A school health service could transform health outcomes for children and bring about a truly ‘people-centred NHS’, says Duncan Enright
Since the 2005 election the parties have been engaged in a bidding war, each declaring their love for the NHS. The coalition wastes time and effort on new structures and organisations, when what we need is new thinking – and the same applies to Labour. Hospitals are a source of pride for the party, but these too often deliver remote healthcare locked away in intimidating warrens. We will not become healthier without turning this on its head. Healthy living begins with the individual, the family, and the community, not the trust or institution.
As health secretary Andy Burnham argued that, ‘the NHS needs to look more and more at whether services can be offered in the community or in the home … services [will] come out of hospitals, [and be] built around individuals. It means spending differently and the NHS working more closely with other partners such as local authorities.’ This thinking did not make it into Labour’s 2010 manifesto.
The health service of the future will offer information and support so people can learn to look after each other and themselves. This sort of approach to healthy lives has to start early. That is why we need to transform the school health service.
Parents and children rely on school nurses for more than jabs and nits. With the right resources nurses can provide an introduction to healthy living that can last a lifetime. Sure start centres have proved that health services delivered locally can be effective and help families. Continuing support can be provided by school health services for every child through to adulthood, hugely reducing the burden on the NHS. The best place to try out a new approach would be in special schools, where a very high proportion of our most vulnerable children go to school.
My eldest child has profound and multiple disabilities and as a result she has a constant stream of appointments across the county. We have an address book full of doctors and therapists who know each other less well than we know them all as we travel the region to different, distant hospitals.
Our experience is not unusual, despite the fact that the number of complex paediatric cases in our county are concentrated in just a handful of schools. Yet few consultants travel outside the walls of their hospital.
Their presence would mirror the one outstanding professional in our lives, the clinical nurse specialist at our daughter’s school. She provides help in creating and managing Katy’s individual healthcare protocols, training support staff, coordinating care, and joining us to make fine judgements about her health. Her post is partly funded by the school and partly by the NHS. Because she works in the school all day she knows the children and their families well, and can also share expertise with teachers.
If we are to improve health in the UK we need to shift some resources away from centralised services and invest in community ones. Where better to start than with school health services? That’s what I would call a people-centred NHS.
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Duncan Enright is a Labour and Cooperative councillor on Witney town council
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