This is a timely and most welcome review by the Commissioner. Paediatricians have known for some time that services for children are under significant pressure and too often we see the impact that waiting for treatment and assessment has on their health. The effect of pandemic restrictions has made the situation worse and as we recover and reset services there is a golden opportunity to act on these recommendations and to engage all relevant stakeholders, including children and young people, in how we deliver health care.
It comes as no surprise that there are too many children still waiting too long, and despite previous commitments by the NI Executive we have not seen much progress since the publication of the Paediatric Strategy in 2016.
Colleagues across the child health workforce are working extremely hard and always go the extra mile to give children the best quality of care possible but we have too many vacancies in both paediatrics and the wider child health workforce and not enough leadership or resource to drive forward the improvements needed in the Health and Social Care System. The RCPCH is preparing for the future in our Paediatrics 2040 programme which forecasts the burden of disease and healthcare activity trends. We have knowledge and expertise to offer but we need to see proper leadership, accountability, resourcing and co-production with professionals, children and families if we are to reverse the trends highlighted in this review.
The RCPCH has previously highlighted its concerns that child health outcomes in Northern Ireland are often worse than elsewhere in the UK and in Western Europe. The RCPCH State of Child Health report highlights the lack of available comparable data that can be effectively used to monitor trends and improve decision making in the commissioning of services. That children then spend excessive time waiting for assessment and referral is simply not good enough for them or their families. We owe our children and young people much more than that and by basing decision making and accountability in the context of children’s rights we hope to see vast improvements in the patients’ experience of their healthcare.
The collapse of the Northern Ireland Executive in 2017 led to a three-year hiatus which delayed crucial decisions and developments across Executive departments. We need stability and a commitment from all political parties to put children and young people at the top of the agenda and for Ministers to demonstrate that they are putting them at the heart of their decision making, especially when it comes to health.
The RCPCH is guided by the United Nations Convention on the Rights of the Child and we work to engage children and young people in all that we do. This report articulates the importance and necessity of creating a child rights-based Health and Social Care system, that is transparent, accountable, and capable of embedding the views of children, their parents and those who care for them at its core.
We must fix and improve the system and we commend the Children’s Commissioner for undertaking this complex and meaningful review. We acknowledge the work of the Health and Social Care Board and the Health and Social care Trusts to facilitate this review and we look forward to working with all stakeholders, including paediatricians and children, to ensure the recommendations in 'More Than A Number' are acted upon with urgency.