Levelling up must start with improving children’s health

They wear the same uniform, listen to the same music and follow the same people on TikTok. But one of them has a life expectancy nearly seven years shorter than the other, because they live in a more deprived area. 

Before the pandemic, almost a third of children (4.3million) in the UK were growing up in poverty, leading to worse health outcomes and reduced life expectancy. And the pandemic has placed even greater strain on children’s health and wellbeing. 

It shouldn’t be this way in 21st century Britain, and it doesn’t have to be. 

The Health and Care Bill, currently making its way through Parliament, is an important opportunity to improve the future for all children. 

But currently it falls well short of that potential and without rectification will prove to be a very costly missed opportunity in the years to come. 

Among the proposals, new integrated care systems across England are expected to reduce inequalities. This is desperately needed. 

For children, health starts in their home, school, and neighbourhood. Children in the most deprived parts of the country are more than twice as likely to be obese as their peers living in the richest areas, and this affects their health for decades to come. 

Disadvantaged children are also at increased risk of developing mental health difficulties, and physical and emotional health are closely intertwined as they grow and develop - one in six children are now likely to have a mental health condition. 

Poor mental health costs the UK economy £74bn-£99bn a year, obesity-related illnesses cost the NHS £6bn a year and at least £2.5bn a year is spent treating illnesses linked to living in cold, damp and dangerous conditions. 

A lot of this support only comes once serious harm has already been done, making it much costlier than it would have been to intervene before the issues had gripped a person’s life. To reduce inequalities, we must intervene earlier. And investing in children, laying the foundations for a lifetime of good health, is the best place to start. 

In his speech in Blackpool last Thursday (September 16), the Health Secretary Sajid Javid’s outlined his welcome commitment to reducing health inequalities. His promise to shake up the health system to fight the ‘disease of disparity’ is exactly what is needed. 

Now the government must prove it by explicitly making this commitment to children, and giving them equal access to health services, so that the system works to ‘level-up’ their opportunities. 

The new integrated care systems must be designed to meet the needs of children, instead of just treating them as an afterthought. Tellingly, of the 42 that already exist, our research found that only one has a visible or stated lead for children and young people. If we’re serious about tackling the big issues, something needs to change. 

For one thing, funds committed through the Better Care Fund, must be used to improve children’s access to vital health and care services. Crucially, we are calling on the Government to commit to a ‘child impact assessment’ within two years of the new legislation, to assess whether it has made a positive difference to their health and wellbeing. 

Without these measures to ensure consistent care for children across the country, we risk entrenching existing health inequalities, rather than reducing them. 

Fundamental to improving the health of children and adults alike, is a shift in the approach to how and where services are delivered. GP surgeries and hospitals play a vital role – but they are not the full picture. Most of what we need to ‘stay well’ happens at home and in the community. 

That’s why Barnardo’s is recommending a ‘family hub’ in every community, which brings together essential early support on issues ranging from health in pregnancy, to nutrition, to mental health, to helping keep children safe from harm. That way we can work together to identify and address challenges, long before children reach crisis point, so they can achieve the best possible chance of a positive future. 

This is a unique opportunity to get the integration of health and care services right – let’s make sure children are at the heart of it.

Michelle Lee-Izu, Co-chief executive (interim) at Barnardo’s