Debate contribution: Children's Year 1 Health Review

Debate contribution by Mr Mike Nesbitt on 10 March 2025.

MLA

Mr Mike Nesbitt

Party at the time

Ulster Unionist Party

Date

10 March 2025

Type

Debate contribution (made as a minister)

Business

Private Members' Business

Heading

Children's Year 1 Health Review

Assembly identifier

Official Report component 4841505

Read the official Assembly record

Text

Thank you very much, Mr Deputy Speaker. I thank the proposer of the motion and the proposer of the amendment for bringing this important issue forward for debate today. One of the first Committees that I sat on when I was first elected was the Education Committee, and I became a fanboy of the late Professor Ken Robinson, who talked about the "element" that is in a pupil. It reminded me that, as a school governor, I used to talk about "the spark". Inside every child, without exception, there is a spark of ability, creativity and talent, and it is our duty as a society to create the environment where they can find out what that spark is and fan it out into a great forest fire of passion for learning and for life. If we want to afford every child the best possible start in life, surely our first base is to deliver on our commitments. If the commitment is to an assessment for every child in the first year, the only acceptable percentage has to be 100%. Every time that we drop below that, we need to ask why. Sometimes there may be legitimate explanations, but 100% has to be the target. I thank Peter Martin for pointing out that these assessments are entirely consistent with my desire to shift left. Absolutely; healthcare should be delivered at home or as close to home as possible, and that should include prevention and early intervention to give the child and the family the best possible start. I acknowledge the crucial work that our health visitors deliver daily. They are integral to supporting families in the first few years of life; they are a vital part of the health and social care ecosystem; and they are instrumental in identifying developmental concerns. They provide advice that is often critical to parents, particularly new parents who are wondering how they are going to manage, and they ensure that families have the support that they need to provide the best start in life for their children. As Members have acknowledged, I have a commitment to addressing health inequalities, which, I am glad to say, is also reflected in the Executive's Programme for Government. The work of health visitors is key in helping to address health inequalities by promoting early intervention, ensuring the health of our children and ensuring that future generations have the best start. Their expertise in child health, child development and family well-being is crucial, and their work is fundamental to ensuring that our children have that best possible start. I recognise the concerns raised by the motion and the statistics that it highlights on year 1 reviews in Northern Ireland generally and the Southern Trust specifically. The fact that 15% of children here did not receive their year 1 review in the financial year 2023-24 is more than concerning to me. The regional disparity due to the position of the Southern Trust in the same period is also troubling. The figures are unacceptable. Every child in Northern Ireland deserves equal access to healthcare, regardless of postcode. The year 1 health review is one of a number of important health contacts in a child's development, allowing us to identify and address potential health issues and ensuring optimal growth and development. The Northern Ireland-wide figures highlighted in the motion relate to 2023-24. Regrettably, during that period, health visiting services in some of our trusts faced significant workforce challenges with a large number of unfilled vacancies. Those issues were particularly critical in the Southern Trust, which experienced significant workforce challenges with a large number of unfilled vacancies that impacted on its ability to fully deliver year 1 reviews as recommended in the Healthy Child, Healthy Future policy. The Southern Trust has worked to increase recruitment to its complement of health visitors to allow it to deliver the services that are required. My Department has supported that increase in recruitment by funding significant training opportunities for nurses and midwives who wish to specialise in health visiting. I am pleased that the trust has been able to resume full provision of the Healthy Child, Healthy Future programme, and I have been assured that, based on current internal monitoring processes, uptake has improved significantly. Throughout that period, the trust took action to assess, manage and mitigate the risks involved. It has also reviewed its health visiting caseload and provided assurance that, in any case in which the year 1 review was not completed, an appropriate review has now taken place. The House will be aware of the wider workforce challenges that we face. The health visitor workforce has, like many other parts of our health and social care system, been under strain. Health visitors are working with and managing much higher levels of complexity in our society, and the recruitment and retention of health visitors has been challenging, which will inevitably impact on service delivery. Work continues across all trusts to address those challenges through workforce planning and recruitment exercises and the prioritisation of health visiting contacts as appropriate. I reassure the House that any decision to stand down any element of core health visiting reviews, as defined in the existing Healthy Child, Healthy Future framework, will be subject to a risk assessment by the trust in question. I absolutely agree with the motion's call to end regional inequalities. The early years are critical to a child's lifelong health and well-being, and every child in Northern Ireland therefore deserves the best possible start. It is our responsibility to ensure that health and social care services are equitable, effective and accessible to all. Members will be aware that Healthy Child, Healthy Future is the framework for the universal child health promotion programme in Northern Ireland. The framework outlines the core health visiting and school nursing reviews that all families with children aged from nought to 19 can expect to receive. It is recognised as being central to improving child health across a range of issues and giving every child and young person the best start in life. I am pleased to be able to confirm that a refreshed framework is nearing completion, and I expect to publish it in May of this year. The refreshed framework will bring increased focus on providing additional support in the first two years of life, from conception to age two, and on tackling inequalities by focusing on families at risk of marginalisation and social exclusion. As the number of children requiring additional support in schools is rising, the framework will have an increased focus on early identification and support, and this should enable children to be school-ready and ready to learn. Improving health outcomes for our school-aged population is a key principle of the refreshed school nursing programme. Improving the emotional health and well-being of our schoolchildren through helping to build resilience and encouragement in the development of healthy lifestyles, together with the promotion of health literacy, is fundamental in improving outcomes for children and young people. As Members have noted, I have also launched a Live Better initiative, which has one strand and a sole focus on starting well. While not solely focused on the year 1 review, the Live Better initiative presents a unique opportunity to work collaboratively to improve access to early years healthcare in communities experiencing deprivation, and it should also help inform future collaborative work more generally. The health and well-being of our children must be a high priority, and the year 1 health review is not just a tick-box exercise but a crucial opportunity to support child development and family health. I am committed to working with all health and social care trusts to ensure that every child in Northern Ireland receives that vital health review within the accepted time frame. The refreshed Healthy Child, Healthy Future framework will play a key role in that.

I thank the Member for his intervention and understand his concern in that area. I will double-check, but I do not have any concerns that anybody who needs to access healthcare in our HSC system, who lives in Northern Ireland and who does not have English as their first language, experiences any difficulty in getting translation services. However, as I say, I am more than happy to check that. We owe it to our children to give them the best possible start in life, and that means ensuring that every child, regardless of where they live, receives the support that they need in those critical early years. By strengthening our health visiting services and addressing those regional inequalities, we can and should build a healthier, more equitable future for all our children. I am committed to working alongside health visitors, local communities and all relevant stakeholders to achieve that. Finally, Deputy Speaker, I address Mr McGuigan, the Chair of the Health Committee. Every day is a learning day: is it Daideo?

Congratulations. I do not know how long you have been a Daideo, but I am sure that you are enjoying it.

1,501 words. Text as published by the Northern Ireland Assembly.

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