Children’s Health: Access to Milk

Mary Glindon Excerpts

Tuesday 28th March 2017 Westminster Hall

[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 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.

[James Heappey (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.

[Mary Glindon]

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.

--- Later in debate ---

[Mary Glindon]

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.

[Edward Timpson]

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 promote 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 must 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.

[Mary Glindon]

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.

[Edward Timpson]

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.