What are the political parties offering our children in 2015?

As paediatricians we are extremely concerned about child health outcomes in the UK which are amongst the worst in Western Europe1. The sixth richest economy in the World should be capable of providing children with a decent standard of health and well-being. As paediatricians we must advocate for children and engage with the political system to ensure that child health and wellbeing is appropriately addressed in policy.

With the May 7th General election rapidly approaching we have reviewed the manifestos of the five main political parties standing in all UK regions (table) and compared these with the manifesto recommendations of the RCPCH A Vision for 20152 which highlighted five key areas to be addressed by the incoming Parliament.

Child Mental Health

All parties promised increased funding for mental health with the Labour Party, Liberal Democrats and Green Party mentioning child mental health specifically. The Conservative Party and UKIP were notably vague in their policy proposals.

In a country where 1 in 10 children under the age of 16yrs have a diagnosable mental health disorder3 we must demand a clear strategy for child mental health and more focus on prevention and early intervention.

Nutrition and Overweight

It is estimated that 1 in 3 children are overweight or obese4,5, the detrimental effects of childhood overweight are well established and the future cost to the NHS is expected to be significant.

The RCPCH recommended that the incoming Parliament should promote healthy nutrition in schools and tackle industry, banning advertisements for foods high in fats, sugar and salt before 9pm, and for the promotion of physical activity among children, building on the legacy of the Olympics.

Labour and Lib-Dems were the only parties to address the marketing of junk food, with Liberal Democrats reiterating RCPCHs watershed policy. The Green Party propose to increase VAT on less healthy foodsand to use the money raised to subsidise the cost of fruit and vegetables. They also outlined plans for free and nutritiousschool lunches. The Conservative Party said they would take actionto reduce obesity and promoteclear food information but did not suggest any specific policies. Labour proposed a minimum of 2hrs physical education per week in schools, while the Conservative Party promised funding to promote sport.

UKIP did not address any aspect of childhood nutrition or physical activity in their manifesto. None of the political parties acknowledged that obesity is unlikely to be tackled with a single intervention alone and there is certainly room for a more decisive approach, particularly assurances that they will engage with industry and advertising.

The obesity epidemic is part of a wider social context that cannot be tackled without addressing poverty and inequality.

Living in Poverty

One in 3 children in the UK are living in poverty, the majority of whom are in a family where a least one parent is working6,7. As we know poverty in childhood negatively impacts on almost every aspect of physical and emotional development.

The RCPCH recommended that the Child Poverty Strategy should focus on health inequalities and called for the disclosure of the impact of the Chancellors annual budget statement specifically on child poverty and inequality. Unfortunately none of the parties had a clear strategy to tackle child poverty.

While the Green Party want to increase child benefit to £40/week for every child, Labour intend to cap the benefit for 2yrs. UKIP want to limit child benefit claims to two children and the Conservatives party plan to deny child benefit to any immigrant who has not contributed to the UK for at least 4 years. Policies such as these will condemn some of our most vulnerable children to even greater deprivation. We have a commitment to the health and well-being of all children living in the UK regardless of the circumstances.

The Conservatives also intend to reduce maximum household benefit claims by £3,000/yr and UKIP support a lower cap on benefits in general. The Labour Party, Lib Dems and the Greens stated that they would promote a living wagewhile the Conservatives and UKIP said they would end income tax on minimum wage. Policies such as raising the tax threshold, as suggested by UKIP and the Lib Dems, have been criticised in the past as net gains are ultimately larger for higher earners. Labour promised no increase in VAT, a highly regressive tax.

The Liberal Democrats intend to implement Universal Creditwhich will amalgamate six benefits including job seekers allowance, housing benefits and child tax credits. The aim is to make work payand it is expected that poorer families with children will net-benefit from the change, however there has been some criticism of the programme and the Green Party have stated that they would oppose Universal Credit.

It was encouraging to see that the majority of political parties, excluding the Conservatives, supported an increase in minimum wage, through one policy or another. There were also suggestions by all parties to reduce tax burden on the lowest paid workers but in some cases through policies of questionable merit.

Child mortality and the first 1001 days

As well as extreme health inequities in the UK we also have one of the worst child mortality rates in Europe8,9. The RCPCH called for a Mortality Planto reduce the number of preventable child deaths, with clear targets for reduction. Despite this only the Labour Party made any mention of infant mortality, saying they would prioritiseit as a key area of improvement for the NHS but with no specified strategy or targets. Early Years interventions did feature in four of the five manifestos with the Greens promising the first 1001 days special attentionand Labour to prioritiseit. The Liberal Democrats also promised to protectthe early yearsbudget. The Conservative Party specifically stated they would strengthen the health visiting programmeand the Greens would provide a free and universalearly education service as well as investing in parenting programmes. UKIP did not make any mention of early years investment or child mortality in their manifesto. Given that we know how crucial the first 1001 days are in a childs life10 this should be key priority for all parties. It was also extremely concerning that only one of the parties mentioned child mortality and that none had a clear strategy to improve outcomes.

Child Rights and combating child abuse

All parties gave some mention to child abuse but only the UKIP and the Conservative party plan to abolish the Human Rights Act, separate themselves formally from the European Court of Human Rights, and create a new UK Bill of Rights, the contents of which was not outlined.

Two parties specifically mentioned sexual exploitationwith Labour promising tough new lawsand the Conservatives an overhaul of how the police and social services work together to protect vulnerable children. The Conservative Party hopes to introduce age verification for access to all sites containing pornographic material.

All parties said that they would support or raise the qualityof child protection services with UKIP calling for wholesale reform, but only Labour and Liberal Democrats specifically pledged to increase the number of social workers.

Any improvement in the standard of child protection services must be accompanied by an increase in resources and an end to scapegoating. We must also be alert to any change in law which protects the Human Rights Act and if a new Bill is created Paediatricians must be on guard to ensure our children remain protected.

Adolescents

Adolescents are a group particularly vulnerable to political neglect. Given that youth unemployment (16-24yrs) is currently more than 16%11, university fees are £9,000 per year, inequality is rising and social mobility falling, many of those graduatingto adulthood in the next Parliamentary term face a challenging future.

All parties placed some focus on apprenticeships and vocational courses. Some apprenticeship programmes have been criticised for exploitingyoung people, the Green Party hope to address this by ensuring no un-paid full-time internship would last for more than 4 weeks.

Both the Conservative and Labour Party want to replace Job Seekers Allowance with a new Youth Allowance. The Conservatives plan to time-limit the benefit to six months after which the young person will be obliged to take an apprenticeship or similar if they wish to continue receiving benefits. The Conservatives also plan to end automatic entitlement to housing benefit for 18-21yrs. We are concerned about these unsympathetic policies. In contrast the Green Party and UKIP plan to continue to housing benefits for the under 25s. The Liberal Democrats and Green Party also promised cheaper bus travel for teenagers. Furthermore the Green Party was the only to suggest reinstating the education maintenance allowance and to lower the voting age to 16yrs.

Miscellaneous

Among other policies relevant to child health and wellbeing several parties proposed reforms in the youth justice system with a move away from unnecessary criminalisation and towards restorative justice. The Green Party was the only one to reiterate the RCPCHs suggestion of 20mph speed limits in built-up areas. They also suggest raising the age of compulsory education to 7yrs. The Liberal Democrats and Green Party were the only parties to mention special education needs.

RCPCH also called for more action to prevent childrens access to alcohol including the introduction of a minimum unit price for alcohol. The Liberal Democrats and Green Party were the only parties to support the introduction of a minimum unit price while UKIP said they would actively oppose such a policy. UKIP would also reverse plain packaging legislation for tobacco products.

Conclusion

As a wealthy nation we can afford to be doing more to give our children a happy and healthy start in life. Adult disease and wellbeing are shaped in childhood; we cannot expect a healthy future for the UK if a significant proportion of our children are left behind.

An unhealthy future will inevitably mean a strained national health service and hampered economic growth. Early intervention is key and prevention will always be better than cure. It is absolutely unacceptable that only one party mentioned child mortality in their manifesto and that none had a clear strategy to address the current poor outcomes. It also concerning that where policies were suggested to tackle childhood illness they were often vague and disconnected from the social determinants of health. Despite Michael Marmots seminal publication, Fair society, healthy lives, in 2010 none of the political parties mentioned health inequalitiesor how to address them.

All children exist in a context and understanding this is fundamental otherwise we cannot hope to make significant changes in health and wellbeing.

Overall, we were disappointed by what the political parties are offering our children in 2015. None of the five parties came close to addressing all the recommendations of the RCPCH. If it is not the largest representative of paediatricians shaping child health policy then who is? If our voices are not heard then we must make them heard. Not necessarily by shouting but by navigating the political system and engaging more effectively with policy makers.

UK trainee group, International Society for Social Paediatrics and Child Health

 

 

References

  1. Lewis, I., & Lenehan, C. (2012). Report of the children and young peoples health outcomes forum. InLondon: Children and Young Peoples Health Outcomes Forum.
  2. Making the UKs child health outcomes comparable to the best in the world, A vision for 2015 (2014) Royal College of Paediatrics and Child Health.
  3. Murphy, M., & Fonagy, P. (2012). Mental health problem in children and young people.Annual Report of the Chief.
  4. Public Health England (2015) Child Obesity. Accessed May 2015. Link.
  5. van Jaarsveld, C. H., & Gulliford, M. C. (2015). Childhood obesity trends from primary care electronic health records in England between 1994 and 2013: population-based cohort study.Archives of disease in childhood, archdischild-2014.
  6. Barnardos (2015) Child Poverty Facts. Accessed May 2015. Link.
  7. Parekh, A., MacInnes, T., & Kenway, P. (2010). Monitoring poverty and social exclusion.
  8. Wang, H., Liddell, C. A., Coates, M. M., Mooney, M. D., Levitz, C. E., Schumacher, A. E., ... & Bui, L. N. (2014). Global, regional, and national levels of neonatal, infant, and under-5 mortality during 19902013: a systematic analysis for the Global Burden of Disease Study 2013.The Lancet,384
  9. Marmot, M. G., Allen, J., Goldblatt, P., Boyce, T., McNeish, D., Grady, M., & Geddes, I. (2010). Fair society, healthy lives: Strategic review of health inequalities in England post-2010.
  10. Leadsom, A., Field, F., Burstow, P., & Lucas, C. (2013). The 1001 Critical Days: The importance of the conception to age two period.London: A Cross Party Manifesto.
  11. Youth unemployment statistics - Commons Library Standard Note (2015) Accessed May 2015. http://www.parliament.uk/business/publications/research/briefing-papers/SN05871/youth-unemployment-statistics

Cron Job Starts