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This morning the papers & broadcast news were full of reports that ‘Labour spending has failed to improve child health’ and that a wave of policies were not offering ‘value for money’.

I was interested to see on what grounds these claims were being made, and if it was a fair summary of the Audit Commission report. The Audit Commission are an independent body, who examine what goes on in local organisations – your local council, local NHS trust etc. In this report they looked at government policy, and how it was implemented, monitored and paid for, between 1999 and 2009. Behind the headlines, was a very dry, and not altogether transparent report. The report claims over £10 billion has been spent of services for 0 – 5s. Most of this money has gone into Sure Start – but some has paid for health visitors and children’s centres.

Sure-start has cost what sounds like a fortune (but let’s face it, £7billion over 10 years is chicken feed really)  and if you believed this document has made very little impact. It’s had no impact on obesity. Or on the number of fillings children have. But this document makes no reference to mental health (and anecdotally sure-start volunteers have made a huge difference to mothers I know). It also makes no reference to educational outcomes – which is one of the missions of the sure-start programme.

Of course, a major problem with a report of this type is that children, as we mums know too well, grow up. By focusing only on 0 – 5s, this report doesn’t look at the impact of early spending on health-outcomes as children grow. Money spent on sure-start that helps a three year old, may not have a measurable impact until they are six.

I’m amazed more hasn’t been made in the media of some hidden gems within this document. For example, lone parents, BME parents, and teenage parents all feel unable to access health services because of the judgemental nature of health professionals. This is a scandal – and I can assure you that white, middle-class, middle-aged, married mothers have their problems with judgemental health professionals too.

The real criticisms in the document, which are not as widely reported in the media, are that local authorities simply aren’t doing anything particularly about 0 – 5s. Most government policy covers 0 – 19s. And local authorities find it easy to monitor children when they enter school, and so don’t do very much with 0 – 5s.The report recommends using targeted interventions to improve the health of under 5s, and evaluation of the effectiveness of those interventions. The danger though surely is that we already find health professionals judgemental – so do we want them monitoring the health of our children in order to meet government targets?

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