Bob Reitemeier016

An open letter from Bob Reitemeier, I CAN Chief Executive, to the Chief Nurse at Public Health England

The Department of Health has commissioned Public Health England (PHE) to carry out a review into the future of health visitor family checks beyond March 2017. Options put forward to ministers include renewing the mandatory requirement, amending the number of visits, or scrapping the requirement altogether. I CAN’s Bob Reitemeier has written to PHE urging them to consider the impact this will have on children with speech, language and communication difficulties.

Dear Viv Bennett,

Re: Children’s public health 0-5 years – review of mandatory health checks

We at I CAN, the children’s communication charity, know that in some areas of the country more than 50% of children starting school have delayed language.  That is a shocking number of children without the skills they need to learn and to make friends, ultimately impacting on social mobility and the wider economy.

We also know that age 2 to 3 (1001 first days of a child’s life) is a critical time for children and their parents. It is a period of rapid growth, learning and development in a young child’s life and is also a key time when a child’s need for additional support from health services or the education system can become clear.

We write to you to express our great concerns regarding the options put forward to ministers relating to the five health checks currently expected between the age of 0 and 2 and a half. Suggested options include reviewing the mandatory nature of the requirement, amending the number of visits, or scrapping the requirement altogether.

There is enormous risk attached to the removal of any of the above options. More children with communication difficulties will go unidentified and fail to receive the support they need.  They will start school without the skills to access education, going on to fail exams, making it more difficult for them to find work.  Children with communication difficulties often end up on the edge of society as adults and many require financial and mental health support from Government during their adulthood.  The importance of the integrated review was recognised by the Department for Education in this report, the findings of which remain critically important today.

Health checks make a real difference to a child’s future outcomes. They enable good parenting practices to be supported, including the achievement of typical communication development. The checks bring together families, health visitors and practitioners and are key in identifying communication difficulties early, so that effective early intervention can be offered for those children who need more support, at an age when interventions are critical and effective.

We know from our evidence that when the correct support is put in place before a child is aged 5 and a half, children are very likely to catch up with typically developing children of the same age. If the five health checks are scrapped, there is likely to be a significant impact on the support and advice parents get for their child’s development and on early identification. This is particularly important for the 32% of disadvantaged 2 year olds who are not attending early years settings.  They would not receive any formal language checks until they enter school.

Without the five checks and more specifically the Integrated Review at age 2 and a half, the 50% of children in some areas starting school without the language skills they need is extremely likely to grow.  Ultimately, this will increase the financial strain for Government and adult services as these children grow older.

I urge you to consider the longer impact a reduction in these checks of any type will have on the future of children and our economy.

Yours sincerely

Bob Reitemeier CBE
I CAN Chief Executive