Menu of policy options
Build your own vision for children’s health by seeing what £3 billion a year from a new levy on the food industry can fund!
A new industry levy on salt and sugar in our food and drink would not only get companies to make products healthier, it could raise up to £3 billion a year.
What if the Government chose to invest ‘every penny’ of this extra money on improving children’s health and increasing access to fruit, vegetables and healthier food?
Our Recipe for Change coalition has a whole menu of options for how the Government could invest this money.
How would you like to see this money spent? Use our interactive menu to choose the programmes you’d most like to see funded.
Recipe for Change’s principles for spending money from food levies
Here are some principles that our Recipe for Change coalition thinks are important ingredients for making decisions on how money from food levies should be spent.
A healthy child is more likely to grow up to be a healthy adult. While the Government has pledged to create the healthiest generation of children ever, tooth extraction is now the most common reason for hospitalisation of children under 11 and childhood obesity remains worryingly high. That’s why we’d like to see money raised from food levies focussed on improving children’s health.
The places we live, work, play and learn shape our lives but often don’t support our health. Any revenues from food levies should be used to ensure that healthy options are the easy, affordable options, and to make healthy food and its promotion the norm in hospitals, schools and all other public sector sites.
Fruit and veg is the most expensive food group in the Eatwell Guide, costing twice as much per 1000kcal as foods high in fat and/or sugar (HFSS). Individuals living on the lowest incomes would need to spend as much as 52% of their weekly food budget to eat their ‘5-a day’. The Government should invest in ways to make it easier to purchase healthier foods, including through new subsidies or additional cash or voucher schemes for families on low incomes. A study by Imperial College has also shown that HFSS taxes are most effective at improving public health when combined with subsidies for healthier food.
Any initiatives funded with levy revenue should be able to demonstrate their impact with supportive evidence. The type of evidence may vary between programmes. This impact should be felt directly by those it is aiming to benefit, including through cash-first options where appropriate . We would also welcome an innovation fund to enable scale-up of smaller initiatives with promise but less evidence behind them.
As the funding from any levy revenue may vary in the long-term, initiatives should be prioritised which can have a lasting impact. This could include through improving infrastructure such as school kitchens or growing spaces, or piloting new initiatives that could become self-sustaining or part of core ongoing national or local government spending plans in the longer term, such as expansion of free school meals.
KIDS MENU
Breakfast
Healthy breakfasts in secondary schools
The Labour Government has committed to providing free breakfast provision to all primary schools across England, and are looking to secure this in legislation through the Children’s Wellbeing Bill. Whilst this is excellent news for students at primary stage, it ignores young people at secondary, who are no less in need, and indeed removes the support which had been provided for the most deprived schools via the previous Government’s National School Breakfast Programme. We are facing a situation where one sibling will have breakfast and another will miss out, just because of their age.
Secondary is a critical time for young people, taking exams that will determine their future choices, and increasingly taking on the stresses of issues at home, leading to increased mental health issues. Physical health is also damaged by cheaper food options, and evidence demonstrates that those not getting a healthy breakfast are more likely to eat unhealthy snack options during the day. This is the age where healthy eating habits are formed, and unhealthy eating relationships take root.
Independent evidence has demonstrated the impact that breakfast has on attendance, behaviour in class and attainment, with research conducted by The University of Leeds (2019) finding that children in secondary school who consume breakfast regularly achieve, on average, 2 GCSEs higher than children who rarely eat breakfast.
The calculations for this programme reflect a total cost of £180 million over a 5-year period and cover the costs for food and delivery, staff costs to support the model, equipment and inflation.
School lunch
Free healthy lunches for children in poverty
The National Dietary Nutrition Survey (NDNS) reveals that children from the least well-off families eat substantially less fruit and vegetables, oily fish, fibre and other healthy foods than children from the most well-off families. Free school meals are the simplest, least intrusive way to ensure that children have at least one well-balanced, healthy and nutritious meal a day.
However, the Child Poverty Action Group estimates that this means 900 million children in England living in poverty are still not eligible for a free school meal. To be eligible for free school meals in England, families must have a total household income of less than £7400 per year before benefits, a threshold that has not changed since being introduced in April 2018, despite rising cost of living and inflation.
The best way to ensure every child living in poverty can access a healthy school lunch would be to expand access to all children from families in receipt of Universal Credit, including children from families with No Recourse to Public Funds in similar economic circumstances. A cost-benefit analysis by Price Waterhouse Coopers for Impact on Urban health calculates that for every £1 invested in providing meals to children from families on Universal Credit, there would be a return of £1.38 in social, educational and economic value.
Free healthy school meals to all primary and secondary pupils
Our state education system should be free at the point of access for every child in the UK, yet we are still means-testing children in the middle of the school day to decide who gets a free lunch and who doesn’t. Other public services, including hospitals and prisons, don’t operate this means testing approach to food. Many countries around the world are now providing meals to all pupils regardless of background, such as Finland, Brazil, India, and several US states. Providing lunches for all pupils who want them would end stigma of ‘free school meals’, enable better planning for caterers, reduce administrative burdens for school staff and support schools instead to have a holistic healthy school food policy. Analysis shows that for every £1 invested in universal school meals, £1.91 is returned in social, educational and economic benefit.
The Mayor of London is now providing primary school meals for all pupils, and Wales and Scotland are rolling out primary meals to all as well. Tower Hamlets in London is now providing lunch for secondary school pupils. But for children elsewhere it remains a postcode lottery.
Long-term we believe that universal healthy school meals should be a core, central part of our Government education budgets, so that children can grow and learn with healthy food on the curriculum and on their plate. But with tight Government budgets, levy income could help fill the funding gap in the short term, and enable effective evaluation of universal school meals. This policy is costed for England only due to the devolved nature of funding for school meals, but our coalition is supportive of children across the whole of the UK receiving healthy free school meals.
Launch a new “Eat and Learn” initiative for schools
The first years in a child’s life are the most important, but childhood obesity rates more than double during primary school and there is very little training and support for staff in nurseries and schools. This is not only a problem in childhood but also leads to long-term issues: a childhood diet low in fruits and vegetables is linked to increased cardiovascular risk in adults. Good nutrition and maintaining a healthy weight in childhood help prevent obesity and food-related ill health later in life.
A national programme to transform nutrition and access to healthy food could give children a much healthier start in life, as recommended by the National Food Strategy.
Schools and early years settings offer a prime opportunity to improve children’s diets. School-aged children eat a substantial proportion of their meals in school during term time, and for some a free school lunch is their main meal of the day. They also have to study food: the curriculum states that schools should attempt to “instil a love of cooking in pupils”, and teach them the skills they need “to feed themselves and others affordably and well, now and in later life”. The Government has not been using this opportunity as well as it might. Sensory food education, which has been shown to increase children’s willingness to try new fruit and vegetables, is not yet widespread. There is no national champion for food education, no team responsible in DfE or Ofsted, no monitoring at a national level, and no subject reviews or research as there are in other subjects. As a result, many schools are simply not meeting the requirements of the curriculum.
As well as the quality of food education, we also need to see further improvements in the quality of food provision in schools.
The annual cost to Government of implementing an ‘Eat and Learn’ initiative is £206m, of which £124m is for food education ingredients.
The National Food Strategy recommends this should be for all children aged 3 –18 yrs, in partnership with the Office for Health Improvement and Disparities (OHID). It would involve a combination of: curriculum changes, accreditation, inspection, funding and recruitment and training.
Outside school
Extend the Holiday Activities and Food programme
Providing holiday activities and food, especially for children from lower income or disadvantaged communities, can provide a lifeline for families during school holidays. 80% of parents on low incomes report being unable to take their children out for activities during school holidays.
Programmes are designed to ensure children access healthy food, learn new skills, exercise their bodies and improve their fitness and sporting prowess, as well as opportunities to catch up on learning and socialise safely with other young people. All of this supports a happier, stronger and healthier return to school. A 2019 assessment of the Holiday Activities and Food programme (HAF) found that children’s socialisation and wellbeing improved as a result of participating in the scheme. Academic analysis indicates that for every £1 invested in enhanced HAF programmes, there could be up to £8 social return.
Following the publication of the National Food Strategy, the Government committed to fund an expanded HAF programme for another three years, until the end of the 2024/25 academic year. Longer-term funding remains uncertain, and it also does not yet provide full coverage across all holiday and half term weeks. Eligibility for free places on these programmes is also mostly limited to those children in receipt of free school meals, meaning 900,000 children in poverty are also unable to get free holiday support. As a minimum, the government could commit to continue investing £200m per year over the next three years to maintain the HAF programme.
Healthy snacks
Advertising campaign to promote fruit and veg
Getting children to eat fruit and vegetables is an important part of ensuring they grow up healthy. Vegetables support children’s development, boosting the immune system to help them fight illness and infection, also aiding digestion due to their fibre content. Children who eat plenty of whole fruit and vegetables are less likely to be at risk of food-related ill health.
The National Diet and Nutrition Survey reports that 89% of children eat less than the recommended five portions of fruit and vegetables a day, whilst 29% of children eat less than one portion of vegetables every day.
The Veg Power campaign has demonstrated the power of awareness-raising, and interactive engagement programmes really work in getting children to learn to love veg, and eat more of them. 77% of parents of children in participating schools said their children were eating more veg at home as a result of the campaign, and 76% of schools agreed they were eating more veg in school too. Even after two years, 44% of parents said the campaign had had a lasting effect on their children’s consumption and preferences. The programme has also had a positive economic effect, generating additional sales worth £132m from 2019-2022 and an extra 1.4 billion portions of vegetables sold at retail.
Revenues from unhealthy food and drink levies could support more of these types of campaigns at a national scale, helping throw the spotlight onto the joys of eating fruit and veg, instead of the constant barrage of junk food advertising.
Expand School Fruit and Veg Scheme to all children in primary school
The School Fruit and Vegetable scheme provides a free piece of fruit or veg to 2.3 million children in KS1 in 16,600 state funded primary schools in England each school day. It is joint funded by DHSC and DFE and costs approximately £40 million a year. Expanding the scheme would help level up some of the inequalities that currently exist in accessing fresh fruit and vegetables. It could also be used to support an expansion of British sustainable horticulture if more fruit and veg was sourced from Britain. Only half of the apples in the Scheme come from the UK, and none of the pears nor tomatoes are homegrown.
We would like to see the scheme expanded to all 4.7 million children in state funded primary school to increase intake of fruit and veg, embed consumption habits and improve diets. The Government should ensure that it meets buying standards, and commit to sourcing at least 50% of all fruit and veg from sustainable sources amongst British growers, ensuring funding is sufficient for paying fair prices to our farmers.
FAMILY & COMMUNITY MENU
Trial a Community Eatwell programme that enables GPs to prescribe vouchers to those on low incomes
Fund a three-year ‘Community Eatwell’ pilot that enables GPs to prescribe vouchers to those on low income with food-related ill health, to purchase fruit and vegetables in their local community. This is based upon Alexandra Rose Charity (ARC)’s Fruit & Veg on Prescription project model.
One of the biggest barriers to meeting the Government’s ‘5 a day’ recommendation is affordability. Fruit and veg is the most expensive food group in the Eatwell Guide, costing twice as much per 1000kcal than foods high in fat and/or sugar. Individuals living on the lowest incomes would need to spend as much as 52% of their weekly food budget to eat their ‘5-a day’.
In November 2022, Alexandra Rose Charity launched the UK’s first large-scale pilots of ‘Fruit & Veg on Prescription’, working with social prescribers at the Bromley by Bow Centre in Tower Hamlets and community health practitioners at the AT Beacon Project in Lambeth.
As recommended in the National Food Strategy, an investment of £2m a year over three years (£6m in total) would enable ARC to scale up in two areas and set up in 5 new areas, benefiting almost 8,000 people over the 3-year period.
Pilot fruit and veg vouchers for families with pre-school children
Fund a three-year pilot of vouchers for families with pre-school children on low incomes to purchase fruit and vegetables in their local community, based upon Alexandra Rose Charity (ARC)’s Rose Vouchers for Fruit & Veg project model.
Alexandra Rose Charity runs the Southwark Rose Vouchers for Fruit & Veg Project, which launched in May 2018. Their vision is for everyone to have access to healthy and affordable food, and their mission is to give families access to fresh fruit and veg in their communities.
The Rose Vouchers for Fruit & Veg Project partners with children’s centres and community-led organisations that work with families with young children living on low incomes who are at risk of experiencing food poverty. Their main focus is on families with pre-school children where the impact of a healthy diet full of fresh, fruit and veg can be most significant.
Families and pregnant women receive Rose Vouchers that can only be spent on fresh fruit and veg at participating local markets, independent retailers and community food projects. Their model creates wider social impact by encouraging regular engagement with these early years services, as well as benefiting the local healthy food environment.
An investment of £2m a year over three years (£6m total) would enable ARC to maintain their scale in Southwark, scale up their work in four existing areas and open in two new areas over the three-year period. This would benefit 7,000 families including approximately 14,000 adults and over 12,700 children, whilst injecting a total of £12.7m into the local food economy and saving the NHS £7m.
Expand Healthy Start scheme to all families in poverty (on Universal Credit)
Every child deserves the best start in life, and adequate nutrition during the first months and years of life is critical to future health and development. However, pregnant women and young children in lower income families can struggle to access healthy food such as milk, fruit and vegetables which is especially important during pregnancy and early years development. Healthy Start vouchers help tackle this health inequality by supporting children and pregnant women with an important means-tested nutritional safety net so families can make healthier food choices. At present families receive £4.25 per week during pregnancy and with children from 12 months to 4 years, and £8.50 per week for those with babies under 12 months, providing additional support for healthy nutrition during breastfeeding and weaning, or alternatively subsidising the cost of formula feeding. The National Food Strategy has also called for this to be expanded to children up to the age of five, when children start to access Universal Infant Free School Meals and other support.
Eligibility for Healthy Start is currently restricted to those with income before benefits of just £408 per month. The Government is also currently consulting on permanent eligibility for pregnant women and children in families living under the No Recourse to Public Funds immigration condition.
Expanding access to all families in receipt of Universal Credit in England, Wales and Northern Ireland would cost an estimated £230 million per year, and expanding to include 4-year-olds in eligible families would be £162 million. In Scotland, the equivalent Best Start scheme provides £5.30 per week during pregnancy and for children aged 1-3, and £10.60 per week for babies up to the age of 12 months.
Currently, uptake of Healthy Start is 62.4% in England, far below the Government’s target of 75%, and despite local efforts to raise awareness, no area is meeting this target. Programmes to automate enrolment could remove a key barrier to accessing this vital nutritional support. The National Food Strategy also called for a £5 million campaign to boost awareness of Healthy Start.
Boosting Healthy Start – increasing eligibility, boosting the value for families, promoting awareness and piloting auto-enrolment are all options for how the Government could choose to invest revenues, if they introduced further food levies.
Expand mobile green grocers to support people living in food deserts
The Liverpool City region has seen growing levels of food insecurity and a need to improve access to fresh produce in the area. In response to this, The Queen of Greens was launched in November 2022: a social-enterprise mobile greengrocer run in partnership by Alchemic Kitchen CIC and Feeding Liverpool.
The Queen of Greens currently stops at 40 communities bringing affordable fresh fruit, vegetables and eggs into the heart of local communities across the Liverpool City Region. It stops at children’s centres, hospitals, GP surgeries, primary schools, community centres and asylum seeker support services. Customers have the flexibility to pay using cash, card, NHS Healthy Start cards, or Alexandra Rose vouchers. The service targets neighbourhoods identified as ‘food deserts,’ where households must travel over 1 km or walk for 15 minutes to reach a store selling fresh produce. In these areas, residents often depend on convenience stores with limited healthy options, leading to unhealthy dietary habits and negative health outcomes. The Queen of Greens addresses this by delivering fresh produce to these underserved areas, providing residents with easier access to affordable and nutritious fruits and vegetables with the aim to reduce health inequalities within the community. Their greengrocers purchase produce from wholesale markets. Priority is given to locally sourced produce and an emphasis on seasonality to not only lower costs but also promote sustainability.
This successful model could benefit many more people living in food deserts if scaled up. The costs here reflect what would be needed each year over 5 years if the programme expanded to four additional cities. This includes purchase of additional vans to ensure operations can continue if one breaks down, as well as drivers, an operations manager, rental of a cold store and subsidies for organic food.
YOUR MENU
You have £3 billion left to spend