Budget Cuts Blamed for Faltering Child Health

Peter Russell

March 04, 2020

Children's health and wellbeing in the UK has stalled or gone into reverse in the last year, according to a report.

Data compiled by the Royal College of Paediatrics and Child Health (RCPCH) found that since its last report 3 years ago, health outcomes had become worse for babies, children, and young people who live in deprived areas.

Progress had been seriously affected by deep cuts to local authority budgets, the report, State of Child Health in the UK , said.

Prof Russell Viner, president of the RCPCH, said: "In many areas of healthcare, we've led the rest of the world. But we're in danger of failing a generation if we don’t turn this situation around."

Trends in Child Health and Wellbeing

The authors highlighted that, even where improvements in children's health had taken place, the UK often lagged behind other comparable countries. 

Despite a fall in the number of emergency asthma admission rates across all four nations, the UK still had one of the highest mortality rates in Europe for children and young people with asthma, they said.

A longer-term trend for declining rates of emergency admissions for epilepsy was marred by rates slightly rising in England, Scotland, and Wales in 2017-18.

Concerns were also raised that in all countries of the UK, the World Health Organisation target of 95% immunisation rates for the second dose of MMR were not met. England fared worst with 86.4% coverage, followed by 91.2% in Scotland to 91.8% in Northern Ireland and 92.2% in Wales.

The State of Child Health 2020 also found inequalities had widened since the last report 3 years ago.

Among the key findings:

  • The UK is fifth from bottom among 27 European countries for infant mortality

  • Infant mortality was more than twice as high in the most deprived areas of England and Wales compared with the least deprived areas

  • The prevalence of children aged 4 to 5 who were overweight or obese has not improved significantly in any of the four countries since 2006-7

  • Childhood obesity is more prevalent in deprived areas, with rates among 4- to 5-year-olds almost four times as high in the most deprived areas (3.8%) than the least deprived areas (1.0%)

  • A total of 4.1 million children live in relative poverty in the UK, an increase of half a million between 2011-12 and 2016-17

  • Relative poverty rates among children rose from 30% to 31% in England, and from 28% to 29% in Wales

  • Child poverty in Scotland plateaued at 24% and decreased from 26% to 24% in Northern Ireland

Dr Ronny Cheung, who co-authored the report, said: "The harsh reality is that, in terms of health and wellbeing, children born in the UK are often worse off than those born in other comparably wealthy countries. This is especially true if the child is from a less well-off background.

"Infant mortality is a globally-recognised sign of how well a country is looking after the health of its citizens. Throughout the world, the number of babies dying in their first year has been steadily falling for decades, as incomes rise and mothers and children receive better healthcare. Yet UK infant mortality rates have stalled, and in England they actually got worse between 2016 and 2017.

"For a high-income nation such as ours that should be a major wake up call."

Recommendations for Improvement

The report points to some good signs. For instance, there had been continued improvement in blood glucose control among children and young people with type 1 diabetes across all four nations. There was also an increase in the completion of key health checks for those with diabetes.

The authors make a number of recommendations for each nation. These included:

  • England regaining its measles-free status, a return to declining infant mortality rates, and stopping the rise in childhood obesity

  • Scotland to fulfil the Government's 2030 poverty and childhood obesity targets

  • Wales to improve breastfeeding rates, mental health and wellbeing, and reduce childhood obesity

  • Northern Ireland to implement actions from the Children and Young People's Strategy to ensure that all children have the best start in life

Dr Rakhee Shah, a community paediatrician and one of the report's authors, said: "Investment in preventative health services must now be prioritised by the new UK Government.

"England has seen a huge decline in spending on local services and I see the results of that every day of my working life especially for my most disadvantaged patients.

"The cuts to services also have an impact on our NHS – people have fewer places to go to get advice, support, and stay well."

A spokesperson for the Department of Health and Social Care said: "We want every child to have the best start in life, regardless of their background, and tackling health inequalities is a priority for the Government.

"Early intervention is key and we are taking urgent steps to improve child health. We have launched the most ambitious plan in the world to cut childhood obesity by half by 2030, we are transforming children’s mental health to give 70,000 more children access to services by next year, and we are improving maternity services."

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