Cllr Evelyn Akoto, Cabinet Member for Community Safety and Public Health, Southwark Council – Written evidence (FPO0024)

SUMMARY

01. As a London borough, Southwark has seen an increase in the number of residents who are struggling to afford basic food items, especially people who rely on benefits and those who are struggling to make ends meet with insufficient salaries. While it is hard to accept that people in 21st century Britain are going hungry, we are passionate in doing what we can to tackle it. We welcome this inquiry as it look at key aspects driving this and the important interlink between inequality, health inequalities and food sustainability.

02. National figures suggest that one in five over 16 year olds in England are food insecure to some degree, and one in 12 are moderately to severely food insecure. This translates to 53,000 of our residents being somewhat food insecure and over 20,000 being so food insecure that they may be skipping meals because they cannot afford to eat and experience real hunger. Simultaneously, food banks in the borough have seen a 31% and 45% increases respectively in referrals during 2017-18, with no sign of the demand abating in the future.

03. As will be made clear in our response, there are principally five reasons behind this, according to evidence available in the borough and academic research: declining or stagnant wages, welfare reform, destitution, no recourse to public funds, and the interaction between ‘food deserts’ and the ‘poverty premium’. Together, these factors create environments where low-income residents struggle to generate sufficient incomes with little or no access to healthy, fresh food options.

04. Southwark Council has worked alongside over 60 local community groups, organisations and businesses to develop its first ever food insecurity strategy, titled Fairer Food Southwark: a borough-wide action plan to increase household food security. The action plan was truly co-produced and has been jointly led by Southwark Council and the Southwark Food Action Alliance (SFAA) to implement, with the aim of developing a more coordinated offer for food insecure residents in the borough, improve those people’s health and support them to understand what support is available.

05. This type of work is crucial as the causes behind food insecurity are multiple and cannot be solved alone. Partnership working and multi-pronged approaches help ensure a more appropriate and well-rounded support system and you are more likely to reach those residents who are most in need but may be difficult to reach.

06. We hope that our response helps inform the committee’s inquiry and we would be delighted to provide any further information on the work that we are doing to tackle this important issue, and what we have found to work locally. Moving this issue up the national agenda is crucial and there are many opportunities for national government to help prevent food insecurity. Some of the measures we strongly recommend in our response are: implementing further reforms to Universal Credit, taking tougher action on advertising of unhealthy foods, introducing a national strategy to reduce food insecurity, funding Free School Meals programmes and Holiday Hunger programmes nationally, and introducing a living wage requirement for all employers.

RESPONSE

1) What are the key causes of food insecurity in the UK? Can you outline any significant trends in food insecurity in the UK? To what extent (and why) have these challenges persisted over a number of years?

07. Within the borough, we and local partners have noted the following factors contributing to increased food insecurity:

Declining or stagnant incomes compared to living costs, plus temporary and zero hours contracts
Negative impact of welfare reform, transition to Universal Credit (UC) in particular
High levels of destitution
People with NRPF ‘stuck’ for a long time with no way to improve their own situation
Unhealthy food environments featuring : proliferation of cheap, poor quality food (food swamps), food deserts and more expensive local stores (creating a poverty premium)

08. Declining or stagnant incomes combined with rising living costs mean that many households are struggling to get by. In Southwark, households are likely to be extra squeezed by high London housing costs. Southwark residents in the lower quartile for income will spend 67% of their median monthly income on rent, compared to a national average of 29%. This places a considerable strain on people’s resources.

National data suggests that households earning below £15,860 per annum after housing costs need to spend 42% of their household income on food to meet the government’s nutritional guidelines, as set out in the Eatwell Plate. A four-person family needs to spend £103.17 per week to meet the Eatwell guidelines, making a healthy diet unaffordable for many.
52% of households with children nationally are unable to afford a ‘socially acceptable diet’ as defined by the Minimum Income Standard. This applies to a diet which is both healthy and allows social participation (e.g. inviting guests for dinner or going out occasionally to a restaurant for a celebration).
According to local food banks, The Southwark Foodbank and Central Southwark Community Hub, insufficient salaries were cited as the reason for almost 1 in 6 referrals in 2017-18.
Those with insecure, variable or lower incomes are particularly vulnerable to food insecurity. This includes freelancers, seasonal workers, those on zero-hours contracts and part-time workers. 60% of food insecure Londoners are either in part-time or full-time work.

09. The challenge with declining or stagnant incomes can be noted in the borough as food bank usage has been on the rise. Southwark Foodbank saw a 31% increase in referrals in 2017-18 from the previous year and the Oasis Hub Waterloo Foodbank saw a 45% increase for this period at its Southwark branch on Borough High Street. The reason for referrals to food banks in Southwark in 2017-18 were recorded as:

Problems with benefits, due to delays or changes in the system (41%)
Low income (16%)
No recourse to public funds (NRPF) (16%)
Debt (11%)

10. Welfare reforms and the introduction of Universal Credit (UC) have had a considerable impact on Southwark’s residents. Whilst not yet fully rolled out across the country, Southwark has been substantially affected by UC, as it was one of the first places in Great Britain to have full service rollout from 2015. By the time the rollout is complete in early 2024 (at its earliest), Southwark Council’s Exchequer Team project that 40,000 households will be claiming Universal Credit. Since the rollout in Southwark, a significant number of claimants have fallen into rent arrears and many struggle to pay back and end up with significant debt. Arrears are amongst Southwark tenants are at around 8% of rent owed. The reasons behind the increase in rent arrears are partly due to the application process to join UC, and partly due to the features of the new system:

UC is paid monthly, rather than weekly. This can be problematic for those who are used to budgeting weekly and who may find themselves short of money at the end of the month.
All benefits are paid together as one lump sum – with the recipient being responsible for paying rent from their monthly payment, if they are in receipt of housing benefit. This means that after rent is paid, there may be little money left for living expenses.
The initial 5-week period without benefit income after applying for UC has had a major impact on claimants as it is paid in arrears. Many of those receiving benefits will not have savings to tide them over during this transition period.

11. Claimants from 2016 have still not been able to repay the rent arrears they incurred through the first years of the UC rollout, and this has a significant impact on the council because Southwark is the biggest social landlord in London. If the current trends continue in the same way since the rollout, the council would be left with a total rent debt of £5.6m by 2024/25. This is at the same time that UC continues to have a persistent and significant negative impact on our tenants, who would be left to deal with the stress of growing debt which they struggle to pay back.

12. There is further evidence that this is not solely the experience of Southwark. In March 2018, the Trussell Trust surveyed 284 users from 30 foodbanks in Great Britain (including Southwark) to look at the effects of Universal Credit rollout, which found that:

70% said that the transition to Universal Credit had put them in debt.
63% of the sample said that they were offered no statutory support during this wait.
57% of respondents said that they had experienced mental or physical health issues as a result of the wait for their first payment.
35% of the sample waited more than 6 weeks for their first UC payment.

13. Furthermore, evidence from the Trussell Trust illustrates that full Universal Credit rollout has led to a rise in people seeking emergency food aid. The charity reported a 30% increase in food parcels needed in areas of full Universal Credit rollout, six months after the benefit went live. This compared to a 12% increase in demand over this time in equivalent areas that are yet to experience the full rollout.

14. Evidence further from Trussell Trust suggests that single people on benefits without children are particularly vulnerable during the migration to Universal Credit, as they do not have a partner’s income or child benefit to sustain them during the transitional period.

15. Further examination of the current structure of Universal Credit is needed at a national level in order to better prevent such extreme levels of rent arrears and debt.

16. The impact of welfare reform and low levels of income cannot be separately from the impact of deprivation. Nationally, 1.5 million people were destitute in 2017, and Southwark’s destitution levels are the 6th highest in London and the 22nd highest nationally. This is another factor which drives food insecurity.

17. Destitution differs from poverty in that it is more severe and means that people cannot afford the bare minimum needed to eat, stay warm and dry and keep themselves clean. People are classed as destitute if they have lacked two or more of the essentials (food, clothes, toiletries, heating, lighting, shelter) in the last month because they have been unable to afford them, or if their income was so low that they could not pay for these things themselves and needed to rely on charity.

18. According to the Destitution in the UK 2018 Report, 62% of destitute people have eaten fewer than two meals a day for at least two days in a row. Those who are at the more severe end of the food insecurity scale are likely to be struggling with other essentials, such as fuel payments and basic toiletries. 36% of food insecure Londoners struggle to keep their homes warm in winter.

19. Another factor which influences the prevalence of food insecurity in the borough relates to no recourse to public funds (NRPF). People with NRPF are vulnerable to food insecurity, and in many cases there is a long wait time before NRPF status is resolved. They are also limited in what help is available to them through statutory routes. 16% of Southwark Foodbank users (Trussell Trust and CSCH) were people with NRPF. Reasons for them requiring food support include:

Free childcare is not available. This takes many women with NRPF out of the workforce – impacting family income and leaving single parents with NRPF without income and at high risk of food insecurity.
Pregnant women with NRPF and their children are not entitled to Healthy Start vouchers.
Secondary school students with NRPF are ineligible for free school meals and would only receive a free meal at the discretion and expense of individual schools.

20. Location may also influence whether a person is food insecure or not – that is, whether they live in a ‘food desert’. A ‘food desert’ is a geographical area where there is a lack of accessible options for buying fresh, nutritious, affordable food. Residents at risk of food insecurity are normally disproportionately hit by the effects of food deserts as they lack the funds for bus fares or cars to travel to competitively priced supermarkets further afield. 85% of those earning under £150 per week in the UK do not have access to a car. Residents at risk of food insecurity may also have disabilities or health problems which prevent them from walking far to go shopping.

21. The final aspect which we have found cause food insecurity relates to the ‘poverty premium’. The ‘poverty premium’ refers to the phenomena where the most socio-economically disadvantaged end up paying more for goods. Generally, people in food deserts rely on convenience stores and corner shops where prices are higher than in competitively priced supermarket chains and the range of fresh, healthy foods is less. BAME residents and low-income families are typically more likely to live in areas with fewer supermarkets and more convenience stores. For example, in nearby Greenwich, a basket of 15 healthy food items which cost £12.50 in Lidl, cost between £18.40 and £34.50 at a sample of 18 shops in deprived areas. The average price for the basket was £24.40. This is illustrates the ‘poverty premium’ that many residents face.

2) What are some of the key ways in which diet (including food insecurity) impacts on public health? Has sufficient progress been made on tackling childhood obesity and, if not, why not?

22. Diet has a significant impact on public health. It is estimated that the costs in Southwark to the NHS of diseases related to overweight and obesity are £92.1 million in 2015. More generally, obesity costs Southwark and the local economy is predicted to cost over £127 million a year. 70% of obese children will become obese as adults, with a number of obesity-related conditions developing during childhood, including type 2 diabetes, asthma and some musculoskeletal disorders. There is evidence that school absence through illness is higher in children who are overweight compared to those of a healthy weight. Childhood obesity can impact on mental health; low self-esteem, anxiety, depression, affecting sleep with fatigue impacting on quality of life.

23. Research has indicated that to tackle childhood obesity there should be an 80-20 split in the focus on diet over exercise. Physical activity should be promoted among children for a host of health and social reason; but the evidence shows that no one can outrun a bad diet.

24. Progress to reduce childhood obesity has been slow due to the large number of social, cultural, economic and political factors which influence people’s chances of maintaining a healthy lifestyle.

25. For low incomes, scarcity of time is a significant factor which influences diet choices. The UK Time Use Survey found that low income families have less time on the weekends than higher occupational groups. Therefore, encouraging families to plan meals in advance and take the time to prepare meals could be hampered by a lack of time. This means that interventions that do not require individual action are more likely to address health inequalities.

26. This suggest that to see a significant change in obesity, interventions and changes to environments need to be given sufficient time to see a change in behaviour.

27. People experiencing food insecurity are likely to have diet-related health problems due to poor nutrition. Poor diet is related to 30% of life years lost to early death and disability. Stress caused by food insecurity can also adversely affect mental wellbeing. A severely food insecure person is five times more likely to experience anxiety disorders and major depressive episodes than someone who has access to adequate food.

28. Children in food insecure households are more likely to develop asthma, depression and other chronic conditions. Their growth and development are impaired. Learning is poorer, and can affect life chances.

29. Food insecure people, particularly women with children, can be especially vulnerable to obesity. Cheap high calorie food choices, as well as cycles of food deprivation and/or overeating are potential contributory factors.

30. There are financial as well as health costs. It is 2-3 times more expensive to treat someone who is malnourished in the UK, compared to someone who is properly nourished.

3) How accessible is healthy food? What factors or barriers affect people’s ability to consume a healthy diet? Do these factors affect populations living in rural and urban areas differently?

31. Although supermarket chains are used as a proxy for the availability of healthy, affordable food, creating more supermarkets is not necessarily the best solution for encouraging food desert residents to buy more fresh fruit and vegetables. American studies have shown that opening large supermarkets in food desert areas did not change the fruit and vegetable intake or quality of the diet of local people.

32. Evidence suggests that small, local interventions run in partnership with food education projects, alongside means-tested subsidies for healthy food, provide a more effective way to both tackle food insecurity and improve health outcomes. Several models exist for this kind of intervention:

Community markets which target vulnerable populations either through location (e.g. on a housing estate) or through accepting vouchers, such as Healthy Start, aimed at low-income households.
Mobile shops or stalls. This solution works well where shop rent is expensive. It also gives local authorities a low-cost way to bring fresh produce into food desert areas. The mobile shop drives its affordable, fresh food to set locations during the week, with its visits coinciding with nutrition or cooking classes.
Online shopping can overcome transport barriers, however it is unsuitable for many low-income groups due to delivery fees, access to digital payment methods and lack of internet access or literacy.
Encourage corner shops to stock more affordably priced, good quality fruit and vegetables. This will need to be coupled with community engagement to ensure that there is demand.

33. Unlike ‘food deserts’ where there is a lack of accessible options for fresh, affordable, nutritious food, ‘food swamps’ are areas where there is a high density of establishments selling fast and junk food in relation to healthy options. These can significantly impact people’s ability to consume a healthy diet.

34. BAME and low-income residents are more likely to live near unhealthy food retailers. American evidence has linked food swamps to an increased risk of obesity, particularly when residents are less mobile and there is greater income inequality. This puts those groups who are vulnerable to food insecurity at greater risk of obesity and diet-related disease.

35. The map in Appendix 1 shows the relationship in Southwark between obesity levels in year six students and concentration of fast-food takeaway outlets. It shows a clear north-south divide in the borough in terms of both obesity levels and numbers of fast food outlets, with the north having high levels of both.

36. When there is a lack of good access to affordable, healthy food (such as in food desert areas) and residents are living in a ‘food swamp’, they may become reliant on takeaway meals.

37. For those without access to good kitchen facilities, such as those in temporary accommodation, takeaway food is sometimes the only option, making the healthy choice a harder one.

4) What role can local authorities play in promoting healthy eating in their local populations, especially among children and young people, and those on lower incomes? How effectively are local authorities able to fulfil their responsibilities to improve the health of people living in their areas? Are you aware of any existing local authority or education initiatives that have been particularly successful (for example, schemes around holiday hunger, providing information on healthy eating, or supporting access to sport and exercise)?

38. Local authorities have an important role to play in creating healthy environments. Responsible for public health, local authorities can create spaces where the healthy option is the easy option, as well as provide a range of services that can help prevent and treat obesity. In Southwark, we are operating a range of schemes that aims to improve the health of our residents and make healthy weight everyone’s business, through partnership and community working. Below are some of the initiatives that the council is delivering.

39. Increase the uptake of Healthy Start vouchers: Healthy Start vouchers were introduced in 2006 to provide a basic, nutritional safety net for pregnant women, infants and children in low-income families, and they can be used for free milk, formula, fruit and vegetables, with the aim of encouraging healthy food choices. The Southwark take-up rate for this scheme in 2018 was 71%, which compares to a national average of 66% and the nationally recommended 80%+. This means that £134,650 worth of vouchers went unclaimed in Southwark during 2017-18.

40. To help increase the uptake of the Healthy Start vouchers, the council formed a cross-sector, multi-agency Healthy Start task and finish group in March 2019, supported by funding from Sustain to test different approaches to increase the uptake of the vouchers locally. One of the early findings from this task and finish group is that education and training is needed for maternity and early years staff across sectors to raise awareness of the vouchers and how to administer them and signpost to them.

41. Alexandra Rose vouchers are funded for three wards in Southwark, increasing low-income families’ access to fresh fruit and vegetables, whilst supporting the local market economy. To increase the uptake of these vouchers and access to healthy foods, the task and finish group is working to ensure there is the cross promotion of the Healthy Start vouchers, Alexandra Rose vouchers and the Healthy Start vitamin D scheme.

42. Promote breastfeeding to boost health of infants and mothers: Southwark has currently achieved level 1 accreditation of the UNICEF UK Baby Friendly Initiative and is working towards level 2. This internationally recognised standard enables public health services to better support families with feeding and bonding. Breast milk provides an infant with food security as it contains the essential nutrients and energy needed for the best start in life. However, food insecure mothers are less likely to persevere with breastfeeding due to the stress and social isolation of their situation. Many will have to return to work early for financial reasons. With formula costing up to £32 per week, ‘formula poverty’ has been identified. To cope, food insecure parents may resort to unsafe practices such as skipping feeds, watering down the formula, adding cereal or introducing cow’s milk too early.

43. The borough is promoting breastfeeding by inviting local venues to participate in the Breastfeeding Welcome Scheme, promoting that they support mothers to breastfeed within their venue. This is in addition to Breastfeeding Cafes where mothers can feed in a supportive environment.

44. Provide high quality affordable childcare and maximise the value of children’s centres: Adequate provision of statutory childcare helps parents to work, improving family incomes. Following a pledge in the 2018 manifesto, the council is committed to extend healthy, free school meals to school nurseries. Providing free, healthy meals at nurseries could have health benefits, including reducing food insecurity and tackling childhood obesity. It is important to set healthy eating behaviours at an early age.

45. Local Children’s Centres have a wide reach with 21,900 individual children and adults in Southwark and they help tackle with food insecurity by offering early years cooking and nutrition classes taught by the local Dietetics team (e.g. Cook & Taste classes, targeted six-week Cook and Eat Well classes). Additionally, there are sessions with snacks, breastfeeding support and family workers who can pick up on food insecurity and signpost/ refer to foodbanks. Peckham, Peckham Rye and Nunhead Children’s Centres reported growing needs around foodbanks, benefit/financial issues and no recourse to public funds in their 2017 report.

46. Across the Children’s Centres, the Community Nutrition and Dietetics team deliver a number of cooking classes, providing families with cooking skills and recipes for cooking on a budget. Families who attended the classes have donated their favourite recipes to be included in a new recipe book called ‘Together we cook’. The recipes have been nutritionally analysed and adapted to increase the amount of vegetables they contain and to make them low or medium in sugar, salt and fat. Once adapted, recipes were tested at Albrighton Community Centre to ensure the recipe maintained its flavour and texture.

47. Healthy Weight Training: To further support professionals’ work with individuals and families to achieve a healthy weight, an online, localised, bespoke healthy weight training package has been developed and is free for all healthcare practitioners working within the borough. The training aims to ensure all practitioners feel competent and confident in supporting children and families achieve a healthy weight.

48. Secure children’s access to food during the holidays: The council’s public health team co-ordinated a pilot school holiday meal provision project in 2018, with Mercato Metropolitano, Central Southwark Community Hub and Guys and St Thomas’ Charity. It showed the need to work with schools, social services and other partners to strengthen the referral system. Local providers have spoken of the need for provision in half terms and the Easter holidays, not just during the long summer break.

49. A network of holiday food providers in the borough has been established over 2018/19 and has been working towards a more coordinated approach across providers, supporting shared interests around improved evaluation, funding support, sharing best practice, volunteer management and stakeholder engagement.

50. Improve the implementation and uptake of free school meals: Overall, 9,517 Southwark schoolchildren are eligible for free school meals (Jan 2018), which is roughly 23.6% of all school-aged children living in Southwark. The provision is as follows:

Primary school: Due to these high percentages, Southwark provides free school meals to all primary school children, regardless of need. This goes beyond the government’s offer of universal free school meals only to those in reception, year 1 and year 2. Over 92% of Southwark primary school pupils take up this offer.
Secondary school: 25.1% of secondary school children in Southwark meet the eligibility criteria for free school meals – which is double the English average of 12.4%. This figure excludes students whose families have no recourse to public funds. The council is working with Guy’s and St Thomas’ Charity to audit the free school meals provision in secondary schools.
Nurseries: The Council Plan 2018-2022 commits to extending free, healthy meals to school nurseries. 62 nurseries will be part of the Free Healthy Nursery Meals (FHNM) programme.

51. In addition to the existing provision, there is interest to explore water-only and dessert-free menus to support the council’s Sugar Smart pledge and healthy weight strategy. If this was to proceed, schools will be offered more support in the commissioning school meals, ensuring best value and the healthy meals for pupils.

52. More understanding is needed about secondary school students whose families have NRPF, the impact of not being entitled to free school meals, and how they are best supported.

53. Promote healthy eating messages through campaigns: As part of Southwark Council’s Sugar Smart pledge, the council established the now national Fizz Free February campaign, encouraging families and children to give up fizzy drinks for the month. The campaign aims to raise awareness of fizzy drinks, which often contain high amounts of sugar and can lead to weight gain as well as dental health problems if consumed regularly.

5) What can be learnt from food banks and other charitable responses to hunger? What role should they play?

54. To answer this question, it is best to begin by outlining the main food crisis providers operating in the borough. This list does not cover smaller, independent foodbanks that the council does not have data for (e.g. initiatives run by faith groups).

Trussell Trust Foodbanks: The Southwark Foodbank is run by PECAN and operates out of five locations in the borough. It received referrals for 2,495 households in 2017-18, compared to 400 in 2009. There is an additional Trussell Trust foodbank in Borough High Street run by the Waterloo Foodbank, which received referrals for 175 households in 2017-18. A referral from a community professional entitles the household to three foodbank packages during a six-month period and is designed for acute rather than long-term support. However, the foodbank have had to relax this restriction due to need. The foodbank will signpost to other relevant support agencies.
The independent foodbank: Central Southwark Community Hub (CSCH) operates out of four Southwark locations and it requires a referral from a community professional. It was formed in December 2016 out of a recognition that the Trussell Trust model of three visits in a six-month period is not enough for the chronically food insecure or for those with more complex needs. Instead, it provides longer-term, client-centred, practical and emotional support. It received 709 referrals in 2017-18.
Statutory support: Southwark’s Emergency Support Scheme offers short-term help to those facing crisis by supplying help through goods (including food) rather than money. In 2017-18 food grants were awarded to 1,295 households who received a food package from ASDA. This service is for those on benefits. It can not be used by those who have NRPF or who have lived in the borough for less than three months. It is administered by Community Southwark and recipients receive recipe cards with their food parcels to encourage healthy eating.

55. Emergency food aid should always be available to ensure that those in crisis have a safety net. However, national food campaigners take the view that food aid alone is not a sustainable, long-term solution, and this is also recognised by the Southwark Food Action Alliance, which is a collection of 60 organisations and community representatives that are interested in the food security agenda.

56. Southwark’s main foodbanks are moving to a model that is more preventive, sustainable, empowering and community based. This draws on work done by the Scottish Government who recommend applying four ‘Dignity Principles’ to the design and delivery of all responses to food insecurity.

Involve people with direct experience in decision making
Recognise the social value of food
Provide opportunities to contribute
Leave people with the power to choose

57. The Southwark Food Action Alliance supports this and recognises the need to go beyond a ‘sticking plaster fix’ to try and address the problem at source because:

Wages and benefits are insufficient for many to live on.
People who are chronically food insecure need help to maximise their incomes as well as to access affordable, healthy food.
80% of food insecure people do not use foodbanks for reasons such as unclear referral pathways and the perceived stigma of using a foodbank, so more accessible and acceptable help is needed.
Food aid providers have little control over the quality and quantity of food offered when they rely on donations. They may stock minimal fresh food and be unable to cater for special diets.

58. Other models of provision are being explored locally and across the country to bring those in food crisis to a greater place of resilience including:

A Pantry Model: Members pay a small fee to access healthy, surplus foods and make decisions about what foods to buy as a community. In a small survey done with social pantry members in Stockport, 100% of members said the pantry had made them feel part of a community. 89% said they were better off financially for joining. PECAN began a pilot Pantry in Southwark during spring 2019 on the Peckham North Estate. Members pay £4.50 per week for £15 worth of food.
Community café: Everyone is encouraged to prepare the food as well as to eat it. The café provides a place for social cohesion and can be used to promote mental wellbeing and tackle loneliness. In Southwark, the Dragon Café in Borough, which is run by Mental Fight Club, offers such a service on a weekly basis. However, the café is closed throughout August.
Wraparound services: Croydon has this in its New Addington Food Stop which combines a pantry with various council and health services. Members can access healthy cooking and stop smoking support at the Food Stop, alongside help with budgeting, benefits, a weekly job club and training courses to help with employment prospects.
Food hub: In the Mayor’s Food Strategy for London, it is suggested that every key area of deprivation in a borough should have a food hub at an existing centre (e.g. school/ community centre/children’s centre) where people can learn more about healthy food and cooking. With Southwark having the largest percentage of residents in social housing in the country (42%), estates and housing associations could also be good bases for hubs. The hub would encompass a community café, cookery classes, holiday provision, lunch clubs and pantries (using surplus from an organisation, such as Fareshare).

6) What impact do food production processes (including product formulation, portion size, packaging and labelling) have on consumers dietary choices and does this differ across income groups?

59. Research by SHIFT has highlighted that a meal from the takeaway sector is on average 50% more calories than the 600 calories recommended for lunch or dinner by the Food Standards Agency and Public Health England. The calorie content of the meals is based on raw ingredients, preparation methods and the portion sizes. 70-80% of an independent outlet’s customers are regulars, reflecting the habitual nature of food purchasing. Protecting these relationships is very important for Food Business Owners and so can prevent changes being made to meals, particularly reducing their portion sizes.

60. The Healthier Catering Commitment is a voluntary scheme in London that supports food outlets to make small changes to the ingredients and preparation of food, for example, not using salt when boiling starchy food and ensuring that smaller/child portions are available. Southwark Council is a signatory to this and is working to recruit more local businesses to the scheme.

7) What impact do food outlets (including supermarkets, delivery services, or fast food outlets) have on the average UK diet? How important are factors such as advertising, packaging, or product placement in influencing consumer choice, particularly for those in lower income groups?

61. Nationally the fast food market has grown by 34% since 2009 and is expected to grow by a further 11% by 2021, with the increasing online market. It is apparent for many low income families takeaway has become an everyday food source. Therefore, delivery and fast food outlets have a large and growing impact, on the average UK diet, particularly those from low-income households. Southwark Council with Guy’s and St Thomas’ Charity are currently developing an enhanced Healthier Catering Commitment to support food business owners to make small changes to the ingredients used, cooking methods and portion sizes, in order to improve the overall nutritional content of meals provided.

62. Southwark Council is currently piloting the Good Food Retail Plan in local convenience stores, which are visited regularly throughout the week by the local community, as they are closer than supermarkets or larger food stores. The pilot focuses on working with retailers to provide healthier options within their stores and ensuring that such options are promoted. The pilot has highlighted the importance of working with suppliers, to ensure that the healthier alternatives are easily available and still affordable for independent retailers.

63. The Collaboration for Healthier Lives, chaired by Danone and Walmart, is currently piloting a number of collaborative models in Southwark and Lambeth. The aim of the collaboration is to explore how large retailers and manufactures can jointly create healthier baskets and encourage healthier changes to be made in supermarkets.

64. To influence consumer choice, particularly those from lower-income groups, it is vital that the healthy choice is not only the cheapest but the easily available.

65. Advertisements also influence the lifestyle choices individuals make. A report published in 2018 by Cancer Research UK found young people who recalled seeing junk food adverts every day were more than twice as likely to be obese. The same study identified 87% of young people found adverts for high fat, salt and sugar products appealing, with three quarters tempted to eat a product after seeing such an advert. As a borough, we have banned the advertisement of high fat, salt and sugar (HFSS) products’ along with alcoholic drinks, across all council owned media sites to promote healthy lifestyle choices to all residents. We support the government’s proposal for a 9pm watershed on the advertising of HFSS products aimed at children on television and on the internet.

8) Do you have any comment to make on how the food industry might be encouraged to do more to support or promote healthy and sustainable diets? Is Government regulation an effective driver of change in this respect?

66. The Sugar Drinks Industry Levy has been beneficial in encouraging the reformulation of sugary drinks, and serves as a powerful evidence base for the effectiveness of government intervention. It is important that such initiatives continue to be ambitious and challenge the food and drinks industry to make healthier choices easier and cheaper. The reformulation of products should be supported by a more rigorous examination of product placement in supermarkets.

67. Another area that needs to be examined relates to wider advertising policies and the use of cartoon characters to promote and sell products. These practices have a marked impact on people’s food choices and more needs to be done to ensure that interventions are fit for today’s society. Whilst the government has consulted on advertising restrictions, 9pm watershed on TV advertising, price promotions, and the promotion of unhealthy food and drink by location, substantive action is yet to be taken.

9) To what extent is it possible for the UK to be self-sufficient in producing healthy, affordable food that supports good population health, in a way that is also environmentally sustainable?

68. While this is not an area of expertise for the council, we are aware that Garden Organic and others have been keen to see support for this agenda and that they have carried out research and trials into the feasibility of this.

69. There are challenges in acquiring, using and coordinating use of land for food growing at scale in London boroughs – although some have succeeded with initiatives such as salad growing in poly tunnels in disused underground tunnels.

70. At a local level more networked, scaled-up, coordinated and sustained approach to food growing would benefit the sector, including access to training, volunteers and funding opportunities.

71. Food growing partnerships that operate in the borough include Glengall Wharf who supply fresh produce to the Southwark Foodbank and Garden Organic, who have taught growing skills on 24 estates.

10) Can efforts to improve food production sustainability simultaneously offer solutions to improving food insecurity and dietary health in the UK?

72. Less complex supply chains and forging better relationships between local producers and communities could support initiatives to support food security. Managing surplus stock and creating more of a local economy might be two positive impacts.

11) How effective are any current measures operated or assisted by Government, local authorities, or others to minimise food waste? What further action is required to minimise food waste?

73. For every two tons of food eaten in the UK, one ton is wasted. From an environmental perspective, this is not sustainable and the Courtauld Commitment calls on the food industry to reduce food waste by at least 20% by 2025. Until the food industry becomes more efficient at minimising waste, a co-ordinated redistribution of food surplus can offer a short to medium-term solution to food insecurity.

74. Southwark is ambitious in trying to minimize its food waste and is working with the local community to reduce it. For example, Southwark was the London Borough to receive the most surplus from Fareshare during April-Oct 2018, with neighbouring Lambeth being 2nd.

75. To increase the use of surplus, infrastructure needs to be in place at the local level with organisations having storage, refrigeration and transport facilities for the food. The quality and choice of food also needs to be acceptable to the organisation. Several local organisations have cited these as barriers that prevent them from using surplus, along with the inability to plan menus in advance due to the uncertainty of what the delivery could include. The table below shows the top five kinds of food redistributed by Fareshare in Southwark according to volume (Apr-Oct 2018). Healthy food types, such as vegetables and protein, are well represented and it covers a key gap, as typically fresh foods are harder to access at foodbanks. The soft drinks category incudes water, as well as less healthy drinks.

76. The Albrighton Centre Community Fridge is a surplus food redistribution project in South Camberwell on the Dog Kennel Hill Estate. It aims to share good quality, unwanted food that would otherwise go to waste. The Fridge is open three times a week. Neighbours and local retailers donate surplus food to the Fridge that anyone can pick up for free. The Fridge was established through a Waste Less, Save More project together with Sainsbury’s and Hubbub. Although not designed as a food crisis intervention, survey data has shown high levels of chronic food insecurity among users.

70% of the sample only go to The Fridge for support with food. 63% visit more than twice a week.
More than half of the sample said they rely heavily on food aid.
Almost 3 out of 10 users felt totally unable to plan where their next meal was coming from.
93% of the sample said they were encountering moderate to high stress and anxiety over their food situation. Almost 1 in 2 respondents placed their stress and anxiety at a ‘5’ on a 1-5 scale of severity.

77. The demographics show that a high percentage of users fall into vulnerable categories such as the disabled, older adults who are not yet drawing a pension and those on, or waiting for, UC. This matches findings from academic research on groups that are at higher risk of food insecurity.

68% of the sample are council or housing association tenants. 11% rent privately.
40% are disabled.
42% have applied or are waiting for UC.
45% are aged 45-64.

78. Further action is however needed to prevent food waste. Lessons can be learned from France, where they have introduced a law that prevents supermarkets from throwing away or destroy unsold food. If food approaches its best-before date, supermarkets should donate the excess food to charities and foodbanks. This is something which the UK government should consider introducing, as it would greatly help our communities, protect our environment, and prevent unnecessary waste.

12) A Public Health England report has concluded that “considerable and largely unprecedented” dietary shifts are required to meet Government guidance on healthy diets. What policy approaches (for example, fiscal or regulatory measures, voluntary guidelines, or attempts to change individual or population behaviour through information and education) would most effectively enable this? What role could public procurement play in improving dietary behaviours?

79. Procurement has an important role to play in improving dietary behaviours. Suppliers need to ensure that healthier alternatives need to be made easily available and finically attractive retailers and caterers. This has been highlighted as a priority area through the Good Food Retail Plan pilot in Southwark and across the London boroughs working with food providers to achieve the Healthier Catering Commitment.

80. A number of regulatory methods are required to encourage healthy diets, particularly around improving high streets’ offers and messaging. There is too much calorie-dense food available and residents are bombarded by invitations and incentives which encourage unhealthy choices.

81. Across ethnicities, all children’s views of what constitutes a heathy balanced diet are at odds with guidelines. Guidelines therefore need to be clearly communicated and avoid any conflicting advice.

13) Has sufficient research been conducted to provide a robust analysis of the links between poverty, food insecurity, health inequalities and the sustainability of food production? How well is existing research on the impact of existing food policy used to inform decision making?

82. No evidence to submit.

14) What can the UK learn from food policy in other countries? Are there examples of strategies which have improved access and affordability of healthy, sustainable food across income groups?

83. No evidence to submit.

15) Are there any additional changes at a national policy level that would help to ensure efforts to improve food insecurity and poor diet, and its impact on public health and the environment, are effectively coordinated, implemented and monitored?

84. Southwark Council believes that the following measures would have a significant impact at a national policy level to improve food insecurity and poor diet:

Introduce a nationally agreed definition and measure of food security/insecurity that is repeated at regular intervals to pick up on impact of substantial policy changes.
A national strategy to reduce food insecurity.
A central funding pot devolved to local authorities to support Free School Meals programmes and Holiday Hunger programmes.
A living wage requirement from all employers.
Reformulation requirements to support healthier products in the cheaper range of convenience foods.
Examine the current structure of UC to understand how it places some residents in rent arrears; with the view of better prevent this from taking place.
Tougher action on advertisement and promotion of unhealthy foods to help people make healthier choices.

Appendix 1

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