Health visitors should become universal service to stem crisis in early years, report says 

The role of health visitors needs to be urgently expanded and better supported to tackle widespread mental health, nutritional and literacy challenges in families, a new report warns.

Reforms are needed to improve children’s development in the pre-school years, amid a growing crisis in the early years.

A new report presents a deeply troubling picture of current barriers facing the country’s youngest children: health visitors report a 91% increase in poverty issues among the families they visit to assess the health of new-born children; numbers of health visitors meanwhile have rapidly declined over the last decade. 

Escalating costs of childcare are making it unaffordable for most parents, and current government ‘under-funded’ plans for child-care will be a backward step for social mobility, as they are unlikely to benefit the least advantaged children. Those interviewed as part of the study said they were concerned some providers will turn away infants whose parents require funded placements in favour of those whose parents can pay full fees.

The report urges those in national and local government to give urgent attention to address the loss of childcare places, the crisis in recruitment and retention in both health visiting and early years provision, and the lack of resource and funding in local government.

Health visitors should be able to promote parent-infant reading and trigger visits from mental health professionals, welfare rights support teams and others when they encounter issues like drug abuse, financial issues and domestic abuse problems, the report says. Supporting parent-infant reading and recording reading activities in a log to accompany the red book would help to develop speech and language skills and encourage early literacy development.

To help make health visiting a universal gateway service local authorities should establish Early Action Groups, bringing together the public, private and voluntary sector. Local councils should have a Cabinet Member for Infants.

The report, A Plan For Early Action: Opportunities for Change in Early Years Policy and Practice, was produced by the South-West Social Mobility Commission. It is endorsed by Sir David Bell, former HM Chief Inspector and Permanent Secretary in the Department for Education.

The South-West Social Mobility Commission was set up to bring about transformational change in education and employment outcomes for children and young people from under-resourced backgrounds. Chaired by Sir Michael Barber, it brings together a dedicated and passionate group of civic leaders from across the South-West peninsula to drive work to break down the barriers facing young people in the region. The University of Exeter houses the Commission Strategy Unit, which produced the report.

Dr Antony Mullen, the report’s principal author, said: “What happens in children’s earliest years of life is foundational to their future success. Health visitors are increasingly expected to deal with parental issues like drug abuse, financial issues and domestic abuse problems. There is a danger services have become more focused on parents than the infants.

“Long-term, large-scale investment in the sector is needed, and in this report we show how there are also low- and no-cost solutions that can implemented locally and relatively quickly.”

Sir David Bell said: “A high-quality experience in the early years can have a profoundly positive effect on children, particularly those from the most disadvantaged backgrounds.

“The report encourages collaborative action at the local level, drawing upon work done by the South-West Social Mobility Commission. It expertly binds together practice and policy to provide a series of important recommendations including the interesting proposal for an Early Action Group within each local authority. I welcome this approach as it speaks to the diverse pattern of provision locally and the need to ensure that it is coordinated properly.

“Thoughtful and well-evidenced reports such as this one will play a key role as we work together to make the United Kingdom the best place in the world to be a child and to grow up.”