PLANNING AND COMMISSIONING OF HEALTH-SERVICES FOR CHILDREN AND YOUNG-PEOPLE

Background Local audits in England and Wales performed in 1994 showed that child health commissioning was not being given priority. We were concerned that child health commissioning was in addition not performe d in a child-centred way, with the best interests of children to the f ore. Method A survey of health authorities and boards was performed, t o investigate child health commissioning in the United Kingdom. A ques tionnaire was sent to all directors of public health medicine in post in November 1994. The main outcome measures were child health experien ce within commissions and the context of children's services within th e wider commissioning process. Results A total of 120 (92%) of 129 aut horities replied. Sixty-nine (58 per cent) had a named person with res ponsibility for child health services, of whom 7 (5 per cent) worked e xclusively within this area, 42 (32 per cent) had experience within cl inical child health, and 19 (15 per cent) had postgraduate qualificati ons in child health. One hundred and five (81 per cent) authorities re plied to a question on the comprehensiveness of the commissioning proc ess; of these, 45 (34 per cent) planned and commissioned children's se rvices in their entirety and 60 (46 per cent) planned and commissioned children's services in the context of other service areas. A majority did not plan and commission acute and community services together. Co nclusion Many authorities had no named person with responsibility for a child health strategy. Of those that did, most named persons had ina dequate experience and few had postgraduate qualifications in child he alth. Most authorities had no comprehensive planning mechanisms for ch ildren's services. In consequence, most commissions were failing to co mply with the UN Convention on the Rights of the Child.