CHAPTER SIX: HEALTH
Introduction
6.1 We talked with parents, carers and children about health services and initiatives designed to promote positive health behaviours.
Health needs
6.2 Echoing the findings under post-natal care, a minority of mothers in the study (from two groups) reported a need for free childcare to allow them to exercise when their babies are young and a wider variety of organised exercise options for example jogging with prams, classes in gyms and so forth.
6.3 Again, echoing the findings under post-natal care, parents of young children want help to plan and prepare healthy food for themselves and their family quickly and easily.
6.4 The cost of food, particularly fresh food, was found to be a fairly common issue. Parents and carers need to be able to buy good quality, fresh fruit and vegetables at prices they can afford. In areas of deprivation, parents and carers reported that they can find it difficult to buy fresh fruit and vegetables because shops don't tend to sell them. They would like to be able to buy it locally so they can buy smaller quantities more regularly rather than making a trip to a supermarket. This is compounded by the fact that only large supermarkets accept the vouchers for fruit and vegetables that some families receive and if there is no supermarket in the local area, then there are transport issues.
6.5 Children often told us that they want their schools and nurseries to have nice, healthy food.
6.6 A minority of parents strongly believed that there should be hot, healthy meals provided to children in schools and nurseries and are concerned about the impact of budget cuts on food, particularly in council nurseries.
6.7 Parents and carers often felt that health practitioners like GPs and nurses in local practices and health centres should co-ordinate all of the health and promotional activities for families in a one-stop-shop approach. They firmly believed that this joined up approach would be most effective.
6.8 A major concern for parents in the study in all areas (although felt more acutely in disadvantaged areas), is alcohol and drugs. The perception is that their use is prevalent amongst young people. One parent said that "the kids are surrounded by it".
6.9 A few adults told us that they need help to know how to talk to their children about sexual health, drugs, alcohol and tobacco and what they can do to try to make sure their children do not get involved in health harming behaviours as they get older. Some parents feel fairly well equipped to talk to their children about these subjects but the majority would like help. In a number of groups there was almost a resignation to the fact that it is inevitable that young people will get involved in alcohol and drug misuse.
6.10 Linked to this, a minority of parents and carers want more information from schools about what and when their children are being taught about sex, drugs, alcohol and smoking and to be given advice on how they and the schools can work together to get the right messages across in a consistent manner.
6.11 One group of parents and carers said that they need some basic first aid training and that it should be given as part of the ante-natal care.
6.12 The study found a few parents wanted calls to NHS 24 to be free, from the initial call to all follow up calls. If a member of the family is in hospital, they want there to be free care available for their children so they can visit the hospital, attend consultations and other appointments. However, they recognised that the practicalities of arranging this type of service would be difficult.
6.13 This care is currently available through social work but parents would prefer it to be provided through another route as they are not keen to engage with social work. Addressing this issue may be about how the care is branded rather than which particular service it is provided through.
6.14 A few parents and carers said that they need free taxi services to take them to hospitals and health centres in emergency situations as well as for appointments.
Experiences of health initiatives and services
6.15 The adults in the study believe that national campaigns for example around healthy eating are effective at getting messages across to children. They reported that children learn a lot about health and healthy lifestyles at school and at nursery which they then tell their parents about and ask for healthy food at home - though not exclusively. This was borne out in the focus groups with children who were all very aware of the importance of healthy eating and what constitutes a healthy diet.
6.16 Some parents in the study said that they can find it difficult to cook healthy meals for their families. A number of groups mentioned a book called "Ready, Steady, Baby" which provides healthy eating information, however there seemed to be lack of awareness about what information the book contained. For example, one parent said they had heard if it but that "no-one reads it".
6.17 They think that the information should be provided verbally, with a demonstration and then the book could be used as a reference. One parent thought that the book contained "too many fancy ingredients".
6.18 A number of the parents and carers had taken part in a healthy eating session through Sure Start and had found it useful. They said that the meals need to be quick to make. One parent expressed the commonly held view that "if no-one is going to eat it you mind less if you've only spent 10 minutes on it, not an hour".
6.19 This indicates that some parents and carers can be unsure about trying new recipes in case their family does not eat them.
6.20 Children are learning about healthy eating at nursery and at school, and parents and carers said that they are discussing healthy food at home and encouraging their parents to buy more healthy options.
6.21 When we talked to children about health practitioners that they know about, they were very clear about what doctors, dentists and nurses do. They generally reported good experiences of these health practitioners and made it very clear that the way that they interact with the children is very important. One child said, "I want the dentist to tickle me".
6.22 Other comments included:
"They should have a nice soft voice"
"I want him (the dentist) to tell me what he is doing"
"I want the doctor to speak to me, not mummy."
6.23 Although another child said that it was better if " the dentist speaks to mum and dad because they will understand what is happening".
One girl's drawing of what she likes about going to the dentist (caption added by an adult on the child's behalf)
6.24 Often children are given stickers when they go to dentists and this form of reward is very important to them, contributing to the positive experience.
Gaps and issues in health
- There should be a wide range of exercise classes and activities for parents where childcare is provided free or children are involved in the activity;
- There is a need to ensure that people in all areas have access to affordable, good quality fresh food including fruit and vegetables. In areas where shops do not provide this, it may be that other initiatives have to be developed;
- Work should continue to make sure that schools and nurseries provide healthy food for snacks and meals;
- Health promotion activities should be co-ordinated through GPs and local health practitioners so that the information that is provided is comprehensive and joined up;
- Alcohol and drugs misuse is a major concern for parents and carers. They want help to educate their children and divert them away from problem behaviour and for schools to work with them on this issue;
- They also want information and advice on how to talk to their children about sex and sexual health. They believe that there should be more communication between them and schools so that they can give consistent messages;
- Parents and carers would like to be given basic first aid training for babies and children as part of ante-natal care;
- Families in the study reported that all calls to NHS 24 should be free;
- They want there to be free transport to hospitals for people who need it and again, for those who need it, free childcare for families who need to visit hospital. They do not want this care to be provided by social work services;
- Practical demonstrations on healthy cooking are highly valued by parents who lack the skills, knowledge and confidence to do it themselves; and
- The attitudes of health staff are very important to children and they like there to be rewards provided by the healthcare worker after appointments, for example, stickers.