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Food and anti-poverty campaigners are calling on the government to “get a grip” on the NHS Healthy Start scheme after it was revealed that Ministers do not know how a major reform to digitise the programme has impacted its effectiveness.
The news is of deep concern to campaigners as families have reported significant issues with the roll-out of the new digital system which, in some instances, has left them unable to purchase healthy food.
Healthy Start
Healthy Start was introduced in 2006, and provides women in England, Wales and Northern Ireland who are at least ten weeks pregnant – and parents with a child aged under four – with support towards the cost of milk, fruit, vegetables, pulses and vitamins, if they are in receipt of qualifying benefits.
The scheme does this by contributing £4.25 per week for pregnant women and children aged between one and four – rising to £8.50 per week if parents have a child under one. Healthy Start has been credited with helping to improve the dietary intake of households whilst reducing health inequalities.
In September 2021, Ministers began to replace old-style Healthy Start paper vouchers with new, prepaid cards which are automatically topped up every four weeks with each family’s entitlement and should be able to be used towards eligible items in any shop accepting Mastercard. The paper voucher scheme ended completely on 31 March this year, with full digitisation of Healthy Start implemented from 1 April.
Bungled rollout
Despite families on low incomes being at the sharpest end of the cost-of-living crisis, answers to questions tabled in Parliament have revealed Ministers have no idea what impact the digitisation of Healthy Start has had on take-up of the scheme, some six months after it was fully introduced.
This admission follows extensive problems reported by families during the “bungled” rollout of the prepaid card system, described as “devastating and humiliating” for those seeking to use them. These problems have included parents having to ‘split’ their trolley of purchases at the checkout; cards frequently being declined at tills; shop staff being unfamiliar with the new payment cards; significant challenges in contacting a government helpline to resolve issues; and families having to use food banks as a result of these problems.
National Director of Feeding Britain, Andrew Forsey, said:
“The Healthy Start scheme offers vital support to young families, and its role is more important than ever as low income parents and carers are grappling with the soaring costs of household essentials like food.
“But for some families Healthy Start clearly hasn’t been functioning as it should, and it staggering that – in the midst of the biggest cost of living crisis in a generation – Ministers still have no idea how their digitisation of the scheme is impacting families’ ability to access it, some six months after it was implemented.
“The government must urgently get a grip on this issue, and ensure all families are receiving the support they are entitled to.”
Anna Turley
Anna Turley, Chair of the North East Child Poverty Commission, added:
“The cost of living crisis is hitting the poorest families hardest, particularly in places like the North East – where almost half of our region’s youngest children were living below the poverty line even before the Covid pandemic hit.
“When Healthy Start is one of the government’s flagship schemes for supporting families on a low income, Ministers have a duty to ensure it is actually working. Yet it’s not clear they even know how digitisation has affected take-up, or what they have been doing to put things right.
“This simply isn’t good enough when families across the country are struggling to put food on the table.”
Professor Greta Defeyter
Professor Greta Defeyter, Director of the Healthy Living Lab at Northumbria University, a Trustee of Feeding Britain and member of the North East Child Poverty Commission, explained:
“The earliest years of a child’s life are absolutely crucial for their development, and can shape their future physical health, wellbeing and life chances, so it’s vital the government ensures that the Healthy Start scheme works well.
“Our research has shown that the new digital scheme has not been working for far too many families – and many of the problems that have arisen with the new prepaid cards could have been avoided had the government listened to, and worked with, families entitled to this support to co-design its implementation.
“It’s also unclear why moving to a digital scheme appears to have made it harder for Ministers to know what is happening with Healthy Start take-up than it was under the old paper voucher system.”
Catherine McKinnell MP
And Catherine McKinnell, MP for Newcastle North, whose Parliamentary questions revealed the lack of information on Healthy Start, said:
“For months, I have been asking the government what impact the rollout of the new prepayment cards has had on the take-up of Healthy Start – and Ministers have been repeatedly unable to answer what should be a simple question about one of their main schemes to support families on a low income.
“It’s totally unacceptable that families have had to turn food banks as a result of the problems caused by the changes to Healthy Start. We need to know that the government is on top of this issue as household bills, and the number of families facing serious hardship, continue to rise.”
Longstanding concerns about the take-up rates of Healthy Start have also led to calls by campaigners, including the charity Feeding Britain and the North East Child Poverty Commission, for the government to find a way to use the data it already has to ensure all eligible families are automatically registered for the programme.
This would significantly simplify the scheme for parents and carers who, at present, must be aware of – and apply for – Healthy Start, with local authorities, health and early years professionals spending considerable time and resources to identify eligible families and support them with the application process. Despite those efforts, it is estimated that millions of pounds of Healthy Start vouchers are going unclaimed each month.

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