Earlier this year, I took up the role of RCPCH's Early Years Clinical Lead to support the College's growing focus on the early years through the launch of the Strong Foundations campaign. As a community paediatrician, I, like many of my colleagues, am acutely aware of the enormous potential that the earliest years of a child's life offer. The first 1,001 days are a critical window to promote healthy development, prevent the onset of health problems and build the foundations for a healthy life. Sadly, too often this opportunity is missed.
When the College launched the campaign in May, we surveyed members who see the challenges facing early years health services first-hand. While the full findings will be published later this autumn, one message emerged clearly: paediatricians are increasingly caring for children with more complex, yet often preventable, health issues that should, have been identified, prevented or addressed earlier through effective family support services.
Many families are missing out on the preventative support that can make the greatest difference, including health visiting, parenting and home learning support, infant feeding advice, trusted health information and advice on healthy lifestyles, and early help for children with additional needs. This kind of early support is essential to building the strong foundations babies need, helping families to provide the healthy, stable and nurturing environments that underpin positive early development.
Failing to get this right means worsening child health outcomes, greater stress for families, increasing waiting times for specialist services and further demand on already overstretched NHS services.
What is the Babies Bill?
A new Bill proposed by Sir Desmond Swayne MP has caught our attention. Due to be debated in the House of Commons tomorrow, the Bill would strengthen support during the first 1,001 days in England by requiring the Secretary of State to:
- regularly assess level of need for infant support services
- ensure an appropriate level of provision of infant support services (these services will be specified in regulations, but would include those for pregnancy, childbirth, health and development of children and parent and infant relationships)
- annually report to Parliament on the services provided and outcomes.
The Bill would be welcome first step to improving government accountability for the early years. We see all too often that as political priorities shift, babies, children and young people can fall down the agenda. The College's State of Child Health 2026 report has brought this into sharp focus, highlighting how progress on many measures of child health has stalled or worsened over the past decade, with the greatest impact felt in the most deprived communities.
By having legislation that explicitly focuses on babies and requires the government to consistently assess levels of need needs and the performance of related services, there would be a much-needed focus on addressing poor outcomes in early years. As a result, it would be harder for services to be quietly stripped back in the future and enable greater scrutiny by organisations like ours and parliamentarians of whether the government is meeting the ambitions it sets out to give every child the best start in life.
What else should the Bill do?
We welcome the ambitions of this Bill, but it does not address the whole picture. As a Private Member's Bill, it is necessarily focused on a narrow set of measures and applies only to England. Current provision for babies and families is not consistently meeting need. Although investment through Best Start Family Hubs and Healthy Babies has strengthened support in some areas, access remains uneven and many families are still unable to access the full range of services they need during a child’s first 1,001 days.
The Bill does not set out which specifically which services will be covered; this will be set out by Government if the Bill passes. There’s a risk, though, that they may not reflect the breadth of health support and the workforce that babies and families rely on during this critical period. In a letter to MPs this week, the College urged parliamentarians to support the Bill while also scrutinising how it can strengthen health services in the first 1,001 days and promote closer collaboration between the Department for Education and the Department of Health and Social Care.
As Parliament scrutinises the Bill in the coming months, we will continue making the case that improving health support for babies and families must be central to both the Bill's ambitions and its implementation.
Beyond the bill
There is much else to be done to address the support provided in the early years of a child’s life, and to strengthen health services delivering care for these children across the UK. Later this autumn, we’ll be publishing a policy report, as part of our Strong Foundations campaign which details some of these solutions, considering action needed to:
- ensure truly universal access for all families to high-quality early years support services across the UK
- improve families' access to trusted health information, advice and practical support
- invest in the paediatric and wider early years workforce so children and families can access the right support when they need it
- improve collaboration and join up within early years services and teams so needs are identified early and preventing problems from escalating
As the Bill makes its way through Parliament, we hope the debates will help keep these issues firmly on the government’s agenda and provide a foundation on which to build stronger early years health provision.
What can members do?
MPs will debate the Bill for the first time tomorrow. If it progresses, there will be further stages of parliamentary scrutiny, creating additional opportunities to encourage MPs, and later members of the House of Lords, to support the Bill and champion the importance of health provision within the first 1,001 days.
If you would like to get involved, you can:
- join the RCPCH Paediatric Influencing Network, where we'll share opportunities to support our work on the Bill, our Strong Foundations campaign and other influencing activities
- write to your MP and share our briefing materials and open letter to parliamentarians, which you can download below. The 1,001 Critical Days Foundation has also developed resources to help supporters engage with MPs and raise awareness of the Bill.