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Sir Al Aynsley-Green: ‘Why do we have such appalling outcomes for children?’

Sir Al Aynsley-Green has spent his career in medicine and public life advocating for children. Now, he’s hoping his new book will ‘light a touch paper’ for some important issues

Sir Al Aynsley-Green has spent his career in medicine and public life advocating for children. Now he’s hoping his new book will ‘light a touch paper’ for some important issues


Picture: Alamy

As the first-ever children’s commissioner for England, Sir Al Aynsley-Green was vilified by some of the press for standing up for children’s rights. His campaign to ban the Mosquito – a device that emits a high-pitched sound that can only be heard by the under 25-year-olds and was being used to prevent ‘hoodies’ from hanging around shopping centres – brought particular criticism.

Ten years on the anti-loitering device is still on sale, but have children’s rights improved? He thinks not and has just published a book, called The British Betrayal of Childhood, in which he sets out why he believes children are still being let down by the health service, education, social care, poverty and the youth justice system. 

‘I am interested in children’s lives and where health fits in with children’s lives and in education’

Life and career

At London’s Great Ormond Street Hospital he was known as a children’s doctor rather than a paediatrician. He thinks the term ‘reinforces the bunker of children’s medical care’.

'I am interested in children’s lives and where health fits in with children’s lives and in education,’ he explains. 

1 in 10 

children have a mental health disorder

(Source: The British Betrayal of Childhood 2018)

To understand where Sir Aynsley-Green is coming from look no further than his background. He grew up in a mining community and his father died when he was ten. He won a place at grammar school, was determined to become a doctor and is one of only 4% of the medical profession to have come from a disadvantaged background. 

He is a former president of the British Medical Association. He was also national clinical director for children in the then Department of Health under Labour following publication of the Bristol Royal Infirmary Inquiry in 2001, which investigated the culture of the NHS following the deaths of babies from heart surgery.

‘Children’s nurses do the most fantastic job’ 

The role of nurses

He has high praise for nurses, saying ‘I have the highest regard for children’s nurses and I can say that through the lens of my 40 years of working with children, especially sick children’. There are also personal connections with the profession.

‘My mother was a nurse who trained in the 1920s,’ he says.

‘I met my wife when we were students together. She is a nurse and one of our daughters is a nurse and been successful in her career. 

‘So, I have seen at first hand through my family links the evolution of nursing in general and the reality of children’s nursing. I just want to say, thank you. I do believe children’s nurses do the most fantastic job.’ 


England’s first-ever children’s commissioner Sir Al Aynsley Green

Asking the question

In writing the book Sir Aynsley-Green says he wants to provoke debate and get action to improve the lives of children and young people, as well as their families. He wants children’s nurses to take up this call to action by identifying good practice and ‘shouting it from the roof tops’. 

‘Why do we have such appalling outcomes for children in our country?’

‘The reality is we have the most amazing children and young people, many of them confronting difficulties that are not of their making – either disadvantage, grief or illness,’ he says. 

1 in 6 

children live in poverty

(Source: The British Betrayal of Childhood 2018)

‘They are supported, by and large, by wonderful families who do care about their children. I have seen that during my time at Great Ormond Street, seeing families whose children are facing the most challenging illnesses with astonishing love.’

Despite this – something Sir Aynsley-Green says is ‘to be celebrated’ – the book also points to an unhappy truth. That, in his own words, ‘for far too many children in Britain today we have some of the worst outcomes, not just for health, but for education, youth justice and social care in the developed world’. 

‘So, my book identifies that and asks the question that politicians are unwilling to ask,’ he says. ‘Why do we have such appalling outcomes for children in our country?’

‘The denigration and the dismantling of school nursing services at this time – when we have issues such as emotional ill health and obesity – is terrible. School nurses should be important’

A burst of light

Sir Aynsley-Green says his research over the past two years has confirmed that, for many, it is the best of times to be a child, but for others things are not so positive. This applies in particular to the most vulnerable, including those with disabilities. He would like to draw more attention to these inequalities.

‘I am coming to the end of my career and it’s an opportunity for me to light a touchpaper and have a burst of light on what is going on,’ he says. ‘I am looking for people to respond. They may not agree with what I am saying but is there a hint of truth in it and, if so, what are you going to do about it?

‘Look at the disaster of emotional ill health in children. That has been known about for at least 20-30 years. Look at the disaster of obesity in children,’ he adds. ‘There are big issues for school nurses. 

‘The denigration and the dismantling of school nursing services at this time – when we have issues such as emotional ill health and obesity – is terrible. School nurses should be important.’ 

‘Political policies for children have been short-term, inconsistent and untrustworthy, in contrast to what I see in Finland’

Society’s attitude and duty

He believes the UK’s attitude to children is what needs to change. 

‘For five years I was the first national clinical director for children at the Department of Health and I was charged with The National Service Framework for Children, Young People and Maternity Services – setting out for the first time the standards of care we would expect children to receive,’ he says. ‘We expected that these would be mandatory and that there would be ring-fenced money to make sure it happened. It didn’t happen.’

He refers to his experiences of Finland, Canada and Holland where they are ‘on a completely different planet over society’s use of children and political views on the importance of children’.

1 in 7 

children have witnessed or experienced domestic violence

(Source: The British Betrayal of Childhood 2018)

‘Political policies for children have been short-term, inconsistent and untrustworthy, in contrast to what I see in Finland,’ he says. 

Politicians and especially the Treasury should recognise how important children are as an economic asset for the future, he says, particularly with an ageing population. However, he says that economics should not 'cloud everything'.

‘Every child matters,' he argues. 'Including those with severe disability, especially learning disability. 

‘Surely it is society’s duty to ensure that those families are supported as best we can.’ 

‘I am trying to raise awareness of the importance of death. What does it mean for children?’ 

Examining grief

Part of the reason for this, he believes, is that health professionals are generally not effective advocates for the children’s best interests. 

‘We have failed to capture the attention of the public and politicians to explain why things need to change and what has to be done. It’s time for doctors and nurses to come together and sing from the same hymn sheet,’ he says.

Exposing the huge cost of unresolved grief in childhood is a particular interest. Last year he published a paper which led to radio broadcasts on the topic in Ireland and Canada. It’s an area that he thinks needs more attention.  

‘I am trying to raise awareness of the importance of death. What does it mean for children? How do they understand it?’ he says.

‘Our children’s hospices do a good job, but what about on the ordinary wards? And how can children’s nurses’ concern about this influence the broader environment of the hospital in which they work?’

More questions that seems worth asking.

  • Read Annette Dearmun’s review of Sir Al Aynsley-Green’s book here 

Reference

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