The Royal College of Paediatrics and Child Health (RCPCH) 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 Northern Ireland, these include:

  • Northern Ireland Executive should act to tackle the causes of poverty and reduce variation to ensure all children have the best start to life, wherever they are.
  • Continue to work on creating a society in which children and young people grow up a healthy weight.
  • Ensure that funding to progress the New Decade, New Approach deal provides all schools with a sustainable core budget to deliver the curriculum, including the focus on wellbeing education.
  • The Maternity Strategy for Northern Ireland 2012-2018 should be revised and implemented in Northern Ireland with appropriate linkage to the Tobacco Control Strategy and A Great Start Breastfeeding to ensure integrated and coherent reporting and targeted intervention.
  • A service specification for neonatal care should be established to improve neonatal services, as recommended within the Department of Health’s ‘Strategy for Paediatric healthcare services provided in hospitals and in the community, 2016-2026’.
  • The Northern Ireland Executive should deliver the commitment to publish the Northern Ireland Cancer Strategy and delivery plan by December 2020, to ensure that innovative treatments and inclusion of children and young people in clinical trials are prioritised.
  • The Department of Infrastructure should continue to provide safer environments for children and young people to walk, play and travel.
  • The Public Health Agency should deliver a public health messaging campaign on the importance of childhood vaccinations and provide signposting for families on how to access vaccination services. Northern Ireland Executive should provide funding for campaigns.
  • Primary school children should have access to free fruit and vegetables in school.
  • A review into the factors affecting access to primary, secondary and emergency dental care, with a view to addressing inequalities in Northern Ireland.
  • Northern Ireland should improve data collection on children and young people’s mental health.

The authors of the report also recommend that the UK Government should: Deliver the committed £1bn Barnett-based investment guarantee to allow the Northern Ireland Executive to deliver the New Decade, New Approach deal, which includes a committed £245m to transform public health services.

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.”

Nadia Duncan

Author: Nadia Duncan


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