Why Scotland needs an 'NHS for food' (inspired by the US military)
The prices in the US military’s PX stores for its personnel can be an estimated 30 per cent lower than those in private supermarkets
At a recent event in Glasgow, First Minister John Swinney pledged to legally cap the price of “everyday items that make up a decent diet”. According to the SNP manifesto, such items would include bread, milk and eggs. Supermarkets would be required to cap the price of at least one variation of the listed items, such as one particular bread, rather than all their breads.
Swinney said that the price cap aimed to tackle both the cost-of-living crisis and ill health. However, a price cap on essential groceries, on its own, is unlikely to produce the changes we really want to see in our food system: more plant-based foods, from wholemeal bread to beans to berries, produced and consumed here in Scotland; sustainable use of our land and seas, with minimal impacts on nature; and weening ourselves off imported inputs like fertiliser and feed for chickens, pigs and salmon.
To realise these changes, we need to start treating food in the way we treat healthcare and education – as a public good. All citizens should feel entitled to sustainably produced, affordable, healthy, convenient and delicious food in the same way we feel entitled to decent healthcare and primary schools.
A public diner to open in Dundee
Capping the price of essential food items isn't enough. We need high-quality, universal free school meals for all learners, from early learning and childcare to college, and government-owned restaurants and supermarkets.
A new food system – one that isn’t run by profit-driven corporations – is already beginning to emerge. With funding from the UK Government, the food advocacy charity Nourish Scotland is setting up a public diner in Dundee.
A public diner is a government-subsidised, everyday restaurant. According to the tender, the restaurant’s menu will be co-developed with local residents, and include popular dishes such as stovies and mince and tatties, with both vegan and meat options.
Ultra-processed foods or ingredients will be used minimally, if at all, and food will be sourced from sustainable and ethical UK producers. A fixed price is proposed of £5 for an adult meal and £1 for a child’s meal. They expect doors to open this summer.
Restaurant pilots offering nutritious subsidised food are not just popping up in Scotland. Last year, food advocate Mark Bittman opened his first non-profit restaurant, called Community Kitchen, in New York City. Rather than being supported by the government, it is funded by other patrons via a sliding ‘pay as you can’ scale. It’s a different vision than public diners, with an emphasis on fine dining rather than an everyday eating place.
Publicly owned supermarkets
Non-profit, publicly owned supermarkets are also on the rise. New York City Mayor Zohran Mamdani recently announced initial details of plans to open five city-owned supermarkets. Under the scheme, the stores would be owned by the city, but run by a private operator which must meet standards set by the city in terms of the food on offer, the prices, and the treatment of employees. The goal is to have one store open by the end of next year.
Self-proclaimed “grocery nerd” Errol Schweizer has long pointed out that government-run grocery stores are not new or radical. He notes that if the American military were a grocery chain, “it would rank in the top 20 by sales” in the USA. This size enables the stores to leverage the same supply-chain efficiencies as the private sector. They keep their costs down by being non-profit and budgeting their running costs centrally. As a result, Schweizer has calculated that their prices can be 30 per cent lower than those in private supermarkets.
To fund this new public infrastructure in this country, we need to stop subsidising private land owners who don't contribute to our food security and nutrition, and we need to tax discretionary foods that are high in saturated fat, salt or sugar. Such a tax needs to go beyond just sugary drinks, to include processed meats, crisps, biscuits, confectionary, and the like.
An ‘NHS for food’ would not be a utility like water, which would imply that it is the only restaurant and supermarket in town. It would be just one option, and the private sector would continue to be able to thrive alongside this public option. However, for these public food services to be widely utilised, they should be high-quality, co-designed with communities, and universally available, not needs-based. It is important that the NHS for food is not seen as charity but rather a core service provided by the government, like a school or a GP.
Healthy, sustainable and ethical
What will it take to realise this thriving alternative food system in Scotland? The first step will be supporting pilots of more public restaurants and Scotland’s first public supermarkets. Alongside this, the SNP manifesto's proposed “public sector food procurement taskforce” should learn from successful programmes like Soil Association Scotland’s “Give Peas a Chance!” pilot project in Aberdeen.
Public procurement is a strong tool for strengthening local supply chains for healthy foods, and the provision of high-quality universal school meals that keep even secondary school pupils on school grounds for a hot school dinner should be a priority for the taskforce.
It’s time to imagine a new food system in Scotland. Relying on legal price caps for a small list of “essentials” sold at big supermarkets isn’t enough. It’s time to shift the responsibility for healthy, sustainable and ethical food from the consumer to the public.
Professor Lindsay Jaacks is the personal chair of global health and nutrition, and head of the Division of Global Agriculture and Food Systems at the University of Edinburgh
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