Marie McInerney writes:
Experts in child and family health are developing submissions for the Federal Government’s new Early Years Strategy, which it says will “shape its vision for the future of Australia’s children and their families”.
Among a number of groups who have shared their concerns and priorities with Croakey (see their responses in full below), the Australian College of Nursing is concerned the early focus of the strategy “does not demonstrate a health equity lens”. We note the verdict on that is mixed.
The ACN points to the Discussion Paper’s aim that a national Strategy “will seek to ensure that all children, wherever they live, enjoy the same opportunities to learn, develop and thrive.”
The ACN says:
This is not a health equity lens.
Instead, it assumes all children, irrespective of class, culture and context, require the same opportunities. This ignores some of the children who need this most, like those children that have different abilities or grow up in specific cultural contexts like First Nations children.”
Maybe the Federal Government should also be turning a sharp eye on all the policies, programs and, of course, politics that are currently causing major harm to young people in Australia, particularly Aboriginal and Torres Strait Islander children, and/or threaten to further entrench inequity.
There are two big obvious examples this week (or three if you count the AUKUS deal, which we should), with terrible timing for Close the Gap Day on 16 March.
Social policy advocates have expressed big concerns about the New South Wales Government’s proposed Kids Future Fund, which NSW Premier Dominic Perrottet says would allow 18 year olds to “invest in their education or use towards buying a home”.
The kicker is that the Government would deposit $400 into a bank account of children aged 10 years and younger, and would match annual payments of $400 from parents and guardians until the child reaches 18 years old – if parents can afford to do so, of course.
It’s a policy that “risks further increasing of the poverty divide, where wealthy families can bolster their child’s financial future while poorer families are left behind,” said the NSW Council of Social Service, echoing multiple concerns from a range of groups
Meanwhile in Queensland, the State Government is set to introduce its punitive youth justice reforms, which, among many other harsh features, reinstate breach of bail as an offence for youth offenders – a breach of the Human Rights Act.
“It is very difficult to reconcile the reforms proposed by the Queensland government with its Closing the Gap commitments to drive down the rate of Aboriginal and Torres Strait Islander children in detention,” said the Aboriginal and Torres Strait Islander Legal Service (Qld) in a submission to a parliamentary review of the new laws.
The new legislation comes amid reports this week that the Queensland government may have broken its own laws by locking up two 13-year-old boys in their cells for up to 24 hours a day at the Cleveland Youth Detention Centre (CYDC) in Townsville.
Coalition of Peaks convenor Pat Turner said the data update for the Closing the Gap Dashboard, released today ahead of Close the Gap Day, again paints “a grim picture” for several socio-economic targets and supporting indicators within the National Agreement.
“While targets relating to healthy birthweight of babies; attainment of a year 12 or equivalent qualification; completion of a tertiary qualification; youth engaged in employment, education, or training; appropriately sized housing; and legal rights or interests in the sea have all seen improvements, none are on track to be met,” she said.
See responses to Croakey’s Q&A on the Early Years Strategy below.
Change the Record
Change the Record is Australia’s First Nations led coalition of legal, health and family violence prevention experts
What’s important to us, of fundamental importance, is that whatever strategy is developed it must have at its core a commitment to address the underlying causes of disadvantage.
There must be commitment to account for and address the ongoing impacts of colonisation on First Nations children and their families, particularly around child removals. What was once child removals to missions is now child removals to out-of-home care.
Governments must ensure that the rate with which First Nations children are removed from families and communities and placed into out-of-home care is drastically reduced. There is a clear link between children in out-of-home care and those who end up in the legal system. Any strategy must address this.
For too long have successive governments criminalised disadvantage instead of implementing effective ways to address it, and so this strategy must consider housing, social security, interaction of police and experience of children at schools.
For many Aboriginal and Torres Strait Islander children in the public education system schools are not safe, many schools have school-based police officers on campus, and many schools lack sufficient resources to identify children with complex needs, behavioural needs and support them accordingly.
Change the Record doesn’t hold a lot of stock in government strategies that fail to look beyond numbers and recommendations and if this Early Years Strategy fails to properly consider, develop and implement solutions for First Nations children, their families and communities then we are yet again paving the way for failure.
Royal Australian and New Zealand College of Psychiatrists
- Have you lodged or are you planning to lodge a submission?
As leaders in child and infant mental health, the RANZCP will be lodging a submission to the Early Years Strategy Discussion Paper consultation. The RANZCP submission to the Department of Social Services (DSS) is guided by a range of expert committees, including the Bi-national Faculty of Child and Adolescent Psychiatry Committee (FCAP) and Bi-national Section of Perinatal and Infant Psychiatry Committee (SPIP). Both the RANZCP’s FCAP and SPIP Committees have provided leadership and expertise on a range of matters relevant to the health and welfare of infants and children in Australia. The RANZCP’s submission to the DSS will be made available on the RANZCP’s website upon the closure of the submission.
- Does the Discussion Paper sufficiently apply a health and equity lens? If not, what is needed?
The current Discussion Paper does not make clear how health and in particular mental health will interact at all levels of government in terms of strategic direction, service provision and evaluation of outcomes.
The most significant issue impacting the first 2000 days of life (0-5 years) with long term consequences is developmental issues including social emotional development, and the mental health and wellbeing of parents who support children in this critical period of their life.
Yet there have been limited discussions with the peak body for perinatal, infant and child psychiatry namely the RANZCP for setting the priorities or indicators for measuring outcomes. The RANZCP would like to see the DSS engage in greater consultation with the RANZCP to address the mental health content of the Discussion Paper.
- What would be your top three asks of the new strategy to address child health and wellbeing?
Development and implementation of a national road map of integrated mental health (parental and child) service and policy priorities with physical health and wellbeing in the 0-5 years age range.
Use of a national road map to address the current fragmentation, duplication and service gaps within health and other non-governmental organisation/social service systems and the early childhood education and disability sector.
Increase resources for the perinatal and child mental health specialist workforce in Australia. This would involve building capacity via ‘community of practice’ to be made possible for joint assessments and management by creating funding mechanisms for such activities to be covered between state, federal, NGO and private sectors and between perinatal and child psychiatry, psychology, paediatrics, allied health professionals.
- Have other nations/jurisdictions developed model strategies? What stands out in their approach for you?
As outlined in the article Stemming the tide of mental health problems in young people: Challenges and potential solutions by Eapen and Colleagues (2022), to address the current issues in access to appropriate child and adolescent mental health care in Australia, a novel Integrated Continuum of Connect and Care (I-CCC) model could be used to integrate relevant services along a tiered care pathway. The I-CCC model could facilitate timely access to mental health services for children and their families, while meeting their specific needs. The RANZCP suggests that the I-CCC model could be incorporated into the Early Years Strategy.
Read this Twitter thread of an address on ‘Build back fairer: health equity for children and young people’ by Professor Sir Michael Marmot, Director of The University College London’s Institute of Health Equity, at an event this week hosted by the RANZCP and Monash School of Public Health and Preventive Medicine
Professor Kathryn Backholer
Professor and Co-Director, Global Centre for Preventive Health and Nutrition, Deakin University
It is stated that ‘Implementation Action Plans will be developed after the Strategy is finalised and will set out what will be done to respond to the priority reforms’ – it is crucial that funding is tied to this implementation action plan, otherwise these documents risk gathering dust on bookshelf.
It will be important that the strategy focuses on nutrition as key driver of children’s health. Strategies should include adoption and full implementation of the International Code on the marketing of breast-milk substitutes (currently we rely on weak industry codes) and policies to restrict unhealthy food marketing, including on digital devices and in retail outlets.
The lens on equity is quite comprehensive. Meaningful inclusion of the voices and values of diverse children and families in the development of the strategy should further strengthen this focus on equity.
Australian College of Nursing
- Have you lodged or are you planning to lodge a submission: if so could we please have a copy and refer to it in our article?
Yes, ACN is planning on lodging a submission – this is still in development.
- Does the Discussion Paper sufficiently apply a health and equity lens? If not, what is needed?
This policy does not demonstrate a health equity lens. If you look at the extract from page 6, ‘all children, wherever they live, enjoy the same opportunities to learn, develop and thrive’ – this is not a health equity lens. Instead, it assumes all children, irrespective of class, culture and context, require the same opportunities. This ignores some of the children who need this most, like those children that have different abilities or grow up in specific cultural contexts life out First Nations children.
This paper focuses on programs rather than the broader social health determinants impacting children and families. Many issues affecting children and their families cannot be fixed simply by implementing early childhood programs. For example, real-time issues facing Australians, like housing stress and insufficient income, increase the risk of neglect, yet the paper does not address this.
- What would be your top three asks of the new strategy to address child health and wellbeing?
What is needed is an early years strategy that intersects with all levels of policy that impacts the health and wellbeing of the Australian population. Children must be front and centre of all policies and not just as incidentals or only included in child-specific policies.
It is important to have a primary health care focus – linked to Sustainable Development Goals and focused on preventative and supportive health measures for local communities.
Currently, the system concentrates solely on deficits, but we also need to highlight strengths and work with families to identify positive childhood experiences. This will also enable us to identify families with complex needs better to ensure no child is left behind in their physical and emotional development.
Integrated services are essential as the silos create many problems. Implementing levers and mechanisms to address silos and inter-professional working methods need to be developed.
It is important to have a standardised and universal approach to the operation of Early Learning Childhood Centres or Early Childhood Centres in terms of the provision of learning (i.e. standard qualification of workers, structured approach to learning methods) and provision of care (i.e. including healthy meals, developmentally appropriate strategies to play).
- Have other nations/jurisdictions developed model strategies? What stands out in their approach for you?
There are some interesting new models from HOPE in the US.
Mental Health Australia
Acting CEO Harry Lovelock
Mental Health Australia welcomes the Government’s initiative in developing the Early Years Strategy. Early childhood is a critical period within which to set the foundations for good mental health later in life.
Mental health support is a critical component of early childhood support, where Mental Health Australia’s 2022 Report to the Nation found that 41% of parents of children aged 0-8 said they had needed mental health support or information for their child recently. It is crucial that the Early Years Strategy is aligned with the National Children’s Mental Health and Wellbeing Strategy, and Mental Health Australia is pleased to see mention of this strategy in the Early Years Strategy Discussion Paper.
Mental Health Australia will be making a submission in response to the discussion paper. Mental Health Australia is keen to see the strategy enable governance mechanisms that can address gaps in government policy and implementation across the social determinants of mental health and therefore across the often siloed government departments. It is only with a truly holistic approach to the early years that children can be supported to thrive.
See Croakey’s archive of articles on youth health.
