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Neglecting child health threatens UK's future prosperity, says expert

Priorities must change now, to halt the slide in health outcomes

BMJ

The low priority given to children and young people's health threatens the UK's future prosperity, argues an expert writing in The BMJ today.

Professor Russell Viner at University College London's Institute of Child Health, says countries that invest in child health "reap impressive economic rewards, with each pound spent on children's health returning over £10 to society over a lifetime."

In contrast, poor health in childhood "leads to reduced workforce participation and productivity and lowers national wealth."

Professor Viner, who takes up the role of president of the Royal College of Paediatrics and Child Health this week, points out that the UK has a higher proportion of children and young people in its population than almost all other Western European countries that will provide us "a future demographic dividend of a larger working-age population if, and only if, we protect their health."

But he argues that "we are poorly positioned to reap these benefits, as our children's health outcomes are substantially worse than those in most other wealthy European countries."

He points out that Scotland and Wales have both recently announced new national strategies to improve children's health. Yet in England, health services for children and young people "struggle for priority and there is no sign yet of a national strategy."

For example, the NHS Five Year Forward View mentions children and young people briefly only in relation to prevention and mental health, while the 2016 General Practice Forward View mentions children only once, despite children making up a large proportion of primary care attendances.

And although patients aged 0-18 years made up 25% of A&E attendances in 2015-16, the 2013 Transforming Urgent and Emergency Care Services in England mentions this group briefly twice.

This lack of focus has begun to tell, writes Viner. Across the UK, large gaps in the paediatric workforce have lowered morale in children's services, recruitment into paediatric training positions in 2017 was the worst ever, and workforce deficiencies, low morale and lack of focus on children are cited as reasons for large numbers of services receiving poor ratings for safety and effectiveness.

He says the moral and economic reasons for action are clear, and he calls for "a new focus on health services for the children and young people who carry all our futures."

For each UK country this means a targeted health strategy, formulated in partnership with children and their families, and covering early life from from conception to adulthood. For England it also means a greater visibility within NHS England priorities in primary care and emergency care and in the new integrated care systems.

"The Royal College of Paediatrics & Child Health is keen to work with governments to achieve these aims. Business as usual for child health will not build a healthy and prosperous United Kingdom," he concludes.

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