22nd January 2026
Today, the Health and Social Care Committee published its long-awaited report on its Inquiry into the First 1000 Days. The new report highlights that the UK has some of the worst health outcomes for young children in Europe and asserts that improving access to health visitors and Family Hubs, whilst boosting vaccine uptake, would help improve the lives of infants in England.
The cross-party Committee’s report focuses on the first 1,000 days of life, from conception to age two. This period is universally recognised as a critical window for shaping brain development and future mental and physical health.
The last decade has seen a collapse in the number of health visitors – meaning they can’t help everyone who needs it because of excessive caseloads. One of the Committee’s primary recommendations is that the Government must commit to recruit at least 1,000 more health visitors in the first instance, to halt the decline in health visitor numbers and rebuild this vital workforce. They also recommend action to end the postcode lottery, with all families receiving at least 6 mandated health visitor contacts during the early years – and a longer term ambition to deliver a service comparable to the rest of the UK.
Another important recommendation is that Family Hubs should be rolled out to more communities where need is greatest. Family Hubs should also offer improved perinatal mental health services to caregivers.
Health visitors are also central to the recommendation to improve access to vaccinations and uptake, with a new strategy which should aim for 95% coverage throughout England. It should explore ways to train health visitors to deliver vaccinations; increasing the size of the workforce should simultaneously improve vaccination rates.
Speaking on behalf of the Committee, Paulette Hamilton MP said:
“Children growing up in our country today stand too great a chance of becoming overweight, developing asthma or tooth decay, or catching life-threatening yet preventable diseases due to missed vaccines. The Royal College of Paediatrics and Child Health says the UK has some of the worst health outcomes for young children in Europe. This should be a source of shame.
“Over the last two decades we have seen a hollowing out of health services for infants – the Family Hubs programme still barely touches the sides of what was once provided by Sure Start centres before they were forced to close. And our provision of health visitor appointments is woefully inadequate in some parts of the country.
“This Committee now calls on the Government to reestablish health visiting as a cornerstone of the state’s support for families in communities across England, offering help with perinatal mental health, advice on a range of issues on health and development and helping to get more children vaccinated against illnesses which should be all but non-existent in 21st century Britain.”
Responding to the report, Alison Morton, iHV CEO, who provided written and oral evidence to the Committee’s Inquiry, said:
“We welcome the Health and Social Care Committee’s thorough review of the first 1000 days and were pleased to contribute evidence to the Inquiry. We particularly appreciate the Committee’s recognition of the vital role that health visitors play in supporting families in these formative years, and its clear call for urgent action to rebuild a workforce that has been severely depleted over the past decade. This is something that the iHV has called for over many years as health visitors see the human face of years of cuts which have left too many families without the support they need. We look forward to the Government’s response and offer our ongoing support to turn its ambition to ‘give every child the best start in life’ into reality.”
Highlights from the Inquiry presented in the report:
Call to revive the health visitor workforce
UNICEF and the NSPCC highlighted the essential work of health visitors in addressing inequalities and giving parents space to discuss sensitive concerns about their baby’s development.
But the number of health visitors has plummeted over the last decade. By December 2024 there were only 6,300 in England – a 43% reduction since 2015. Our CEO, Alison Morton, gave written and oral evidence to the committee and this features heavily in the report, with a clear case to reduce health visitor caseloads which have become unmanageable in many areas (you can watch Alison’s oral evidence session here, with iHV written evidence submission in our news story).
Recommendations:
- The Committee recommends that the Government must commit to recruiting 1,000 health visitors, and to use individual caseloads as a measure of how many will need to be recruited every year.
- The Government must set out steps to improve poor performance of local authorities where families are not receiving sufficient health visits.
- Ministers should commit to increasing the number of mandatory health visitor contacts for children in England from five to six, alongside plans to scale up the health visitor workforce. England is an outlier in only mandating five health visits – Scotland mandates 11 visits, Northern Ireland mandates nine visits, and Wales six.
Family Hubs in every community
Family Hubs are local centres that act as one-stop shops for children and caregivers, offering access to midwives, health visitors, GPs, youth workers, family support workers, and early years practitioners. Research by the Centre for Social Justice found that every £1 spent on Family Hubs saves £2.60 in provision of services later in a child’s life.
Recommendations:
- The Government should set out plans to expand the Family Hub network to every community, with ringfenced, long-term funding (beyond the current £500m tranche of funding up to 2028/29 set out in the current policy).
- Clear guidance on how Family Hubs will work alongside Neighbourhood Health Centres to avoid potential overlap.
Vaccination Strategy branded a failure
In 2024, the UK recorded the highest number of measles cases since 2012, with 2,911 confirmed cases in 2024 and one child dying. 11 infants tragically died from whooping cough in the same year.
The UK’s routine immunisation schedule provides protection against 15 vaccine-preventable infections during childhood, including in the first 1,000 days of life. While the UK Health Security Agency’s latest annual data shows modest increases in vaccine coverage for children up to age five, the latest quarterly data shows that coverage decreased across all vaccinations, part of “an ongoing declining trend”.
Recommendations:
- The Government should accelerate a pilot scheme of training health visitors to deliver vaccines to families in their homes or at medical centres and Family Hubs.
- The Government should reinstate its target, based on World Health Organization advice, to achieve 95% vaccine coverage across England.
- The 2023 Vaccination Strategy should be branded a failure and a new plan should be developed with a specific focus on improving uptake. The Committee recommends that every Integrated Care Board should have a named officer with responsibility for vaccinations.
Perinatal mental health support
The Committee reported that they were struck by the amount of evidence it received regarding perinatal mental health concerns and links with negative impacts on mother-infant attachment and the child’s emotional and psychological development, leading to long-term issues in mental health, emotional regulation, and resilience.
Recommendation:
- The Government should set out actions to improve access to perinatal mental health care within Family Hubs, supported by specific targets to improve access for women from ethnic minority backgrounds.
