Sustain: The Alliance for Better Food and Farming – Written evidence (FPO0071)

Summary

1. Sustain is the UK alliance for better food and farming, a registered charity. We work to achieve a healthy, fair and sustainable system for food, farming and fishing, for the benefit of all.
2. Some key causes of UK food insecurity include roll-out of Universal Credit; Tax and Welfare reforms disproportionately affecting those on lower incomes; reduction of provision of meals on wheels services; changes to free school meal entitlement; and the extra costs linked to having a disability.
3. Levels of childhood obesity are at an all-time high. Since the launch of the Government’s first Childhood Obesity Plan in August 2016 there has been little progress in implementation of key measures designed to improve the food environment in which children grow up. The key measure to be implemented has been the introduction of the Soft Drinks Industry Levy which has removed 90 million kg of sugar from drinks since 2017. The Children’s Food Campaign and Sustain urge the Government to move forward with key measures to increase the pace of change on childhood obesity.
4. Income and welfare payments are low, so many families struggle to afford the food needed to enjoy a nutritious diet. Recent research found that in order to follow the UK Governments EatWell Guide, households in the bottom two deciles would have to spend 42% of their income after housing costs.
5. Poverty and household food insecurity are experienced differently in rural areas, often more ‘hidden’ than in urban areas. The voices of people experiencing poverty in rural communities are often missed.
6. There are some existing examples of schemes to increase access to healthy foods for key populations on very low incomes, like Healthy Start. However, Healthy Start has limitations as eligibility has rapidly declined, its value was last updated in 2009, and the proportion of eligible people claiming vouchers has decreased to on average a low 64% in England and Wales. This needs much better promotion.
7. Local authorities have an important role to play to improve access to healthy food. They control or influence food and drink in schools, nurseries, civic centres, leisure centres and other places. They also control planning, public and environmental health, leisure and recreation. Local authorities should improve catering under their control e.g. in schools, staff cafeteria, leisure centres, etc., and support the public, private and voluntary sectors to improve their food.
8. There is a growing body of evidence of the association between exposure to food advertising on television and online, and children’s increased preferences for, and purchase and consumption of foods high in fat, salt and sugar. Unhealthy food advertising should be further restricted.
9. A systemic shift is needed. The recognition of the Right to Food in UK law would help embed measurement of household food insecurity; give vulnerable people and their advocates the right to demand action on factors affecting people’s personal circumstances; put a duty on local and national authorities to take practical steps and provide adequate resources to improve incomes long-term, as
   well as help people through crisis, and trigger a requirement for provision of helpful and dignified support, facilities and services, as well as the necessary funding and other resources to achieve these. Political support for the Right to Food has recently leapt forward, with commitments from the Labour Party, Co-op Party, Lib Dem Party and the Scottish Government to adopt the Right to Food into law, see: https://www.sustainweb.org/news/sep19_political_support_for_right_to_food_leaps_forward/The Government’s National Food Strategy provides an opportunity to secure such this approach in UK-wide strategy and implementation.  Sustain’s Right to Food programme would be pleased to offer a specialist session for the House of Lords Select Committee on the right to food.

Sustain: The alliance for better food and farming advocates food and agriculture policies and practices that enhance the health and welfare of people and animals, improve the working and living environment, enrich society and culture and promote equity.

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?

Universal Credit

1. Universal Credit has been repeatedly identified as a causal factor for the rise in food insecurity in the UK. Trussell Trust data has found that on average, 12 months after rollout, emergency food banks see a 52% increase in demand, compared to 13% in areas with Universal Credit for three months or less. This increase cannot be attributed to randomness and exists even after accounting for seasonal and other variations.[1]
2. Research undertaken by the End Hunger UK coalition with 70 food aid providers across the country showed that there was a surge in demand after Universal Credit was rolled out in an area due to a combination of delays, errors, a lack of flexibility and inadequate support.[2]
3. Former Amber Rudd MP, Secretary of State for the Department of Work and Pensions stated in the House of Commons in response to an oral question by Sharon Hodgson MP that the delay in claimants receiving their Universal Credit payments was leading to a rise in food bank use.[3]

Tax and welfare reform

4. Overall tax and welfare cuts made since 2010 have had a regressive effect on social protection. The cumulative impact assessment by the Equality and Human Rights Commission (EHRC) shows that key human rights requirements have not been met: the principle of proportionality, non-discrimination, protection of most disadvantaged groups and independent review.
5. The Office for Budget Responsibility said in 2016: “The scale and sustained nature of the welfare spending cuts seen over the current and previous Parliaments are in some respects unprecedented”.[4]
6. As a result of changes to benefits and tax credits and Universal Credit, households in the second and third deciles have lost more than twice as much as those in the top 20%. At this pace, in four years from now 1.5 million more children will live in poverty, the child poverty rate for lone-parent households (90% of whom are women) will increase from 37 to 62%, and households with at least one disabled adult and a disabled child will lose 13% of their income. Lone mothers will lose almost one fifth of their annual income.[5]
7. Welfare payments are capped and most working age benefits have been frozen since 2016 meaning that welfare has not been kept in line with the average cost of living.[6] A piece of research looking at families affected by the two-child limit found that 88% of respondents said it affected their ability to afford food or clothing.[7]
8. The Office of National Statistics has found that low-income households observed greater impact of rises in prices and costs than high-income households, with poorer households seeing price rises of 2.6% whilst wealthier households have seen average annual price rises of 2.2%.

Disability and mental health

9. People with disabilities face additional barriers and costs linked to their condition. The disability charity Scope has estimated that this additional cost for items such as heating, insurance, equipment and therapies can work out to an average of £583 a month.[8] This figure takes into account disability benefits such as PIP. These extra costs can seriously impact upon a households ability to obtain an adequate standard of living and be food secure.
10. A research project from the University of Oxford found that over half of households who used a food bank had at least one family member with a disability, 75% had one instance of ill health in the household, and one third of people had mental ill health.[9] The Equalities and Human Rights Commission (EHRC) found that 18.4% of disabled people aged 16-64 were considered to be in food poverty in 2014 compared with 7.5% of non-disabled people.[10]
11. Analysis of public spending in England found that households with more disabilities suffer much larger losses that represent over £2,900 per year than those with fewer disabilities. This is largely due to social care cuts. [11]

Older people

12. Older people are traditionally underrepresented in food insecurity data or amongst food aid users. In Scotland 1% percent of people over 65 reported to be food insecure compared to 8% of the general population.[12] However malnutrition was more common in individuals over 65 than under (35% v. 24%). [13]
13. Reduced care provisions from local authorities has had a knock-on effect on older people’s food security. In Sustain’s submission to the APPG on Hunger’s inquiry into food poverty on hidden hunger and malnutrition and older people we set out how meals on wheels services, where warm or frozen meals are dropped off at clients’ homes, have been significantly cut in recent years. Under half (48%) of local authorities provide meals on wheels services, down from 66% in 2011. [14] Yet there are examples of meals on wheels services bucking this trend.[15] Councils and government should support such initiatives to thrive and expand.

Children

14.          It costs approximately £437 per year to provide a child with a school meal during term time.[16] Due to changes to eligibility, one in eight children will now no longer be in receipt of free school meals that would have been eligible under the legacy system.[17]
15. Families who are already struggling financially may find the extra cost of feeding children during the holidays an additional cost that they may not be able to face. This in turn can lead to a ‘learning slump’ over the holiday period for children who rely on free school meals and free breakfast clubs during the term time. [18]
16. Food aid providors often find that there is normally an increase during holiday periods to families with children.[19] There are also hundreds of holiday clubs that have been set up in order to respond to the demand for both food and activities for children living in food insecure households. However these activities do not address the underlying causes of food insecurity for these families and attendance may lead to children and their parents experiencing stigma from their peers. [20]
17. Food is not just about the calorie intake; children in food insecure households can find themselves socially isolated during the summer either due to the lack of ability to partake in reciprocal play dates or lacking the funds to join activities that cost money. [21] 

Immigration status

18. Research into destitution by the Joseph Rowntree Foundation found that migrants' routes into destitution were in many ways similar to those by UK-born interviewees, but they faced further compounding difficulties such as lower than average income and lack of eligibility for certain benefits.[22]
19. Research by Project 17 showed how vulnerable to poverty families are with the immigration condition No Recourse to Public Funds (NRPF) are, in particular due to their exclusion from the welfare system. [23]
20. A number of measures that currently exist to help mitigate food insecurity for pregnant women and children, such as Healthy Start Vouchers or Free School Meals, are not accessible to people with NRPF due to the fact that the eligibility criteria for many of these schemes is tied to ‘qualifying benefits’ and they are therefore ineligible.[24]
21. Children whose parents have the immigration condition No Recourse to Public Funds (NRPF) are currently unable automatically to access free school meals beyond year two, when Universal Infant Free School Meal entitlement ends. Many families cannot afford to fund their children’s meals, and without provision from the school these children are faced with the choice of either skipping meals or being pushed into debt.[25]
22. The United Nations Committee on Economic and Social Rights states that “all children within a State, including those with an undocumented status, have a right to receive education and access to adequate food and affordable health care”.[26]

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?

23. Levels of childhood obesity are at an all-time high. One in three children have a weight classified as overweight or obese when they leave primary school, with the most disadvantaged children significantly more likely to be affected[27]. The Government has laid out an ambition to halve childhood obesity by 2030. 86% of the UK public believes child obesity is a serious problem, 80% are concerned about the impact of obesity on the NHS, and 69% agree that any new Prime Minister should continue to prioritise actions to reduce childhood obesity[28].
24. Since the launch of the Government’s first Childhood Obesity Plan in August 2016, and the publication of Chapter Two in June 2018, we have seen a number of government consultations but little progress in implementation of key measures designed to influence the food environment in which children grow up. The key measure to be implemented has been the introduction of the Soft Drinks Industry Levy which has removed 90 million kg of sugar from drinks since 2017 (approx. 45 million kg per year), and which has contributed to a decline in sales of regular sugary fizzy drinks whilst low and no-sugar drinks sales have increased[29]. Soft drinks saw an 11% sugar reduction in the first year of Public Health England’s Sugar Reduction Programme, compared to an average of just 2% across food and drink overall, indicating the relative power of fiscal measures compared with voluntary industry programmes.
25. The Children’s Food Campaign and Sustain urge the Government to move forward with key measures to increase the pace of change on childhood obesity, including action to:

1. Maintain a priority commitment to halving child obesity by 2030, as outlined in the Childhood Obesity Plan (Chapter 1 2016 and Chapter 2 2018) and the 2019 Prevention Green Paper.
2. Make a firm commitment by Government to continue collecting the Soft Drinks Industry Levy and channelling the proceeds to tackling childhood obesity and poor health.
3. Extend the Soft Drinks Industry Levy to include sugar-sweetened dairy drinks. To incentivise further reformulation, the threshold should be lowered and levy rate increased above inflation rises with revenue raised reinvested in measures to improve public health.
4. Recognise that children are in school for 190 days each year, and strengthen interventions designed to make schools Healthy Food Zones, and ensure that all schools in receipt of state funding are meeting or exceeding School Food Standards.
5. Protect children from exposure to advertising for food and drinks high in fat, sugar and salt (HFSS) with a 9pm watershed on all media including on TV, radio, online, cinema and digital out of home.
6. Restrict multi-buy price and location-based promotions of HFSS products in stores, recognising their effect on purchasing and consumption.
7. Restrict HFSS adverts from display within 100 metres of schools should be extended to include nurseries, children’s centres and community sports and leisure centres, and HFSS brand sponsorship banned from schools and major sporting events and venues.
8. Control the use of child-friendly brand equity and licensed characters, banning these from being associated with HFSS products.
9. Explore application of fiscal measures (such as changes to VAT or further levies based on calories/energy density) to other product categories where sugar or calorie reduction/reformulation is not in line with Government targets.
10. Make the Healthy Schools Ratings Scheme mandatory for all schools in receipt of state funding and require schools to supply evidence of (a) compliance with the School Food Standards and (b) delivery of mandatory food education as part of the scheme.
11. Plan for UK to be European leaders on breastfeeding rates, with actions and investment to support an increase so that 75% of infants at 6-8 weeks receive some breastmilk and 50% are exclusively breastfed, with support to continue breastfeeding throughout the first year.
12. Use planning and licensing tools to tackle the issue of food swamps and food deserts and creating a healthy high street standard that tackles proliferation of outlets selling high amounts of HFSS products and which promotes retail diversity.
13. Back the Peas Please campaign’s call for 5 billion more portions of fruit and veg consumed by 2020, and increase fruit and veg production in the UK by 100,000 hectares to meet healthy eating targets.

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?

26. Income levels and welfare payments are at such a level that many families currently struggle to afford the food that would enable them to have a nutritious diet. Recent research by Sustain alliance member the Food Foundation found that in order to follow the UK Government’s EatWell Guide households in the bottom two deciles would have to spend 42% of their income after housing costs.[30]
27. Research published by the Mayor of London’s office in June 2019 suggests that nearly 2 million people, including 400,000 children, have low or very low levels of food security.[31] The findings are based on a survey of thousands of Londoners, which asked a variety of questions about their ability to afford or access food. The highest levels of food insecurity was amongst children in East London (32%) and lowest in South West London (9%). Of the adult Londoners struggling to afford or access food, 40% were either black or Asian. In addition, the survey found that more than a quarter of parents in London have struggled to find sufficient food in the past year.

Rural communities

28. Poverty and household food insecurity are experienced differently in rural areas and are often more ‘hidden’ than in urban areas. The voices of people experiencing poverty in rural communities is often missed. A combination of factors and challenges lead to the people having to spend more to access food – due to higher costs of food itself and/or expenditure to access it, as well as limited options. People living in poverty in rural communities can struggle due to distance from services, transportation costs and access to information.
29. Information on people facing food poverty in rural areas is limited and people can feel forced to hide poverty and poor access to food. Uptake of free school meals and pension tax credits by eligible groups is often lower in rural areas, not because the need is not there but because of multiple barriers. The compounding effect of multiple challenges requires a holistic approach, rather than separate responses to individual challenges. Yet few organisations focus on (food) poverty in rural areas.[32]

Limitations of Healthy Start

30. There are some existing examples of schemes to increase access to healthy foods for key populations on very low incomes, like Healthy Start. However, Healthy Start has several limitations. Firstly eligibility has rapidly declined and it’s currently fewer than 500,000 individuals – a 30% reduction since 2011, when it is estimated that up to 14 million people are struggling in poverty, including 4.1 million children. Secondly, its value was last updated in 2009, despite rises in food prices. Finally the proportion of eligible people claiming the vouchers has decreased over the past five years and is on average 64% in England and Wales.
31. The Department of Health and Social Care should fund a national programme to ensure that staff in health, social care and early years’ settings actively help all eligible pregnant women and new parents claim their Healthy Start vouchers. This programme could indicatively be funded from the underspend from unclaimed vouchers, estimated at £28.6 million in 2018.
32.          The Government should also set in motion a public consultation on Healthy Start to support families on low income as per the second chapter of the childhood obesity plan.

Poor access to fresh fruit and vegetables vs. ultra-processed foods

33. Many communities do not have any easy access to healthy fresh fruit and vegetables, with convenience stores and hot food takeaways, focussing on heavily processed foods, the only choice for many communities. As a result, the Healthy Survey for England, National Diet and Nutrition Survey and the voluntary Family Food Survey reveal the extent of the problem. We should be eating 3.5 portions/400g of vegetables per day but 80% of children, 95% of teenagers and 80% of adults are not reaching that target. People on lower incomes eat half a portion less.
34.          Our vegetable consumption is in decline and is no better than it was in the 1970s, despite the 5-A-Day campaign. On the contrary, ultra-processed foods (often high in fat, sugar and salt as well as calories, and low in beneficial nutrients) accounts for over 50% of food purchases in the UK.

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)?

35. Healthy Start is a national scheme that offers pregnant women who are on a low income or under the age of 18, as well as children 4 years of age and under, vouchers to purchase fruit, vegetables, cow’s milk and infant formula. Promotion of the scheme is typically done by midwives, nurses, health visitors and GPs, who are required to sign off all applications forms, which are then reviewed for eligibility by the DWP. However, promotion is highly variable across local authorities, with take up of the scheme as low as 55% in some areas. On average, take up in 2018 was 64% and in some areas it may be as high as 82%.
36. The Healthy Start scheme is an excellent way for local authorities to promote healthy eating, particularly during the first few years of a child’s life, and especially among low-income families. However, local authorities are not properly supported by the DHSC to do this job effectively. There is no national promotion programme, and very limited promotional materials available (either by post or to download online). They are not offered training and many health professionals and beneficiaries report that the application process is complicated, burdensome and frequently leads to incorrect rejections from applicants. Moreover, the value of the voucher has remained £3.10 per week for 10 years, despite the rising prices of food.
37. Local authorities have an important role to play to improve access to healthy food. They control or influence food and drink in schools, nurseries, civic centres, leisure centres and others. They also control planning, public and environmental health, leisure and recreation.
38. Local authorities should improve catering under their control e.g. in schools, staff cafeteria, leisure centres, etc., and support the public and voluntary sectors to improve their food. They can achieve this by working towards the Government Buying Standards or running accreditation programmes such as Food for Life Catering Mark or Sustainable Restaurant Association and build these standards into contracts as they come up for re-tender.
39. Local authorities should design and implement healthier catering schemes to encourage outlets to switch to healthier ingredients, products, menus and cooking practices.
40. Planning and licencing law should provide specific guidance to local authority planning committees to, for example:

1. Monitor the location of new convenience stores and type to ensure all communities are able to purchase healthier foods, particularly fresh fruit and vegetables locally.
2. Deliver more community growing spaces. New developments need to provide access to community gardens/allotments.
3. Discourage the proliferation of hot food takeaways, ban those within close proximity to schools and public buildings and use licensing to encourage them to improve the standard of food sold.
4. Consider supplementary guidance for hot food takeaways, specifically in areas around schools, parks and where access to healthier alternatives is limited
5. Put in place weighted/financial support or favourable treatment in planning or access to land and premises for healthier affordable retail e.g. greengrocers, co-operatives, street markets, etc., especially in deprived areas.
6. Ensure Public Health is consulted on planning applications, including at pre-application stage

41. Local authorities should develop coherent policy on future corporate partnerships and encourage sponsorships and advertising that welcomes opportunities for investment, whilst avoiding those that promote unhealthy foods and drinks.
42. Local authorities should use influence to encourage businesses to accept Healthy Start Vouchers, and run campaigns to support healthier foods e.g. Sugar Smart, Veg Cities or Meat Free Mondays.
43. Finally, they should support, be part of and promote local voluntary and community food partnerships and projects that encourage a healthy and sustainable food culture e.g. food partnerships that sign up as a member of the Sustainable Food Cities Network.

Example one: Islington targeted approach to takeaways near secondary schools and in planning.[33]

44. The Healthier Catering Commitment was initially promoted in Islington through Hearty Lives Islington, a British Heart Foundation grant-funded project, and is now funded by Islington Council. The cost is approximately £125 per outlet plus the associated administration, monitoring and evaluation costs. There are currently over 240 businesses signed up (16 per cent of all catering outlets), serving approximately 26,600 meals a day.
45. In 2013 Islington ran a pilot targeting takeaways within 500 metres of secondary schools and of the 25 initially targeted 16 signed up. In 2014 the secondary schools project was rolled out across the whole borough. In total 90 hot food takeaways within 500 metres of 11 secondary schools are now aware of the Healthier Catering Commitment and around 70 have signed up and meet the required criteria. Businesses include pizza premises, fish and chip shops, kebab shops and sandwich bars. The work is promoted to young people through the Youth Health Forum and to schools via Junior Citizens for primary school age children and through secondary school food technology teachers.
46. In parallel, the new Supplementary Planning Document approved in April 2016 restricts the opening of new hot food takeaways within 200 metres of schools and will only grant planning/ change of use permission to outlets that have a minimum three star Food Hygiene Rating and gain the Healthier Catering Commitment award within six months.
47. Islington Council is using its procurement powers to promote further take up of the Healthier Catering Commitment. Children’s centres with cafes are contractually required to have the award and adventure playgrounds and green space concessions are expected to work towards it.

Example two: Tower Hamlets Buywell Food for Health markets project [34]

48. The Food for Health Award and Buywell were launched in Tower Hamlets in 2009 as part of the Healthy Borough Programme, a whole systems approach to tackling the environmental causes of obesity. The award scheme recognises restaurants, cafes and market traders for making small, healthy changes to the food they sell and recognising them through a three-tiered award system -standard, silver or gold. Buywell supports convenience stores to increase purchase of fruit and vegetables by improving availability, positioning and promotion.
49. The Buywell Food for Health markets project builds on these schemes and supports market traders to increase their fruit and veg sales by providing them with the help of a retail and marketing expert who works with them to help grow their business and boost their sales. By improving the quality, range and freshness of their produce, displays, pricing and promotions, sales have increased by nearly £1.5M a year through the Buywell Food for Health project.
50. Traders can then be assessed for a Food for Health Award. To qualify for a standard award, fruit and veg stalls must increase by 40% compared to sales before joining the scheme, for silver they must develop a partnership with the local community where appropriate (for example by supplying the local school tuck shop) and gold winners have to demonstrate innovation.
51. A pilot started in 2015 to help low-income families buy more fresh fruit and vegetables from their local market by supporting traders to accept the government’s Healthy Start Vouchers. This scheme provides £3.10 or £6.20 a week to families which can be spent on healthier produce. The pilot project focused on two gold Food for Health fruit and vegetable stall traders in Chrisp Street Market. This is one of four Buywell markets across the borough located in a deprived area, who had been struggling to survive financially. The pilot was funded by the Mayor of London’s High Street Fund. The £3,440 budget covered retail advice to traders, support with setting them up in terms of systems and processes, banners and posters. It also provided support to, and gained support from, parent volunteers from the local children’s centre who undertook targeted outreach to spread the word to families and friends and encourage them to spend vouchers in the market.
52. After the six-month pilot, the project continues to grow and has proved its sustainability. The scheme offers great quality affordable and easily accessible fruit and vegetables to identified low income families. Traders are benefiting from a marketing campaign that brings them new customers, estimated to be worth £20,000 per annum.

Example three: 365 days of school lunches in North Lanarkshire and Glasgow [35]

53. North Lanarkshire and Glasgow City Council both recently committed to providing school lunches all year round. In North Lanarkshire, in 2018-2019 Budget discussions, Councillors approved plans to provide free meals for children in low-income households every day of the year. The Food 365 programme will cover the 175 days of the year when pupils are not at school during weekends and school holidays. A pilot project will take place in Coatbridge during the 2018 spring break and, following an evaluation, the programme would then be extended to cover the whole of North Lanarkshire in time for the summer holidays. Based on a successful pilot, the programme will be delivered in 23 'hubs' across the authority area, usually in community facilities. Based on demand for other previous holiday initiatives, the cost is estimated to be half a million pounds.
54. Residents in both areas have high obesity rates and low consumption of vegetables so it is expected that lunches will provide much needed quality meals and to those that need it the most.
55. In its budget proposal for 2018-2019, Glasgow City Council allocated £1.5m to extend free school meals to every pupil in Primary 4 in publicly funded schools, and £2m for a programme to provide free meals for children from low-income families during school holidays. Since 2015, all children in primaries 1, 2 and 3 have been entitled to a free meal (after that, many had to start paying).

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

56.         The UK has the fifth largest economy in the world, a stable food supply through both domestic production and imports, yet an estimated 8.4 million people are food insecure.[36]
57.         It is neither realistic nor feasible to expect the charitable sector to fill in the gaps left by the work and welfare system. As elaborated in our response to question 1, wages and welfare payments are not keeping up with living costs. Food aid will not be able to tackle the underlying issues that are causing food insecurity.
58.         It is important that the focus be put upon efforts that tackle the overarching policies that cause poverty and hardship. Department for the Environment Food and Rural Affairs commissioned research found that whilst food banks provide immediate relief to hunger they have a limited impact on household food insecurity levels.
59.         Food banks and other charitable food aid organisations can play a valuable role within local food poverty alliances, food partnerships or other networks to develop a joined-up plan to reducing food poverty in their area, including by taking action on the root causes of food poverty (where action can be taken at the local level). Many food aid organisations are actively involved in food poverty alliances supported by the Food Power programme, London Food Poverty Campaign and other programmes. There are multiple examples of their positive work building alliances[37] and developing food poverty action plans (or a similar set of actions).[38] Plans have contributed to a wide range of positive impacts.[39] Notably, they usually take an upstream, positive approach to tackling the root causes of food poverty and practical interventions to address this, thinking and acting ‘Beyond the Food Bank’ (Sustain-led programme in London)[40] by, for example:
1. Improving the uptake of Healthy Start vouchers
2. Promoting breastfeeding via the Baby Friendly Initiative
3. Harnessing the value of children’s centres
4. Ensuring low-income families have adequate access to childcare
5. Ensuring children’s access to food 365 days a year
6. Becoming a (real) Living Wage employer and promoting the (real) Living Wage
7. Ensuring all residents have physical access to good food
8. Supporting and enhancing meals on wheels provision
9. Supporting financial advice services and providing crisis support
10. Developing an action plan to tackle food poverty

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?

60. There is a growing body of evidence of the association between exposure to food advertising on TV and online, and children’s increased preferences for, and purchase and consumption of foods high in fat, salt and sugar. Most recently a study by Cancer Research UK & University of Liverpool found that children who can recall seeing unhealthy food and drink adverts on television every day are twice as likely to be obese than children who do not recall such adverts[41]. Further evidence from these same partners suggests that children who are online for more than 3 hours per day are four times more likely to purchase unhealthy food and drink than those who use the internet for little or no time. The Government’s own consultation document on introducing price and location promotion restrictions indicated a potential £3.1 billion saving in public health impact costs if promotions of HFSS products were restricted, resulting in fewer impulse and multi-buy purchases and excess calorie consumption associated with these. In relation to low income groups, PHE has indicated in its own research that price promotions typically encourage people to spend more, rather than saving people money[42]. Cancer Research UK analysis of Kantar Worldpanel data[i] indicates high users of HFSS promotions tend on average to purchase more unhealthy food and drink, an average of 11 HFSS products per month for a typical family of 2 adults and 2 children, compared to low promotional users.
61. The Food Foundation analysed data on advertising spend in the UK from January 2010 to June 2016 and found only 1.2 per cent of food advertising spend went to vegetables. Most went to foods high in sugar, fat or salt such as cakes, biscuits and soft drinks. Junk food companies spend 27 times more on advertising than the Government does on promoting healthy eating, and the role of advertising in driving us towards unhealthy foods cannot be underestimated.
62. In a survey of members of the Children’s Food Campaign Parents’ Jury in 2018, 56% cited TV advertising as the marketing tactic they were most concerned about (given a choice of 3 options), and nearly 9 in 10 (87%) agreed that the Government should introduce a 9pm watershed on advertising unhealthy foods. The second most popular action supported by parents would be a ban on the use of child-friendly TV and film characters on unhealthy foods[43]. An Obesity Health Alliance/YouGov national public poll in February 2019 also revealed that 72% of adults support the introduction of a 9pm watershed on TV[44]

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?

63. If vegetable consumption increased in line with dietary guidance, the UK would have the chance to grow more vegetables, which would contribute to the economic growth of the sector.
64. At the city level, small-scale community food growing and urban agriculture projects can contribute to increased access to vegetables as well as provide benefits to the individual for mental health and wellbeing and levels of physical activity. They can encourage the growth of local food economies and develop skills and the improved employability amongst participants.
65.          Urban agriculture has a huge potential to produce a lot more vegetables. A recent study using Google’s Earth Engine software, as well as population, meteorological, and other datasets, determined that if fully implemented in cities around the world, urban agriculture could produce as much as 180 million metric tons of food a year—perhaps 10 percent of the global output of legumes, roots and tubers, and vegetable crops.[45]

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?

66.         Whilst voluntary industry sugar and salt reduction programmes are off-track in meeting targets, the introduction of the Soft Drinks Industry Levy in April 2018 had removed an estimated 90 million kg of sugar through reformulation by the April 2019 (an estimated 45 million kg per year), and is forecast by the OBR to raise an estimated £340 million income for investment in children’s health – therefore £1.37 billion over the next four years to 2024. However a commitment to continue ring fencing the income from the levy for child health is dependent on the next Comprehensive Spending Review (whilst no mention of this income was made in the spending round announced in September 2019).
67.         Extending the soft drinks industry levy to include milk-based sugary drinks, which are currently excluded, would close one loophole contributing to excess sugar in diets. For other sugary products, such as confectionery, biscuits and cakes, rather than a sugar levy, it may be more appropriate to introduce similar fiscal levers on the basis of calories or energy density, recognising the interaction of both fat and sugar in these products and the difficulty of reformulation compared with soft drinks. A recent research study led by the London School of Tropical Hygiene and Medicine suggested that a ‘snack tax’ which delivered a 20% increase in the price of biscuits, cakes, chocolate and sweets, could lead to a reductions in consumption of these items equivalent to 8900 kcal per year, equivalent to 1.3kg in weight[46].

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?

68.          Other countries appear to have a more coordinated response to ensuring older people’s access to food. In autumn 2019, Simon Shaw, Food Power Programme Coordinator at Sustain will travel to France, Italy and South Korea to explore provision as part of his Winston Churchill Memorial Trust Fellowship.[47] Simon would be very happy to share his findings with the Committee on his return.

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?

69. The UK has ratified a number of international treaties that proclaim the right to food, but this human right has not yet been incorporated into UK national law.
70. Sustain is working with the Institute for Health and Society at the University of Newcastle, Just Fair and the Nourish Scotland network to champion formal adoption of the Right to Food into UK law. We have been undertaking advocacy work to prompt uptake of this approach with a broad range of academics, civil-society organisations, policy-makers and others.
71. The adequate recognition of the Right to Food domestically would, for example, help embed measurement of household food insecurity; give vulnerable people and their advocates the right to demand action on factors affecting people’s personal circumstances (e.g. wages; housing and energy prices; and eliminating the ‘poverty premium’); put a duty on local and national authorities to take practical steps and provide adequate resources to improve incomes long-term, as well as help people through crisis; and trigger a requirement for provision of helpful and dignified support, facilities and services (e.g. breastfeeding support, free school meals, meals on wheels), as well as the necessary funding and other resources to achieve these.
72. In fact, the UN made important recommendations in this regard, on the UK’s progress on key Right to Food measures, noting that:

“The Committee [of the UN on Economic, Social and Cultural Rights] is concerned about the lack of adequate measures adopted by the State party [UK] to address the increasing levels of food insecurity, malnutrition, including obesity, and the lack of adequate measures to reduce the reliance on food banks”[48]

73. The Committee went on to recommend specific action to: promote and ensure improved access to healthier diets; support breastfeeding; introduce more fiscal measures to reduce junk foods and sugary drinks; consider adopting strict regulations on the marketing of such products; and to take action to achieve progressive realisation of the right to adequate food in the context of national food security.
74. Improving household food security is a cross-departmental responsibility, and requires action by many players, at national and local level. Any legislation seeking to apportion duties and responsibilities must take into account the ‘multiple actor’ and balanced nature of this work.
75. There are also duties and responsibilities that are applicable to local authorities. The Right to Food legislation should also set out requirements for local authorities to act, and provision for how the flow of resources, responsibilities and reporting requirements will relate to the national Right to Food Strategy. The types of responsibilities that could be placed on local authorities (given the adequate resources to fulfil them) are illustrated by the suite of measures that Sustain has for several years measured as part of our London Food Poverty programme, measuring and comparing the progress of London boroughs for their implementation of practical action to alleviate food poverty.[49] These include, for example, adopting a local food poverty action plan; paying the London Living Wage; promoting uptake of Healthy Start fruit, vegetables and milk vouchers for low-income pregnant women and children; providing meals on wheels services; supporting schools to provide free school meals for children from low-income families, and more.
76. Further, we note that in the UK, political support for the Right to Food has recently leapt forward, with commitments from the Labour Party, Co-op Party, Lib Dem Party and the Scottish Government to adopt the Right to Food into law, see: https://www.sustainweb.org/news/sep19_political_support_for_right_to_food_leaps_forward/, and commitments with similar effect are also evident in Wales. The Government’s new National Food Strategy, launched in 2019, provides an opportunity to secure such this approach in UK-wide strategy and implementation.
77. It is also worth noting and underlining that the Right to Food is widely understood as being primarily about ending food poverty and hunger. However, we note that the path provided by the Right to Food takes us further than this, to more fundamental system-wide changes related to ‘food sovereignty’ – access to land, a safe and secure food supply, and sustainable production that ensures good food, protects natural resources and means decent and secure livelihoods for the food producers upon whom we all depend. Securing a universal Right to Food, for everyone and for future generations to enjoy, requires a fundamental review of the way we treat food production, from farm to fork. Fully realised, the Right to Food is as much about the well-being of the soil, water, climate, pollinators and sustainable farm livelihoods as it is about citizens who eat the food. We welcome the fact that the National Food Strategy process launched in 2019 signals in its terms of reference that it will look at this more systems-wide approach – a welcome signal that the National Food Strategy – as well as the Agriculture Bill, Fisheries Bill and other key post-Brexit policies - can and must deliver a food system that is good for people and planet, and play its part in addressing climate and nature emergency.
78.          Sustain’s Right to Food programme would be pleased to offer a specialist session for the House of Lords Select Committee on Food, Poverty, Health & the Environment, in order to understand the transformative role that a Right to Food approach could unlock, to address the root causes of food poverty, inequality, and sustainability issues in the food system. We are able to connect the Committee with food aid, food poverty, poverty, legal, rights and other practitioners, as well as academics who specialise in this area. We think this could be a lively and informative session bringing a fresh new approach to unlocking persistent systemic problems, for good.

Kath Dalmeny Chief Executive, Sustain Alliance

Imogen Richmond-Bishop, Coordinator of the Right to Food Campaign, Sustain Alliance

The Sustain alliance is a registered charity (number 1018643) and a company limited by guarantee, which is registered in England and Wales (number 02673194).

Sustain: The Alliance for Better Food and Farming

28 September 2019

17