In The Guardian today, there is an article in which the Children’s Commissioner, Anne Longfield, is calling for more adventure playgrounds across the country, especially in our ‘poorer’ neighbourhoods. She believes we need more play schemes across the country for the long summer holidays which she argues are having a profoundly negative effect on children’s physical and mental health. Most starkly, she cites a study in which “primary school children lost 80% of the fitness levels gained during term time. The poorest 25% experienced a drop in fitness levels 18 times greater than the richest 25%”. Sadly, this undoes some of the great work of schemes like ‘the daily mile’ in schools and has hugely negative consequences in terms of future health risks.
I would personally therefore welcome such a move – it is absolutely the case that increased active play and exercise improves a child’s physical, mental and social health. There is no doubt that more facilities, especially located closer to home would be better than having none at all….but I don’t really think it’s quite that simple (and for the record, I don’t think Anne Longfield thinks it is that simple either, she is a great champion for children across the UK). There is a danger, that by saying children need to play more, that it gets oversimplified by policy makers and could perhaps sound a little too Marie Antoinette! Yes our long summer breaks are becoming like ‘battery hen’ experiences for many children across the UK, but simply building them more parks is not going to change this, and I can give you few reasons why. To understand why kids are spending more time indoors and on screens, we need to dig a little deeper into some pretty uncomfortable truths and wrestle with the complexity of them.
I have a friend, who is one of the kindest and best people I know. On top of his very heavy work schedule, he invests an enormous amount of time into young people, who are often living with really challenging circumstances. Every summer, he runs activities for them, right through the summer break and does extraordinary things. Ten years ago, when he applied for funding through a variety of grants (and let me tell you he is a seasoned wizard at winning bids for such things) he was getting £20k for a packed out summer programme. These days, he struggles to raise £4k. That leaves the situation in which he is having to ask families to contribute more for the care of their kids over the summer. What this leads to is a drop in numbers and more kids stuck in at home.
I have another friend, who runs a school in one of our most deprived communities. Throughout the summer break, her school opens up to ensure the kids from the locality do not go hungry and so that families can afford to eat. There have been emergency appeals from many food banks this year. Many working families are seriously struggling to provide both childcare, through the long summer breaks and food….there are some really tough choices to be made. Out of 50 young people on a local holiday scheme, that I know of, 19 of them were relying on daily food parcels, meaning they have no idea from one day to the next what they will be eating and actually no choice about it. When you are working two jobs and struggling to make ends meet, what else can you do with you kids? Just let them roam the streets?
I know a police officer who works on some of the toughest estates in the UK. He tells me that the war on drugs has utterly failed and the gangs are absolutely running the show. Cuts to the policing budget and massive stress levels in the force, as a result, are seeing whole neighbourhoods overrun with crime. The play parks in these places are totally unsafe. No parent in their right mind would let their child out to play in such an environment. It’s a bit different in leafy Surrey or middle class suburbiaville. Without police to build relationships with young people and keep the streets safe, simply building new parks or putting on play schemes will not be enough. Without children’s centres, youth centres and health facilities readily available (many of which have been closed or privatised and so less affordable to communities who need them most), there are less places to go.
If I’ve learnt anything over the last few years, it is that we have to stop coming up with schemes that we think are good for communities and simply delivering them. We have to really learn to listen to people’s stories and the complexities of their situations and from that place hear what it is that they want and need and then create real partnerships to bring about that change together. Hilary Cottam is all over this in her brilliant book ‘Radical Help’, which is a must read.
I love that Anne Longfield, Tanni Grey-Thompson and Sarah Woolaston see this whole issue as being so massively important. Play schemes and parks and cutting sugar (though all excellent) will simply not be enough in and of themselves to get kids out doors and playing in them. We need a a very holistic approach which starts with communities, hearing what their dreams are for their kids and hearing the hopes and desires of the kids themselves. Next we need to understanding what the steps will be to get there. Then we have to build that together. I would suggest a great place to steward this kind of resource would be through health and wellbeing partnerships, like the ones we have in Morecambe Bay. Cross public and voluntary sector partnerships, rooted and working well in their local communities. But I can also guarantee, that this idea will require the right kind of resource – appropriate funding of the required schemes, affordable access to facilities, work that pays a decent wage so families can afford to eat and taking the safety of our streets seriously. That is going to take both a reimagining of youth work/social provision and appropriate help and resource to a diminished and struggling police force. Bring on the parks, but first listen and make sure they can be used!




We’ve got a problem (well 4 actually), when it comes to medical education! The first is this: Jeremy Hunt is promising loads of new places at medical school – I know this doesn’t sound like a problem, it sounds like a solution. But the truth is, once you actually do some number crunching, the new places won’t even account for the losses we will have due to retirement over the next 10 years, let alone account for the increased need there is in the system. So…..we’re still going to be short of doctors. Unfortunately – there isn’t a political appetite to increase these numbers further, and with our exit from the EU we’re genuinely facing an ongoing crisis.
creative way, to work more smartly and differently, with a flexible workforce, but due to the pressures upon the system, there is little room for people to put much time or imagination into this and there is also a huge leap of faith involved. There is simply not the evidence base in place to support the leap we are asking GPs, in particular, to take in restructuring their practices and not replace GPs with GPs, but with combinations of paramedics, advanced practitioners, physician assistants, physics, mental health workers, health coaches and the like. However, the issue is that the system finds itself, like Indiana Jones, at the edge of a cliff, with no way back and the only thing for it is to step into the unknown and hope that God supplies the stepping stones…..Those in leadership positions are going to have be given space and grace to try some things, get it wrong and try again……One of the vital things that will be involved is proper engagement with the communities we serve. Clinicians and the general population need to have a better and deeper understanding of one another. There is a huge language void to be bridged and a collaboration that is needed in understanding how services can be more helpfully redesigned for the benefit of everybody. It also means where there are are difficult decisions to be made, there are no cloak and daggers or suspicion, but honest, open communication in the light of day that builds trust and partnership.
Fourthly, our medical schools are delivering a curriculum, designed centrally but based on yesterdays NHS. There is not enough creative vision around the curriculum to build the right kind of future doctors. There is still far too much focus on illness and disease and no where near enough thought or teaching about wellness, healthy lifestyles, nutrition and non-pharmacological options. The role of the future doctor is much more population focused and digitally savvy. It is our medical schools more than anywhere else that carry the responsibility to ensure the future NHS is catered for. We need a radical shake up in medical education and some brave people to rewrite the curriculum that will enable medical schools to be more creative and engaging in helping to raise the doctors we need for the future.