Parents should be given an extra vote for every child in their family in a bid to end politicians’ disastrous neglect of child health, the leader of the UK’s paediatric body has said.

Professor Neena Modi, president of the Royal College of Paediatrics and Child Health, says children are being failed. Issues from child poverty to obesity are not being addressed. As these children grow up, they are likely to become unhealthy adults, suffering in later life and putting more pressure on a struggling NHS.

“If we don’t get this right right now we will be – and are already – reaping terrible consequences down the line. The latest figures I’ve seen are 10 to 20 fewer years of healthy life if you go into young adulthood obese,” Modi told the Guardian in an interview.

The problems set in even earlier, she said, pointing out that 80% of obese children will become obese adults. And the infant children of obese mothers will have more adipose – fatty – tissue, which makes it more likely they will have weight problems as they grow up.

“The policy implications are absolutely crystal clear,” she said. “Break this cycle. But have we seen strategy, coherence, action? No, we’ve seen piecemeal attempts.”



The invisibility of children, who are 25% of the population but have no vote, could be overcome, Modi believes.

“Now we could fix that. By giving parents proxy votes for their children,” she said.

“Why not? My view is that 25% of this democracy is being denied their democratic rights. Society accepts that parents stand as proxies for their children in all other respects. Why not this one too?”

Governments are also ignoring the economic consequences of failing to improve child health, from obesity to mental illness to the diseases caused by air pollution, she says. “Take the obesity example. 80% of obese children will be obese adults and an obese adult will lose 18 years of healthy life. Clearly that is going to have a double whammy on the health of the nation. You lose adult productivity and you impose another burden on the health services,” she said.



Modi was speaking out as the college published its second State of Child Health report, looking at progress against a series of recommendations in its first report a year ago. Child poverty in the UK is at its highest level since 2010, 100 out of every 1,000 young people under 19 are likely to have a diagnosable mental health disorder, and one in three 11-year-olds is overweight or obese, says the report. Scorecards show that while Wales and Scotland have made some policy improvements, England has hardly moved at all.

The scorecards reveal the absence of any coherent strategy, Modi says. England scores positively for the sugar tax and a new tobacco control plan, but badly for the deepening public health funding cuts which are disproportionately affecting children’s services, says the report. Spending is now 5% lower than it was in 2013/14.



Scotland, on the other hand, has passed an act to reduce child poverty and has a new mental health strategy. It plans to increase health visitors and has committed to more breastfeeding support for women. Wales has extended smoking bans to playgrounds, school grounds and NHS grounds and is expanding child health research.

Modi says she is shocked that people do not appear to understand the huge part that poor health and nutrition in the early years plays in disease in later life, as well as the impact of deprivation. The evidence is there, but “we haven’t taken the lessons of science”, she says.

She is also, she says, “very, very concerned about the state of the NHS”. There is talk about the slow pace towards insurance-based healthcare in this country and there are increasing inequities, with the rich able to access more treatment than the poor. “This is not going to serve children well. It’s not going to serve any of us well, but when things fail whole societies, children tend to do worse,” she said. And children’s doctors are demoralised, leading to shortfalls in the profession, she added.

Modi would like to see industry incentivised to produce food that is healthier for us in place of fast food, unhealthy snacks and junk. The approach has worked with drug companies, who have been incentivised to trial children’s medicines. Government is too worried about upsetting the industry, she said. “I think perhaps there’s a lack of vision.”

The report was applauded by others in child health. Caroline Cerny from the umbrella group Obesity Health Alliance, of which the college is a member, said: “The number of children with an unhealthy weight is at an all-time high and rising, but there is a huge gap in the government’s approach to tackling childhood obesity. The government is failing to protect children from being bombarded with junk food adverts, which research shows influences their food choices.” She called for a 9pm watershed on junk food adverts on TV.

Anne Longfield, the Children’s Commissioner for England, said the report showed that children’s health needs to be a top priority across government. “We need to see a more joined-up approach across government and the health system that puts the interests and needs of children at the heart and the start of policy-making and which recognises the importance of early intervention,” she said.