This week, the Equality and Social Justice Committee of the Senedd has published the report of its inquiry into child poverty – Calling Time on child poverty: how Wales can do better. The inquiry was prompted by the high levels of child poverty in Wales and concerns about the Welsh Government’s draft strategy to eradicate it.

The report provides stark data and challenge, asking:

“Across the United Kingdom 4.2 million children under 18 live in poverty… Why do we tolerate that when we are part of the 6th richest economy in the world?”

The latest figures show 28% of all children in Wales are living in relative income poverty. That is 8 children in a class of 30. Most child health outcomes are socially driven, with the poorest children consistently and disproportionately disadvantaged compared to their more affluent peers. The Committee’s report recommends a root and branch review of the Welsh Government’s approach as it finalises its new child poverty strategy.

At the iHV, we support the Senedd’s Equality and Social Justice Committee call for a dedicated Minister for Babies, Children and Young People to be appointed to provide a more coherent response to the scourge of child poverty.

Under the current Welsh Government arrangements, the Minister for Social Justice has responsibility for tackling child poverty, while the Deputy Minister for Social Services and the Deputy Minister for Mental Health and Wellbeing lead on children’s well-being issues, and the Minister for Education retains responsibility for their educational attainment.

The Committee is calling for one Minister to be accountable for the wellbeing and happiness of babies, children and young people. This role should incorporate overall responsibility for tackling child poverty and implementing children’s rights with other key areas such as childcare, education and supporting families.

The report is also recommending that the Welsh Government set ambitious and realistic interim and longer-term targets for reducing child poverty, learning from the approaches taken in other countries such as Scotland, Norway and New Zealand.

Jenny Rathbone, MS Chair of the Equality and Social Justice Committee, said:

“Our central message is that the Welsh Government needs to follow the evidence and prioritise those policies which make the maximum contribution to tackling child poverty. This may involve difficult decisions and trade-offs. But it must embed children’s rights in policy and in practice.

“The Government needs to overcome its aversion to setting targets. The evidence from Scotland and New Zealand is clear: targets work. Alongside other measures and milestones, they set the direction of travel, and keep track of progress.

“Finally, appointing a Minister for Babies, Children and Young People would send the clearest signal that Wales is serious about giving every child the best start in life.”

 

 

The Institute of Health Visiting (iHV) publishes the findings from the largest UK survey of frontline health visitors working with families across the United Kingdom.

Our survey findings paint a bleak picture with health visitors seeing first-hand the realities that families with babies and young children in the UK are facing. Health visitors are reporting epidemic levels of poverty, with more parents struggling under the weight of the cost-of-living crisis that is forcing them to turn to food banks to feed their children.  Alongside this, more parents are living with mental health problems, domestic abuse and adversity, that pose risks to the health and wellbeing of babies and young children.

Health visitors are witnessing the impacts of stress associated with poverty on children’s safety, health and development. At the same time, there are insufficient health visitors to meet the scale of rising need. This is being felt most acutely in England, as health visitors are battling to deliver a service following a loss of almost 40% of health visitors since 2015.  Consequently, despite health visitors’ best efforts, many families are not receiving the support that they need, and this is being intensified by a lack of capacity in other health and social care services who are also experiencing extreme pressures.

Alison Morton, Executive Director at the Institute of Health Visiting, says,

“Through their universal reach, health visitors have a privileged and unique view into the lives of babies, young children and their parents/ carers across the UK. Health visitors’ experiences presented in this report provide an important ‘early warning signal’ of the most pressing threats and challenges to the health and wellbeing of our youngest citizens which are often hidden behind front doors and invisible to other services.

“The findings also paint a deteriorating picture of a health visiting workforce under immense pressure as practitioners struggle to meet the scale of rising need. Families are facing the brunt of these challenges with a widening postcode lottery of health visiting support across the UK.”

We publish at a time of ongoing uncertainty with political and economic instability, and ever-increasing health inequalities that will get worse if not addressed. The whole of the health and care system is also struggling to rebuild in the wake of the pandemic. As health visitors often work alone, or in small teams in families’ homes, their work is often hidden and it’s easy to overlook how important it is. The NHS backlogs regularly hit the headlines, but they are only one part of the legacy left by the pandemic on the healthcare system; less high-profile backlogs of care and unmet need in health visiting services have been overlooked within a ‘baby blind spot’ in national policy which will leave equally serious challenges for both mental and physical health for babies, children and families across the UK, now and in years to come.

Alison concludes:

“Because the first years of life are so important for lifelong health, wellbeing and success, ignoring this tsunami of unmet need being experienced by our youngest citizens risks undermining the life chances of so many children.

“It is not too late to change direction and pursue reforms, but the situation is serious. There is now unequivocal evidence that the current rate of health visitor workforce attrition, and insufficient training places to plug the forecasted gaps, is not sustainable and will jeopardise the delivery of all UK Governments’ child health programmes.

“In England, the Government categorised health visiting as one of six priority services in its Start for Life Vision for the first 1001 days. However, this commitment is at risk without investment and a plan to rebuild the health visitor workforce.”

Rising needs and widening inequalities – child safety, health and development: the problem, some key facts and stats:

  • 91% of health visitors reported an increase in poverty affecting families over the past 12 months
  • 91% reported an increase in families needing foodbanks
  • 83% reported an increase in perinatal mental illness
  • 75% reported an increase in domestic abuse.

Health visitors have witnessed first-hand the impact on babies and young children’s safety, health and development:

  • 84% of health visitors reported an increase in children with speech, language and communication delay
  • 76% an increase in child behaviour problems
  • 60% of health visitors reported further increases in child safeguarding over the last 12 months (building on significant increases reported last year).

Health visitors in England also raised serious concerns that national data mask increases in child safeguarding, as:

  • Children living with significant risk and vulnerability are not detected as services are cut, and
  • Social workers’ caseloads are capped to a maximum – growing numbers of children living with significant risk and vulnerability now fall below higher thresholds.

Only 7% of health visitors in the UK felt confident that all families would be able to access the support they needed when a problem was identified. 86% reported that there was not enough capacity in other services to pick up referrals for support/ treatment

Our main policy recommendations:

  1. Prioritise the first 1001 days of life – a shared cross-government ambition and strategy for the first 1001 days is needed to improve health outcomes and reduce inequalities for babies, young children and families. This needs to be prioritised by the Treasury and seen as the smartest of all investments in our nation’s future, rather than as a cost.
  2. A shift towards prevention and early intervention is needed to support all people to lead healthy and fulfilling lives by addressing the key public health priorities that pose the greatest threats to our nation’s health, thereby preventing debilitating and costly ill health in later life.
  3. Equity of access to support is needed for all babies, children and families across the UK and an end to the current postcode lottery.
  4. System’s thinking – the benefits of an effective health visiting service accrue to numerous government departments and across a person’s lifetime. Complex system’s principles need to be applied across all aspects of health and care delivery, including workforce planning, funding and the development of measures that capture health visitor’s input and impact across the system.
  5. Integrated clinical care pathways with significant ‘front-loaded’ investment in prevention and early intervention are needed across health visiting, school nursing, midwifery, social care, General Practice, and early years, to ensure:
  • All babies, children and families are supported to reduce inequalities in key priority areas
  • All children at risk of poor outcomes are identified early
  • A continuum of support for a continuum of need is provided to achieve shared goals for key public health priorities for babies, children and families.
  1. Strengthening the health visiting service requires a clear plan focused on the following three areas:
  • Funding – All areas need sufficient funding to deliver the full national specification for the health visiting service and preventative public health programme for children
  • Workforce – A demand-driven, well-resourced national workforce strategy is needed to increase the number of health visitors to address current and forecasted losses, and improve retention, job satisfaction and career progression for experienced staff
  • Quality – National government must do more to:
    • support local authorities with resources to provide health visiting services at a level that delivers everything that government and NICE guidance expects of them, and that families need
    • hold local authorities to account when services are not meeting national guidelines
    • support the ongoing research, development and sharing of evidence-driven models of best practice based on proportionate universalism.

The second annual State of the Nation Report which is published and laid before Parliament today from the Social Mobility and Child Poverty Commission (SMCP), shows that Britain is on the brink of becoming a permanently divided nation.

The Report says that while a strong economic recovery and a record number of people in work are welcome, the social recovery needed to get Britain back on track to abolish child poverty has not happened. Instead it predicts 2020 is set to mark the end of the first decade since records began without a fall in absolute poverty.

The Report warns that “2020 could mark a watershed between an era in which for decades there have been rising living standards shared by all and a future era where rising living standards by-pass the poorest in society.”

It warns that the link between effort and reward on which social mobility relies has been broken by changes in the housing market – with home ownership rates halving among young people in 20 years – and the labour market – with 5 million workers trapped in low pay.

When combined with cuts in welfare and public spending, these changes put Britain on track to become a permanently divided nation unless radical new approaches are taken by the next government to meet this 2020 challenge. It finds no political party is being honest about the impact of planned spending cuts or has sufficiently ambitious plans to tackle entrenched levels of low pay.

It comes to the reluctant conclusion that there is no way the government can meet the statutory target to eradicate child poverty by 2020. It calls on the next government to supplement the existing targets with new measures to give a more rounded picture of poverty and to publish a new timescale for achieving them.