Welfare Foods: consultation

4. Phase 2 of Welfare Foods: a new approach for Scotland – milk and under 5s

4.1 The current UK Nursery Milk Scheme

The UK Nursery Milk Scheme ( UK NMS) funds milk for approximately 1.5 million children across the UK and costs the Department of Health and Social Care and the Scottish and Welsh Governments around £70 million per year. The statutory obligation to provide the Nursery Milk Scheme is set out within the Welfare Food Regulations 1996.

The UK NMS reimburses childcare providers ^[12] for the cost of supplying milk. Childcare providers can claim for 189 mls or 1/3 of a pint of milk ^[13] for children under the age of five who attend for two or more hours a day. With a greater proportion of children in early learning and childcare ( ELC) aged three to four, they are the most likely beneficiaries of the scheme.

The UK NMS is administered by a Nursery Milk Reimbursement Unit on behalf of the Department of Health and Social Care. The Reimbursement Unit processes claims from eligible childcare providers, or agents operating on their behalf, for the full cost of providing milk. Childcare providers are responsible for purchasing their own milk and are encouraged to seek value for money, but there is no cap on the price of milk that can be claimed. Childcare providers can choose to claim for reimbursement.

Claims are usually submitted on a monthly basis ^[14] . Some local authorities will submit one claim on behalf of all the local authority run nurseries in their area. We estimate in Scotland, there are around 30,000 claims made each year by childcare providers. The scheme costs the Scottish Government around £4 million in claim costs each year.

One of the benefits of bringing the powers of this scheme to Scotland is the opportunity to reduce the current administrative burden, particularly for children in funded Early Learning and Childcare.

4.2 The importance of milk

Milk is an important part of children's diet and we must continue to support its provision. It is a nutrient dense food and a good source of protein, zinc and vitamins A, B ₂, B ₃, B ₆ and B ₁₂. Milk also contributes towards the intake of iodine, and calcium.

'Setting the Table' ^[15] provides nutritional guidance and food standards for early years childcare providers in Scotland and advises that children need three servings of dairy foods each day. Whole milk should be offered to children under the age of two, with semi-skimmed milk being gradually introduced from age two onwards ^[16] .

4.3 A new approach for Scotland: links to funded Early Learning and Childcare

Devolution provides us with the opportunity to focus on broader nutrition and health promotion than the current UK NMS, which simply reimburses for the cost of providing milk. The development of a flexible and high quality ELC programme is almost doubling the current level of provision ^[17] . The ELC expansion will provide accessible and affordable childcare and will improve outcomes for all children, especially those who live in more challenged communities, and help to close the attainment gap.

As part of this expansion and in order to improve health and wellbeing at this crucial stage in a child's development, we will be providing free meals to all children in funded ELC from 2020. We are looking to integrate the provision of milk into this offer. Funded ELC provides us with a clear route for the universal provision of milk at age three and four due to the near universal uptake of places, as well as reaching those two year olds eligible for funded provision.

Some children who attend full-time childcare receive as much as 90 per cent of their daily food within the childcare setting and as much as 40 per cent when in a part-time setting ^[18] . So it is crucial to make the most of this key opportunity to establish healthy eating patterns which can be carried on into later life. The new Health and Social Care Standards, which apply to ELC, are clear that children should be able to 'choose suitably presented and healthy meals and snacks, including fresh fruit and vegetables'.

By 2020 we propose nursery milk is delivered as part of the Early Learning and Childcare funded provision, complementing the free meal offer.

Q8. What do you think about the proposal to offer milk as part of the free meal offer for all children in ELC funded provision by 2020?

To deliver this we propose removing the administrative burden of the UK NMS by providing milk to children as part of their funded ELC offer, removing the need for a reimbursement scheme. This will include children whose funded ELC place is with a provider in the private or third sectors, including childminders. This would be in Phase 2 of our new Welfare Foods policy for Scotland and we would propose this comes into place at the same time as the free meal provision in 2020. The provision of milk would be available to children accessing funded ELC provision, whether this is offered in a local authority, private, third sector or childminder setting. We would discuss and agree funding with local authorities.

By providing milk through funded ELC provision we also have the opportunity and flexibility to improve on this offer. Data tells us that children are under-consuming the recommended five-a-day fruit and vegetable intake, with 48 per cent of two to four year olds eating less than three portions a day and four per cent are eating none ( Scottish Health Survey, 2016).

We are considering including an offer of a daily healthy snack such as a piece of prepared fruit or vegetable. This will complement the free meal offer for all children in ELC funded provision by 2020.

As with milk, the healthy snack could be available to children in funded ELC provision, whether this is offered in a local authority, private, third sector or childminder setting. We would discuss and agree funding with local authorities.

Q9. What are your views on the proposal to include an offer of a healthy snack to complement the free milk and meal offer for all children in early learning and childcare funded provision by 2020?

4.4 How do we provide milk for children outwith funded Early Learning and Childcare?

We recognise the importance of milk for children in the earliest of years and want to continue providing milk for all children under five in Scotland. We need a new delivery mechanism for children outwith funded early learning and childcare provision, particularly one that works for and supports childminders, private or third sector nursery settings in providing milk and infant formula for children in their services.

We will maintain the offer currently provided through the UK NMS for children outwith the funded ELC provision. This offer provides for 1/3 of a pint of whole or semi-skimmed pasteurised cow's milk for children under five in childcare for two or more hours per day. Children under the age of one will continue to be entitled to powdered infant formula milk from the list of pre-approved brands under the current UK NMS ^[19] . Childcare providers who are eligible for the current UK NMS will continue to be eligible in Scotland.

We recognise that there will be administrative challenges in capturing a system that caters for many childcare providers without recreating the current UK NMS reimbursement model. We would propose a new system goes live in 2020 to align with the timing for funded ELC provision.

As with funded ELC, we want to consider whether delivering a healthy snack to the children outwith funded ELC provision, such as a piece of prepared fruit or vegetable, will help tackle under-consumption of fruit and vegetables in the earliest years.

Q10. We are interested in your views on how we can best support childcare providers to provide milk to children outwith funded ELC entitlement. How could this work in practice without creating a costly administrative system?

Q11. What are your views on the proposal to include an offer of a healthy snack for children outwith funded ELC entitlement?