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Long-term, cross-Government strategy needed for first 1000 days of life, MPs say

The Government must kick-start an Early Years Revolution to improve support and services for children, parents and families, says the Health and Social Care Committee.

The Committee’s report on the first 1000 days of life says that if a child’s body and brain develop well then their chances of a healthy life are improved.

Exposure to adversity during this period, however, can have lifelong consequences.

The review follows a study in The Lancet in 2017 that found that people who experienced at least four adverse childhood experiences (ACEs) were more likely to get heart disease, cancer and many mental health problems than those with no experience of ACEs.

The Committee is asking the Government to produce a long-term, cross-Government strategy for the first 1000 days of life, setting demanding goals to reduce adverse childhood experiences, improve school readiness and reduce infant mortality and child poverty.

This should be led by the Minister for the Cabinet Office, with the support of a small centralised delivery team.

The Committee then wants all local authorities to develop plans – with the local NHS, communities and the voluntary sector – to implement this strategy, bringing improved support for children, parents and families in their area. Funds should be pooled to deliver shared, agreed actions.

The report also calls for the Government’s Healthy Child Programme to be revised, improved and given greater impetus. The Committee recommends that the programme should be expanded to focus on the health of the whole family, begin before conception, deliver a greater continuity of care for children, parents and families during this period and extend visits beyond age 2½ years.

Under the current programme, all families are entitled to 5 visits from health visiting services up to age 2½ years. The Committee recommends that an extra visit should be introduced at age 3-3½ years to check children are on course to achieve the level of development deemed necessary to start school.

Some children, parents and families need extra, more intensive, support if their child’s development is off track.

The Government must use the Comprehensive Spending Review in 2019 to shift public expenditure towards intervening earlier rather than later and thereby secure long-term investment in prevention and early intervention to support parents, children and families.

Dr Paul Williams MP – a practising GP – who led the Committee for this inquiry, said: “There is a crisis in children’s mental health in this country. But all we are seeing are cuts to health visiting, children’s centre closures and increasing child poverty.

“The Government must now show inspiring leadership to help children get the best possible start in life.”

Nuffield Trust Chief Executive Nigel Edwards said: “Child health has been notably absent from policy thinking in recent times and our own research has found that we are trailing behind our counterparts in other countries when it comes to several vital measures including breastfeeding, immunisation and obesity rates.

“The report is right to prioritise tackling social deprivation, which we know is linked with infant mortality, in order to address some of these worrying trends.

“The Government must take this report seriously or we will continue to fail to give children the best start in life, with consequences that will haunt them and our public services for years to come.”

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