Milk and Healthy Snack Scheme (Scotland) Regulations 2021: equality impact assessment

Background

Currently a UK-wide nursery milk Scheme is administered by the UK Department of Health and Social Care (DHSC) under the terms of an Agency Agreement. Under the terms of the Scheme, all pre-school children who are in a day care or early years setting in Scotland for two or more hours a day are eligible to receive a free daily drink of cow's milk or first infant formula (1/3 pint/189mls).

It is the devolution of welfare foods powers through section 27 of the Scotland Act 2016 which enables the Scottish Ministers to create a Scottish Milk and Healthy Snack Scheme to replace the current UK-wide Nursery Milk Scheme.

The Scottish Government's consultation on Welfare Foods ran from 5 April to 28 June 2018. It included proposals to replace the UK Nursery Milk Scheme in Scotland with a new Scottish Scheme which would increase the age of eligibility from under 5 years to include 5 year olds; and offer a daily healthy snack item (a portion of fresh fruit or vegetables). It was proposed that this be delivered as part of Early Learning and Childcare funded provision, complementing the free meal offer. Provision to unfunded providers was also considered. 147 responses were received from both individuals and organisations. The majority of respondents were in favour of the proposals and responses to the consultation – where respondents have agreed to publish – have been published along with the publication report on the consultation findings and messages.

Prior to and after the consultation we held discussions with representatives both internally and externally that have connections with or that support recipients of the current UK Nursery Milk Scheme. This helped us identify key issues and inform development of the new Scheme.

The new Scheme will to continue the offer for 189mls (1/3 pint) of whole or semi-skimmed pasteurised cow's milk and first infant formula (under 12 months) to all children who spend two or more hours a day in a day care provider or childminder setting but will also improve the offer to:

• Extend the Scheme to include all pre-school children who are enrolled with a day care provider or childminder
• Include provision of a healthy snack item (a portion of fresh fruit or vegetable).
• Include alternative to cow's milk such as goat milk and sheep milk and unsweetened calcium enriched non-dairy alternative drinks (over 12 Months) for those children who cannot consume cow's milk for medical, ethical or religious reasons.
• Reduce administrative burdens by moving to an 'up front' payment approach rather than the current claims and reimbursement model. This will be delivered via local authorities to all day care and childminder settings registered with the Scheme.
• Aligning with broader Scottish policies such as Best Start Foods and the 1140 hours for universal ELC provision for children aged 3 to 4 and eligible 2's.
• Raising awareness initiatives to embed healthy eating messages and to maximise participation of the new Scheme to ensure day care providers and childminder settings are supported adequately to make this provision available to all eligible children in their care.

The new Scheme aims to support children to establish healthy diets during the formative years of their life and provide additional nutritional options which will account for children cannot consume cow's milk for medical, ethical or religious reasons. Establishing good nutrition and healthy diet habits in infancy is also important as good practices can be taken forward into childhood and throughout adult life. Maintaining a healthy weight is key for both physical health and mental wellbeing. The Scheme can directly influence eating habits in the early years and is, therefore, key to supporting a healthy weight. There is strong and growing evidence of the impact of diet in early years on longer term outcomes including educational attainment.

Who was involved in this EQIA?

We received responses on a draft EQIA we shared with a wide range of stakeholders and organisations from the childcare sector, local government, and the dairy industry as an opportunity to feedback views and suggestions to ensure we developed a comprehensive impact assessment.

Prior to and after the consultation we held discussions with representatives from the childcare sector, local government, and dairy industry both internally and externally that have connections with or that support recipients of the current UK Nursery Milk Scheme. This helped us identify key issues and inform development of the new Scheme. This also included the engagement outlined below:

Consultation

The Scottish Government's consultation on Welfare Foods – a consultation on meeting the needs of children and families in Scotland, ran from 5 April to 28 June 2018 and received 147 responses from both individuals and organisations. The majority of respondents were in favour of the proposals and responses to the consultation – where respondents have agreed to publish – have been published along with the publication report on the consultation findings and messages.

Consultation outcomes

Many responses related to the introduction of the Best Start Foods Scheme. Of those that responded on the questions relating to a new milk and health snack Scheme;

• 90% agreed with the proposal to provide free milk to all children in funded ELC provision from 2020, although many pointed out that dairy-free alternatives should be available.
• Majority of respondents agreed with the proposal to provide free milk to children out with funded ELC provision.
• 96% of respondents agreed with the proposal to provide a healthy snack to all children in funded ELC provision from 2020.
• 83% of respondents were in favour of providing a healthy snack to children out with funded ELC provision.

The consultation also indicated a clear desire to include non-dairy alternative drinks as part of the Scheme.

We have considered the findings from the consultation throughout the policy development process and will continue to evaluate any further evidence that becomes available.

Nursery Milk Short Term Working Group

Utilising the experience of local authorities, COSLA, childcare, third sector organisations and health professionals who support day care provider and childminder settings in Scotland, we established a Nursery Milk Short Term Working Group to help inform the development of this policy. The remit of this group was to discuss and make evidence based recommendations on the devolution of the UK NMS in Scotland. Representatives included:

• NHS Health Scotland
• COSLA
• Scotland-Excel
• Scottish Childminding Association
• National Day Nurseries Association
• Early Years Scotland
• ASSIST
• Association of Public Service Excellence (APSE)
• Education Scotland
• Scottish Government - Early Learning and Childcare Quality Unit
• Scottish Government – School Food Provision and Food Education
• Scottish Government - Rural Livestock Policy (Food and Drink)
• Scottish Government - Analytical Services
• Scottish Government - Procurement Portfolio Specialist
• Scottish Government - National Maternal & Infant Nutrition Co-ordinator

Food Standard Scotland

We liaised with Food Standards Scotland (FSS) who are responsible for providing advice to Scottish Government on a range of food related issues including advice on how what we eat will promote good health. We sought advice relating to what alternative drinks can be offered within the Scheme for those children who do not consume cow's milk for medical, ethical or religious reasons.

They advised that goat, sheep and unsweetened calcium enriched non-dairy alternatives for those children who cannot consume cow's milk because of medical, religious or ethical reasons can be offered as part of the Scheme. Whilst non-dairy alternative drinks are not nutritionally equivalent to cow's milk, not providing an alternative for children whose parents/carers choose for them to not consume cow's milk, for whatever reason, would mean that these children are nutritionally disadvantaged through the Scheme.

This helped inform and reinforce nutritional advice and identify the types of additional animal milks and non-dairy alternative drinks that can be included as part of the new Scheme which would have the best health benefits and outcomes for children who do not drink cow's milk. This ensured the policy is based on the most up to date scientific evidence and dietary advice.

The Vegan Society

As representatives of those who eat a vegan diet we held discussions with this group which ensured that the issues and concerns raised were properly considered in the final decision making process for this policy. At the time of our discussion they recognised there were no appropriate non-dairy alternative drinks currently available, however the snack element would still allow vegan children to build a solid foundation in relation to medical religious or ethical reasons. Our continued work with FSS has now identified that unsweetened calcium enriched soya drinks for children over 12 months with other unsweetened calcium enriched non-dairy alternative drinks can now be offered as part of the Scheme.