The UK has the second highest death rates in western Europe among children under five, according to an international study. The shocking figures in a country with free universal healthcare came as a surprise to the authors - and will be a shock to the UK's parents.
Almost five children die for every 1,000 born, the Institute for Health Metrics and Evaluation in Seattle, found. The UK's rate, at 4.9, is nearly double that of Iceland, the European country with the fewest child deaths, at 2.4 per 1,000 births.
The UK has the second worst child death rate in western Europe after Malta, where there are seven deaths per 1,000 births.
Child death rates are worse in central Europe, with 6.7 deaths per 1,000 births, and eastern Europe, with 9.7. The UK rate is similar to that in Serbia and Poland.
"We were surprised by these findings because the UK has made so many significant advances in public health over the years," said Dr Christopher Murray, the institute's director and the study's senior author.
"The higher than expected child death rates in the UK are a reminder to all of us that, even as we are seeing child mortality decline worldwide, countries need to examine what they are doing to make sure more children grow into adulthood."
The figures are published online by The Lancet medical journal, whose editor, Dr Richard Horton, said politicians need to take child health more seriously.
"These figures show the significant health burden that children bear in the UK compared with their European neighbours," he said.
"The reasons for this are likely to be complex, but undoubtedly include the poor organisation of children's health services in the UK.
"Until our politicians begin to take the health of children – the health of the next generation of British citizens – more seriously, newborns and older children will continue to suffer and die needlessly."
Death rates of children under five are high in the UK at almost every stage – in the first six days of life, between one month and one year old and between one year and four years old.