complicated query can lead to long waits for callers down the queue. Meanwhile, those applying online may face data costs. Claimants also report that no reason is given if their application is rejected. They need to reapply if they think the decision is incorrect but, unhelpfully, they will not know what they got wrong. Support takes effect from the date that an application is approved, but there is no backdating for those who had to reapply.

The expectation that a card system would mean improved coverage has not always materialised. The prepaid cards can be used at any outlet that accepts Mastercard. Unfortunately, that means that some outlets that previously accepted the paper vouchers are no longer able to accept the prepaid cards. They include independent local stores, which often supply culturally appropriate foods to minority and marginalised communities, market stalls, and those making direct sales from the farm gate, which is a particular issue in relation to rural poverty. Even some well-known high street names that previously accepted the paper vouchers had the wrong Mastercard merchant code and could not accept the cards, as food retailing is not their main business. I am not sure whether that issue has been resolved; perhaps the Minister could confirm that.

Finally and distressingly, while we may have expected that the use of a prepayment card would reduce stigma, Feeding Britain points to worrying research from Northumbria University; it shows that shoppers need to split their trolley of purchases at the check-out; cards are frequently declined at the check-out, causing anxiety, embarrassment and humiliation; and shop staff are unfamiliar with the new prepaid cards, unable to help or offer conflicting advice. We hope that those are teething problems and will reduce as stores become familiar with the cards, but it is troubling that the new scheme should have compounded poverty with stigma in this way.

Having said all that, I repeat my support for the Healthy Start scheme, but it could be so much more effective at reducing poverty and improving maternal and child nutrition if changes were made. I will conclude with some questions and suggestions for the Minister. First, sort out the helpline. I cannot understand the logic of a service that is intended to support low-income households imposing call charges that exacerbate family poverty. Healthy Start is not alone in that. It is high time that the Government carried out a comprehensive review of the cost of calls to helplines across Government that are specifically designed to enable people on low incomes to reach the services and benefits intended to help them, including Healthy Start. While I am on the subject, a review is needed of the data charges when accessing services online.

Next, deal with the delays—if necessary, by increasing helpline staff numbers to reduce waiting times. Will the Minister review the routing of calls depending on their nature, so that complex queries do not create bottlenecks that lead to long waits for other callers?

As I have said, eligibility for Healthy Start starts from the 10th week of pregnancy. In practice, however, the support takes effect from the date of a successful application, so an expectant or new mother who has only belatedly discovered that she is entitled to support will lose out. Does the Minister agree that support should take place from the 10th week of pregnancy in all cases, and be backdated if necessary? That would help those whose initial applications are rejected and who successfully reapply. Will the Minister look at what can be done to ensure that applicants are clear about the reason for refusal if their application is rejected?

As I have said, Healthy Start is available until a child is four, which leaves a gap of several months before children start school and may become eligible for free school meals. Will the Minister consider extending coverage until a child starts school? Will she look at the value of Healthy Start, at extending it further up the income scale—many claimants in receipt of universal credit are ineligible—and at automatic uprating, so that the value of the benefit keeps pace with inflation? The Co-operative Group topped up the value of the vouchers as families struggled during the pandemic. With the cost of living now rising so sharply, there is a need for the Government to act urgently.

Crucially, will the Minister urgently launch a vigorous and comprehensive national take-up campaign, working with local and regional government; retailers and industry bodies such as the Co-op and the Association of Convenience Stores, which work hard to promote the scheme among their members; charities, foodbanks and pantries such as the Bread and Butter Thing and Community Fridge; the advice sector; schools and family hubs; registrars in NHS settings; and organisations that provide support to new mums and pregnant women? There is good practice on which to build—for example, Kellogg’s is partnering with the Greater Manchester Poverty Action Group to run a pilot in four schools and colleges that gives parents access to a financial inclusion officer, who will be available in informal settings such as school breakfast clubs in order to offer parents advice on how to access benefits, including Healthy Start.

Finally, a more accessible application process would also help take-up, so will the Minister work with the Department for Work and Pensions to introduce a tick box as part of the universal credit application process, and with local authorities to introduce a similar tick box on applications for council tax support? Better still would be to introduce a system of automatic enrolment, as Feeding Britain has proposed—perhaps with the option to opt out—to replace the system that we have now, which requires parents to opt in. Is that something the Minister would consider?

I know the Minister takes the health and welfare of pregnant women and children very seriously. Healthy Start has an important role to play, and I hope she will find the suggestions that I have made this morning helpful. I look forward to her reply, and to hearing how she intends to take action to ensure the scheme does all that it has the potential to do to help children to thrive.