Many children in wealthy countries such as the UK face huge yet avoidable adversities, risk factors for toxic stress and lifelong physical and mental health problems. Al Aynsley-Green notes how the covid-19 pandemic has compounded this scandal, but presents a chance to reset the baseline and end the betrayal
Our children overall have some of the worst outcomes in the developed world for health, education, social care, justice, and poverty, as my 2018 book The British Betrayal of Childhood documented. High levels of childhood adversity can give rise to a toxic stress response, with lifelong implications for physical as well as mental health.
In 2017, the Royal College of Paediatrics and Child Health documented shocking key indicators, including for child mortality, preventable injuries, mental ill health, adverse health behaviours, long term conditions, and family and social environments. Three years later progress has stalled or is even reversing.
The covid-19 response
Children seem more resistant to covid-19 infection, but have suffered disproportionately from 2020’s lockdowns: school closures, isolation, loss of education continuity, denial of play and sport, with soaring domestic violence, child abuse, and obesity.
The pandemic has also had deleterious impacts on children’s health services. Particularly vulnerable children, including those with special educational needs, disabilities, and in the criminal justice system may be faring worst.
Far from being a leveller, the pandemic is exacerbating the widening social inequality exposed by Sir Michael Marmot.
Prioritise children’s needs
The Children’s Society charity wants the government to put children’s interests at the heart of recovery from coronavirus despite children’s needs seemingly forgotten as a government priority, eclipsed by economic concerns of getting parents back to work.
Why does British society have such long standing indifference to children? And why are children being let down so savagely now? We have four fundamental problems.
First, unhelpful attitudes towards children and the importance of their start in life are rife in public and political discourse. It’s engrained that families care for their own children, but society does not care enough for other people’s children, especially if they are different or troublesome. Political polarisation of the roles of the state and parents in feeding children was recently laid bare by the footballer Marcus Rashford’s campaign to provide free meals to poor children in school holidays.
Second, untrustworthy politicians and short-term decision making systematically decimated the internationally applauded Every Child Matters policy. Every department of state had been obliged to promote five key outcomes. Local directors of children’s services provided local coordination, focused on Sure Start Centres, most of which have closed.
Who in government now is responsible for children’s needs overall? Who has responsibility for developing joined-up policies to support children?
Third, the sector lacks coordinated advocacy. Fourth, silos within and between professions, organisations, and government departments are ubiquitous. Individuals and organisations with passion, skills, innovation, and knowledge are waiting to build on what has gone before. But the gap between what is needed and what seems possible is often too daunting.
Building local communities with resilient children should be embedded in all policy and practice. Needs should be identified early and interventions made available. This takes inspirational local leadership, as is being developed in Newark and the north east and Cumbria.
Reasons for optimism
The pandemic gives some reasons for optimism. Greater family cohesion, home learning, and imaginative online study can mitigate adversity. The Co-space Study has shown remarkable resilience in some young people, and we must acknowledge articulate and motivated young people themselves.
Not all rich countries had similarly dismal outcomes pre-covid-19, and the Netherlands, Norway, and Denmark may have done best for children during covid-19. Canada shows how local organisations can map the needs of children and families across health, education, social justice, and poverty.
Article 12 of the UN Convention on the Rights of the Child insists we listen to children. We must put their needs at the centre of healthcare services, schools, outdoor space, the built environment, care systems, and courts.
Children are the future of the very society that keeps letting them down so badly. As we emerge into a post-covid-19 world, we must rethink the society in which we hope to live. We must reset a better baseline for adversity in childhood to reduce the impact of toxic stress. We cannot allow children to be betrayed again.
Practical steps to improve outcomes
- Appoint local directors of children’s services to integrate all aspects of their lives
- Commission “mapping” of local children’s lives from routinely collected data across sectors
- Collaborate with education, social care, justice, and child poverty–child health and wellbeing are not just the preserve of health professionals
- Confront barriers between primary care, hospital, community, and mental health services
- Establish a cabinet level secretary of state for babies, children, young people, and families responsible for integrating all aspects of policy for children
- Empower doctors and nurses through effective leadership to speak out for the best interests of expecting mothers, babies, infants, children, and young people
Al Aynsley-Green, Former first Children’s Commissioner for England 2005-9; Professor Emeritus of Child Health, University College London; Visiting Professor in Advocacy for Children and Childhood, Nottingham Trent University
Competing interests: None declared
Provenance and peer review: Commissioned; not externally peer reviewed.