UK in danger of failing a generation of children

The Royal College of Paediatrics and Child Health has warned that the UK is in danger of ‘failing a generation’ of children, with progress of health well-being having stalled.

The RCPCH’s State of Child Health 2020 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. The report combines 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.

Two weeks after the publication of the Marmot Review, children’s doctors are warning that, across most indicators, health outcomes are worse for children who live in deprived areas, with inequalities in some outcomes seen to have widened since the last State of Child Health report in 2017.

One reason highlighted in the research is ongoing 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.

The RCPCH recommends the government introduce a cross-departmental National Child Health and Wellbeing Strategy to address and monitor child poverty and health inequalities, and restore £1 billion of real-terms cuts to the public health grant for local authorities. This is in addition to ensuring that future investment in public health provision increases at the same rate as NHS funding and is allocated based on population health needs.

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.”

A Local Government Association spokesperson said: “Councils want to work with government to ensure children get the very best start in life. The government’s announcement of a real-terms increase in public health funding this year will help, but this report reinforces our call for long-term investment in councils’ public health and early intervention services if we are to protect children’s health, and reaffirms the widening health inequalities we are seeing across the country.

“Councils know their communities best and are committed to improving their health. Through their services, councils help people live longer and in greater health, in better conditions while improving their emotional, mental and physical well-being. We have long argued that previous reductions to the public health grant have been a false economy, which only compound acute pressures for NHS and social care services further down the line

“We also back the report’s call for reinvestment in the children’s health workforce. We would like to see a workforce strategy which in addition to ensuring we have a sufficient supply of specialist public health nurses, recognises the benefits of having a diverse range of health visiting, school nursing, children’s centre and other early years staff in children’s and health services.”