Children's health gap 'has widened'

3 Feb 10
Health inequalities among children under five have barely improved in the past decade despite more than £10bn of government investment, research has shown
By David Williams

3 February 2010

Health inequalities among children under five have barely improved in the past decade despite more than £10bn of government investment, research has shown.

A study on child health in England published today by the Audit Commission shows that the increase in the numbers of obese children appears to be slowing and that there has been some lowering of death rates among the very young.

However, Giving children a healthy start also concludes that infant mortality rates remain higher than in Ireland, Sweden, France, Germany and Spain. It found that dental health among the under-fives is declining, and that the overall health gap between the richest and poorest children has become wider.

Children from ethnic minorities are also more likely to have health problems.

Commission chief executive Steve Bundred described the findings as ‘disappointing’. He said: ‘Children need a healthier start in life and policies are not delivering commensurate improvement and value for money.

‘Even before they are born, for many, place and parents’ income determine their quality of life and their lifespan.’

The commission calculates that, since 1998, £10.9bn has been spent on initiatives that directly or indirectly aim to improve the health of children aged under five.

That sum includes £7.2bn on Sure Start children’s centres. However, it also noted that the number of health visitors has declined by 10% over the same period, and that parents from the most vulnerable groups were less likely to use available services.

The commission argues that more effective intervention now could cut future rates of diabetes, heart disease and hypertension. Currently, these cost the NHS £4.2bn a year and this is expected to double by 2050.

It recommends stronger partnership working between primary care trusts and councils, which should set ambitious joint targets and establish clear lines of responsibility for improving children’s health.

Local Strategic Partnerships should identify the total spent on young children in an area, and invest only in projects that can be shown to lead to improvements, the report says.

Jo Webber, deputy director for policy at the NHS Confederation, which represents health trusts, said effective partnership working between health trusts and councils was made harder by Whitehall guidance.

‘You do find yourself getting things that are supposed to link together and don’t necessarily at first sight link as well as they could,’ she told Public Finance.

‘Performance indicators [from the Department for Communities and Local Government and the Department of Health] might not be matching up.

‘They look different, they feel different… there is a recipe that could be confusing. Clarity and transparency is something that needs to be developed a bit further,’ she said.

A Local Government Association spokeswoman said the commission was right to highlight the importance of partnerships between councils and primary care trusts, but said improvements were being made.

‘There is a focus on reducing inequalities in all areas of life, which will continue to drive progress in this area,’ she said.

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