Dialogue: Neglected children need action, not words

IAN HASSALL* says that only an explicit government policy on children's health will overcome years of wilful neglect.

"Child health a disgrace," said a recent Herald headline. It was not the first of its kind. Most people know now that by many measures we have failed to keep up with other countries in providing for our children. Why is this? How can we do better?

The Herald went on to ask child health administrators and advocates what they thought. One answer was that the public were curiously inert when it came to demanding improvement.

Parallels were drawn with the Waitara shooting, which attracted such a public outcry. Any one of a number of issues of the day could have been chosen to make the point that there does not seem to be sustained public attention to the problem of doing better for children.

It is not that people don't care. Children and young people's welfare come high up on lists of concerns when polls are taken. High rates of death by injury and of young male suicides, low rates of immunisation and so on are well known.

What seems to be missing is a framework of action into which the problem can be fitted. What is the underlying nature of the problem and what policies would deal with it?

Without such a framework, expressions of concern, heartfelt though they are, flare up and die on the same day, as happened with the Herald article. They do not become a sustained story because there is nothing to attach them to. So they don't drive action.

By contrast, the Waitara shooting, for example, fitted into several frameworks as an ongoing story, each of them with well-known policy action implications. There were the stories of possible racism, of police use of firearms, of an impoverished rural community and so on.

Are there no policy frameworks behind the dismal child health statistics within which action can be demanded? Of course there are. Why are they not well known and the subject of sustained media stories?

I suspect it has something to do a universal need to believe that we are not wilfully placing children in jeopardy.

It is to overcome this wilful neglect that Children's Agenda has sought an explicit Government child policy to sit alongside policies on defence, law and order, health and the like.

Child policy may sound a little specialised and obscure but it is made up of specific items. One of these is child mortality review. It is a good example of a major policy which would make a difference to the child health statistics but which has languished for want of public championing.

Child mortality review is simply the careful review of every child's death to find ways of preventing future deaths. To succeed it needs a structure and legislative protection. These are to be found in every state of the United States, in Britain and in Australia but not in New Zealand.

Why? It is not for lack of meetings, reports and recommendations stretching back 10 years at least. We make progress but glacially slowly.

There is a bill before Parliament's health select committee but it has made no recent progress and there is now a proposal to replace it.

This is not well known to the public but it is the real story of how we might deal with our poor performance in child health. It is something that is worthy of public attention. It has all sorts of interesting and even controversial aspects to it.

We need to get beyond periodic outbursts of shock over child illness and death and get on to the ongoing story behind it of policy failure and neglect.

The sustained public attention that will generate should see better and more timely decisions being made.

* Ian Hassall is the chairman of the child advocacy group, Children's Agenda.