'Welfare Foods - a consultation on meeting the needs of children and families in Scotland' was published in April 2018 and invited views on the Scottish Government's approach to Welfare Foods following its devolution through the Scotland Act 2016. UK Welfare Foods currently includes: Healthy Start Vouchers, Healthy Start Vitamins, and the Nursery Milk Scheme. The Scottish Government proposes to replace Healthy Start Vouchers with Best Start Foods, administered through a smartcard system. It also proposes to offer free milk to all children in funded and non-funded Early Learning and Childcare ( ELC) provision from 2020.
The consultation consisted of 11 open-ended questions. 147 respondents completed the consultation, including 75 individuals and 72 organisations. These responses have been analysed thematically and qualitatively, although agreement or disagreement in response to questions 7 – 11 has also been quantified.
Views on how to increase the awareness and uptake of Best Start Foods
A large majority of respondents suggested a national awareness raising campaign through a range of media, and in both paper and digital formats, to raise the uptake of Best Start Foods.
The role of frontline staff was seen as key for raising awareness and uptake of Best Start Foods – in particular healthcare professionals; early years providers and schools; local authority and third sector welfare rights advisers; and staff working in social care and community roles. Healthcare staff, health visitors and midwives were identified by most respondents. It was felt that training and awareness-raising for frontline staff would cascade down to families and parents.
Retailers were also seen as important for promoting awareness and uptake amongst users. However, it was pointed out that, in order for retailers to play this role, they would need to be: (i) be made aware of the system through awareness-raising activities; and (ii) be supported, technically and logistically, in delivering Best Start Foods.
Stigma was seen as a barrier to the uptake of Best Start Foods. It was felt that this could be partly addressed by emphasising a positive image of Best Start Foods and advertising the scheme widely. A large majority of respondents felt that the application process should be as straightforward as possible to encourage uptake.
Views on the smartcard system
There was a consensus amongst respondents that the new smartcards should be easy to use and flexible. Being able to check the balance on the card, carrying forward unused funds and easily replacing damaged or stolen cards was seen by many respondents as important. An App was suggested by many respondents as a possibly additional functionality of the smartcard.
It was suggested that the smartcard system should also be easy to use for retailers, and that they would benefit from support and training.
Concerns were expressed that retailers without facilities for card payments would be excluded from the system, which would restrict users' choice (particularly in rural and remote areas). Suggestions were made to overcome this problem, including enabling smartphone payments (through an App), supporting small retailers to install electronic point of sale ( EPOS) systems, or giving users the option of using paper vouchers instead of the smartcard. A number of additional concerns and questions were posed by retailers' organisations.
Many respondents welcomed the proposed increase in the value of the smartcard, although some respondents commented that it was still low. Others suggested varying the value across regions in line with cost of living, and linking it to inflation.
The fact that eligible foods was being expanded was welcomed by many respondents. However, concerns were expressed that tinned fruit and vegetables should not be in syrup or brine.
Suggestions for a programme to support families establish healthy eating habits
A nationwide campaign that goes beyond promotion of Best Start Foods and addresses healthy eating was suggested by a large majority of respondents. This should be a 'whole country' approach with consistent messaging and branding. It was felt that this campaign would benefit from linking with existing campaigns, such as Eat Better, Feel Better.
An educational programme through informative resources and workshops was also suggested by a majority of respondents. In particular, recipes using Best Start Foods ingredients were suggested by most respondents. The idea of an App was again popular as a way of disseminating these resources. Cooking and weaning lessons, in partnership with healthcare staff, ELC settings and schools, and other community organisations, were also suggested by many respondents.
It was felt that retailers could support these initiatives by distributing information leaflets and recipes alongside Best Start Foods ingredients and by actively promoting healthier foods. Cooking demonstrations and tasters in stores were also mentioned by some respondents.
Some respondents pointed out that accessibility and affordability of healthy food is an issue that cannot be ignored when considering how to develop healthy eating habits amongst the population.
Views on eligibility for children's vitamins
50% of respondents disagreed with the proposal that eligibility to children's vitamins be linked to eligibility for Best Start Foods, compared to 40% who were in favour. The reason given by most respondents who rejected the proposal is that free vitamins should be provided universally to all children under three years of age. Furthermore, many respondents argued that they should be provided up to age five, as per current health guidance .
Views on providing free milk and healthy snacks for all children receiving funded ELC entitlement
90% of respondents agreed with the proposal to provide free milk to all children receiving funded ELC entitlement from 2020, although many respondents pointed out that dairy-free alternatives should be available. It was also argued that consideration should be given to the funding and provision of the milk offer.
96% of respondents agreed with the proposal to provide a healthy snack to all children in reciept of funded ELC provision from 2020. Clarification was sought by many respondents on what constituted a 'healthy snack', and some thought it should be restricted to a portion of fruit or vegetables. Similar comments were made regarding the funding and provision of snacks as with milk.
Although it was not explicitly asked, a large majority of respondents were in favour of providing free milk to all children, and not just those receiving funded ELC entitlement. It was suggested that this could be administered through: a voucher or smartcard; direct payments to childcare providers (similar to the current UK Nursery Milk System); or by embedding milk for non-funded ELC provision in the wider procurement of milk for childcare providers within each local authority.
A large majority of respondents (83%) were also in favour of providing a healthy snack to children outwith the ELC funded entitlement using the same funding mechanisms for free milk. Comments regarding the definition of a healthy snack were repeated here.