Tag Archives: health

On the Boundaries of Being Human and Big Data

Atlas, the Boston Dynamics created robot, won hearts and minds this week as it stoically survived man being mean.  Our collective human response was an emotional defence of the machine, and criticism of its unfair treatment by its tester.

Some on Twitter recalled the incident of Lord of The Flies style bullying by children in Japan that led the programmers to create an algorithm for ‘abuse avoidance’.

The concepts of fairness and of decision making algorithms for ‘abuse avoidance’ are interesting from perspectives of data mining, AI and the wider access to and use of tech in general, and in health specifically.

If the decision to avoid abuse can be taken out of an individual’s human hands and are based on unfathomable amounts of big data, where are its limits applied to human behaviour and activity?

When it is decided that an individual’s decision making capability is impaired or has been forfeited their consent may be revoked in their best interest.

Who has oversight of the boundaries of what is acceptable for one person, or for an organisation, to decide what is in someone else’s best interest, or indeed, the public interest?

Where these boundaries overlap – personal abuse avoidance, individual best interest and the public interest – and how society manage them, with what oversight, is yet to be widely debated.

The public will shortly be given the opportunity to respond to plans for the expansion of administrative datasharing in England through consultation.

We must get involved and it must be the start of a debate and dialogue not simply a tick-box to a done-deal, if data derived from us are to be used as a platform for future to “achieve great results for the NHS and everyone who depends on it.”

Administering applied “abuse avoidance” and Restraining Abilities

Administrative uses and secondary research using the public’s personal data are applied not only in health, but across the board of public bodies, including big plans for tech in the justice system.

An example in the news this week of applied tech and its restraint on human behaviour was ankle monitors.  While one type was abandoned by the MOJ at a cost of £23m on the same day more funding for transdermal tags was announced in London.

The use of this technology as a monitoring tool, should not of itself be a punishment. It is said compliance is not intended to affect the dignity of individuals who are being monitored, but through the collection of personal and health data  will ensure the deprivation of alcohol – avoiding its abuse for a person’s own good and in the public interest. Is it fair?

Abstinence orders might be applied to those convicted of crimes such as assault, being drunk and disorderly and drunk driving.

We’re yet to see much discussion of how these varying degrees of integration of tech with the human body, and human enhancement will happen through robot elements in our human lives.

How will the boundaries of what is possible and desirable be determined and by whom with what oversight?

What else might be considered as harmful as alcohol to individuals and to  society? Drugs? Nictotine? Excess sugar?

As we wonder about the ethics of how humanoids will act and the aesthetics of how human they look, I wonder how humane are we being, in all our ‘public’ tech design and deployment?

Umberto Eco who died on Friday wrote in ‘The birth of ethics’ that there are universal ideas on constraints, effectively that people should not harm other people, through deprivation, restrictions or psychological torture. And that we should not impose anything on others that “diminishes or stifles our capacity to think.”

How will we as a society collectively agree what that should look like, how far some can impose on others, without consent?

Enhancing the Boundaries of Being Human

Technology might be used to impose bodily boundaries on some people, but tech can also be used for the enhancement of others. retweeted this week, the brilliant Angel Giuffria’s arm.

While the technology in this case is literally hands-on in its application, increasingly it is not the technology itself but the data that it creates or captures which enables action through data-based decision making.

Robots that are tiny may be given big responsibilities to monitor and report massive amounts of data. What if we could swallow them?

Data if analysed and understood, become knowledge.

Knowledge can be used to inform decisions and take action.

So where are the boundaries of what data may be extracted,  information collated, and applied as individual interventions?

Defining the Boundaries of “in the Public Interest”

Where are boundaries of what data may be created, stored, and linked to create a detailed picture about us as individuals, if the purpose is determined to be in the public interest?

Who decides which purposes are in the public interest? What qualifies as research purposes? Who qualifies as meeting the criteria of ‘researcher’?

How far can research and interventions go without consent?

Should security services and law enforcement agencies always be entitled to get access to individuals’ data ‘in the public interest’?

That’s something Apple is currently testing in the US.

Should research bodies always be entitled to get access to individuals’ data ‘in the public interest’?

That’s something care.data tried and failed to assume the public supported and has yet to re-test. Impossible before respecting the opt out that was promised over two years ago in March 2014.

The question how much data research bodies may be ‘entitled to’ will be tested again in the datasharing consultation in the UK.

How data already gathered are used in research may be used differently from it is when we consent to its use at colllection. How this changes over time and its potential for scope creep is seen in Education. Pupil data has gone from passive collection of name to giving it out to third parties, to use in national surveys, so far.

And what of the future?

Where is the boundary between access and use of data not in enforcement of acts already committed but in their prediction and prevention?

If you believe there should be an assumption of law enforcement access to data when data are used for prediction and prevention, what about health?

Should there be any difference between researchers’ access to data when data are used for past analysis and for use in prediction?

If ethics define the boundary between what is acceptable and where actions by one person may impose something on another that “diminishes or stifles our capacity to think” – that takes away our decision making capacity – that nudges behaviour, or acts on behaviour that has not yet happened, who decides what is ethical?

How does a public that is poorly informed about current data practices, become well enough informed to participate in the debate of how data management should be designed today for their future?

How Deeply Mined should our Personal Data be?

The application of technology, non-specific but not yet AI, was also announced this week in the Google DeepMind work in the NHS.

Its first key launch app co-founder provided a report that established the operating framework for the Behavioural Insights Team established by Prime Minister David Cameron.

A number of highly respected public figures have been engaged to act in the public interest as unpaid Independent Reviewers of Google DeepMind Health. It will be interesting to see what their role is and how transparent its workings and public engagement will be.

The recent consultation on the NHS gave overwhelming feedback that the public does not support the direction of current NHS change. Even having removed all responses associated with ‘lefty’ campaigns, concerns listed on page 11, are consistent including a request the Government “should end further involvement of the private sector in healthcare”. It appears from the response that this engagement exercise will feed little into practice.

The strength of feeling should however be a clear message to new projects that people are passionate that equal access to healthcare for all matters and that the public wants to be informed and have their voices heard.

How will public involvement be ensured as complexity increases in these healthcare add-ons and changing technology?

Will Google DeepMind pave the way to a new approach to health research? A combination of ‘nudge’ behavioural insights, advanced neural networks, Big Data and technology is powerful. How will that power be used?

I was recently told that if new research is not pushing the boundaries of what is possible and permissible then it may not be worth doing, as it’s probably been done before.

Should anything that is new that becomes possible be realised?

I wonder how the balance will be weighted in requests for patient data and their application, in such a high profile project.

Will NHS Research Ethics Committees turn down research proposals in-house in hospitals that benefit the institution or advance their reputation, or the HSCIC, ever feel able to say no to data use by Google DeepMind?

Ethics committees safeguard the rights, safety, dignity and well-being of research participants, independently of research sponsors whereas these representatives are not all independent of commercial supporters. And it has not claimed it’s trying to be an ethics panel. But oversight is certainly needed.

The boundaries of ownership between what is seen to benefit commercial and state in modern health investment is perhaps more than blurred to an untrained eye. Genomics England – the government’s flagship programme giving commercial access to the genome of 100K people –  stockholding companies, data analytics companies, genome analytic companies, genome collection, and human tissue research, commercial and academic research,  often share directors, working partnerships and funders. That’s perhaps unsurprising given such a specialist small world.

It’s exciting to think of the possibilities if, “through a focus on patient outcomes, effective oversight, and the highest ethical principles, we can achieve great results for the NHS and everyone who depends on it.”

Where will an ageing society go, if medics can successfully treat more cancer for example? What diseases will be prioritised and others left behind in what is economically most viable to prevent? How much investment will be made in diseases of the poor or in countries where governments cannot afford to fund programmes?

What will we die from instead? What happens when some causes of ‘preventative death’ are deemed more socially acceptable than others? Where might prevention become socially enforced through nudging behaviour into new socially acceptable or ethical norms?

Don’t be Evil

Given the leading edge of the company and its curiosity-by-design to see how far “can we” will reach, “don’t be evil” may be very important. But “be good” might be better. Where is that boundary?

The boundaries of what ‘being human’ means and how Big Data will decide and influence that, are unclear and changing. How will the law and regulation keep up and society be engaged in support?

Data principles such as fairness, keeping data accurate, complete and up-to-date and ensuring data are not excessive retained for no longer than necessary for the purpose are being widely ignored or exempted under the banner of ‘research’.

Can data use retain a principled approach despite this and if we accept commercial users, profit making based on public data, will those principles from academic research remain in practice?

Exempt from the obligation to give a copy of personal data to an individual on request if data are for ‘research’ purposes, data about us and our children, are extracted and stored ‘without us’. Forever. That means in a future that we cannot see, but Google DeepMind among others, is designing.

Lay understanding, and that of many climical professionals is likely to be left far behind if advanced technologies and use of big data decision-making algorithms are hidden in black boxes.

Public transparency of the use of our data and future planned purposes are needed to create trust that these purposes are wise.

Data are increasingly linked and more valuable when identifiable.

Any organisation that wants to future-proof its reputational risk will make sure data collection and use today is with consent, since future outcomes derived are likely to be in interventions for individuals or society. Catching up consent will be hard unless designed in now.

A Dialogue on the Boundaries of Being Human and Big Data

Where the commercial, personal, and public interests are blurred, the highest ethical principles are going to be needed to ensure ‘abuse avoidance’ in the use of new technology, in increased data linkage and resultant data use in research of many different kinds.

How we as a society achieve the benefits of tech and datasharing and where its boundaries lie in “the public interest” needs public debate to co-design the direction we collectively want to partake in.

Once that is over, change needs supported by a method of oversight that is responsive to new technology, data use, and its challenges.

What a channel for ongoing public dialogue, challenge and potentially recourse might look like, should be part of that debate.

Free School Meals: A political football and the need for research to referee

I wrote this post in July 2014, before the introduction of the universal infant free school meals programme (UIFSM) and before I put my interest in data to work. Here’s an updated version. My opinion why I feel it is vital that  public health and socio economic research should create an evidence base that justifies or refutes policy. 

I wondered last year whether our children’s health and the impact of UIFSM was simply a political football, which was given as a concession in the last Parliament, rushed through to get checked-off, without being properly checked out first?

How is UIFSM Entitlement Measured and What Data do we Have?

I have wondered over this year how the new policy which labels more children as entitled to free school meals may affect public health and social research.

The Free School Meal (FSM) indicator has been commonly used as a socio-economic indicator.

In fact, there is still a practical difference within the ‘free school meals’ label.

In my county, West Sussex, those who are entitled to FSM beyond infants must actively register online. Although every child in Reception, Years 1 and 2  is automatically entitled to UIFSM, parents in receipt of the state income benefits must actively register with county to have an FSM eligibility check, so that schools receive the Pupil Premium.  Strangely having to register for ‘Free School Meals’ where others need not under automatic entitlement in infants – because it’s not called as it probably should be ‘sign up for Pupil Premium’ which benefits the school budget and one hopes, the child with support or services they would not otherwise get.

Registering for a free school meal eligibility check could raise an extra grant of £1,320 per year, per child, for the child’s primary school, or £935 per child for secondary schools, to fund valuable support like extra tuition, additional teaching staff or after school activities. [source]

Researchers will need to give up the FSM indicator used as an adopted socio-economic function in age groups under 8. Over 8 (once children leave infants) only those entitled due to welfare status and actively  registered will have the FSM label. Any comparative research can only use the Pupil Premium status, but as the benefits which permit applying for it changed too, comparison will be hard. An obvious and important change to remember measuring  the effects of the policy change have had.

One year on, I’d also like to understand how research may capture the changes of children’s experience in reality.

There are challenges in this; not least getting hold of the data. Given that private providers may not all be open to provision of information, do not provide data as open data, and separately, are not subject to the Freedom of Information Act, we may not be able to find out the facts around the changes and how catering meets the needs of some of our youngest children.

If it can be hard to access information from private providers held by them, it can be even harder to do research in the public interest using information about them. In my local area Capita manages a local database and the meal providers are private companies. (No longer staff directly employed and accountable to schools as once was).

[updated Aug 30 HT Owen Boswara for the link to the Guardian article in March 2015 reporting that there are examples where this has cut the Pupil Premium uptake]

Whom does it benefit most?

Quantity or Quality and Equality?

In last year’s post I considered food quality and profit for the meal providers.

I would now be interested to see research on what changes if any there have been in the profit and costs of school meal providers since the UIFSM introduction and what benefits we see for them compared with children.

4 in 10 children are classed as living in poverty but may not meet welfare benefit criteria according to Nick Clegg, on LBC on Sept 5th 2014. That was a scandalous admission of the whole social system failure on child poverty. Hats off to the nine year-old who asked good questions last year.

The entitlement is also not applied to all primary children equally, but infants only. So within one family some children are now entitled and others are not.

I wonder if this has reshaped family evening meals for those who do not quite qualify for FSM, where now one child has already ‘had a hot meal today’ and others have not?

The whole programme of child health in school is not only unequal in application to children by age, but is not made to apply to all schools equally.

Jamie Oliver did his darnedest to educate and bring in change, showing school meals needed improvement in quality across the board. What has happened to those quality improvements he championed? Abandoned at least in free school where schools are exempt from national standards. [update: Aug 25 his recent comment].

There is clearly need when so many children are growing up in an unfairly distributed society of have and have-not, but the gap seems to be ever wider. Is Jamie right that in England eating well is a middle class concern? Is it impossible in this country to eat cheaply and eat well?

In summary, I welcome anything that will help families feed their children well. But do free school dinners necessarily mean good nutrition? The work by the Trussel Trust and others, shows what desperate measures are needed to help children who need it most and simply ‘a free school meal’ is not necessarily a ticket to good food, without rigorous application and monitoring of standards, including reviewing in schools what is offered vs what children actually eat from the offering.

Where is the analysis for people based policy that will tackle the causes of need, and assess if those needs are being met?

Evidence based understanding

It appears there were pilots and trials but we hadn’t heard much about them before September 2014. I agreed with then MP David Laws, on the closure of school kitchens, but from my own experience, the UIFSM programme lacked adequate infrastructure and education before it began.

Mr. Laws MP said,

“It is going to be one of the landmark social achievements of this coalition government – good for attainment, good for health, great for British food, and good for hard working families. Ignore the critics who want to snipe from the sidelines.”

I don’t want to be a critic from the sidelines, I’d like to be an informed citizen and a parent and know that this programme brought in good food for good health. Good for very child, but I’d like to know it brought the necessary change for the children who really needed it. [Ignoring his comment on hard working families, which indicates some sort of value judgement and out of place.]

Like these people and their FOIs, I want to ask and understand. Will this have a positive effect on the nutrition children get, which may be inadequate today?

How will we measure if UIFSM is beneficial to children who need it most?

Data used well gives insights into society that researchers should use to learn from and make policy recommendations.

The data from the meal providers and the data on UIFSM indicators as well as Pupil Premium need looked at together. That won’t be easy.

What is accessible is the data held by the DfE but that may also be “off” for true comparison because the need for active sign up is reportedly patchy.

Data on individual pupils needs used with great care due to these measurement changes in practice as well as its sensitivity. To measure that the policy is working needs careful study accounting for all the different factors that changed at the same time. The NPD has pupil premium tracked but has its uptake affected the numbers as to make it a useful comparator?

Using this administrative data  — aggregated and open data — and at other detailed levels for bona fide research is vital to understand if policies work. The use of administrative data for research has widespread public support in the public interest, as long as it is done well and not for commercial use.

To make it more usefully available, and as I posted previously, I believe the Department of Education should shape up its current practices in its capacity as the data processor and controller of the National Pupil Database to be fit for the 21st century if it is to meet public expectations of how it should be done.

Pupils and parents should be encouraged to become more aware about information used about them, in the same way that the public should be encouraged to understand how that information is being used to shape policy.

At the same time as access to state held data could be improved, we should also demand that access to information for public health and social benefit should be required from private providers. Public researchers must be prepare to stand up and defend this need, especially at a time when Freedom of Information is also under threat and should in fact expanded to cover private providers like these, not be restricted further.

Put together, this data in secure settings with transparent oversight could be invaluable in the public interest. Being seen to do things well and seeing public benefits from the data will also future-proof public trust that is vital to research. It could be better for everyone.

So how and when will we find out how the UIFSM policy change made a difference?

What did UIFSM ever do for us?

At a time when so many changes have taken place around child health, education, poverty and its measurement it is vital that public health and socio economic research creates an evidence base that justifies or refutes policy.

In some ways, neutral academic researchers play the role of referee.

There are simple practical things which UIFSM policy ignores, such as 4 year-olds starting school usually start on packed lunch only for a half term to get to grips with the basics of school, without having to manage trays and getting help to cut up food. The length of time they need for a hot meal is longer than packed lunch. How these things have affected starting school is intangible.

Other tangible concerns need more attention, many of which have been reported in drips of similar feedback such as reduced school hall and gym access affecting all primary age children (not only infants) because the space needs to be used for longer due to the increase in numbers eating hot meals.

Research to understand the availability of facilities and time spent on sport in schools since the introduction of UIFSM will be interesting to look at together with child obesity rates.

The child poverty measurements also moved this year. How will this influence our perception of poverty and policies that are designed to tackle it?

Have we got the data to analyse these policy changes? Have we got analysis of the policy changes to see if they benefit children?

As a parent and citizen, I’d like to understand who positions the goalposts in these important public policies and why.

And who is keeping count of the score?

****

image source: The Independent

refs: Helen Barnard, JRF. http://www.jrf.org.uk/blog/2015/06/cutting-child-benefit-increasing-free-childcare-where-poverty-test

Thinking to some Purpose – a new era, a new look

Regular readers here or on twitter, may notice the new-look.

I’m moving away from The Amateur Book Blogger banner, and will be posting simply as me, as I go on.  The start of the summer holidays seemed as good a day as any, to saunter out into the sunshine on my own.  [I may even see if it’s worth updating my resultant twitter handle @TheABB]. The reason? This week, the View From Here Magazine announced it will be closing on November 1st, 2014. After seven  years on the writing team, it is not only the end of an era, but perhaps the start of a something new.

I started on the comms side, announcing writing events and industry news, and later moved into interviews. It’s been an amazing experience. Editor Mike French was a great remote-mentor. We’ve met only once, at the launch of his latest novel, Convergence, in The Dandelion Trilogy.  Mike both enabled and encouraged me to interview some great writers, editors, scouts and publishers, every quarter. I learned something new each time, from every contribution, and had great fun. All of which I enjoyed, but some stand out in the memory more than others, and every one was unique.

I travelled to The London Book Fair in 2010, the year the Icelandic volcanic ash prevented many traveling from abroad by plane.  The resulting bonus, many people’s meeting schedules became unexpectedly less full. I got squeezed in to film a serendipitous  interview with Jamie Byng at Canongate and  spoke with Helen Garnons-Williams, which led to producing a three part interview with her, the then newly head-hunted Editorial Director for Fiction at Bloomsbury UK.

Thank you to all whom I have interviewed since 2006, but also to readers and fellow unpublished writers who supported me, the team, and made the community at The View From Here what it is. With eclectic tastes, I learned much on writing, but also enjoyed the art of the creative collective.

The most recent interview I did for them, was here, with Isabel Allende. In her wide ranging career, it was hard to know what to ask and how to narrow it down, but one thing stays with me, in all she said, on the role of a writer:

“Writers have no obligation to comply with the official story or the official version, their only obligation is with their own consciousness.  Honesty above all.”

The other part of my writing recently has been more akin to her engagement in politics and civil society. I’ve been on twitter really only for the last nine months, throughout the difficult pregnancy of care.data, pronounced care [dot] data. If you missed it, that’s the government proposed scheme to suck up our GP medical records, merge them with data already held at the central Health and Information Centre from our hospital care, and then use the new, richer record for commissioning purposes and potentially more, as yet undefined.  Since our hospital and other health sourced-data is already sold to private companies and will continue to be so in future, but without having asked for informed consent, I’ve been a very skeptical critic and lay voice for positive changes for these wide secondary uses. [In case you’ve landed here for the first time,  I’ve a background in tech database implementations, communications and change, and I took it upon myself to fully understand and follow the subject, a year ago when I came across the topic online, by accident.]

It looks now, as though some improvements on past failings will  happen, but much remains undefined in detail, and as we all know, that’s where the devil likes to sup. I look forward to seeing some of the recently discussed changes and definitions in the Care Act, for example, becoming concrete.

So, that’s the reason for the insignificant changes on my part, and should I explain the image? I’ve chosen my favourite coffee mug for my header photo, with my favourite scarf. I use both often. The latter, reminds me a little of Bridget Riley’s op art. As a retro fan that appeals to me. The former, depicts the cover of Susan Stebbing’s most popular work Thinking to some purpose (1939) which was described on the cover of the first Pelican Books edition as being:

“A manual of first-aid to clear thinking, showing how to detect illogicalities in other people’s mental processes and how to avoid them in our own”

The work arose out of a synopsis she wrote for a series of radio broadcasts intended for the BBC. Published on the eve of the Second World War, Stebbing wrote:

“There is an urgent need to-day for the citizens of a democracy to think well. It is not enough to have freedom of the Press and parliamentary institutions. Our difficulties are due partly to our own stupidity, partly to the exploitation of that stupidity, and partly to our own prejudices and personal desires.”

Her words seem very timely.

To borrow from Wikipedia here: “This metaphor seems to me to be appropriate, because potted thinking is easily accepted, is concentrated in form, and has lost the vitamins essential to mental nourishment. You will notice that I have continued  the metaphor by using the word ‘vitamins.’ Do not accept the metaphor too hastily: it must be expanded.”

I wrote about use of language and the need for common sense in its use around our health, as well as food marketing, in a previous post. But on the book, Professor Stebbing [British philosopher 1885- 1943] went on to say:

Potted meat is sometimes a convenient form of food; it may be tasty, it contains some nourishment. But its nutritive value is not equivalent to that of the fresh meat from which it was potted. Also, it must have originally been made from fresh meat, and must not be allowed to grow stale. Similarly a potted belief is convenient; it can be stated briefly, sometimes also in a snappy manner likely to attract attention. A potted belief should be the outcome of a belief that is not potted. It should not be held on to when circumstances have changed and new factors have come to light. We should not allow our habits of thought to close our minds, nor rely upon catch-words to save ourselves from the labour of thinking. Vitamins are essential for the natural growth of our bodies; the critical questioning at times of our potted beliefs is necessary for the development of our capacity to think to some purpose.”

So here’s to that, my ‘critical questioning’ may have shifted from one arena into another, but I hope I continue ‘thinking to some purpose’.

The Universal Free school meal Programme applied. Free, but what will it really cost?

I have children who are entitled, come September, to the universal free school meal programme. Department of Education advice came out last week. See here >>universal infant free school meals.

I wonder whether this will bring back a national treasure to benefit those who need it most, or is it just a Pandora’s box of problems?

I must admit to feeling ignorant. How much evidence is there, that FSM for all, benefits those who need it more than a means tested system? There is certainly evidence of need, but how do we best address that need?

All the average parent can know well, is how the new system will affect our own child’s experience of school meals.

NetMums did a survey of lots of us. There are simple practical things which policy ignores, such as 4 year-olds starting school usually start on packed lunch only for a half term to get to grips with the basics of school, without having to manage trays and getting help to cut up food. The length of time they need for a hot meal is longer than packed lunch.

But it raises common concerns too which perhaps need more attention, many of which seem to be coming in, in drips of similar feedback: reduced school hall and gym access because the space will need to be used for longer due to increase in number eating hot meals, lack of good kitchen facilities, fears over cooked food quality.

The theory that a nutritious, hot meal at lunch time for all infants, is not what will be delivered in reality. All are valid concerns, over which parents have little control.

How will this change the standards and quality of food compared with today, What considerations have been made for food waste and Is it the wisest way for state money to be best spent to help all who really need it?

Firstly, let’s take to task the nutritional decision making. New standards are now mandatory again, after having been, and then not been – instead left at heads’ discretion. Swings and roundabouts.

There is a blanket ‘low fat’ approach. The trouble is,  this often also means ‘replace all fat with fake stuff for flavour’. It fails to recognise that not all fats are nutritionally equal. Cholesterol is often branded a villain, but is a necessary building block for the body. Whilst parents are lambasted for creating obesity in our children and that we don’t understand enough about food, I don’t know that I agree the Government does either.

Whilst I fully understand the popular and State-driven drive for cutting down obesity levels, cutting out fat across all the food groups may not be the key to achieving it, and improving national health. This ‘low-fat is good’ approach is controversial, and low fat in particular in dessert, replaced with artificial sweeteners, also potentially harmful, is a false choice. I believe that a gentle paleo approach to food, back to basics, is a better choice. Throw out artificial things, and eat almost everything that is natural, in moderation. Not all fats are the same. Children who are growing, need the kind of fat that is in milk. It’s not the same as chips. Sugar, yes, cut it out, but don’t replace with artificial sweeteners. Not everything served on plate should be classed food.

The whole programme of child health in school is based on sweeping generalisations, but they’re not made to apply to all schools equally.  We can be told an awful lot of twaddle of how our kids should eat and exercise by state-sent leaflets in book bags. Add to that, the fact that the BMI comparison is flawed, and its communications to parents method is fundamentally flawed. (Letters saying your perfectly healthy, well proportioned child is obese, or underweight, partly due to its tool as an average cross group measure, in the National Child Measurement Programme (NCMP) anyway. But that’s another, longer story.) It’s no wonder parents are confused, not knowing the best thing to do on these school meals or not.

“On 17 June 2014 the department announced a new set of simplified standards. The new standards are designed to make it easier for school cooks to create imaginative, flexible and nutritious menus. They will be mandatory for all maintained schools, academies that opened prior to 2010 and academies and free schools entering into a funding agreement from June 2014, and will come into force from January 2015.
One significant change in the new standards is that lower fat milk or lactose reduced milk must, from January 2015 be available for drinking at least once a day during school hours. The milk must be offered free of charge to pupils entitled to free school meals, and to all pupils where it forms part of the free school lunch to infants.”

There is conflicting information about milk consumption and asthma for example, so I’d like to see more information around this, on expected benefits overall. The milk given to them to drink often is UHT, skimmed and processed. If you take all the good stuff out of the milk, is it doing the kids who drink it any good? I’d like to know. We should know the general standards and calorie and nutritional content of their meals in both the theoretical guidelines and ask at practical local level on the ground, because one hot meal at lunchtime, a balanced diet does not make.  We need to know what the kids are getting, in order to try and fit it into the bigger picture of their whole intake.

Secondly, we haven’t talked much about waste.

Currently, my children every week, eat both hot lunches and packed lunches from home. I pay the school’s private provider, for regular, hot lunches three days a week, and I provide packed lunch on two. (I can see ahead of time online, what’s on the provider’s menu, and I can plan and coordinate with the rest of what and how we eat, according to our family schedule.)

From September, I will no longer be able to choose to book and pay for those meals myself. And I will no longer be able to choose for some days and not others. It’s all or nothing.

The local provider will also no longer permit parents of  Reception-Year 2 children to book meals and pay for them, so even if I am fortunate enough and wanted to, I can’t opt out of the state system and pay for only those meals my children will actually eat.

The result is, if I want to continue the mix of hot and packed lunch choice I make for them, based on our family life, schedule and the nutritional content of what I want them to eat, I am required to sign them up for all five days, and either they get the imposed routine and eat more hot dinners – or carry on with our current set-up and two days a week the other hot lunches will go to waste.

However having spoken to my local school meal service today, they confirmed that after 4 weeks they plan to have a review of waste, and cut back on food provided. They won’t be paid less.

The net result, the local private provider will receive more money from the State, for my children’s hot lunches, than I pay myself now. And likely as not, there will be food wasted as well, because the providers will need to allow that some children may take it up all days.

I understand that to administer detailed choices would potentially be costly. But already we have moved admin cost back from parent to school. From September, schools will need to administer how many children are taking up the meals, and any changes in numbers week on week. Until now, I could manage it with the provider online.

However, it need not increase the admin cost to schools or state, if I could continue to book for my children, as I do now, selecting their days and meals in advance, there would be a more cost effective use of our State money, without any change in administration. It would be up to the provider to bill as used, not blanket. Surely in these days of electronic charging, not hard, and could be made without manual intervention by the state, except for regular audits, which will need to happen anyway in any well governed accounting system.

Is this the wisest use of helping those in real need?

It feels as though the Government simply doesn’t trust us to feed our children properly. I think most I know do a fairly good job. And before anyone has a go at making it a class or wealth issue, I fundamentally disagree. You get good and bad parenting and cooking skills across the board. No one is perfect. I know families who are well off but their nanny takes them to McDonalds more than one night a week for tea. Families in poverty and moving out of poverty should get support in school meals for children, but I dislike the sweeping TV benefits-hype notion that ‘poor people can’t feed their children properly.’ As if somehow, wealth is an indicator of capability or ‘doing a good job’. I do believe that parents will always try and do the best to feed their children. There are of course the rare and horrific Daniel P. exceptions whose whole care was failed by parents and State alike. They will always exist and we as a society and State need to think how they can be best addressed. But is a rushed and inflexible system of school meals going to really address those exceptions? I don’t think so. That’s not what this is about and we shouldn’t let genuine individual cases, as well as media hype of individual suffering railroad discussions.

How was it done in the past? Some were granted the support of free school meals, so if they were then, and still are now what has driven the need for change? Is this new system, in fact a huge political admission that  welfare support is not enough for the many, many families where both parents work hard and still find each month a stretch to get good food on the table every day of the month? I believe so.

{ Sept 5th 2014 update confirms: 4 in 10 children are classed as living in poverty – but may not meet the welfare benefit criteria according to Nick Clegg, on LBC. That’s a scandalous admission of the whole social system failure. He believes working parents can’t afford to feed their children properly? So fix the overall income levels, welfare, social housing balance. Not FSM. The statement that schools ‘have to manage lunch anyway’, shows a failure to understand what an average primary is like. Not the best political collected response to a flagship policy which he should expect to be quizzed on in ‘Back to School’ week. Hats off to the nine year-old who nailed it.}

I welcome anything that will help families feed their children well. However, school dinners does not necessarily mean good nutrition. I remember friends who got FSM vouchers and chose chips as a main course and chocolate brownie for pud. The work by the Trussel Trust and others, shows what desperate measures are needed to help children who need it most and simply ‘a free school meal’ is not necessarily a ticket to good food, without rigorous application and monitoring of standards, including reviewing in schools what is offered vs what children actually eat from the offering.

Parents know what their children like and will eat. There is a risk some children will simply eat less if they don’t like what’s on offer.

The entitlement is also not applied to all primary children equally, but infants only. So within a family some children are entitled and others are not. Will this reshape family evening meals, where now one has ‘had a hot meal already today’ and others have not? Feedback so far seems to indicate that there are great unknowns, and that the practical application of this policy will not live up to the nice theory.

It feels like we’re being distracted, with a pretty sticking plaster on a gaping social wound.

A personal perspective

I know our family will be happy to save any money we can, having just taken on a mortgage for our first home. But we are very fortunate, and to be honest, I just feel like we’re not entitled to it. I want the funds to go where most needed. I’ll be glad to have extra money at home, but we manage without it and I’ll still send them some days with packed lunch. Yes if  it were only about cash and ‘entitlement’, we could choose to give any savings to school funds or another charity, but I also hate food waste.  I worry that the quality of food standards will fall, for everyone. Why will this time be different compared with standards which were so poor in the past?

Why impose this method on all without rigorous planing and evaluation and a transparent communication of that to parents and schools? My school certainly doesn’t feel that has happened or been communicated, and has had a ‘a couple of emails”.  And they are a great primary school who care about things being done well. At the end of summer term,  ‘it’s a bit of an unknown.’ And as for parents, we got an SMS and asked how many might be interested back in March I think. Nothing since then. If this is such a key initiative and so important for the future well being of our kids, why are parents should be being well informed.

I now have to decide, to keep my kids in hot dinners, take them out, or keep our as-is preferred mix but feel wasteful.

Where do you draw the line between support  and interference in our family life?

You could say don’t look a gift horse in the mouth, but it’s what is going into the mouths of our children that matters most. Jamie Oliver did his darnedest to educate and bring in change, showing school meals needed improvement in quality across the board. What has happened to those quality improvements he championed? Abandoned in free school & political dogma. There is clearly need when so many children are growing up in an unfairly distributed society of have and have-not, but the gap seems to be ever wider. Sheffield in 2012 had a 22% child poverty rate. Where is the analysis for true quality change, rather than change for a point of policy?

Is our children’s health a political football, which is being given as a concession in this Parliament, now rushed through to get checked-off, without being properly checked out first?

I’m not sure I trust the state imposed food standards to do a good job if the funding should be reduced in future, quality will fall again, back to the bad old pre-Jamie days.

Quality must be paramount if we are now expecting to see a larger portion of society, starting out with school meals, fed by State defined standards.

It seems there were pilots and trials but we haven’t heard much about them. There is plenty of history, but where is current discussion? I agree with David Laws, on the closure of school kitchens, but this mother believes current infrastructure and education should be fundamental to this programme, not coming in later as a secondary support measure. I wouldn’t normally choose to link to the Mail, but no other broadsheet seems to have covered it since the Department for Education guidance was issued last week.

Mr. Laws MP said,

“It is going to be one of the landmark social achievements of this coalition government – good for attainment, good for health, great for British food, and good for hard working families. Ignore the critics who want to snipe from the sidelines.”

I don’t want to be a critic from the sidelines, I’d like to be an informed citizen and a parent with choice. [and please, stop using hard working families, it indicates some sort of value judgement, which is borrowed from the coalition partners and not in a good way]

This is a consumer choice and health issue, having an effect on a practical aspect of my parenthood. It’s not a tenet of education substance.

Like these people and their FOIs, I want to ask and understand. I have questions: How will it affect the majority? Will this have a positive effect on the nutrition children get, which may be inadequate today? What guarantees are there that adequate food safety and quality issues are properly and independently governed? Will it be overall less costly and beneficial to children and parents? Will it reduce stigma? Will it increase hot dinners consumed and reduce packed lunch intake? (So much less healthy, we are told.) Is the cost worth the benefit for a minority or even for the many? Will it benefit the health of all our children?

Free, but what will it really cost?

Honestly, I don’t know. But that’s my main concern. It’s being done in such a rush without due transparency and communication, I don’t think anyone knows.