Children’s right to health: is Scotland fulfilling its obligations?

Jamie Spiers reflects on the barriers for children in accessing their rights and calls for robust rights-based training in schools.

The Investigating knowledge and understanding of the right to health report commissioned by the Health and Social Care Alliance Scotland (the ALLIANCE) highlights profound inequalities surrounding right to health in Scotland. These barriers are often amplified when it comes to children and young people accessing their right to health.

UNCRC

With the recent passing of the United Nations Convention on the Rights of the Child (Incorporation) (Scotland) Act 2024 (hereinafter referred to as “the Act”), children and young people in Scotland have their right to health enshrined in Scottish law. Article 24 of the UNCRC says that all children everywhere have the right to the best possible health. When the Act comes into force on 16 July 2024, can Scotland really say that children’s right to health is being upheld?

Barriers to right to health

Children and young people face unique barriers when it comes to accessing their right to health. The report indicates that there is “a prevalent lack of understanding within the public of both the right to health and of how to access information on the right to health.” Although many children will receive some form of education about their rights/UNCRC in school, in some instances that education may not include what each individual right could look like in practice. There are also children and young people who will receive no form of education about their rights and will not know that they have the right to health or how to claim that right.

The barriers to right to health are more pronounced for children and young people from a marginalised background, such as disabled children, refugee children, children with English as an additional language, and children who live in poverty.

Complaints

The report notes that “complaints processes are long, complex, and difficult to navigate”. These difficulties are going to be more severe for children and young people and may be impossible to navigate for marginalised children. There is a stark lack of child-friendly complaints procedures in the medical field, and those that exist are not widely advertised. There is a lack of legal advice and advocacy services to assist children with claiming their right to health and making a complaint.

Conclusions and recommendations

The Scottish Child Law Centre supports the recommendations advanced by the ALLIANCE in the report. It is the responsibility of duty bearers to ensure that everyone’s right to health is met. It should not be the case that individuals are consistently having to fight to have their rights upheld. The report calls for complaints procedures to be more streamlined and accessible. All complaints procedures must have a child-friendly accompaniment and an accessible way for children and young people to ask questions about the complaints procedure, including getting assistance where necessary. The report recommends that information on human rights must be developed and that it must be accessible, practical and inclusive. The Scottish Government must invest in consistent, robust rights-based training in schools including what it means to have a right to health. There must be more funding channelled into legal advice and advocacy services so that children can get legal help when their rights have been breached. The report also calls for the recognition of the “constant change to healthcare demands in response to societal and economic changes”. New policies must be advanced to deal with waiting times for services. By way of example, the Child and Adolescent Mental Health Service wait times are very lengthy. This could be considered a breach of children’s rights as they are not able to access the support they need in a timely manner to realise their right to health.  Given the impending coming into force of the Act, this is unacceptable.

It is clear from the report and from engagement with children and young people that their right to health is unfortunately not being met. The Scottish Child Law Centre calls upon the Scottish Government as a duty bearer to implement the recommendations in the report.

This opinion forms part of a specially commissioned series by the Health and Social Care Academy which reflects on learning and insights from the report ‘Investigating knowledge and understanding of the right to health’. This work aligns with the ‘Be Human‘ Ambition which set out the conditions for long term, meaningful and sustainable change in health and care.

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