---

Healthy Start Scheme and Welfare Food (Amendment) Regulations 2005

My Lords, I shall respond briefly to the points raised in this debate on these important regulations. On the alleged new burdens on midwives and health visitors, they, after all, already see pregnant women now and are best placed to give advice about a healthy diet, which is the purpose of this scheme. We have discussed these issues with their professional bodies. It is worth bearing in mind that, if I may gently say to the noble Lord, Lord Chan, that the number of midwives is increasing, a time when the birth rate has been falling. So these issues have been actively considered. Why Devon and Cornwall? I shall not reply ““Why not?”” The selection of Devon and Cornwall for phase 1 was based on three main criteria. First, it is geographically self-contained, with borders that do not cut across large urban communities; secondly, it includes a mixture of current approaches to the supply of infant formula through the Welfare Food Scheme; and, thirdly, it includes both urban and rural areas and pockets of deprivation as well as larger identifiable disadvantaged populations. There will be some degree of involvement in the scheme by people from black and minority ethnic groups. We will of course closely monitor that after wider roll-out of the scheme. On the issue of the value of the voucher—why £2.80?—the amount equates to the average cost of seven pints of liquid milk provided through the existing Welfare Food Scheme. It was decided not to vary this value from the average cost of seven pints of milk to ensure equity with people on the Welfare Food Scheme outside Devon and Cornwall. But, as part of the evaluation of phase 1, the voucher value and the quantity of Healthy Start foods purchased with it are intended to be examined. Will the voucher amount be increased at the rate of inflation? We intend to regularly review the value of vouchers and we will increase it in line with the increase in the retail prices of foods available through the Healthy Start scheme. Picking up on a point made by the noble Lord, Lord Chan, we will of course look at the types of food that are appropriate. The noble Baroness, Lady Morris, raised the issue of babies who do not feed well or who may not be able to tolerate cows’ milk. Healthy Start, like the Welfare Food Scheme, is designed to meet the nutritional needs of healthy pregnant women, babies and children. If a baby has a specific health problem with the mother, a health professional should be consulted, and specialist infant formulas can be prescribed through the NHS if there is a clear medical need for them. NHS prescriptions are, of course, free for all children. The noble Baroness, Lady Barker, asked why asylum seekers were not included under the Healthy Start scheme. They are not included because their needs are currently met by the National Asylum Support Service—and this principle has been reinforced by the High Court. We are keeping NASS informed of our plans for implementation of the Healthy Start scheme, so that it can review the support it gives to asylum seekers who are pregnant or have young children, and modify it as appropriate. Soya-based products are excluded from the scheme on the basis of expert medical advice that they are not as nutritionally adequate as cows’ milk. Soya drinks are low in energy, compared with cows’ milk, and lack several vitamins and minerals. Never let it be said that I do not bring education to this House. The issue of retailer monopoly was raised by the noble Baroness, Lady Barker. Registration is open to any retailer selling one or more relevant products, and we will encourage the widest range of retailers to take part, to provide choice and greater accessibility. Vouchers, in most instances, must be exchanged for goods to their full value in order to ensure that the voucher is exchanged for only Healthy Start foods. Regulation 13 applies especially to milkmen, who may take the voucher and provide milk throughout the week. We understand the concerns of the dairy industry. There is already a decline in the number of milk-round men in general outside the changes proposed by the Welfare Food Scheme, but we will keep things under control. I believe that the changes set out in these regulations will help us better to support the nutritional needs of low-income families. On those points I have not been able to respond to I will write to noble Lords. In the mean time, I commend the regulations to the House, and I hope that we can approve them. On Question, Motion agreed to.