iHV welcomes today’s publication of the Royal College of Paediatrics and Child Health (RCPCH) report, State of Child Health 2020, the largest ever compilation of data on the health of babies, children and young people across all four UK nations.


The report shows that for many measures of children’s health and wellbeing, progress has stalled, or is in reverse – something rarely seen in high income countries.

Across most indicators, health outcomes are worse for children who live in deprived areas. Inequalities in some outcomes have widened since the last State of Child Health report in 2017. Progress has also been seriously affected by deep cuts to local authority budgets – used to finance public health initiatives and community services.


Commenting on the launch of the State of Child Health 2020, Dr Cheryll Adams CBE, Executive Director of the iHV, said:

“The results of this report make very sad reading. They build on the evidence base from the recent Marmot 10 years on report and our own latest published research with the health visiting workforce. The State of Child Health 2020 recommendations are excellent and now need to be implemented by ministers. You don’t get a second chance with children – those most disadvantaged today, will be drawing disproportionately on health and wellbeing services tomorrow.

“If the government has any ambition to leave the country in a better place than it was in when they picked up the reins, they must listen and respond quickly to all these recent reports. Our most vulnerable citizens are becoming more vulnerable and only government can change that. Children really can’t wait. Already, many children face uncertain futures as their families haven’t received vital support during their early years.

“It is positive to see health visiting identified as a solution in the RCPCH report. Yes, it is a solution, but very urgent action is required to reinvest into public health before the implications of not doing so become even more stark.”

State of Child Health 2020 brings together 28 measures of health outcomes, ranging from specific conditions – such as asthma, epilepsy, and mental health problems – to risk factors for poor health such as poverty, low rates of breastfeeding, and obesity.

The authors make a number of policy recommendations for each nation. For England, these include:

  • Introduce a cross-departmental National Child Health and Wellbeing Strategy to address and monitor child poverty and health inequalities.
  • Restore £1 billion of real-terms cuts to the public health grant for Local Authorities.
  • Ensure future investment in public health provision increases at the same rate as NHS funding and is allocated based on population health needs.
  • Implement in full commitments from the prevention green paper, Advancing our health: Prevention in the 2020s.
  • Implement commitments to provide a Youth Investment Fund, with protection of the committed £500m funding.
  • Provide health-based support for children throughout education, including funding for increased numbers of school nurses and school counsellors.
  • Provide renewed investment in services for children and families, which support the child’s school readiness.
  • Ensure that health visiting services are protected, supported and expanded with clear and secure funding.

Child health is suffering at the hands of a disjointed approach from central Government is the warning from the Royal College of Paediatrics and Child Health (RCPCH) as it publishes its “State of Child Health: One year on” scorecard today.

The scorecards for England, Scotland and Wales describe progress against the series of recommendations made a year ago in the RCPCH’s landmark State of Child Health report.

The England scorecard reveals progress in some areas including the launch of a Digital Child Health Strategy, the publication of a new Tobacco Control Plan, the initiation of some specialist service reviews in paediatrics and the implementation of the sugar tax. However, there has been no improvement in several fundamental areas, including:

  • No plans for an overarching child health strategy
  • No junk food advertising ban
  • No way of measuring UK breastfeeding prevalence
  • No increased investment in child health research

The greatest areas for concern are the deepening public health cuts which have worsened in the last year and are disproportionately affecting children’s services.  The scorecard marks this ‘black’, quoting latest statistics that show public health spending is over 5% lower in 2017/18 compared with 2013/14.

Professor Neena Modi, President of the RCPCH, said:

The science exists for all to see; invest in the health of children and make a huge difference to their health in later life and hence to their economic productivity. For example, four-fifths of obese children will remain obese as adults and this will result in them losing between 10-20 years of healthy life. That’s a very frightening statistic and something that Government must get to grips with. It’s no wonder the NHS is burgeoning under the weight of ill health. This is time for a long vision for the sake of the nation’s wellbeing and prosperity yet the focus remains short-term and ineffective.”

Dr Cheryll Adams CBE Executive Director of the iHV said:

“Sadly the scorecard results are not a surprise, the Institute is repeatedly warning that cutting public health budgets is a false economy and will impact, not only on children now, but also on future generations and the fiscal spend.  In particular the reduction in health visiting numbers we are seeing following such a very short lived, but exciting growth up until 2015, means that according to our own survey many children are not being seen by a health visitor at all after the 6-8 week contact.  There is a research base clearly demonstrating why prevention matters and its very encouraging to see other countries responding to this by investing in child and family health.  The Institute hopes that England’s ministers respond to the report by reinvesting into public health and particularly the early years and poverty reduction.”

The scorecards reveal that the Scottish and Welsh Governments are making greater strides in enacting policies to improve child health. For example, in Scotland there has been:

  • The passing of the Child Poverty (Scotland) Act with defined poverty reduction targets
  • A new Mental Health Strategy including a commitment to improve transition to adult services
  • An announcement of plans to expand the number of health visitors by an additional 500 by the end of 2018 through the full roll-out of the Family Nurse Partnership programme
  • A commitment from Scottish Government to ensure specialist breastfeeding advice and support is delivered to women

And in Wales:

  • The Public Health (Wales) Act has been enacted which includes extending bans on smoking in public places to school grounds, playgrounds and NHS grounds.
  • A new state of the art facility in Cardiff has opened to expand capacity for child health research

Professor Russell Viner, RCPCH Officer for Health Promotion, said:

“Child health isn’t being given the political attention it deserves in Westminster, which is disappointing given the real commitments from the Scottish and Welsh Governments. While policies such as the soft drinks industry levy and new tobacco control plan are to be applauded, the approach is piecemeal.

“Getting it right in childhood means setting up future generation for a lifetime of better health. Investing in children is an investment in the entire population.”

The RCPCH is calling for each national government to commit to a ‘child health in all policies’ approach, meaning that whenever legislation is passed, the impact on child health must be considered. The RCPCH also wants to see a cross-party committee established to develop a child health strategy.

Professor Modi added:

“We need parity of esteem between acute and preventive healthcare. It is no good only throwing money at treating established problems; there must be far better investment in prevention, which will reap immeasurable long term benefits. This means much bolder public health policies and a reversal of the current destructive cuts to preventive services.”

View the full report and summary here.

The Institute of Health Visiting (iHV) welcomes the findings of the Royal College of Paediatrics and Child Health (RCPCH) landmark report into the State of Child Health which calls for Government to introduce a comprehensive, national, child health and wellbeing strategy, reverse cuts to public health, and tighten controls over smoking, the sale of alcohol and advertising of foods high in fat, salt and sugar.

According to the report, a lack of strategic national focus and persistence of a wide gap between rich and poor in the UK is damaging the health of the nation’s infants, children and young people. Compiled by child health experts, with input from children and young people themselves, the report provides clear recommendations to improve child health.

Dr Cheryll Adams CBE, executive director of the iHV, said:

“The Institute of Health Visiting welcomes the findings of the report and fully supports all its recommendations.  The snapshot of children’s health in the UK captured in this State of Child Health report is very worrying and upsetting.  As a nation, we can’t afford to not invest in our children as they are our future, yet recently their needs seem to have become invisible against the many competing demands being made on government and the NHS. We know so much today with respect to what can influence children’s outcomes across their life course, and in turn benefit the whole country. It’s time to act, to help ensure the best health outcomes for all UK children today, and in the future, by giving them the best start in life.  As an absolute priority and first step, the cuts to public health budgets must be stopped.”

The State of Child Health report brings together data for the first time on a comprehensive list of 25 measures of the health of UK children, ranging from specific conditions such as asthma, diabetes and epilepsy, risk factors for poor health such as obesity and a low rate of breastfeeding, to child deaths. The data provide an “across the board” snapshot of child health and wellbeing in the UK.

Nearly one in five children in the UK is living in poverty and inequality is blighting their lives, with those from the most deprived backgrounds experiencing much worse health compared with the most affluent. Despite some improvements in the health of UK children over the last decades, there is clear disparity with Europe and other developed countries, and major cause for concern.

Dr Adams added:

“We at the iHV will be working with the RCPCH to support their campaign to ensure child health becomes a key political priority, as only then will the prime minister’s aspirations for reducing inequalities become a reality.”

State of Child Health report:

Available on Thursday 26 January – www.rcpch.ac.uk/state-of-child-health