Debate contribution: Children's Year 1 Health Review

Debate contribution by Mrs Diane Dodds on 10 March 2025.

MLA

Mrs Diane Dodds

Party at the time

Democratic Unionist Party

Date

10 March 2025

Type

Debate contribution

Business

Private Members' Business

Heading

Children's Year 1 Health Review

Assembly identifier

Official Report component 4841429

Read the official Assembly record

Text

I beg to move

Thank you, Mr Deputy Speaker. I am going to make some important points at the start of my speech, so it is to be regretted that the Minister is not here to hear them.

I am sorry, Minister; thank you. It is good to see you. I tabled the motion because I believe that the debate is hugely important not just for the Department of Health but for other Departments. Health visitors have a hugely important role in recognising when things are not quite right with children or when they are not reaching their milestones. That will have an impact on every Department. It will have an impact on the Department for Communities through poverty and social cohesion and so on, but it will also have an impact on the Department of Education. We cannot throw our hands up in horror in the Chamber and pretend that we did not know that the children concerned had all those difficulties or that they require statements when they arrive aged 3 or 4 into nursery school or P1 if we do not document those difficulties in the year 1 review. It is really important to recognise that our children are not only our most vulnerable but our most precious of citizens, and we want to make sure that they are properly looked after and given the best start in life that we can possibly provide. This is about the importance of the role of the health visitor and their relationship with families. We want that to be valued and resourced, because we know the difference that they can make to young lives by maintaining children's good health and well-being. That can also be a huge safety net, however, and it is essential for prevention of and early interventions in ill health. Health visitors are valuable in helping parents to understand cognitive development, nutrition and the importance of immunisation. The Healthy Child, Healthy Future (HCHF) programme offers a series of reviews to support parents to make choices to give children the best chance of being healthy. The year 1 review includes a family health assessment as well as topics such as growth, language development, oral health and dental registration, parenting support and health promotion. In 2023-24, 15% of children did not receive a year 1 review. In the Southern Trust, an area that I represent that includes large areas from Dungannon through to Banbridge, Lurgan, Portadown, Newry, Armagh, Kilkeel and Annalong, the percentage of cases in which no contact was made rose to an alarming 46%. That is deeply regrettable and detrimental. A missed year 1 review is a lost opportunity to monitor, among other things, growth, feeding status and speech and language development. The Southern Trust had been struggling with unfilled vacancies, and full provision of all interventions appears to have resumed. There were commitments that everyone would get their yearly review. I would appreciate the Minister's confirmation that that continues to be the case. At one point, as I understand it, as a result of workforce pressures, the Public Health Agency (PHA) issued interim guidance to trusts that the one-year contact would be omitted in specific circumstances. I understand that those interim measures have been stood down, with a marked rise in the number of contacts taking place on time. Where one trust is trailing far behind the others, consideration needs to be given at a Northern Ireland-wide level as to how we do more to ensure an equivalent level of service. That goes back to what I continually reference in the House: there are social and economic inequalities in health, but there are also deep structural inequalities, which are perpetuated by trusts not having the same level of service across various parts of the health service. We should have a situation in which staff can work across boundaries. There is no magic wall between the Southern Trust and the South Eastern Health and Social Care Trust or the Western Health and Social Care Trust: staff should be able to work across boundaries and they should do so. That is very important. Minister, you have looked at a regional approach to breast cancer referrals, so maybe that is something that we should be looking at in this case. In September, there were 23 vacancies across our trusts and recruitment was actively under way to fill them, including six vacancies in the Southern Trust and six in the South Eastern Trust. I was contacted recently by parents, and have been looking into the issue of skeletal dysplasia and the support that children with the condition receive so that they can engage in daily activities in as similar a way as possible to their peers, thrive and realise their full abilities. I tabled a number of important questions on the issue, and, so far, have been discouraged by some of the answers. That is an area where health visitors, through developmental reviews, will help ensure that children are referred to the appropriate services for assessment and receive the appropriate additional support. The findings of an Institute of Health Visiting survey of health visitors across the UK, which was unveiled in January, showed a rising need among families that face increasingly complex health and developmental challenges, with support becoming harder to access. Service gaps were also flagged, with massive differences in the availability of services across the United Kingdom. Health visitors spoke of being under immense pressure with challenging workloads, and that is no different in our part of the United Kingdom. Mental health problems were considered to be the main reason for increased demand, with the behavioural problems of the child, including growing concerns about neurodevelopmental issues such as autism or ADHD, being the second most common reason for families needing extra help. Practitioners said that work was more dominated by social concerns, with more families impacted on by poverty and safeguarding concerns. That goes back to the coherent service that children and young people should expect from the Department and the lack of social work access experienced by many families, which is particularly acute for families of children with disabilities.

Again in the Southern Trust, I have had conversations recently with families who have real concerns about the development of their children but have not been able to access appropriate social work help. We need to look not only at the health visiting needs but at continuing that work by having a coherent service for children and young people.

In a recent conversation with the Southern Trust — I digress a little because this annoyed me so much — I felt as though the officials were simply going through the motions: "I have to deal with this difficult MLA, and I'll have to have the call and the meeting". Behind that call was a family in real distress. Everybody is under pressure, but it is really important that we look at how we help children to access services at the earliest stage but also as they progress through their lifetime. Help for mothers who may have difficulties with the birth or development of their children is another issue. I know that you have been doing some work, Minister, on exclusion in areas of social and economic deprivation. This issue neatly fits into that programme. I want children, no matter where they are born in Northern Ireland, to have access to services and to be able to grow up, develop and thrive in the best way possible. In Northern Ireland, unlike some parts of the United Kingdom, there has been some rise in the birth —.

Yes, of course, Mr Deputy Speaker. Minister, it is a really important debate. It attacks the most fundamental part of a child's development and progress. I hope that you will have some positive things to tell us.

1,304 words. Text as published by the Northern Ireland Assembly.

Assessment

Not flagged

Jev’s structured answers

Assessed 21 October 2026 at 12:06 UTC by jev-1.13.0 (requested as typesafe/jev) under rubric 2026.10-r9, methodology 1.9.

Disagree with this assessment?

Classifications can be challenged. A person reads every challenge, and any change is recorded publicly above with its reason.

Challenge this classification