Upholding children’s rights in health and social care

A reflection on some of the key issues impacting children and young people’s human rights.

Children’s rights have recently received a lot of attention in Scotland. In addition to Scottish Government’s commitment to incorporate the UN Convention on the Rights of the Child into Scots Law (this link will take you away from our website), evidence gathering to contribute to the UN Committee on the Rights of the Child’s reporting cycle (this link will take you away from our website) is currently underway. 

The Policy Team (including The Academy) and the Children and Young People Programme at the ALLIANCE, have been actively involved in these ongoing policy developments, contributing to discussions and advocacy with other third sector colleagues and Scottish Government. In early July, we responded to a survey circulated by Together (Scottish Alliance for Children’s Rights) which sought to identify the top three human rights issues faced by children and young people in Scotland.  

Our views represent the positions of our members who work with disabled children and young people, those living with long term conditions, and their families/carers.  

Rise in the cost of living 

Recently published statistics from the Department for Work and Pensions (DWP) show that 4,000 households in Scotland are affected by the benefit cap. In March 2022, the Scottish Government set out plans to mitigate the impact of the benefit cap through the Tackling Child Poverty Delivery Plan (this link will take you away from our website). However, further work is needed for the Scottish Government to implement actions to meet its commitment to mitigate the impact of the benefit cap on children, young people and families across Scotland. This must consider the additional needs of families where at least one person is disabled or has a long term condition, who are disproportionately impacted by the cost of living crisis. 

Families with a disabled adult or child have faced a range of additional challenges throughout COVID-19, including reduced or disrupted access to care and support, and increased living costs. Evidence highlights the financial impact of COVID-19 on families across the UK. As summarised in a recent report by the Poverty Alliance (this link will take you away from our website): 

“The income received from social security, frequently insufficient to cover living costs before Covid-19, was inadequate to meet these new and rising costs. Increased food bills, due to feeding children who would normally be at school or resulting from reduced availability of cheaper products in supermarkets, placed additional pressure on household budgets, a pressure which was not offset by support through social security provision.” 

Research conducted by the University of Glasgow, ‘Left Out and Locked Down’ (this link will take you away from our website) explored the impact of COVID-19 on marginalised groups, including disabled people. It found that families were significantly impacted by challenges, including a lack of respite and support for single parents, a lack of access to outdoor spaces, and unequal access to digital technology. 

The rise in cost of living compounds a host of other challenges that disproportionately affect disabled children and young people, those living with long term conditions, and their families. These can, and should, be disaggregated to understand the different domains within which children’s rights are at risk as a consequence of the cost of living crisis. 

These challenges potentially have a direct impact on the rights of children and young people under the UNCRC (this link will take you away from our website), including Articles 18, 24 and 26. 

Access to mental health services 

Evidence suggests that disabled children and young people are at additional risk of experiencing mental health challenges, and the impact of the ongoing COVID-19 pandemic has been particularly felt by this group due to the impact on access to primary care, social care, schooling, and limitations to daily life. Statistics on Child and Adolescent Mental Health Services (CAMHS) waiting times (this link will take you away from our website) indicate that waiting times for children and young people accessing mental health services have lowered, with around 70% of young people being seen by CAMHS within 18 weeks by the end of December 2021. However, the ALLIANCE continues to gather evidence from frontline practitioners and professionals on the long waiting lists that children and young people they support are facing to access CAMHS, which in some instances can take up to 27 months. Further, research (this link will take you away from our website) has indicated that eight health boards (out of 14) failed to meet the Scottish government target of treating a child within 18 weeks of their referral.  

ALLIANCE members have also reported concerns around the use of detention under mental health legislation, and the impact this has had on people with autism and learning disabilities, who have been in psychiatric wards for prolonged periods of time. People are experiencing a lack of tailored and person-centred approach to care, which is deteriorating people’s health and wellbeing. Research published by the Mental Welfare Commission (this link will take you away from our website) indicates concern about the impact of psychiatric wards on human rights. While the report found positive findings related to care and support, it highlights key concerns around moving people on from low and medium security wards.  

Finally, recent evidence has highlighted concerns on the use of restraint and seclusion in Scottish schools. The Children and Young People’s Commissioner for Scotland published an update (this link will take you away from our website) on restraint and seclusion, which outlined that “[t]he investigation in schools found that disabled children were more likely to be restrained than their able-bodied peers despite being entitled to additional protections under the UN Convention on the Rights of the Child (UNCRC), so their care must be especially closely scrutinised.”  

Difficulty of understanding and accessing available support, including social care, and others. 

A recently commissioned research project by the ALLIANCE (report forthcoming), which explored how the pandemic has impacted disabled children and young people’s access to support, also highlighted that despite the range of social care benefits that disabled children and young people have access to, their understanding and engagement with this aspect of their care is limited (versus their more in-depth understanding of the health care services that they require and access). This is because the information available on social care and other benefits they are entitled to is complex to navigate, and more often than not it is not available in any alternative/accessible formats. This not only has an impact on their experiences of accessing child services in a timely way, but also for their transition to adult services. Parents and carers also often find accessing information and services a complex, timely, and frustrating process.  

These challenges potentially have a direct impact on the rights of children and young people under the UNCRC, including Articles 12, 13, 18, 23, 26, 27 and 42. 

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