The Institute of Health Visiting joins over 80 signatories to sign a letter, coordinated by The Food Foundation, calling for the Government to ensure that pregnant women/ people and those with babies and toddlers who are living in poverty receive the basic support they need for children to grow up healthily. The letter asks for the Government’s Child Poverty Taskforce for urgent improvements to the Healthy Start scheme to ensure children are receiving the nutrition they need at this critical stage of development.

Currently, households with children are persistently at higher risk of food insecurity than households without. In June 2024, The Food Foundation found that food insecurity was experienced by 18.0% of households with children, compared to 11.7% of households without children. This shows how important it is that the government’s Healthy Start scheme, which is supposed to provide a critical nutritional safety net for pregnant people and families with children under 4 who are living in poverty, reaches these families.

The Healthy Start scheme has huge potential to help families in England at risk of food insecurity to access the basic nutrition they need through weekly payments for fruit, veg, milk, formula and multivitamin supplements. However, it is currently failing to reach those in need due to:

  • Restrictive eligibility criteria and only being available to those with a household income of £408 per month or less, excluding benefits.
  • Low value of £4.25 a week. The payment hasn’t increased since 2021 and so has failed to keep up with inflation. For comparison, the Best Start Foods scheme, which is the Healthy Start equivalent in Scotland, has a value of £5.30 a week.
  • Low uptake, with about a third of eligible families currently not signed up to the scheme due to lack of awareness and administrative hurdles.
  • Families currently only being eligible until their child turns 4, meaning there is a gap before children start school and have access to Free School Meals.

High levels of food insecurity among households with children are particularly concerning given how important good nutrition is in pregnancy and for young children’s growth and development. Food insecurity in pregnancy has been linked to antenatal depression, gestational diabetes, and excessive or insufficient weight gain in mothers. For babies, good nutrition is essential for healthy growth, strong immunity and preventing diet related illnesses later in life.

The letter, addressed to Rt Hon Bridget Phillipson MP, Secretary of State for Education, Chair of the Child Poverty Taskforce,  Rt Hon Liz Kendall MP, Secretary of State for Work and Pensions, Chair of the Child Poverty Taskforce and Rt Hon Wes Streeting MP, Secretary of State for Health and Social Care, calls for improvements to the Healthy Start scheme to be made as part of the upcoming Child Poverty Strategy.

Signatories of the letter are calling on the government to:

  • Expand eligibility to include all families on Universal Credit, and extend the age-eligibility to include children under five years old
  • Increase the value of the Healthy Start allowance in line with inflation
  • Introduce auto-enrolment, with an “opt-out” rather than the current “opt-in” system to remove barriers faced by families in applying

Signatories of the letter include NGOs, local government, medical bodies and anti-poverty campaigners, including chef Tom Kerridge, representatives from Barnardo’s, the Institute of Health Visiting, Royal College of Midwives, Sustain and The Royal College of Paediatrics and Child Health.

Shona Goudie, Policy and Advocacy Manager, The Food Foundation, said:

“By the time children start school, one in five are already an unhealthy weight, with rates twice as high among the most deprived communities compared to the most privileged. Not only that, but a third of five-year-olds have tooth decay. These shocking figures highlight a glaring truth: more needs to be done to ensure our children are getting a nutritious start in life. Government should be doing everything it can to prevent our children getting sick in the first place. The Healthy Start scheme has enormous potential to help the most deprived children access healthy food from their earliest years but is currently falling short. We urgently call on Government to recognise the incredibly beneficial impact this scheme could have if it was improved. This would help children access much-needed healthy food at one of the most critical times in their lives for growth and development.”

Vicky Gilroy, Director of Innovation and Research, Institute of Health Visiting, said:

“Healthy Start provides an essential nutritional safety-net for babies, children and families living in poverty.  The Institute of Health Visiting fully supports the call to expand and extend the Healthy Start scheme, including auto-enrolment, expanded eligibility criteria, and increased value. This will support more families to access healthy foods, enabling babies, children and families in poverty to eat well.”

Today, the Inequalities in Health Alliance (IHA) which represents 257 members (including the Institute of Health Visiting) has sent an open letter to Andrew Gwynne MP – Public Health and Prevention Minister. The letter urges the government to take action to address growing health inequalities if it is to achieve its ambition to raise the healthiest generation of children in history and support people back into work.

The IHA has called for a cross-government strategy to reduce health inequalities since 2020 – one that tackles the root causes of ill health such poor housing, employment and food quality.  The alliance previously welcomed this government’s pre-election commitment to establish a mission delivery board for health and its ‘significant potential to drive’ action across all government departments.

The letter says the government must now set out its plans for this board, and that all wider causes of ill health – such as poor housing, the commercial impacts such as marketing of alcohol and the availability of tobacco, the ability to make healthy food choices, and air quality – must be covered if the government is to achieve its ambitions to halve the gap in healthy life expectancy and reduce demand on the NHS.

Commenting on the letter, Philippa Bishop – Director of Learning & Development at the Institute of Health Visiting – said:

“The Inequalities in Health Alliance (IHA) has today stressed to the Public Health and Prevention Minister that reducing the avoidable differences in health across the population must be a priority for this government. As Specialist Community Public Health Nurses, health visitors are witness to the impact of the wider determinants on health of families; a mission delivery board would be an excellent first step to bring together all national stakeholders to set targets and build the commitment needed to deliver change. The Institute of Health Visiting supports the letter and the opportunity to work with the government through a delivery board, recognising the government ambition to raise the healthiest generation of children in history and the contribution of health visiting to the nation’s public health.”

Today, UNICEF UK published an open letter to the Prime Minister calling on the UK government to deliver a National Baby and Toddler guarantee for every young child, regardless of where they live.

Young children across the country are missing out on vital support at the most important time of their lives. From health visitor appointments to mental health support, to affordable childcare – parents and carers need better access to local services because #EarlyMomentsMatter. A child’s first few years are the foundations for their ongoing health, development and safety.

Celebrities and children’s charities have joined the campaign. If enacted, the National Baby and Toddler Guarantee would set out the basic services that every young child is entitled to – and make sure they get them. It would mean parents and carers know what support they will receive to support their baby’s health, wellbeing, and early education, right from the start.

Alison Morton, iHV CEO, says:

“This welcomed campaign by UNICEF UK shines a much-needed spotlight on the importance of the earliest years of life. At the moment, too many babies, young children and families are missing out on vital support. At the same time, we have a poor state of child health in this country with widening inequalities compared to other similar nations. Our children’s health, wellbeing and safety is too important to be left to chance – we join with a growing body of other children’s charities and celebrities calling for a National Baby and Toddler Guarantee for all, regardless of where they live”.

The Institute of Health Visiting and SAPHNA (School And Public Health Nurses Association) have written an open letter to Neil O’Brien MP, Parliamentary Under Secretary of State (Minister for Primary Care and Public Health) in advance of next week’s Spring Budget.

The Spring Budget 2023 will be presented by the Chancellor of the Exchequer, Jeremy Hunt, to Parliament on Wednesday 15 March 2023.

 

iHV has co-signed an open letter to Sajid Javid, Secretary of State for Health and Social Care, calling on Government to give families a #FairStart. Signed by 25 organisations and several cross-party MPs, the letter urges the government to rebuild the health visiting service and to improve access to mental health services for new parents.

Further to the letter spear-headed by the NSPCC, in Westminster today, parents and professionals presented Sajid Javid with a Fight for a #FairStart petition signed by almost 22,000 people across England – urging him to improve access to perinatal mental health support, to rebuild health visiting services and to invest more in family help.

Georgina Mayes, iHV Policy and Quality Lead, attended the Parliamentary event to represent the Institute and provide evidence to support the call – including our most recent State of Health Visiting Survey and our popular useful infographic, “Who are health visitors and what do they do?” Health visitors provide a vital infrastructure of support for all families, addressing numerous cross-government department priorities for health, education and lifelong wellbeing and the prosperity of our nation. Yet this is often poorly understood, and places the health visiting service at high risk of cuts in the never ending short-term policy cycles.

Health visitors have the potential to do so much for our babies, our families, and our public services. The first 1001 days is a period of opportunity and vulnerability. Support for our babies, children and families is needed now, more than ever. Health visitors support children’s development and help to keep them safe. They are skilled Specialist Community Public Health Nurses able to engage and build relationships with families, understand their health and care needs, offer support and intervention, and broker engagement with other services.

Current resourcing decisions mean that many health visitors cannot effectively do the important work they were trained to do. Since 2015, when responsibility for health visiting was transferred to local authorities, it is estimated that at least 30% of the health visiting workforce has been lost, with further losses forecast. The Public Health Grant has fallen in real terms from £3.99 billion in 2015–16 to £3.3 billion in 2022-23, this is at a time when need has increased.

NSPCC’s new analysis of the latest Public Health England data shows that 19% of babies didn’t receive their 12-month health visitor review by the time they were 15-months old. In addition, the number of babies missing this vital check is up from five years ago when 18% of 15-month-old babies had missed their 12-month review, equating to a 10% decrease in the proportion of babies who had had their 12-month review by the time they were 15 months.

The under-resourced health visiting services are causing a postcode lottery of access to support.

The ‘Fight for a Fair Start’ campaign aims to improve access to mental health support for the one in five mums and one in ten dads who experience perinatal mental health problems during pregnancy and in the first year after birth. With the right support parents can continue to develop a healthy relationship with their baby, but without this support problems can worsen and leave parents struggling with day-to-day tasks.

‘Thank you from the iHV and all health visitors’ to all the parents and organisations who recognise the value of an effective health visiting service and have supported this campaign.

Together, we are fighting for a #FairStart for every family.

iHV joins a large coalition of charities, led by Sustain and The Food Foundation, and including Royal College of Midwives and Royal Society of Public Health, to send a letter to the Secretary of State for Health and Social Care, Sajid Javid, asking him for urgent action on the Healthy Start scheme.  He is being asked to extend the paper vouchers while the digital scheme is fixed.

The rising cost of living is adding more pressure to families in the UK already struggling to afford and access an adequate diet. On average, each month, 8% of households did not have enough money for food over the financial year 2019-20 according to the Government’s UK Food Security Report. Food insecurity levels in households with children remain extremely high. According to data from the Food Foundation, over 2.5 million children live in households that have experienced food insecurity in the past six months.

Against this backdrop, the Healthy Start scheme plays a vital role in supporting low-income young families and pregnant mothers to eat well. However, there are concerns about the roll-out of the digitisation of the scheme. These concerns have been raised repeatedly with officials at the NHS Business Services and the Department of Health and Social Care (DHSC) but the problems have not been rectified and time is running out before paper vouchers are removed from circulation on 31 March 2022.

The digitisation of Healthy Start can help to reduce access barriers if managed properly and with a clear understanding of the circumstances of those it is targeting. However, without urgent action, hundreds of thousands of families across England, Wales and Northern Ireland are at risk of losing the nutritional safety net provided by
Healthy Start.

First 1001 Days logo

The Institute of Health Visiting (iHV) joins over 60 First 1001 Days member organisations who have today jointly written to the new Secretary of State for Health and Social Care, Sajid Javid, asking him to address the impacts of the pandemic on babies and their families, and to take longer-term action to ensure all our children have the best start in life.

Alison Morton, Executive Director iHV, said:

“The importance of getting it right for every child cannot be over-emphasised. The needs of babies, children, and young people have all too often been overlooked in pandemic policymaking. Although some money has recently been spent on mitigating the impact of the pandemic on older children, nothing has been spent or allocated to children aged under two.

“We now need the Government to prioritise on babies’ health and wellbeing, and those of their families, to ensure that all children have the best start in life. Giving our babies the best start in life can improve health and wellbeing for decades to come and positively impact future generations.”

The letter describes three things that the Secretary of State should prioritise to make a significant difference:

  1. Securing funding in the upcoming Spending Review to deliver the Government’s Best Start for Life vision.
  2. Setting out clear expectations in the Health and Care Bill that local partners will cooperate in order to improve outcomes and reducing inequalities for children in the first 1001 days.
  3. Ensure that the new Office of Health Promotion can intervene when a local area is not delivering the Healthy Child Programme or is experiencing poor, declining, or unequal outcomes in the first 1001 days, providing additional support and resources where needed.

This year’s remit letter from Jo Churchill (Parliamentary Under Secretary of State for Prevention, Public Health and Primary Care) to Michael Brodie, Chief Executive at Public Health England (PHE), was published today confirming PHE’s strategic remit priorities for 2021 as an Executive Agency of the Department of Health and Social Care.

In the letter, the Minister thanks PHE’s staff for their vital role in protecting and improving the public’s health since the agency was formed in 2013 and, in particular, for their contributions to the pandemic response stating:

COVID-19 represents the greatest health challenge in living memory. Everyone working in PHE has shown extraordinary dedication in the face of this global challenge and your work has, and continues to have, a tremendous impact”.

The letter also builds on the Government’s plans to strengthen the public health system, including this year’s ongoing transitioning to new public health arrangements with the establishment of the United Kingdom Health Security Agency and the new Office for Health Promotion (OHP).

PHE will continue to respond to the wider health impacts of COVID-19, as well as acting on the following key priorities:

  • Reducing health inequalities
  • Obesity, healthy weight and nutrition
  • Mental health
  • Tackling health harms
  • Sexual and reproductive health
  • Early years
  • Public health reforms

We are delighted to see that the Early Years are once again formally acknowledged as a priority for the Government as a key part of their plan to reduce health inequalities. The remit letter also recognises the impact that the COVID-19 pandemic has had on children’s health and development, especially those children and young people identified as vulnerable within the Vulnerability Framework.

The key early years priorities for 2021/22 include:

  • Modernisation of the Healthy Child Programme, with a focus on speech, language and communication, and intensive parenting support to contribute to reducing health inequalities.
  • Contributing evidence to Leadsom’s Early Years Review for maternity and the first 2 years.
  • Improving the evidence and developing training to support a healthy weight and healthy lifestyle during pregnancy and during early years (0 to 5).
  • Supporting the Department of Health and Social Care (DHSC) in the evaluation of the Ages and Stages Questionnaire digitalisation programme, and provide data and analytical support for contract negotiations.

Georgina Mayes who has recently joined the iHV as Policy and Quality Lead said:

“I am delighted to see the Government’s renewed clear commitment to the early years with prioritisation of levelling up to ensure that no child is left behind. This work to reduce inequalities and improve outcomes for all children cannot start soon enough. Health visitors, as leaders of the Healthy Child Programme, will be central to the delivery of these plans through their universal reach into all families. We look forward to working closely with PHE to support the translation of these priorities into practice.”

100+ organisations (including the Institute of Health Visiting) say that despite the Prime Minister’s pledges, the needs of babies, children, and young people have all too often been overlooked in pandemic policymaking.

In a letter to the editor of the Daily Telegraph, the children’s sector has called for children and families to be put at the heart of recovery plans. The letter is published as the Telegraph launches its own Campaign for Children.

quote from Children at the Heart campaign

#ChildrenAtTheHeart

As part of the Children and Young People’s Health Policy Influencing Group, the Institute of Health Visiting joins organisations calling on the Secretary of Health to put #ChildrenAtTheHeart of the upcoming Health and Care Bill.

Alison Morton, Executive Director, iHV, commented:

“iHV joins together with partners as a signatory to this letter. The Integrated Care Systems plans have so much potential for good – let’s make sure they set off with children at the heart. At the moment services and policies for children are fragmented from the top of Government to the frontline.”

Logos of signatories of the Children and Young People’s Health Policy Influencing Group letter to the Secretary of Health