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UK's Child Mortality Performance Is Unacceptable

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One of the most shocking statistics relating to children in our country is the fact that five lives under the age of 14 would be saved each day if our record on child mortality was the best in Europe - that's the equivalent of 1600 avoidable child deaths a year; a truly startling figure.

The government's response to this, published today, is to sign a pledge to reduce child deaths and demand others with the power to make a difference to join them in doing so. The aspiration is that "for the very first time, everyone across the health and care system is determined to play their part in improving health outcomes for children and young people".

Why, one might ask, when we are talking about a section of society we have all at one stage been a part of, and one that accounts for up to a quarter of the population, have children been an after-thought rather than a priority in health provision for so long?

The problem is, of course, complex, but there are some simple issues which need attention. General Practice primary care is not working as well as it should do for children - death rates for illnesses which rely heavily on primary care services such as asthma and pneumonia, are higher in the UK than other comparable countries. Throughout the system there are too many errors by staff who have inadequate paediatric training or supervision. This is reflected in the fact that the Healthcare Commission reported that nearly a half of acute trusts are weak on outpatient care for children with services designed around acute illness rather than chronic disease. Poor GP provision for children has meant that hospitals have become overwhelmed with acute and minor illnesses whilst services for long term conditions suffer.

The pledge to reduce child deaths is a clear sign the government is committed to radically improving outcomes. It follows a report of the Children and Young People's Outcomes Forum, a panel of independent experts appointed by the then secretary of state for health, Andrew Lansley, to advise on what outcomes matter most to children, young people and their families, and what the reformed health system can do to help improve these. The Forum made a wide range of recommendations to address the current failings: giving children a stronger voice in the health service, improving an 'unacceptable' situation with children's medication, and the old chestnut of health and other services needing to work together more efficiently.

Accompanying today's pledge is a "sector wide response" which, while not offering solutions to every issue raised by the Forum, does contain some very welcome commitments. There is hope of better data on the health challenges children experience and their views on the health services they access, with the piloting of a new health and wellbeing survey. The government is also committed to considering the feasibility of accepting all of the Forum's recommendations on improving outcome indicator measures for children.

An area which will need some more development is ensuring that children and young people get their just portion of attention through the various measures in the new system to promote patient and public involvement, and to empower patients in decisions about their own care. The National Children's Bureau have been calling for a young person's version of the NHS constitution - this is not just about 'easy read' but about explaining patient rights in a way that is relevant to how children and young people access health services.

What is probably most encouraging, however, is the unequivocal recognition by government of the challenge. As the minister, Dan Poulter, stresses in his foreword to the response, many children are not getting the care and support they need. But it will be hard to make progress without key partners acknowledging that there is a problem; hopefully all those agencies working on child health at a local level and across central government will now join in signing up to the pledge. That would be an important first step on the road to making sure we deliver the very best health care for our children.

NCB has issued a press statement on the government plans.