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No Fare Conference Report

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No Fare Conference Report

Morning Chairperson's Introduction

Gillian Kynoch, Scottish Food and Health Co-ordinator

Gillian Kynoch gained wide clinical and managerial experience as a dietician. She then specialised in public health nutrition and health promotion. As Scottish Food and Health Co-ordinator she is based within the Health department but works across all departments, sectors and settings to give impetus to implementation of the Scottish Diet Action Plan. She believes that the keys to success are building effective partnerships and encouraging people to be active in seeking health. Crucially, healthy eating messages need to be matched by efforts to ensure that healthier food choices are genuinely available to all.

We have organised today's conference because part of our vision for taking the Diet Action Plan forward with renewed vigour is to put issues of food access at its core and to make sure that food access is the platform from which we continue to build the work.

We have here in this auditorium a depth and breadth of experience around food issues that I haven't seen gathered together for a long time and we intend to mine that experience to the fullest today.

You will see from the delegates list that we have a very wide range of expertise here. There are people from NHS primary care, people from the key agencies involved in policy making and delivery, we have people here from healthy living centres and healthy living networks, we have people from community development, from regeneration partnerships, we have NHS boards, council and local authority organisations, community food initiatives, people from the voluntary sector and the voluntary health sector, retailers, food producers and processors, researchers and academics - and I think that there are a couple of food champions hidden among you.

To set the scene for our work we have Mary Mulligan, the Deputy Minister for Communities, looking at 'Fairer access- the way ahead'. The Minister is followed by four speakers who are actively involved in a variety of initiatives that are 'Working together for fairer food access in Scotland'.

We have brought together speakers from diverse backgrounds to support you in thinking about food access in a broad way. For the purposes of today's event we are taking a very broad definition of food access; not jut looking at access to shops, this conference is about access to food.

The four themes we would like you to consider in your work today are:

  • availability,

  • affordability,

  • culture, and

  • skills.

We hope that these will underpin all of the work and discussion taking place today.

Deputy Minister's Presentation

Mary Mulligan - Deputy Minister for Communities

Mary Mulligan MSP

Born in Liverpool, Mrs. Mulligan studied at University of Manchester where she graduated with BA Hons. in Economic and Social Studies.

She worked in retail management and was elected as a Labour councillor for the Stenhouse ward of Edinburgh District Council in 1988 and 1992.

She was returned to the Scottish Parliament as MSP for Linlithgow in May, 1999, and served as Deputy Health and Community Care Minister. After the 2003 election she was appointed Deputy Communities Minister.

I am delighted to see such a diverse range of people and organisations who are all committed to improving access to quality healthy food. The diversity of representatives here today is a strong reflection of the diversity of the solutions we need to find to give everyone in Scotland the right of access to a healthier, affordable diet.

The International Conference on Nutrition in 1992, and the world food summits in 1996 and 2002 stressed that access to a safe and healthy variety of food is a fundamental right. An optimum supply of safe and nutritious food is a prerequisite for the protection and promotion of health.

Diet is central to our health throughout life and is therefore integral to balancing health inequalities.

As part of this realisation the First Minister launched the 'Healthy Living' campaign which is at the 'front-end' of our efforts to improve the Scots diet but as most of you are aware, there is a huge raft of work underway throughout the entire food chain aimed at improving diet. Improving food access and availability is at the core of all work. It is a truly cross cutting issue.

"the Health Improvement Challenge. sets out an integrated approach to delivering improvements to the health of the people of Scotland. Health Improvement has been recognised as a cross cutting policy for the whole programme of Government. Therefore issues surrounding food access will be tackled within this all encompassing framework."

The Challenge

Earlier this year we launched the Health Improvement Challenge. This sets out an integrated approach to delivering improvements to the health of the people of Scotland. Health Improvement has been recognised as a cross cutting policy for the whole programme of Government. Therefore issues surrounding food access will be tackled within this all encompassing framework.

Over the coming years our efforts will be particularly focused on 4 key areas.

  • the early years.

  • the teenage years.

  • in the workplace.

  • and finally, we wish to learn from, build on and step up the contribution of community-based and community-led health improvement.

Our nutrition strategy aims to promote health and prevent nutrition deficiencies and chronic diseases to ensure optimal health especially in low-income groups and during critical periods throughout life. We want to ensure that enough food of good quality is available, while helping to stimulate our rural economy and to promote truly sustainable development in Scotland.

Food Access

Improving food access is about closing the opportunity gap, about social justice - about working, not just at a strategic level, but through consulting, involving and engaging local communities, working to find solutions to meet local problems. We are all too familiar with the direct and unacceptable connection between poverty, diet and poor health.

We need to build communities which work together to tackle the problems they face. For this to work we cannot face each problem in isolation. Food access is inextricably linked to local food production, and distribution issues affecting farming, and the demise of local shops and services in urban and rural areas. It is an issue linked to transport, as well as town planning, and housing.

Food must be part of the mainstream national and regional policy agenda for area regeneration, for tackling poverty, social exclusion and for reducing inequalities in health.

Availability Affordability, Culture and Skills

Making this happen will require more recognition that we actually have a problem, and strong collaboration across government departments and between central and local government to tackle the barriers of Availability, Affordability, Culture and Skills that limit fair equitable access to healthy food for all.

In terms of Availability and Affordability, these barriers - most often combinations of them - are being tackled on a daily basis across the country at a local level. There are representatives here today from food co-operatives, community cafes and fruit and vegetable barras from both urban and rural communities who are tackling availability and affordability as well as providing an important social service that is often overlooked.

Work on tackling the culture barrier can be seen in family centres, nurseries and schools which provide excellent examples of intervening with the early years, and often incorporate parents as well.

Many local communities have also identified the need to improve skills. Cooking skills have been shown to have the potential to do so much more than just help you keep the lumps out of the custard. They build up the knowledge and self-esteem that is essential to encouraging confident critical consumers.

Social Inclusion Partnerships

Social Inclusion Partnerships are one of many locally based organisations that are working towards not only improving access to healthy foods, but also working with the community to increase their knowledge and skills around food.

The Skypoint Café in West Dunbartonshire immediately springs to mind as an example of such a project. As well as promoting healthy eating options the café also provides a breakfast club and cooking classes for excluded groups.

The café is currently undertaking feasibility work with a view to developing a market garden on an old football pitch next to the café. This garden will grow fresh fruit and vegetables for the café and the local community.

Similarly, in East Ayrshire the SIP operates in partnership with local community based food initiatives, community dieticians, health promotion staff and the private sector to address issues of food poverty and promote healthy eating. This is achieved by increasing awareness of the issues around food and the range of choices that are available amongst low income communities, Kids Clubs and looked after young people.

The Way Forward

The challenge is to implement integrated agricultural, environmental, food, nutrition and economic policies that put health at the fore. Today is about the ongoing search for pragmatic solutions for Scotland. Learning where we have come from and looking forward. This is not the beginning nor will we be able to scope the whole solution today.

Conclusion

I would like to thank everyone who was involved in organising this event, including, the Food Standards Agency, Communities Scotland, the Scottish Community Diet Project, CoSLA, Health Scotland and the teams within the Scottish Executive .

And of course I must thank you all for your attendance and active involvement, both in the forthcoming workshops and in the future. We will all be partners in taking forward the conclusions of this conference - turning ideas into reality - turning strategy into action.

What is Community Planning?

Karen Cawte - Policy Support Officer for Community Planning, Dumfries and Galloway Council.

Karen spent her early working career in the hospitality industry. This gave her a real feel for customer focus which she transferred to her first local government post of Marketing and Customer Relations Officer for Dumfries and Galloway Council's Housing Service. She moved to the Communications Unit as Research and Communications Officer in 2000. Here her remit covered communications, including dealing with the media, and also involving and consulting residents of the region regarding the Councils business. She has recently taken up the post of Policy Support Officer for Community Planning in Dumfries and Galloway.

Community Planning is a way of working now enshrined in legislation. The recent Local Government Scotland Act says that we all now have a duty of community planning as this responsibility covers all local agencies.

Our experience in Dumfries and Galloway shows how the community planning process can be used to address the barriers that have been identified today to ensure that everyone has access to a healthier diet.

The community planning structure in Dumfries and Galloway is shown in figure 1. It comprises a joint board, made up of the Chief Executives and Chairpersons of the Council, NHS Dumfries and Galloway and the local enterprise company. The board champions community planning.

diagram

Linked to the Joint Board is the strategic change group who make sure that the principals of community planning are cascaded through their organisations. This group has representatives from the voluntary sector as well as a range of strategic agencies.

At grass roots level there are four local rural partnerships spread across the region. Their role is to link directly with the communities and provide the link between strategic and policy development work and the front line agencies. They are working partnerships, operating with the council's area committees and the local health care co-operatives to agree local priorities and policy development.

Surrounding the structure are the three themes that everyone works to:

  • enterprising and learning

  • safe and healthy communities

  • inclusive communities.

Dumfries and Galloway has a health improvement co-ordinator developing the health agenda within the council and across agencies and community. The post is underpinned by the community planning structures and the health improvement co-ordinator also supports the safe and healthy community work. The joint health improvement plan, a sub plan of our community plan, outlines key actions towards safe and healthy communities in Dumfries and Galloway.

Examples of community planning

I have chosen four examples which I think fit the principles of community planning and link directly with the health, food and diet agenda.

Food in Schools Partnership

This is part of the inclusive communities theme and is a multi-agency group comprising education staff, DLO staff, council health improvement co-ordinator and NHS health improvement staff.

As well as looking at healthy food options, the group also explore wider issues relating to the diet of young people and also promote initiatives such as water in school, fruit tuck shops and breakfast clubs.

Building Healthy Communities Project

The Building Healthy Communities Project is a series of community based actions. These local initiatives aim, through community development, to support individuals and communities to build capacity, identify local health needs and find innovative solutions to these needs as well as developing the infrastructure for health in local areas. They have been involved in many initiatives linked with food, nutrition and diet including healthy eating initiatives in the community and schools, and the development of a healthy community cafe using local produce.

The Scottish Healthy Choices award

The Healthy Choices award operates in Dumfries and Galloway and aims to encourage local businesses to provide healthy food options. The criteria for the award include implementation of environmental health standards, nutritional standards and offering a wide variety of healthy eating options.

We now have over 50 small businesses involved in providing high quality, locally produced food and drink. Many of the raw materials are locally produced and processed to add value to the whole package

Castle Douglas Food Town

This project gained its impetus from the foot and mouth disease crisis. Businesses in the region were decimated by the disease and needed to do something to get people to come back to the area.

Through this project we now have over 50 small businesses involved in providing high quality, locally produced food and drink. Many of the raw materials are locally produced and processed to add value to the whole package.

Castle Douglas food town is not just a business initiative, it has been working with the council, enterprise companies and the health service to promote not only food businesses but also looking at peoples diet and peoples access to healthier food.

Community planning

Community planning has been in place in Dumfries and Galloway for four years and it is still in its early stages. To make community planning happen you need significant cultural change in people and organisations and that is a very slow process, but, we believe that in Dumfries and Galloway it is a worthwhile process.

What is Community Planning?

"A process whereby public services in the area of the Local Authority are planned and provided after consultation and co-operation. Among all public bodies and with community bodies".

Local Government in Scotland Act 2003

Community Food Initiatives

Mike Cook - Development Co-ordinator. Community Food Initiatives North East

In the 1980s Mike worked as a neighbourhood community worker in Urban Aid projects involved in youth work, community flats, welfare rights advice, housing action groups, food co-ops, mother and toddler groups, local newsletters, etc. At the end of the 80s, he became a full time father, returning to work as administrator of a council employees credit union he had helped establish. In 2002, he joined the Food Co-op Network North East (later to become Community Food Initiatives N. E.), helping to support and develop locally run community food outlets across Aberdeen.

I work for Community Food Initiatives North East (CFI,NE), a small voluntary organisation committed to partnership working around food issues. Our focus is on using a community development approach to support and develop local community food outlets.

As an organisation committed to social justice we concentrate on the poorer areas in Aberdeen and wider afield. In terms of access we don't think that the issues are just economic and political as there are also issues of access that are tied into culture, including:

  • what people know,

  • what their habits are,

  • their experiences,

  • the social and family circumstances they find themselves in.

All of these affect the decisions they make about food and health as well as every other aspect of their lives.

What are the hot issues in poor communities just now?

If I was living in the area were I work I would be worried about drugs, violence, crime, policing, housing, services from statutory agencies, money, benefits, managing bills, neighbours, coping, depression and isolation.

Although they are not directly associated with food all those things need to be considered when promoting healthy eating and health improvement.

We need to think about those issues and wonder why is it that people are not jumping up and down when we go and mention healthy eating to them, whether they should be eating grilled mackerel or whatever.

Culture in that broad sense, is the daily practice of our projects and fully informs what we have to offer. Using a community development approach we ask and answer questions:

  • Who is appropriate to bring the news of healthy eating or health improvement to people in those communities?

  • Who is going to persuade and sometimes argue with them that what they should be doing is different from what they are doing now?

  • Who are they going to trust when it is time to take the risk of exposing their ignorance when trying something new as that is something that none of us like doing?

I think a community development approach can begin to tackle these difficult issues. Building relationships with the people in these areas and working from the bottom up, is an important factor in how we can all address the issues here today.

This significantly helps us to understand what the problems are, because we as professionals are not the people who should be defining the problems. We may have a perspective on what the problems can be but there are other perspectives as to what the problems are. And understanding of these only come if you listen to people in these areas.

I think by creating a local, positive resource for people in terms of local food provision using local people we can help address those issues in a different way that adds value. What we are doing, in this process, is actually helping people in terms of their own personal development and in community capacity building too, while people are learning new skills.

My view is that we shouldn't look on volunteers as people who simply give, because volunteers get back from their giving. And that is part of the deal and I think that is recognised and it is a way into and a way out of the issues for both workers and residents.

It is an attraction to some people to know that there are people who will support them to learn new things, but also, that there is a way out for them when their skills have taken them somewhere else or their interests have taken them somewhere new.

I would be worried about drugs, violence, crime, policing, housing, services from statutory agencies, money, benefits, managing bills, neighbours, coping, depression and isolation.

This is a great thing, and it is a positive success but sometimes it means that our organisations suffer because if we are very good at what we do, the people that we have invested loads and loads of time in go somewhere else and take that investment with them. It is great for them, but it is sometimes a bit frustrating and from the outside it can look as if your organisation hasn't moved, and in fact you are often worse off than when you started.

While this might appear to be a loss, in reality, the organisation is bigger than the sum of the parts.

For the future, we are developing a 'crisis fair share' idea. The aim is to take food that is approaching the end of its shelf life in supermarkets and deliver it to homeless hostels or people who don't access that kind of quality food on a regular basis. We see it as fitting in with our general aims. The homeless folk who will be involved as volunteers running the project will move from being helped to becoming helpers. That process is important to us, as important indeed as the access to the food.

Food, social justice and health are things that all of us in the country are involved in and interested in. What I am calling for today is for us to continue to have as wide an approach to tackling the issues as we can.

All those things although they are not directly associated with food need to be considered when promoting healthy eating and health improvement. Building relationships with the people in these areas and working from the bottom up, is an important factor in how we can all address the issues here today.