Achieving health for children in public care: Editorial

Hill, Catherine M. and Mather, Mary (2003) Achieving health for children in public care: Editorial. British Medical Journal, 326 (7389), 560-561. (doi:10.1136/bmj.326.7389.560).

Abstract

Every year in England and Wales over 80 000 children experience public care because their parents are unable to look after them, enough to fill the new stadium at Wembley on cup final day. Unlike football crowds their voices remain largely silent. A primary care trust serving a population of 200 000 will be responsible for the health of about 300 looked after children, equivalent to a medium sized primary school.1 The recent guidance from the Department of Health, Promoting the health of looked after children, for the first time explicitly charges chief executives of primary care trusts with improving the health of these most disadvantaged children.
Efforts to address the poor health of looked after children are not new. Since 1948 children entering care have been subject to regular medical surveillance. Despite 50 years of medical checks the House of Commons Select Committee published a damning report in 1998, highlighting the appalling health outcomes for these children and the failings of a system that should have been protective.3 The government responded by injecting £885m ($1426m; €1359m) into the budgets of local authorities through the “Quality Protects” (England) and “Children First” (Wales) programmes. However, performance monitoring of local authorities has highlighted continued neglect of health in looked after children. In September 2001 only 71% were up to date with the national immunisation schedule, only 67% had had a recent dental check, and only 68% had had an annual health assessment

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