Child health agenda moving forward but policy commitments must be delivered, say doctors

Children’s doctors are praising Scottish Government for its commitment to child health, but warn much more must be done to better tailor the health system to meet the needs of children and young people if the ambition to create a healthier Scotland is to be realised.

That’s the message from a new scorecard launched today which looks at policy progress one year on from the RCPCH’s landmark State of Child Health report.

Policies that will improve childhood obesity rates, breastfeeding rates, women’s health during pregnancy, child poverty and child and adolescent mental health have all been welcomed in the new scorecard, which sees the Scottish Government performing far better than the Westminster Government when it comes to its focus on child health. However, doctors say that in Scotland, ‘the key now is to ensure these policy commitments are delivered.’

Key recommendations from State of Child Health that have been adopted include:

  • An announcement to expand the number of health visitors by an additional 500 by the end of 2018 through the full roll-out of the Family Nurse Partnership programme.
  • A commitment from Scottish Government to ensure specialist breastfeeding advice and support is delivered to women
  • A commitment from Scottish Government to review statutory sex and relationships education in all schools
  • A commitment from Scottish Government to create a system to ensure that child deaths are properly reviewed
  • A commitment to deliver a Child and Adolescent Health and Wellbeing Action Plan
  • A commitment from Scottish Government to tackle obesity by supporting families to lead active lives, encouraging more women and girls to take up sport and launching a consultation with the view to publishing a strategy later this year

Dr Steve Turner, Royal College of Paediatrics and Child Health’s Officer for Scotland, said:

“It’s heartening that the child health and wellbeing agenda is moving forward in Scotland. At the end of 2017 the Child Poverty (Scotland) Act was passed by the Scottish Parliament, providing a positive first step towards reducing child poverty. The Scottish Government has led the way nationally by setting a minimum unit price on alcohol, it has committed to deliver a child and adolescent health and well-being action plan in 2018, an obesity strategy and has committed to adopt a ‘child health in all policies’ approach. All of these developments indicate how serious Scottish Government is taking child health and they will help Scotland become a healthier country for children. “Considering only a year has passed since the launch of our State of Child Health report, it is encouraging that so many commitments to child health have been made. The key now is to make sure these commitments are delivered effectively.

“One commitment in particular – the creation of a system to ensure child deaths are properly reviewed, requires urgent implementation. Around 450 infants, children and young people die in Scotland each year and many of these deaths are preventable. This system will determine why some of these children are dying unnecessarily and will allow measures to be put in place in order to prevent future fatalities.”

Despite the encouraging overall picture, the scorecards also reveal several areas which require urgent improvement in Scotland, including:

  • There has been no movement on funding mandatory child health training for GPs (around a quarter of a GP’s patients are under 19, most GPs have no formal postgraduate child health training).
  • There has been no movement on providing every child and young person with a long-term condition with a named doctor or health professional – crucial for continuity of care.
  • There has been no movement to include the views of children and young people in the patient surveys of GP services and inpatient settings. The RCPCH wants to see this extended to cover outpatient and community settings and include the views of children and young people.

Dr Turner said:

“Currently Scotland has amongst the worst outcomes for child health in Europe, and it’s clear much more needs to be done, specifically around ensuring the health system meets children and young people’s needs.

“It’s disappointing that there has been no progress made on funding child health training for GPs. We know it will improve decision making, it is likely to reduce pressure on the health service as a whole and GPs support it. We now just need the financial support from Government.

“Another recommendation that needs urgent attention is providing every child with a long-term condition with a named doctor or health professional. This simple measure will ensure that children with a long-term condition have continuity of care and a health professional responsible for coordinating their treatment so that any action required is taken at the earliest opportunity.”

The scorecards, which have been produced for Scotland, Wales and England show that comparatively, both the devolved nations are performing well and are outperforming Westminster. For Wales, policy commitments relating to breastfeeding, obesity and protecting children from tobacco have been achieved but concerns remain around levels of poverty in the country. For England, public health cuts are proving to be a particular area of concern while some progress has been made in relation to smoking and obesity with the publication of a New Tobacco Control Plan and the implementation of the sugar tax.

Dr Turner added:

“With 2018 being the year of the young person in Scotland, the Scottish Government has a real opportunity to shape the nation’s health. Investing in early intervention and ensuring services are tailored to better suit children’s needs, not only protects the future health of the nation, but also saves the NHS money in the long term. We look forward to working with Scottish Government on these recommendations over the next year and to making Scotland a healthy place to grow up.”


Dowload 'State of Child Health: One year on' scorecard for Scotland

Download 'The State of Child Health Scotland 2017' report