‘Deep unease' over NHS services for vulnerable children

Speaking at an event on the future of child health, the confederation’s deputy policy director Jo Webber said there is "deep unease" about the way in which children will be protected and kept healthy in the new NHS.

Currently, child protection and health services are commissioned and provided by local councils and NHS primary care trusts (PCTs).

But under the NHS reforms, this responsibility will be divided up among four different organisations; the NHS Commissioning Board, Public Health England, local authorities and clinical commissioning groups.

The government is still yet to clarify who will take over certain duties, such as which organisation will have responsibility for providing specialist safeguarding services at a local level.

Webber argued that is also unclear how the new-look NHS will foster joint working between public services, adding that there must be some formal requirement for different services to work together.

"We have ample evidence from the past of what goes wrong when organisations are not co-ordinated to work together properly,” she said.

"Through joint work between councils and the NHS, we have made great strides since then. There is deep unease in the NHS that, in reorganising the system, we are resetting to a model that is potentially riskier and certainly more fragmented.”

She argued that the government is right to devolve power to the lowest level possible. But insisted more must be done to avoid introducing a postcode lottery of provision.

“Outcomes for protecting children should not vary. The safety and health of some of the most vulnerable people in our society can not be subject to local discretion,” she said.

"Vulnerable children with complex needs will now find the responsibility for their care and their safety spread out between a range of organisations – and on the NHS side, all of them will be completely new.”

She went on: “We know through painful experience that it is between the gaps in responsibilities that the most tragic and difficult cases fall. With nothing making these organisations work together in the way they should, we have to be honest that the risk of us failing is more likely.

"The time has come to be honest with government and together now resolve these issues before a policy problem becomes a tragic failure."