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State of Child Health: Northern Ireland – Two Years On

This document is entitled “State of Child Health: Two Years On” as it is two years since our landmark State of Child Health report was published in January 2017. We had intended to publish policy recommendations at the same time in Northern Ireland, but mere days before our launch date, the Northern Ireland Executive collapsed. Optimistic that power would be restored, we proceeded to publish our recommendations for Northern Ireland in June 2017. But two years on from the intended launch date, we remain in the same situation. No Executive, no Assembly. And minimal progress in advancing integrated policies that positively impact meaningful child health outcomes.

This scorecard reveals a stalled position for child health policy without a Northern Ireland Assembly or Executive. Where significant progress had been made before dissolution – for example with a draft Children and Young People’s Strategy, and a draft Suicide Prevention Strategy – the absence of Ministers and Members of the Legislative Assembly has meant that very little policy development or implementation have been achieved since.

It is not all bad news, as our scorecard demonstrates. The Department of Health published Delivering Together - Progress Report which stated that the regional paediatric managed clinical network had been initiated and is being led by the Public Health Agency. A graduated driver licensing system is set to be introduced in 2019/20 to protect young drivers from road traffic incidents. The Public Health Agency have prioritised safe-sleeping to reduce sudden infant deaths and will soon launch a public awareness campaign on this issue. New guidance for health professionals on smoking cessation in pregnancy has been published. The Department of Health have produced a mid-term review of their breastfeeding strategy and set out a monitoring report to assess its implementation. And 20mph speed limits have been rolled out in various residential areas across Northern Ireland, creating safer spaces for children to walk, cycle and play.

This minimal operational progress does not come close to contributing to the recommendations set out two years ago. The vast majority of our recommendations simply cannot be progressed without an Assembly or Executive. Meanwhile, children and young people’s mental health in Northern Ireland remains at crisis point. Obesity rates are stark, with a quarter of children in Northern Ireland overweight or obese. And Northern Ireland remains without a child death overview panel, despite 2018’s hugely concerning Hyponatraemia Related Death Inquiry Report highlighting the pressing need for its development.

With no end to Northern Ireland’s political turmoil in sight, and Brexit, with all its uncertainties, just around the corner, we fear that child health and wellbeing in Northern Ireland is in real jeopardy. The delivery of healthcare to children and young people in Northern Ireland is intimately bound up with the Republic of Ireland and Great Britain for highly specialist work – and this needs careful work and preservation as we approach the UK’s departure from the European Union. We need clear, decisive leadership in Northern Ireland to implement these recommendations, which is why we are calling for a commitment from all political parties to put an end to this damaging deadlock and progress its work-streams currently on hold with the Department of Health and other partner agencies to put child health at the top of the agenda before it is too late.