New projections assess impact of the recession on government child poverty targets

The Government would need to spend £4.2 billion extra on tax credits for low-income families to be on track to hit its short-term child poverty target for 2010–11, according to research funded by the Joseph Rowntree Foundation and carried out at the Institute for Fiscal Studies and the Institute for Social and Economic Research at Essex University. Without this spending, child poverty in 2010-11 is forecast to be 600,000 above the target.

Published by the Joseph Rowntree Foundation (JRF) on 18 February and written by Donald Hirsch, Ending child poverty in a changing economy is based on new JRF-commissioned modelling work from the Institute for Fiscal Studies (IFS), also released this week. The report estimates the cost of meeting the 2010 target to be £4.2 billion a year. JRF have warned Ministers that there target will be missed unless they commit to significant additional spending.

JRF state that two effects of the recession are expected to cancel each other out. Some children will enter poverty as their parents lose their jobs. Others, with parents in low-paid jobs, could move out of relative poverty, as Child Benefit and tax credits rise faster than average earnings. In a recession, planned welfare-to-work measures are unlikely to bring about the previously projected large increase in the number of lone parents with jobs. Children whose parents lose their jobs due to the recession are likely to experience severe poverty making it more costly to lift each child above the poverty line.

Although the government has allocated an extra £2 billion a year to tackle child poverty in the past two Budgets, the further spending required to meet the target remains at just above £4 billion, as estimated in JRF’s original 2006 report, What will it take to end child poverty? This is because of an unexpected rise in child poverty since 2004, combined with the increased costs of the recession.

JRF also say that the 2010 projections suggest that, under existing policies, about 1.1 million fewer children will be in poverty than in 1998 when the target was set. Despite this progress, it will achieve only two-thirds of the targeted 2010 reduction. This will make it more difficult to meet the more ambitious goal of eradicating child poverty by 2020. Without any new policies to help low-income families, child poverty could rise againto 3.1 million by 2020.

Previous JRF research suggested that over the long-term, child poverty is costing at least £25 billion a year in extra spending, lost taxes and lost GDP. If during a recession the government were to cut back on investment to tackle child poverty, evidence shows that this would continue to affect these children’s prospects throughout their lives, with costly consequences for society.

Study highlights lack of awareness about TB in pregnancy

A national study to be published in BJOG: An International Journal of Obstetrics and Gynaecology has highlighted a lack of awareness about Tuberculosis (TB) in pregnancy. The study found that ethnic minority women, particularly those who have recently arrived in the UK, are most commonly affected.

The number of women who die from TB during pregnancy is increasing in the UK. TB has been classified as a priority infectious disease, and TB incidence in the UK is now higher than that in most western European countries.

In this study, researchers identified cases of TB during pregnancy using the UK Obstetric Surveillance System (UKOSS). Cases of TB were recorded between August 2005 and August 2006. All 229 of eligible UK hospitals participated, representing 100% coverage of women giving birth in the UK.

During this period, a total of 33 women were diagnosed with TB during pregnancy. All of these women were non-white. Researchers found that TB in pregnancy in the UK appears to be exclusively limited to ethnic minority women and almost exclusively to those born outside the UK.

The authors noted that screening for TB during pregnancy, while recommended, does not seem to be undertaken routinely. This may contribute to a delay in diagnosis. The increase in TB incidence may also be due to a lack of awareness of TB in pregnancy among obstetric and midwifery staff. It is particularly important to remain alert to the diagnosis in ethnic minority women.

Lead author, Dr. Marian Knight, Senior Clinical Research Fellow and Honorary Consultant in Public Health at the National Perinatal Epidemiology Unit, University of Oxford, said: “This national study shows that for every woman who dies from TB in pregnancy, more than thirty have TB and survive. Importantly, there are differences in the pattern of TB in pregnant women compared to the non-pregnant population. Ethnic minority women, particularly those who have recently arrived in the UK, are most commonly affected. Both women and their doctors and midwives should be aware that the symptoms of TB in pregnancy may be different, and consider the diagnosis, especially in recently arrived immigrant women, presenting with non-specific symptoms.”

Prof. Philip Steer, BJOG editor-in-chief, said:

“The increased incidence of TB among pregnant ethnic minority women raises serious concerns about access to services and quality of care. These findings call upon all health professionals involved in the care of pregnant women to remain alert to the possibility of TB within this population. Proper screening remains essential to ensuring the timely diagnosis of TB during pregnancy, and to preventing further maternal deaths.”

Government calls for more awareness on Sure Start centres

Children’s secretary Ed Balls today urged local authorities to publicise government care centres among parents more effectively.  Research from the Department for Children, Schools and Families (DCSF) discovered that about a fifth of parents had no knowledge about Sure Start networks in their area, despite knowing about the scheme.

The research also discovered that nine out of ten people who did use the centres were satisfied with the service.  But many families did not learn about the sites through government publicity and were told about the centres through their health visitor or friends instead. 3,000 Sure Start centres currently exist in England and the moment and the government has pledged to creating 500 more by next year. The centres provide health, welfare and childcare provisions for young people under the age of five.

Balls explained: “Today’s research shows that children’s centres are accessible and available to all families but it is vital that centre leaders work with health colleagues to inform parents about the excellent range of parenting and health services available to them.  This support is particularly valuable in an economic downturn when parents are increasingly reliant upon support and advice from professionals to help them stay in, or get into employment and get the affordable childcare they need.”

Children’s minister Beverley Hughes said: “Parents are really pleased with the services they know about but centres working with local health partners must do much more to promote the invaluable health services available to families across the country. Many now offer a range of support and health services, including child nutrition information, immunisations, as well as maternity services for new mums and a wide range of support and activities for dads.”

Consultation on proposals to legislate on the eradication of child poverty by 2020 announced

The Treasury, the Department for Children, Schools and Families (DCSF), and the Department for Work and Pensions (DWP) announced the publication of a consultation document on proposals to legislate on the Government’s commitment to eradicate child poverty by 2020.

Yvette Cooper, Chief Secretary to the Treasury, made the announcement noting that where children grow up on low income, suffering either material deprivation or falling too far behind their peers, they can be disadvantaged throughout their lives. She also confirmed that child poverty had doubled in the 20 years from the late 1970s to the mid 1990s, leaving far too many British children deprived of important opportunities in life. This led to the Government setting an ambitious target in 1999 to end child poverty in a generation. This has already led to 600,000 children being lifted out of relative poverty to date and the number of children in absolute poverty being halved. However, too many children still suffer from poverty or disadvantage.

She confirmed the committment to enshrine in legislation the pledge to eradicate child poverty by 2020 and announced the consultation document which outlines how the Government will use primary and secondary legislation to set a framework for achieving the Government’s 2020 aims, including setting targets for the future. It will also set a requirement for Government to report annually on progress and improved accountability and a clear and comprehensive definition of progress will provide a platform for a renewed approach to break the cycle of poverty.

The consultation document sets out the four key elements of the child poverty strategy:

·          more parents in work that pays and allows them to balance work and family life;

·          financial support that is responsive to families’ situations;

·          improvements in children’s life chances so that poverty in childhood does not translate into poor outcomes; and

·          safe, cohesive communities that support children to thrive.

Alongside this document the Secretary of State for Children, Schools and Families is publishing “Next Steps for Early Learning and Childcare”, and the Secretary of State for Work and Pensions is publishing “Realising Potential: Developing Personalised Conditionality and Support”.

The promotion of UNICEF Baby Friendly Initiative in areas of high social deprivation

Maria Miller MP, Shadow Minister for Family questioned the Department of Health (DH) about the steps being take to promote the initiative to maternity units in areas of high social deprivation. Dawn Primarolo, Minister of State for Public Health responded noting that the DH are investing £4 million in 2008-09 for primary care trusts to develop local interventions to promote breastfeeding. These include implementing the principles of the Baby Friendly Initiative in both hospitals and community settings. She also noted that part of this initiative was to provide training to all frontline staff and that the overall aim is to increase breastfeeding rates, maximise the coverage of numbers of non-breastfeeding mothers in England and address inequalities.

Drinking too much water is bad during childbirth

New research to be published in BJOG: An International Journal of Obstetrics and Gynaecology reveals the potential dangers of high water intake during childbirth.

Hyponatraemia (too little sodium in the blood, plasma sodium < 135 mmol/l) occurs when a person consumes too much water. The common symptoms are: irritability, headaches, nausea and vomiting. If left unchecked, without excess water being removed, swelling of the brain (cerebral oedema) occurs resulting in convulsions and at its most severe, coma.

287 pregnant women in Kalmar County Hospital, south-east Sweden were studied from January – June 2007. Women were allowed to drink freely during their labour. Blood samples were collected on admission and after delivery. Cord blood samples were also taken and analysed to see if the effects could be detected in the baby

In the study, 61 women had taken more than 2,500 millilitres of fluid during their labour, and 16 of them were found to have hyponatraemia ≤ 130 mmol/l. Researchers found that a reduction in plasma sodium levels correlated with a longer second stage of labour. Also, maternal plasma sodium was also observed to be lower in women following instrumental vaginal delivery and emergency caesarean section for failure to progress

Hyponatraemia is difficult to diagnose during labour as the initial symptoms may be confused with the symptoms of pre-eclampsia. Hyponatraemia has been found to be a common condition following labour because the ability to deal with fluid overload is reduced during labour. There are no guidelines on the safe levels of water intake during labour in the UK (nor in several other European countries or Australia) and some previous studies have shown that higher fluid intake improves obstetric outcome. However, from their study findings, researchers warn that as water load tolerance falls during labour, and increased fluid volumes can cause hyponatraemia, women should not be allowed to drink excessively during labour.

Professor Philip Steer, BJOG editor-in-chief said:

“Although it is important to replenish ourselves with liquids, previous studies on athletes have shown that there can be problems with drinking too much water too quickly, even if you are feeling thirsty. At one time, a myth became prevalent that drinking lots of water each day was a healthy habit. However, recent research shows clearly that in general, one can trust one’s natural body messages, and that we only need to drink more when we feel thirsty. Drinking too much water can be as harmful as drinking too little. As this research shows, it is important for doctors and midwives to note how much fluid is drunk by women who are in, or about to go into labour, in order to avoid hyponatraemia.”

The Good Childhood Report launched by the Children’s Society

The report published last week suggests that three times as many three-year-olds living with a lone or step-parent have behavioral problems, compared to those living with married parents. The aggressive pursuit of personal success by adults is now the greatest threat to British children, the major independent report on childhood also says. 

The Children’s Society conducted their work over three years, with 11 experts and more than 3,000 children and adults.  Their conclusions claim that excessive individualism in parents can have a negative impact on children. The report blames adult selfishness for some of the problems afflicting children and includes family breakup, teenage unkindness, unprincipled advertising and too much competition as factors that impact on childhood happiness. It calls for a more caring ethic and less aggression. 

Following traditional Conservative lines, the collapse of the family is also seen as a crucial factor in the raising of children. It also suggests that women’s financial independence has contributed to family break-ups and calls for professional family support if relations get difficult and free parenting classes around birth.  A significant redistribution of wealth and an increase in taxes to counter child poverty, are other suggestions put forward. 

New GP survey shows ‘chickens coming home to roost’ in health visiting crisis

The health visiting crisis has been further highlighted by new research revealing that more than 70% of GP practices are experiencing increased demands for postnatal care – the traditional role of health visitors. Unite, the largest union in the country, said that it predicted four years ago the increased demand on GPs caused by the health visiting cutbacks. Unite, which embraces the Community Practitioners’ and Health Visitors’ Association (CPHVA), said that ‘the chickens are coming home to roost’, as the latest NHS workforce statistics revealed that a full-time health visitor job was being lost every 27 hours.

The survey, carried out by Independent Nurse magazine, showed that 71% of 474 GPs who replied had seen an increase in young mothers seeking help with problems, such as postnatal depression, sleep disorders and feeding problems. Some GPs said they felt ill-qualified to offer young mothers advice and others warned they could not fill the health visitors’ child protection role.

The new findings dovetail with Unite/CPHVA’s own research last year which showed that more than 40% of health visitors reported that communication with their clients’ GPs had become harder in the previous two years. Cheryll Adams, Unite Lead Professional Officer, Strategy & Practice Development, said: ‘We welcome the new GP findings in as much that it gives further evidence to our campaign to restore the UK’s health visiting service for the benefit of families and communities. We are unsurprised by the effects of health visitor cuts on GP workloads with young families, as this was predicted four years ago when the serious cuts started. Health visitors also started to be moved out of GP surgeries to work in neighbourhood-based teams. This trend has made the vital communication between doctors and health visitors more difficult.’

 

Department of Health questioned about independent midwives

In response to a question from Harry Cohen MP about the impact on independent midwifery of the implementation of Article 5 of the draft European Directive on the application of patients’ rights in cross-border healthcare, Dawn Primarolo, Minsiter of State for Public Health, responded that the draft directive on the application of patients’ rights in cross-border healthcare is currently subject to negotiations as part of the European co-decision process.  She also noted that the Government have already signalled their intention that independent midwives should have professional indemnity cover and are committed to supporting them to do so.

UK benefits system hindering child poverty efforts

An independent report for the Scottish Parliament’s Local Government and Finance Committee on child poverty in Scotland has raised concerns over the current UK benefits system and the failure of work to ensure low income parents are better off. The report showed children in Scotland are more likely to miss out on experiences of childhood because of poverty than those across the UK and that for many parents in poverty entering employment meant a loss of income.

Alongside tackling the problem of benefits to reduce income poverty it highlighted building council and social housing, free school meals and smaller class sizes as key steps that could reduce the social rather than financial poverty. SNP MSP Alasdair Allan and SNP Work and Pensions spokesman John Mason MP have voiced their concerns that Labour’s proposed benefits reforms will make the situation worse.

The report shows that:

·       Children in poverty in Scotland were more likely to miss out on experiences of childhood than their counterparts across the UK (holiday, sports, playgroup, school trips etc).
·       Single parents with young children are unlikely to be better off by returning to work.
·       Forcing people into work will do little to tackle child poverty and may make the situation worse
·       Reducing benefits to force people into work will not overcome poverty or improve conditions for children.
·       The main issues with an impact on children in poverty are reserved to Westminster.

Deputy Convener of the Local Government committee Alasdair Allan MSP said;

“This report highlights the poverty trap created in Scotland by the UK benefits system. Whilst many parents whose children are living in poverty wish to train or to work they too often find they are penalised by the system for doing so.  With people put off applying for work and college because they will lose benefit support and others put off the tax credit system because of the “irrationality” with which it operates there are real concerns here that must be addressed. Disturbingly the UK Government’s proposed changes to the system seem more likely to increase poverty amongst those with illnesses or one parent families than to tackle the real problems.

SNP Work and Pensions spokesman John Mason said;

“This study confirms that few of those on benefits want to be living on benefits. The measures the Scottish Government has introduced to reduce class sizes, to build new council  and social housing, to increase nursery provision and to offer free school meals are all part of tackling the social side of child poverty in Scotland however there can be no escaping the real impact low incomes have on too many of our children. This study confirms that the UK Government’s proposals to cut benefits and force people back into work risk having a detrimental effect on children in poverty.  At the same time if those returning to work are earning less than they would do on benefits we must ask if the minimum wage is meeting it’s targets.”