RCPCH Says UK in Danger of Failing a Generation of Children and Young People

The Royal College of Paediatrics and Child Health has today published State of Child Health 2020, the largest ever compilation of data on the health of babies, children and young people across all four UK nations.

The report shows that for many measures of children’s health and wellbeing, progress has stalled, or is in reverse – something rarely seen in high income countries.

Across most indicators, health outcomes are worse for children who live in deprived areas. Inequalities in some outcomes have widened since the last State of Child Health report in 2017.  Progress has also been seriously affected by deep cuts to local authority budgets – used to finance public health initiatives and community services.

The authors highlight that, even where there have been notable improvements in children’s health, the UK is often lagging far behind other countries. For example, although there has been a fall in the number of emergency asthma admission rates across all four nations, the UK still has one of the highest mortality rates in Europe for children and young people with asthma.

Dr Ronny Cheung, Clinical Lead for RCPCH and co-author of the report, said: “Two weeks ago, the Marmot Review presented a stark picture about life expectancy in England. Now, our own report shows troubling signs for children and young people across the UK.

“The harsh reality is that, in terms of health and wellbeing, children born in the UK are often worse off than those born in other comparably wealthy countries. This is especially true if the child is from a less well-off background.

“Infant mortality is a globally-recognised sign of how well a country is looking after the health of its citizens. Throughout the world, the number of babies dying in their first year has been steadily falling for decades, as incomes rise and mothers and children receive better healthcare. Yet UK infant mortality rates have stalled, and in England they actually got worse between 2016 and 2017. For a high-income nation such as ours that should be a major wake up call.”

State of Child Health 2020 brings together 28 measures of health outcomes, ranging from specific conditions – such as asthma, epilepsy, and mental health problems – to risk factors for poor health such as poverty, low rates of breastfeeding, and obesity.

Community paediatrician and co-author Dr Rakhee Shah, said: “Investment in preventative health services must now be prioritised by the new UK Government. England has seen a huge decline in spending on local services and I see the results of that every day of my working life especially for my most disadvantaged patients. The cuts to services also have an impact on our NHS – people have fewer places to go to get advice, support, and stay well.”

The authors make a number of policy recommendations for each nation. For Scotland, these include:

  • Action all measures contained in the Child Poverty (Scotland) Act and ensure these actions are appropriately resourced and funded, enabling the interim and 2030 targets to be met on time.
  • Provide sufficient funds to Local Authorities to support families and provide early intervention services.
  • Scottish Government should reintroduce smoking reduction targets for pregnant women.
  • Local Authorities should provide local pathways, agreed by multi-agencies, which improve access to support, resources and services for women seeking to breastfeed.
  • NHS Scotland should ensure full implementation of the Vaccination Transformation Programme by April 2021.
  • Local Authorities should review planning and licensing arrangements to ban fast food outlets (FFOs) from within 400 metres (approximately five minutes walking time) of schools and other locations with a high child footfall (e.g. leisure centres, parks, hospitals).
  • Scottish Government should continue to resource and fund the Scottish Violence Reduction Unit, which provides a preventative, multi-agency public health approach to tackling youth violence.
  • Scottish Government should introduce and fully fund criteria free, community-based therapies for all children and young people, as well as family therapy to address all levels of mental health needs.

President of the RCPCH, Professor Russell Viner, said: “We’ve got a lot of work ahead of us if we’re to get a grip on the state of child health in the UK. This report is the only one of its kind to zoom out and look at the full picture and it’s not a pretty sight. On many vital measures we risk lagging behind other European countries.

“There some positive signs – teenage pregnancies have fallen hugely, Scotland is leading the way on reducing youth violence, and we’ve made huge strides in the treatment of conditions like diabetes. These outcomes are invariably the result of good policy, political commitment, and proper funding.

“In many areas of healthcare, we’ve led the rest of the world. But we’re in danger of failing a generation if we don’t turn this situation around. The government has made welcome commitments on childhood obesity and young people’s mental health but we need to see delivery in these and other areas. We have the evidence, the experience and the expertise to make real progress in the life of this government. It’s now time to deliver for children and young people.”

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