UK’s child mortality performance is unacceptable

There’s a grim reality at the heart of the UK’s performance on reducing child mortality: if we were performing as well as the best countries in Europe, then we could save five children’s lives every day. That equates to over 1,600 children every year. A shocking reminder that complacency is not an option in reforming the NHS.

The government has now published its response. One of the measures is to sign a pledge to reduce child death and to encourage all the other organisations and individuals whose work impacts on child mortality to do the same. The over-arching aim is to unify people working across the health sector in improving health outcomes for children and young people. With children accounting for up to a quarter of the population, there are clearly questions to be asked about why their health concerns have not been prioritised sooner?

It is, of course, a complex issue, but there are some clear solutions. Primary care provided by GPs to children, for example, needs to be improved. In the UK, illnesses such as pneumonia and asthma, which rely heavily on treatment through primary care services, have lagged behind other Western countries. Across the health system there needs to be better paediatric training.

The Healthcare Commission recently reported that nearly a half of acute trusts are weak on outpatient care for children with services designed around acute illness rather than chronic disease.  Poor GP provision for children has meant that hospitals have become overwhelmed with acute and minor illnesses whilst services for long term conditions suffer.

The government’s plans announced build on recommendations by the Children and Young People’s Health Outcomes Forum, a panel of health experts convened by the former Health Secretary, Andrew Lansley. The Forum called on government to ensure that health, social care and education services work together more effectively, and that children and young people should be given a stronger voice within the health system, both as patients involved in their own health care and as valued participants in shaping services.

To this end there needs to be a children’s version of the NHS Constitution – the key document that sets out patient rights in the health system. This would enable children to hold different parts of the NHS to account, over the quality of care they receive.

The government’s ‘sector wide response’, while not responding to all of the Forum's concerns, does include some heartening commitments. A new health survey will help gather the views and experiences of young people about the health services they engage with, and a new ‘children’s champion’ should help guarantee that young people’s right to participation is protected. The government has also committed to considering the Forum’s recommendations on improving outcome indicator measures for children.

What is most encouraging, however, is the unequivocal recognition by ministers of the challenge  ahead saying they are determined ‘that children and young people should be put at the heart of the new health and social care system.’ And whilst signing a pledge can be seen largely as a symbolic step, it does very visibly signal the need for close collaboraton and co-operation between all parts of the healthcare system, at a local and national level, if we are to achieve the improvements in health outcomes that children deserve.

Enver Solomon is director of evidence and impact at the National Children’s Bureau. He is also chair of the End Child Poverty Coalition, which is made up of more than 150 organisations from civic society