What does the UK prime minister want for Christmas? He certainly hopes not to see children going hungry. “We will do everything in our power to make sure that no kid, no child, goes hungry this winter during the holidays…” he said at the start of this week. 

This was in response to the campaign by Marcus Rashford, a footballer and campaigner for free school meals, to provide food vouchers to cover school holidays for children in England from low-income backgrounds—already available in Wales, Scotland and Northern Ireland. 

That was his response to the millions who have backed the campaign: from Children’s Commissioners and food campaigners, to a host of children’s charities; from MPs and Lords on every side of the House of Commons and the House of Lords, to teachers, social workers, businesses leaders, and citizens right across the country.  

And that was his response to the open letter from the Royal College of Paediatrics and Child Health—signed by me and nearly 3,000 other paediatricians in just 24 hours—asking him to do the right thing for children.

I admit to feeling underwhelmed. 

It is appalling that children are going to bed hungry anywhere in the world. But it is shameful that the leader of a rich country like the UK should offer a vague assurance that children will have enough food over the Christmas holidays. 

Back in June, The Royal College of Paediatrics and Child Health warned that covid-19 was increasing deprivation; families who were previously getting by OK were coming under severe financial strain. Eight months in, and many of those families are now unable to provide even the basics of nutritious food. 

But food poverty is not just a problem of the pandemic—4.1 million children in the UK were living in poverty before we’d even heard of covid-19. Just days before the whole country went into lockdown, The RCPCH released our State of Child Health report. It showed the detrimental effect deprivation was having on the UK’s children and young people and how we’re in danger of falling behind many other comparably wealthy countries on so many measures of child health.

You know it and I know it: good nutrition is central to the health, wellbeing, and development for children and young people. Without it, children’s health outcomes worsen. Their health as adults suffers and their life chances are impaired.

We know, too, that under-nutrition negatively influences cognitive development and academic performance. So just when so many have missed out on weeks of schooling, a lack of good food—or sometimes, any food—is leaving children with less energy and interest for learning and reduced levels of concentration. At the same time, knowing where the next meal is coming from is central to a child’s feeling of safety and security.

If the moral arguments are somehow not convincing, shouldn’t the financial ones sway any government? Study after study has shown the economic benefit of investing in our children—and the cost of failing to do so. 

When we wrote our open letter, I’ll admit I thought we were pushing at an open door. Sadly, I was mistaken. So what’s behind this baffling intransigence? 

We’re told that local authorities will sort out the problem. 

That would be great if authorities had money ring-fenced for this, but they don’t. Provision for vulnerable children is already their priority. But the short-term hardship funding that the Government provided has now run out and they are making increasingly difficult decisions about which budgets can be raided. Helping the poorest families is being weighed up against providing for the rise in rough sleepers, for adult social care, for child protection services… 

We hear that parents need to be “better at budgeting.” Tell that to the children we paediatricians see, who feel frightened and guilty that their parents are going without meals so that they can eat.  

Others argue that poverty “isn’t just about food.” I couldn’t agree more; we need to look at deprivation across the board—housing, infrastructure, and all the other inequalities which give some children a poorer start in life. At the RCPCH we believe it’s imperative that all UK governments adopt a “child health in all policies” approach to policy-making across every department. 

But that’s long term. Right now, prime minister, it’s really quite simple; children are wondering where the next meal is coming from. Help them. 

Max Davie, RCPCH Officer for Health Improvement, and a consultant community paediatrician in south London.

Competing interests: None declared