I had a wonderful conversation with a friend and colleague the other day. He talked about the importance of having hope, even when the world seems a dark place. I have thought a lot about those words in writing this message. My inbox is full of emails from paediatricians who are desperately worried about the plight of children in the Middle East. I have also had many conversations with paediatricians in the last few weeks who are finding the levels of antisemitism and Islamophobia here in the UK terrifying.
It is crucial that we have hope. We must believe that solutions will be found – even if they are a series of tiny steps in the first instance. As a Royal College there is very little we can do that will make a material difference to those caught up in this conflict. However, we can advocate for all children and stand ready to help. We wrote to James Cleverly when he was Foreign Secretary on two occasions describing our concerns about the impact on child health of conflict across the region.
This week we have written to Lord Cameron following his appointment to the role and have used the opportunity to again make the case for the survival and safety of all children caught up in the conflict, asking specifically for adequate humanitarian access and provision of medical supplies to Gaza.
We have created a resources page on the Middle East Crisis, as we did previously for the war in Ukraine. We will keep it updated so we can let you know when there are opportunities for paediatricians to articulate the impact of war on children and families and to keep you up to date on the College’s advocacy for children caught in the conflict. As a membership organisation of paediatricians, we also need to look after each other and stand behind the single inalienable imperative, that we must protect our children, wherever they may be.
Child mortality report
I have a second reason to reflect on why having hope is key. Last week saw the publication of the 2023 National Child Mortality Database annual report. Reviewing these new data leaves one with a sense of despair. How can it be, that in the sixth richest nation on the planet, we have rising child mortality rates that link directly to poverty? The report makes very sobering reading and every one of us needs to take a look, as this is relevant to all paediatricians practising in the UK (even though the data are from England). The discrepancies in health outcomes between black and white, between poor and rich, and between the north and south are evidence of how poverty and the lack of focus on levelling up is creating a country of ‘haves’ and ‘have nots’.
As desperate as these results are, there are things we can all do, and this is why we should not feel hopeless in relation to this topic! Tackling health inequalities in the UK must be part of day-to-day clinical practice. For some it will mean writing to your local MP to point out what you are seeing locally and using your patients’ stories to give life to this data. For others, it will be making sure you ask about housing and fuel poverty when you are seeing repeat attenders in A&E.
Each of us can play a role and if you aren’t sure what you can do, please take a look at our excellent resources on the link between health inequalities and both poverty and climate change. It’s time again for every one of us to #ShiftTheDial.
Winter pressures, viruses and vaccines
You don’t need me to highlight that British winter has started and our acute children’s services are busier than ever. This time of year always tests us and this one has the dual challenge of the ever-increasing elective backlog alongside the pressures from all the usual winter viruses.
This is my third winter as College President and my frustrations at the lack of a comprehensive vaccine strategy for England continue to rise. I have lost count as to how many times I have raised the issue of the RSV vaccine with senior NHS and Department of Health and Social Care leaders, including the Health Secretary. The fact is that the RSV vaccine has the potential to reduce hospital admissions by 85%, bringing huge opportunity to transform our highly pressured services.
So, while I am thrilled that there is a commitment to include the varicella vaccine in the routine childhood schedule, what we desperately need is a speedy rollout of the RSV vaccine so that the winter of 2024-25 won’t put pressure on our services in the way we are seeing currently.
UK Government reshuffle
It won’t have escaped your notice, if you live in the UK, that we’ve had a bit of shake up in the Westminster Government this week. Most of the health ministers, including the Health Secretary, have changed roles and so we are now working hard to establish new relationships with the team and make the case for children as we do with politicians of all political persuasions.
I note that Dame Andrea Leadsom MP will take on the early years and public health brief. She has a long career working with new parents and young families and I really enjoyed interviewing her for RCPCH Podcasts.
Creating a smokefree generation and tackling youth vaping
I have written before about how important the government plans for changing the legislation around smoking is. Alongside this is a consultation from UK Government on how to create a smokefree generation on which we will be submitting College evidence. To help us do this as well as possible, we would be very grateful if you would complete this very short survey.
We’re pleased to see that Government is heeding our warnings on disposable vapes and is now actively considering a ban, as well as wider restrictions on flavours, packaging and advertisement. We must take advantage of this opportunity to potentially influence new legislation – so please help us do this thoroughly.
Reminder from the British Paediatric Surveillance Unit
My children endlessly moan at me about nagging… so I hate to end with a nag! But the British Paediatric Surveillance Unit (BPSU) is an extremely important resource that allows us to monitor rare diseases and respond quickly to sudden changes in disease patterns, like the acute hepatitis outbreak we saw last year.
For the BPSU to be credible and function well we are reliant on every paediatric consultant and SAS doctor taking part in both reporting these rare events and just as importantly reporting that they haven’t seen any cases in the previous month. Some of us will have had a letter in the post from the BPSU last month asking us to use a QR code to indicate if we are still in practice and to update our details as appropriate. The closing date is 4 December so please spend a couple of minutes checking your post box or tray, and if you have a letter from the BPSU, scanning the QR code and using the unique identifier on your personal letter - it’s very simple, I promise!
With my very best wishes to you all – and take care,
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