Our manifesto for the next UK government

With the UK general election on the horizon, we have an opportunity to make our case, explains Russell, for urgent action on the challenges facing both our workforce and the children and young people we support.

An election looms. A time when change is possible. It feels as if the stakes for us – and the children and young people we represent – have rarely been higher.

Brexit will loom large but it’s already clear that health and the NHS will play a significant part in the campaign. A few health leaders have called for the NHS not to be a political football during the campaign. While I support that (who wouldn’t, the various UK football teams generally fumble the ball) I’m a lot more sanguine – and believe it’s right that healthcare and equity should be at the heart of political debate. 

Today we published our election manifesto. For us, this is an opportunity to make the case for urgent action on the challenges facing our workforce and those facing the country’s children and young people. These two issues are at the heart of our college - of Paediatrics, of Child Health – and are entirely intertwined. It’s essential to give them equal prominence in our pitch to the next government.

Stressed and stretched are the new normal. This is unsustainable

I’m writing this on the train to Newcastle – and I know only too well from my travels around the UK that is very hard to provide safe and high quality care in a system that is bursting at the seams. Stressed and stretched are the new normal. This is unsustainable. It should not be so. It must not remain so.

We know that the context is challenging wherever you work. Our population of children and young people is growing, emergency attendances and admissions are increasing and primary care seems overwhelmed. There’s no getting away from the reality that we need more paediatricians and more money in the system. On the supply side, we don’t have nearly enough incoming medical students. For those who do join our speciality the journey can feel long, and we lose too many excellent young doctors along the way. Rota gaps, long hours and the sheer weight of work in an under-resourced environment takes its toll on your enthusiasm and commitment, even on the most extraordinary individuals. Even for our youngest consultants, the iniquitous pension issues are adding fuel to the fire.

One of our most important duties as adults is to ensure children truly do have the best possible start in life

We must protect and listen to the people who show up to work in our health service every day. That’s why we’ve called on an incoming government to prioritise the publication of full and coherent workforce plans. Community paediatrics is also badly under resourced and desperately needs more people, more money and better integration with properly multidisciplinary care teams. We’ve also called for urgent reform of the pension tax rules which are disincentivising junior and senior clinicians from taking extra shifts and leading many consultants to take early retirement to avoid huge tax penalties. 

On health improvement, we’re calling for a cross-government children and young people’s strategy to coordinate services, plans and programmes across government. In England, we want to see the implementation of the NHS Long Term Plan, which for the first time in 15 years places children and young people front and centre of our health policy planning. If it’s implemented in full in the life of the next government, it will make a real and lasting difference to children and young people. 

Prevention and investment in public health are also burning issues. We know how vital early years are for child health, yet millions of children grow up in circumstances that make a mockery of ‘the best start in life’. Rising rates of child poverty are completely unacceptable in a society like ours, and one of our most important duties as adults is to ensure children truly do have the best possible start in life. This means investing in public health programmes in local communities, prioritising universal early years care and resourcing programmes to tackle major health challenges like obesity, vaccination uptake and mental health. 

We’ve made the case for urgent investment in public health services so that health visiting, smoking cessation programmes and breastfeeding support are available and easy to access for pregnant women and new mums. On obesity, the outgoing Chief Medical Officer has left a roadmap for the next government and we want to see chapters two and three of the Childhood Obesity Strategy implemented in full

On mental health we’re asking for a whole systems approach to the prevention of mental illness and the promotion of wellbeing, including a commitment to train child health professionals across all grades and disciplines to support children who present with mental health problems.

You can read the full manifesto on the election hub. We’ve got a busy campaign ahead and I really encourage you to engage with your local parliamentary candidates to make sure our issues are on the agenda. Collectively, we have some influence as paediatricians but it’s worth remembering our vital role as individual electors in a competitive contest. If you have questions or ideas, you can contact our public affairs team at public.affairs@rcpch.ac.uk.