Ten actions the government can take to improve children’s health

Introduction

Children’s health and wellbeing has seen a concerning decline in recent years, with children in the UK experiencing some of the worst health outcomes in Europe. Many lifelong health issues are established in childhood, and unless strong and meaningful action is taken to change course, the current generation of children is set to become an unhealthy generation of adults. This will have serious long-term implications for the economy, the health service and society as a whole – as well as consequences for the children themselves. Investing in the health of children and young people is an investment in the future and will provide long-term returns.  
 
Improving children’s health will take comprehensive effort across all of society. The government has committed to raising ‘the healthiest generation of children in our history’, and this briefing focuses on a list of actions that the government should prioritise. While the list is not comprehensive, we believe that these steps are ones that should be taken as soon as possible to maintain the government’s momentum on its commitment.

Current context

Children’s physical and mental health outcomes in England are on a downward spiral. More than 1 in 5 children are living with obesity by the time they leave primary school, referrals to mental health services for anxiety have more than doubled since before the Covid-19 pandemic and the height of 5-year-olds in the UK has been falling since 2013.  
 
Health inequalities (which can be driven by socioeconomic status, poverty, ethnicity, income and housing) have a strong influence on child health outcomes – with children from lower-income families less likely to eat healthy food, less able to access the medical care they need, and more likely to experience adverse childhood experiences that have a cumulative negative effect on physical and mental health in later life. Reducing health inequalities as a result of child poverty will be key to improving children’s health. 

Inadequate nutrition in particular is playing a central role in the declining health of children. The trends we’ve outlined coincide with the introduction of austerity measures (which have increased the number of children living in poverty) and are linked to food poverty, resulting in poor diets that lack essential nutrition. If these trends continue, we will see severe long-term health consequences. Making sure that children receive a balanced and appropriate intake of nutritious food, and are protected from ultra-processed foods that lack essential nutrients, is crucial to them growing up healthy. 

Schools play a wide and increasingly engaged role in children’s health. Recent reports talk of primary school staff having to administer laxatives due to a sharp rise in the number of children suffering with constipation – a 60% increase in hospital diagnoses of constipation in primary school children in the past decade. The food a child eats at school makes up around 30% of their daily intake, and the availability of free school meals presents an opportunity for children to receive a nutritious meal. In England, free school meals are provided for all pupils up to Year 2 (apart from in London, where all primary school pupils receive free school meals). A recent survey found that more than 1 in 3 schools said hunger and food insecurity were affecting children’s ability to learn and function at school, resulting in poor concentration, increased tiredness and behavioural issues. 
 
The rates of children and young people with probable mental health conditions has increased from about 1 in 8 children and young people in 2017, to 1 in 5 in 2023. There is growing concern around the use of social media and technology among children and young people and the impact on their mental health and wellbeing. Access to adequate mental health services and support is a huge problem, with recent data showing that 40,000 children waiting for mental health support experienced a wait of more than two years.  
The evidence is clear that health inequalities begin in the early years of a person’s life, and become entrenched over the course of childhood and into adulthood. Children and young people living in poverty are at greater risk of experiencing poor health outcomes. In the UK, around 4.3 million children are living in poverty, and between 2014 and 2021 the UK had the largest rise in relative child poverty of any advanced nation. The effects of this are wide-ranging and have an impact on children’s physical health, mental and emotional wellbeing, and education.  
 

Health and care services for children

Demand on the children’s health and care workforce has continued to increase at an unprecedented rate. Combined with shortages across the children’s workforce, ranging from midwifery and health visiting to consultant paediatricians, school nurses and allied health professionals, this means a record number of children are waiting to access health services. Children’s health services have witnessed underinvestment and reprioritisation at system and local levels, with a gap between research and innovation for adult health services and children’s health care, and children’s health services frequently being out of the scope of government investment – for example, many system-level targets and delivery plans are adult-focused. A growing gap between demand and capacity means that waiting lists for children’s health services are rising at twice the rate of adult waiting lists, with NHS England data showing that more than 50,000 children have been waiting more than 52 weeks for elective and community health services. Such long waits for care are especially concerning because in children intervention is often needed by a certain age or developmental stage.  

In terms of NHS expenditure, only 8% of mental health spending is allocated to provision for children and young people, despite them making up 30% of the demand. Across England, local health plans produced by integrated care systems (ICSs) show variation in which groups of children are included, and the types of need that are prioritised, with crucial vulnerable groups of children often missed out completely.  
 
Vaccination is a highly effective intervention to prevent children and young people from serious diseases and prevent hospitalisation. In England, vaccination uptake for children has been declining for the past ten years, and for the past six consecutive years the UK has not met the World Health Organization’s (WHO) target of 95% coverage for any routine childhood immunisations. Evidence of this decline is being seen in the rise in cases of whooping cough and measles. This target was removed from the NHS planning guidance for 2025/26, with no mention of moving towards WHO-recommended levels of vaccine uptake.  
 
In its first few months in office, the government has already taken a series of measures to improve children’s health – including introducing the supervised toothbrushing programme, a ban on TV junk food advertising past the 9.00pm watershed and creating the first ‘smokefree generation’ through the Tobacco and Vapes Bill. To continue addressing the issues that are contributing to the poor health of the nation’s children and risking their futures, and to achieve its manifesto ambition to ‘raise the healthiest generation of children in our history’, the government will need to keep up the momentum on actions it takes in this space.  

What can the government do?

As previously outlined, children’s health and wellbeing is influenced by a complex range of factors, which is why action to improve health and wellbeing must come from across government.  

Children’s health has been heading in the wrong direction for too long; the need for change is urgent and requires a multifaceted, multi-system approach. The government has a pivotal role to play in ensuring that every child has a healthier childhood. Adopting the recommendations outlined in this briefing would go a long way to turning the tide and creating a healthier generation of children that is able to reach its full potential.