Why stop at breakfast? We paediatricians think all of England’s primary pupils should have lunch for free

As a nation, we are at a crossroads with child health. Waiting lists are soaring and children now make up three-quarters of all patients who wait more than a year for community health services. When they are eventually treated, their symptoms are more chronic and complex.
As a paediatrician, and the president of the Royal College of Paediatrics and Child Health (RCPCH), I have watched with horror as this all unfolds. The cost of living crisis has dragged down the health of our children. One in five parents say that because of the cost of living crisis, their children’s physical health has suffered. It is no surprise to me that the number of children with eight or more chronic health conditions doubled from 7.6% in 2012 to 14% in 2018.
Last year, nearly half of school nurses said they dealt with children suffering due to a lack of healthy food on a daily or weekly basis. One tragic fact that really exposes the parlous state of our children’s health is that removing decayed teeth is the most common operation in the UK for children. The leading cause of tooth decay is poor diet. Meanwhile, the growth of a generation has, quite literally, been stunted after an extended period of austerity: British five-year-olds are shorter compared with their peers in Europe.
Of course, only a wide range of measures encompassing diet, housing and education can reverse this awful trend. But there is one policy that will provide significant and long-lasting benefits to our children: the extension of free school meals for every primary school child.
That’s why the RCPCH, and the 23,000 paediatricians I represent, have joined the National Education Union’s No Child Left Behind campaign. Paediatricians have welcomed Labour’s commitment to introducing free school breakfasts for all primary school children in England, and we hope this rollout will begin without delay. It is a good start – but it’s not enough.
But in England we have a job half done. Free school meals are universal in reception, year 1 and year 2. But from year 3 this stops, and millions of children miss out on a healthy, hot school lunch. There is no medical reason to deny the scheme to children at this age.
Earlier this year, we saw the London mayor, Sadiq Khan, commit to a permanent extension of free school meals for all, because the evidence showed that when pupils have a hot, nutritious meal in school every day, almost every key health and education indicator went up. Wales has also completed a rollout of universal free school meals in primary schools – proving there are plenty of examples for the government to follow elsewhere.
As doctors, we know – and it is also common sense – that prevention is better than cure. Many lifelong physical and mental health issues are established when children grow up with unaddressed ill health and multiple morbidities. Healthy habits start early. To prevent lifelong chronic health issues, why not start with interventions in childhood? It is just common sense. By supporting children to have healthy food at school, we are supporting them to have a healthy life today and tomorrow.
If we are to make Britain “the best country to grow up in and the best country to grow old in”, as Keir Starmer so boldly envisions, this government must take swift action to reverse years of deteriorating child health. Where past governments have failed, Labour can break the mould. We need free school meals for all now.