Intended for healthcare professionals

Education And Debate

Who is speaking for children and adolescents and for their health at the policy level?

BMJ 2000; 321 doi: (Published 22 July 2000) Cite this as: BMJ 2000;321:229
  1. Albert Aynsley-Green, president, Association of Clinical Professors of Paediatricsa (,
  2. Maggie Barker, director of public healthb,
  3. Sue Burr, adviser in paediatric nursingc,
  4. Aidan Macfarlane, consultantd,
  5. John Morgan, college officer for Walesg,
  6. Jo Sibert, professor of community child healthe,
  7. Tom Turner, college officer for Scotlandg,
  8. Russell Viner, senior lecturer in adolescent medicinea,
  9. Tony Waterston, consultant paediatricianf,
  10. David Hall, presidentg
  1. a Great Ormond Street Hospital for Children and the Institute of Child Health, University College London, London WC1N 1EH,
  2. b Camden and Islington Health Authority, London NW1 2LJ,
  3. c Royal College of Nursing, London W1M 0AB,
  4. d Public Health Resource Unit, Institute of Health Sciences, University of Oxford, Oxford OX1 3PT,
  5. e University of Wales College of Medicine, Llandough Hospital, Penarth, Cardiff CF64 2XX,
  6. f National Children's Bureau, London EC1V 7QR,
  7. g Royal College of Paediatrics and Child Health, London W1N 6DE
  1. Correspondence to: A Aynsley-Green
  • Accepted 21 June 2000

Personal view p 249

The Bristol inquiry has put children at the heart of the public's agenda on health. This contrasts with the seemingly low position of children on the Westminster government's own health agenda. This status is exemplified by the current consultation exercise to draw up a national plan for health. Although this, together with the increase in funding for the NHS, is welcome, paediatricians are dismayed at the inadequate voice for children and adolescents in the modernisation action teams that are taking forward the definition of the plan.1 Only one registered children's nurse and a health visitor have been appointed to be custodians of the interests of all children and young people. This reinforces a widely held perception by children's doctors and nurses that the government is not committed to ensure that the interests of children and adolescents—whose needs are different from those of adults—are spoken for as a client group in the health service. We argue that there is an urgent need for children and adolescents to be explicitly represented at all levels of health policy. Furthermore, measures need to be implemented to deliver not only a coherent strategy for children's health in England, but also more effective responsibility for integrating service delivery at the local level.

Summary points

Children and young people are a nation's most precious resource, and their health is vital for the future success of our society

Despite this, improving the health of English children is not a key government target

Children are not young adults: their special health needs should be acknowledged

A strategy needs to be defined for children and young people, with responsibility allocated for integrating care within the health service and between sectors

It needs to be recognised that children have fundamental human rights for which protection is needed

These …

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