Specifically, but not exhaustively, we would like to suggest that a proposed Council Recommendation on a EU Child Guarantee address the following issues:
- Improve links between the 2013 Council Recommendation for Investing in Children (wider policy framework) and the current proposal for EU Child Guarantee.
- Ensure that the recommendations in the progress report on the implementation of the 2017 Recommendation for Investing in children are being implemented. These called for e.g., the need to focus on children and families at high risk, which can be very hard to reach, and for a more comprehensive, multi-dimensional and coordinated approach to investing in children.
- Most EU states make healthcare services for children free of charge, but the definition of ‘free’ differs greatly with e.g., pre-payments constituting a real barrier for free care. Although unmet medical and dental needs among children are relatively low, current approaches to identify this may not reflect real need and regional and income-related differences are substantial. Poor children in Belgium are 5 times more likely not to access dental care they need than their wealthier peers. Access to mental health care for children in many EU states is suboptimal as well.
- Like other medical interventions, access to health promoting and preventative measures like childhood vaccination and immunisation are subject to a social gradient. A recent drop in measles immunisation rates in rich-economies is most likely to have occurred amongst vulnerable families, as factors like income, maternal education, place of residence, the sex of the child, and poverty are all linked to access to levels of vaccination coverage (UNICEF data). Those further down the socio-economic gradient may also be less likely to access mental health services or positive parenting programmes, which studies have identified as effective to reduce inequalities in childhood (DRIVERS project).
- Taking a multidimensional, coordinated approach to investing in children also means ensuring that children facing vulnerability can live, learn and play in environments that promote their health. It means that they can breathe clean air (indoors, outdoors), have access to green and safe public spaces that support physical and mental health and that these environments are not obesogenic.
- Cost can be a key factor inhibiting families on low incomes from enjoying healthy diets. Fiscal measures as well as targeted interventions are needed to ensure families have access to foods that promote rather than undermine health. Education settings should also be involved in ensuring this, as well as other approaches to improve the health and wellbeing of children in need, as health and educational attainment are inextricably linked. Such support must be provided in non-stigmatising ways.
- Efforts to address gaps in educational attainment must also focus on the digital divide. The pandemic has clearly reflected the inequitable access to devices and in skills.
- Finally, there is a real need to improve and harmonise the collection of disaggregated data on child health, wellbeing and social inclusion to help monitor, compare and assess progress towards reducing child health inequalities, child poverty and vulnerability. EU states should also identify and learn from the most effective, evidence-based approaches across the EU, to apply resources better.
Our response complements our input to a joint response by the EU Alliance for Investing in Children.