UK NGOs urge government to extend Healthy Start Scheme to migrant and refugee families

21 Nov 2023 --- Sustain and the Food Foundation are appealing to the UK government for an extension of the Healthy Start Scheme to include migrant and refugee families facing destitution. The call is in response to a Sustain survey revealing alarming malnutrition rates among such communities.

“The vast majority of migrant and refugee families with no recourse to public funds (NRPF) are not eligible for Healthy Start,” Vera Zakharov, sustainable food places campaign co-ordinator at Sustain, tells Nutrition Insight.

NRPF is an immigration restriction affecting an estimated 1.4 million people and 175,000 children residing in the UK. Some asylum seekers included in this figure sometimes have to wait years while their case is pending.

The survey of frontline health service workers and representatives from community organizations conducted by Sustain found reduced nutrition and caloric intake, exacerbated by the rising cost of food, to be the most significant concern in such communities. Nearly 90% of respondents believe that the Healthy Start Scheme should be extended, 58% of respondents can only support families by securing additional resources or volunteers, and 18% of respondents said they cannot meet the level of need at all.

An estimated 1.4 million people and 175,000 children residing in the UK cannot access the Healthy Start Scheme because of their immigration status.Sustain and the Food Foundation have sent a letter to the minister of Primary Care and Public Health, Andrea Leadsom, calling for children in migrant and refugee low-income NRPF households to be granted permanent access to the nation’s Healthy Start Scheme.

Determining eligibility
Zakharov explains that one of the challenges is that most eligible families are unaware they can apply. “Indeed, most frontline health professionals are unaware of this application pathway either.”

“The Scheme extension for families with British National children is not very well promoted by the Department of Health and Social Care (DHSC) or the National Healthcare Service Business Services Authority (NHS BSA) who run the Healthy Start Scheme.”

“The second challenge is that families with a child who is a British National can apply via a special application process directly with the DHSC, but it’s not easily comprehensible what makes an infant or a child automatically a British National,” she says.

She argues that it needs to be more readily apparent even to health professionals who can or cannot apply, which makes it difficult to offer adequate and immediate application support.

“Lack of clarity around waiting times and application status further creates a sense of confusion and uncertainty. For families already experiencing the impacts of long waits and lack of transparency on their immigration status decisions, it’s disheartening that they have to experience this again when applying for Healthy Start and potentially get their hopes up needlessly.”

Nearly half of the frontline staff surveyed found the application criteria and process needed to be completed. One respondent said it is challenging to support a family to sign up as they need to have all relevant documents on hand to prove nationality, so it requires repeated meetings to support them to apply. 

“Also there is no timeline for approval or rejection of applications, so families are left in the dark about whether they will be successful in applying. The application process is longer than the standard Healthy Start Scheme online application process,” Zakharov adds.

Effects on mothers and children 
The survey further highlights staggering levels of destitution among pregnant mothers and children, with charities stating that they are struggling to meet the escalating needs.

“Several survey respondents noted that they are seeing reduced nutrition among pregnant mothers and children due to relying on limited hotel food and little other food support otherwise,” continues Zakharov.

“One respondent stated that a parent had to skip meals to make their limited food support go further to feed their children. Another respondent noted that some families resorted to taking food out of waste bins to feed their families. Another cited the mental and emotional impact of families unable to cook and enjoy meals together as a result of their circumstances. These cases, on top of the ongoing mental health impacts of navigating the asylum process, clearly put a further strain on families’ mental well-being.”

The Healthy Start Scheme is an initiative providing funds and essentials such as fruit, vegetables, milk formula and multivitamin supplements for low-income pregnant women and young children. 

Campaigning for change
The Sustain survey highlights staggering levels of destitution among pregnant mothers and children.Sustain and Food Foundation’s letter addressed to Andrea Leadsom has been signed by 148 signatories representing NGOs, local governments and it emphasizes the difficult situation of children from households with NRPF.

“In the short term, we want to see clear and publicly accessible information from NHS BSA on what documents are needed to apply for the Scheme extension and adequate promotion of the Scheme extension to health professionals,” alerts Zakharov.

“In the medium term, we want to see the Healthy Start Scheme extended to all low-income families regardless of immigration status and do away with the current process, which is complicated and creates a false sense of hope for many ineligible families.”

Zakhatov further points out that for the past two years, Sustain has been awaiting an update from the Department of Health on the consultation to permanently expand the Scheme to all low-income families with no recourse to public funds. “We hope our open letter on behalf of local and national organizations will finally result in the promised consultation.”

“We will be working with the Food Foundation and other organizations in our alliance to use every opportunity to obtain an update. We expect a formal response to our letter from Dame Andrea Leadsom, which we expect will shed light on timelines for the consultation. We will continue campaigning with our network, as it is abundantly clear that some of the most vulnerable and destitute families in our communities urgently need nutritional safety nets.” 

By Milana Nikolova