The Institute for Fiscal Studies research on Sure Start, the policy credited with a big positive effect on children’s health and millions of pounds in savings to the NHS, highlights the wider impact on health inequalities – not to mention the public purse – of the government’s disinvestment in early years prevention (Labour flagship Sure Start ‘delivered major health benefits to children’, 4 June).
The cuts at children’s centres and across the youth services have left a legacy that the new public-health approach to youth violence and responses to the mental health “epidemic” affecting young people now struggle with. But not to be overlooked is that when Sure Start was launched it formed just one part of an early intervention strategy to tackle the impact of poverty on families, going beyond the need for affordable childcare and employment advice. Fast forward to 2019 and a groundbreaking study in Croydon has shown how adverse childhood experiences like exposure to domestic violence, parental substance abuse and mental illness are still having a generational impact on youngsters’ health and wellbeing. The investment needs to go deeper into communities, to fund preventive work that forms lasting relationships, builds trust and gives whole families the support they need to thrive, before we can be confident again of achieving sustainable health benefits for children experiencing poverty and neglect.
Steve Phaure
CEO, Croydon Voluntary Action
• It made my day when I read that research by the IFS shows that Sure Start children’s centres provided major health benefits for young children in the most deprived areas. The government responded by citing its Healthy Child Programme which provides five mandatory health visitor checks before a child is two-and-a-half. Notwithstanding the benefits of this, it hardly compares to the initial Sure Start programme, where integrated health and family support and early-years education were delivered through a wide range of innovative and accessible services. It was always going to take time for Sure Start to demonstrate that interweaving early-years development with linked health and social goals could have an impact on reducing health inequalities – time it wasn’t granted. Without those immediate results local authorities were never going to prioritise something that might bring about a tangible long-term benefit when statutory services were being stripped to the bone. As for the Department for Education response that “local councils decide how to organise and provide services for families to meet local needs”, this pretence at decentralisation is simply devolving the fall of the axe.
Gwyn Fields
Sheffield
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