Child rights and wellbeing impact assessment: health and social care statutory guidance refresh

7. What evidence have you used to inform your assessment?

Given the breadth of children's services – covering both health and social work – that may be delegated to the 31 integration authorities across Scotland, it is difficult to establish a single, unified perspective on children's services.

National statistics in this policy sphere, however, detail that as at 31 July 2021:

• '14,946 children in Scotland were Looked After or on the Child Protection Register, representing 1.5% of Scotland's under 18 population.
• 13,255 children and young people were looked after.
• 2,104 children were on the child protection register.
• 413 children were both looked after and on the child protection register.'^[1]

Data also indicates that child health pre-school reviews across different age groups remain consistently high, with significant improvements in the number of children aged between 4-5 year receiving such health reviews. Coverage was similar across all levels of socio-economic deprivation and sex^[2].

Meanwhile, children's mental health has been declining and demand for services has been increasing. Negative mental health amongst children is not experienced equally, with children from deprived background, those with experience in care, females, and those who identify as LGBT+ experiencing poorer mental health^[3].

Overall, children's early experiences are widely recognised as having a significant impact on life outcomes, with socio-economic deprivation linked to health inequalities later in life^[4]. With the UK's Gini coefficient – a measure of household income inequity – remaining high^[5], and projections of rising child poverty in Scotland^[6], it is likely that challenges lie ahead in relation to children's health and care and, consequently, on later life outcomes.

In summary, positive health and care experiences for children are important in providing a robust springboard for the entirety of the life course. Challenges exist in terms of rising inequality, which can negatively impact children's development and health outcomes and can translate into greater demand for health and care services now and in the future.

The proposed programme of work may have a positive influence in encouraging improvements to children's services and upstream health and care interventions, and therefore have a positive impact in this sphere, but it is also clear that the proposed work programme alone cannot solve the wicked problems posed by child poverty and the resulting health inequalities.