- 09 April 2019
Sir Albert Aynsley-Green, the former first children’s commissioner for England now Visiting Professor of Advocacy for Children and Childhood at Nottingham Trent University and Professor Emeritus of Child Health at University College London, discusses the need for public health to be at the forefront of efforts to support children and young people to thrive
Is childhood across Britain in crisis? The answer in my new book The British Betrayal of Childhood is an unequivocal ‘yes’! And it is time for politicians, practitioners in public health and the public to wake up to the reality.
Children matter - to parents, families and communities. They are our nation’s most precious resource because more older people are living longer. Who will provide the wealth to support them? - children today.
So, through an economic lens we need healthy, educated, creative and resilient, happy children with the life skills for those who can become confident adults and parents. But we must also make sure that those who can’t through disability or disadvantage are also supported to develop their full potential. Surely, this should drive political policy? But, does it? My analysis concludes that it doesn’t.
Yes, we have fantastic children everywhere, many overcoming difficulties of illness or disadvantage not of their making; most are supported by loving families and motivated staff in children’s services. But the uncomfortable reality is that we have some of the worst outcomes for children across health, social care, education, youth justice and poverty in the developed world. The 'exam question' is ‘why’? A question that politicians seem unwilling to answer.
My answer is fourfold:
- indifference in public and political ‘attitude’ to the importance of children in stark contrast to what I’ve seen in Holland, Canada and Finland;
- government policies that are short term, inconsistent, and in the case of dismantling ‘Every Child Matters’ shown to be untrustworthy
- the failure of effective political advocacy for the best interests of children and, finally,
- the ubiquitous presence of bunkers and silos in and between organisations in the children’s sectors.
Local authorities are facing intolerable pressures as a result of savage austerity. Some, for example Northamptonshire, are near bankrupt, with others not far behind. Impossible choices are being faced by local politicians, the majority really caring about the communities they serve. So, how can the needs of children be protected in the face of overwhelming demands for services for the elderly alongside shrinking budgets?
The devastating impact on children’s services is stark. Inadequate access to mental health services is a national scandal in the light of the tsunami of emotional ill health even in young children. Families with children with disability, especially learning disability, have to ‘wade through the swamp', all to get the support they are entitled to.
The number of homeless children and those needing protection is soaring, with many authorities failing to intervene until complex cases reach crisis point; over 47,000 children (65% of all looked after children) are in 63% of councils that, say Ofsted, are inadequate or require improvement.
But what is the ‘lived reality’ of children and families suffering the consequences? The BBC exposed the plight of Torie Brooks, a mother of four children with profound disabilities in Northampton, who said that ‘nobody deserves to be treated this way’ after the loss of vital support. She is not alone in experiencing despair in 2018 in one of the richest counties in the world. Who cares? Who is speaking out?
So, let’s step back and ask what do babies and children need to thrive?
I argue it is time to change public and political attitudes to the importance of children, get a long-term cross-political party, evidence-based agenda for them based on a clear definition of what we are trying to achieve for them. Developing effective advocacy for the best interests of children is urgently needed alongside getting out of the bunkers and silos to see best practice elsewhere. ‘It doesn’t have to be like this’ should be the mantra.
In my view they need ‘nurture’, and this should be everybody’s business, as best encapsulated in the African proverb ‘It takes a whole village to raise a child’.
Thus, parents are fundamentally important, but local communities are vital for play, managed risk, connection with nature alongside sport, music and the arts. Faiths promote spirituality and purpose of life, whilst local politics provide resources for statutory children’s services in health, education and social care supported by the voluntary sector.
How do we ‘build villages for children'? I argue that public health should be at the forefront of leading change – but is it?
Based on The Human Early Learning Partnership model in Canada I suggest understanding the local context is fundamental through ‘mapping’ children’s lives from routine data. The concept is simple – to ‘map’ by postcode locality the routinely collected data on the life of the child – inputs, outputs and outcomes across health, education, social care, youth justice and poverty. The locality-based data are used in Canada by childhood coalitions, schools, government ministries of health and education and researchers, particularly to inform advocacy for children’s needs, and to recommend changes to policies and funding.
The mapping encompasses:
- the population and its demography;
- description of local services - who’s who? what’s where?
- the local economics of children’s services – what is spent, where and how? What needs to be spent?
- developing a long-term strategy embedded in ‘beginning with the end in mind’ – in other words, what are we trying to achieve?
- defining objectives and metrics;
- listening to children, young people and families and working with the media.
The power of the model in transforming local communities is shown by the benefit from ‘mapping’ the ‘nurturative’ assets for children by school postcode as I have seen in Alberta. In this exercise, I saw a computer printout by school locality that listed resources for children from crèches and early years facilities for babies and infants, alongside resources for older children and teenagers through school and after school sports groups, arts and public service opportunities. This gives an amazing ‘snapshot’ of how communities are taking seriously their responsibility for the nurture of their children.
So, to my ‘exam question’ – is there a need for the ‘mapping approach’ here in Britain? From my many-fold visits to Canada and from seeing for myself the use of this approach to improving localities for children, I am persuaded that the philosophy has huge relevance to us.
However, it is sad to report my depressing experience over the last ten years or more of trying to get local authorities and government to see the power of the approach. In my view, it’s time for public health practitioners and politicians to understand the Canadian approach and to road test it here. In particular, we need to understand the economics of not getting it right for childhood today.
At the end of the day, it is local leadership that will drive progress. But, are we doing enough to find authoritative leaders especially from the younger generation of colleagues? Do we give them the toolkits and clout to get traction?
Does anyone speak effectively for children in your organisation? If not, why don’t they?
So what do you think? What actions can you take to improve the outcomes for your children? If you don’t, who else will?
Sir Al Aynsley-Green’s book The British Betrayal of Childhood is published now by Routledge.
Find out more about RSPH’s work with children and young people through the Level 2 Young Health Champions Award.