Intended for healthcare professionals


Reaching all children

BMJ 2001; 323 doi: (Published 28 July 2001) Cite this as: BMJ 2001;323:176

Providing services for mobile and marginalised children is challenging

  1. Margaret A Lynch, professor of community paediatrics (,
  2. David Gough, deputy director (
  1. Newcomen Centre, Guy's Hospital, London SE1 9RT
  2. Social Science Research Unit and Evidence for Policy and Practice Information and Coordinating Centre, Institute of Education, University of London, London WC1H 0NR

    Primary care p 210

    In Britain the many initiatives to improve the wellbeing of children are operating against the backdrop of a government commitment to reduce health inequalities and improve access to services. Yet ensuring the right of all children to have equal access to services remains challenging.

    In this week's issue Webb et al highlight the unmet health and developmental needs of children living with their mothers in a refuge for victims of domestic violence (p 210).1 Not only are these children likely to have special needs associated with living in violent households2; they also have poor access to services, including “universal” services such as immunisation and health promotion. All children from marginalised populations face this double jeopardy. For many, such as travellers, homeless families, children living rough, and asylum seeking and refugee children,3 this is because of poor access to both mainstream and specialist services.4 For others, ironically, it is because a specific health or social care need has been identified and led to the provision of selective services. For example, children receiving specialist disability services may have less contact with general practitioners and health visitors5; children considered “in need” by social services may have less …

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