Baroness Cass (CB)

My Lords, as we have discussed at length, this is a multifaceted Bill, so I would welcome our achieving greater clarity of purpose. Without purpose, there is no focus, and we can get very lost in complexity. As we progress through Committee, I ask noble Lords to consider the opportunities offered in this Bill to improve well-being through healthier young lives. Let us not lose sight of health, because without good, healthy young people there is no opportunity for learning or well-being. I am talking about both physical and mental health. When I was president of the Royal College of Paediatrics and Child Health between 2012 and 2015, we had slipped over the preceding 15 years to being one of the worst-performing countries in Europe for infant and child mortality. Mortality, in particular infant mortality, is used globally as a sensitive indicator of the health of a nation. It is the canary in the coal mine for how we are looking after children and young people; it signals alarm if that is not going well. Since then, we have seen infant mortality rise among infants born to poor families while it continues to fall among the wealthy. We are looking at a variety of public health issues that should give us pause for thought, including poorer vaccine uptake and worsening health inequalities more generally, in particular obesity. Between 2014 and 2019, teenage mortality edged up rather than down, and noble Lords are well aware that teen mental health is deteriorating. In relation to the Bill, it is important that we think carefully about how we are using the public health workforce, such as school nurses and others, and give careful consideration to the multiple pulls on their time and how different parts of the Bill differentially pull on those resources. Equally, we must consider how significant system change is going to impact designated doctors and nurses, whose carefully worked out roles are, at best, stretched, so that those do not become further stretched by the changes in the systems. During the passage of the Bill, we should consider carefully exactly what is going to happen to that precious workforce, which we should use to maximal effect. I hope the Minister can give us her thoughts on how care will be given to that aspect.