There are cracks running through all our communities. Cracks symptomatic of over a decade of Tory rule. In my constituency of Broxtowe where I am standing at the next election, I see how public services are close to breaking.
No case is more tragic, or underappreciated than that of school nurses. Nurses form part of the foundation of the public health offering to young people in every school across the UK and since 2010 have come under increasing pressure. They are one of our unsung heroes when it comes to community health professionals.
But over the last decade, we have seen the gradual erosion of schools having access to a dedicated school nurse. But like so many of these cuts, it was a false economy. Many of our children’s poor health outcomes can be attributed to the lack of early identification and intervention, which is the role of our essential school nurses.
Traditionally school nursing has played a key role in our education systems. School nurses have provided support for children and young people and educators. They:-
Since 2010 the Government has significantly reduced this type of support in schools, and consequently we have seen the rise in child mental health, a reduction in the uptake of immunisation and vaccines and the ongoing impact over unidentified specific learning disabilities. There has been an increase in poor oral health, childhood obesity and the rise in teenage pregnancy. The cutting back of our school nursing services across all education settings as had a profound and no doubt lasting effect.
The move to local authority commissioning of public health services between 2013 and 2015 in England has led to the fragmentation of school nursing services. The RCN School Nurse Survey (RCN 2016) suggests that there is an increasing use of healthcare support workers rather than registered nurses with a short-term focus on specific aspects of health.
They obviously work very hard and are highly dedicated. But a small number of less qualified nurses, often operating in a hub-type service where one school nurse serves several schools over a large geographical area, inevitably has a detrimental impact.
This can be seen in three ways; falling immunisation rates, increasing mental health problems and rising obesity.
According to the WHO, having at one point effectively eliminated the virus, the UK no longer has measle-free status. There are thousands of children who are exposed to vaccine-preventable diseases in the UK. Those particularly susceptible to not being inoculated are vulnerable children – those in care, disabled children and those without a GP.
In Nottingham, MMR immunisation rates sit at 83.1%. Nationally they sit at 87.4% (UK measles and rubella elimination indicators and status – GOV.UK (www.gov.uk). We need to do more. The recent pandemic has underlined the importance of vaccinations as a preventative health tool.
The increasing prevalence of mental health problems among young people should also be a concern. One in eight 5 to 19-year-olds in England “had at least one mental disorder” in the most recent NHS data from 2017. This figure has been rising for over a decade and left untreated these can be compounded into a negative spiral of academic and social achievement. The capacity to identify these problems early, with nurses based in schools who know the children, not only results in better outcomes for children but also for wider society.
Obesity among children has reached one in ten by the time they begin primary school. Fewer than 2 in 100 had obesity in the mid-1980s. 22% of boys and 18% of girls are obese by the start of secondary school. Obesity during childhood has significant health implications for later life. Obesity is linked to type 2 diabetes, increased cancer risk, heart disease and strokes. According to public health England, in 2019, nearly one in four children in year 6 in Nottingham were obese.
The common factor in all these issues is they require close relational care, the kind that can be provided by a nurse embedded in a school with a relationship with both the children and the parents.
Long-underappreciated school nurses in places like Broxtowe are crucial in helping young people and the community thrive. They create a healthy environment for young people at a crucial stage in their development with consequences that extend far beyond the school gates.
This kind of short-sightedness is why the country is in a state under the Tories. People from Broxtowe to Blackpool need a government with vision and ambition, which understands the value of investing in people. They need a Labour government.
To read more about Labour’s mission for health in all aspects, take a look at No More Sticking Plasters: Labour’s Health Mission.
