Final Report > Chapter 29: The Care of Children > Leadership of children's healthcare services > A broad-based approach

A broad-based approach

40 In the course of the Inquiry it became apparent that the picture presented to us of children's healthcare services, that of fragmentation, patchy implementation of guidance, a variable regard for the particular needs of children, and the absence of information about and monitoring of performance, is a picture which is not unfamiliar to other areas of children's services, most notably the services for children in the care of local authorities. It was put to us that there is a wider systemic weakness in the formation of policy in government, in that the particular needs and the voice of children and young people are generally given a low priority. This is despite the recognition in the UK of the UN Convention on the Rights of the Child, such that this recognition may appear to some to be a triumph of gesture over action.

41 We have been deeply touched by the evidence that, in terms of public policy, the interests of children have for far too long been neglected. Although it is beyond our remit, we consider there to be merit in the arguments we have heard for the creation of an office of Children's Commissioner. Various arrangements are emerging in the UK with regard to the status and authority of such an office as well as to the range of issues which could fall within its jurisdiction. Understandably, since there is as yet little experience of such an office, the evidence as to its relative effectiveness has yet to emerge. The Welsh Assembly has appointed a Children's Commissioner for Wales with a remit, under the Care Standards Act 2000, to review and monitor all social care services for children, including, for example, children's homes and fostering and adoption services. The Scottish Parliament is also considering the creation of a similar office with a wider remit: to monitor the implementation of the UN Convention on the Rights of the Child. Recently, the Welsh Assembly initiated a public consultation exercise on proposals to widen the role and powers of its Children's Commissioner so that he could review the effect on children in Wales of the exercise or proposed exercise by the Assembly of any of its functions. [16] The Scottish proposal, if it goes ahead, would seem to embrace the advocacy of children's rights to healthcare, that being one of the wide range of services provided by the state on which the Convention touches. We note also here the joint initiative of the Save the Children Fund and Oxfordshire County Council. They state that they have established the first Children's Rights Commissioner in a local authority in the UK. The aim of the initiative is to establish standards on children's rights, which can be incorporated across the local authority's agencies into all policy documents, planning proposals, initiatives, funding applications and monitoring.

42 A range of other approaches with the aim of raising the quality of children's services is emerging. For instance, in the case of standards of care in local authority homes, the new National Care Standards Commission in England will have a Children's Rights Director with the responsibility to inspect and regulate homes where children are in care. At the same time, and arising from the Government's policy to address the social exclusion of children and young people, the Prime Minister in June 2000 announced the establishment of a new Cabinet Committee on Children and Young People's Services. The Committee is charged with ensuring the coherence and success of the Government's policies on preventing poverty and underachievement among children and young people. Healthcare and health services are not specifically mentioned as falling within the responsibility of the Committee, although a Health Minister is amongst its members. This must change. The Cabinet Committee should specifically include in its remit matters to do with healthcare and health services for children and young people.

Footnotes

[16] The Children's Commissioner for Wales, Mr Peter Clarke, was appointed in March 2001. In the same month the National Assembly for Wales published a consultation paper on proposals for new and extended functions under the Children's Commissioner for Wales Act 2001