An interesting conference, for some depressing reasons

Abstract

Recently, I attended a conference on children and young people's health outcomes for the purpose of updating my knowledge on a subject that has long been a practice, teaching and research interest. The optimistic tone of the rhetoric seemed at odds with the lived experience of those of us broadly associated with the ‘coalface’ of care. The opening speaker, representing NHS England, despatched an impressive array of statistics acknowledging the challenges of inequality and the gaps in appropriate services. A number of clinical toolkits were mentioned, including a product of the NHS Maternity Review: a new care bundle consisting of smoking cessation and improved fetal monitoring. However, no explanation was offered as to how this care bundle might be delivered when midwife retention and recruitment is in crisis (Royal College of Midwives, 2016). A consultant psychiatrist made an inspiring speech on young people's mental health, lamenting the £17 billion cost of the failure of government to move proactively to prevent mental illness. Naming the causal link with poverty as ‘the elephant in the room’ this speaker was resigned to the fact that political short-term thinking meant that the outlook for meaningful long-term investment was bleak. The alternative plan tabled—that we should all sort it out together through joined-up thinking—was, for me, rather predictable. The ‘we’ implied were school nurses, teachers and that good old ambiguous corporate concept, ‘community’, being urged to raise awareness and address stigma while providing listening support. This rallying call to the community was all the more meaningless in the light of a later presentation by the head of public health in a London borough, who spoke with great enthusiasm about an innovative local school nurse programme to reduce child obesity. Any enthusiasm this contribution might have spread was stopped dead in its tracks when it transpired that school nursing in the same borough was likely to be decommissioned next year. It was cheering to hear of innovative practice but investment is needed for such practice to be sustained and shared.