As part of our 10 years of children's public health in local government interviews, Ruth Tennant, Director of Public Health, Education and Inclusion at Solihull Metropolitan Borough Council, has a unique perspective on children’s health. Her role at Solihull Metropolitan Borough Council covers both public health and schools, she discusses what the experience has taught her.
For the last two years Ruth Tennant has been Director of Public Health, Education and Inclusion at Solihull Metropolitan Borough Council. She has taken on the combined role on an interim basis while children’s social care at the council is revamped under the guidance of the government-appointed commissioner.
So, what have the extra responsibilities taught her? “It seems barn-door obvious – but it does need stressing - just how fundamental schools and nurseries are to the wellbeing of children and the scale of some of the challenges they are facing,” she said.
“I have been visiting schools and talking to teachers and that has given me a great insight. The complexities they are dealing with are immense. Things that may traditionally have been picked up by the NHS, such as speech and language issues and social and emotional mental health problems, are now being dealt with by schools.
“We have growing numbers of children starting school who are not ready to learn. We have children with anxiety and behavioural problems which are causing them to struggle in school and like all developed countries we have seen a fall in school attendance.
“Of course, the pandemic had an impact on all this and we are also probably identifying issues earlier than we may have done in the past. But there are such long waits for treatment and support in the NHS and, despite programmes such as mental health support teams, schools are managing complex issues on a daily basis.
“In many ways, I’m not sure we would want these issues medicalised, but it has stressed to me the importance of getting the right support around schools. I think a key role DPHs can playing is helping stitch things together. The problem is schools don’t always know what the NHS or community and voluntary sector can offer locally and vice versa. We need to help map and identify what is available and where the gaps are.”
Rising to the challenge
The past decade has, Ms Tennant said, shown how public health can rise to challenges like this and bring the skills and experience of its staff to bear.
“Moving public health into local government has definitely been beneficial. We’ve shown we have been able to develop services in a way that would not have been possible in the NHS.
“Take family hubs, for example, in Solihull public health has led on setting them up and identifying where they should be located, before children’s services have taken them on operationally. We have all the data on things like breast-feeding rates and child development so we have been able to locate them where they are most needed.
“And we have been able to integrate and co-locate staff so we have health visitors, community midwives and family support workers alongside the toothbrushing programme, early help, social care, mental health and community groups. It has ensured we have all the services in one place that can help children and families.”
Obesity and vaping
But one area of child health where there has not quite been the progress she would have hoped is obesity. “Councils have done lots of local projects to support children and their families – and we have managed to chip away at it. But to truly make progress we are reliant on national policy and in particular what we call the commercial determinants. It really requires cross government working and that is a challenge.
“The rise in vaping has also been something we have had to respond too. This has been a tricky area as the messaging has to be subtle. They are undoubtedly an important tool for helping people to quit smoking, but we don’t want children and young people taking it up.
“Industry was very quick to move into this and aggressively market these products at children. Could we have acted quicker? Ideally, maybe. But it always takes time for policy to develop. We need to look at the evidence and reach consensus.
“However, now with the legislation that is coming in to ban the sale of single use vapes we have the tools we need to really start to tackle this. I am optimistic we can get the balance right.”
Coping with funding squeeze
And despite the current challenges being faced in terms of readiness for school, Ms Tennant said local government should be proud of what it was able to achieve in maintaining the support available in the early years prior to the pandemic.
“The economic climate has been tough. There is no doubt about that. We kept those mandated health visitor visits – and that was by no means a given at the time. So, to be able to continue to provide a universal offer when the money is so tight is a real achievement.
“And we have continued to provide support for breast-feeding and work on teenage pregnancy too. Often in these situations we retreat to just providing support to the most in need.
“I think until the pandemic started, we saw the benefit of this – rates of being school-ready at five were holding. We’ve had to be innovative. We’ve changed the skill-mix of teams. I know health visitor numbers have taken a hit and there is local variation, but in the context of what could have happened we should be proud.
“This is an important lesson. We know at the moment money is so tight in the public sector, but that can be a driver for change and innovation and doing things differently. We need to rise to that challenge in the years to come.”
Please note this is an independent article. The content and views reflected within are those of the named contributor and not necessarily those of the LGA.
