Currently, there is a widespread agreement that children and teenagers must be conferred with about their health and health needs and that their opinions must be taken into consideration in the planning and formulation of health services. With the confirmation and endorsement of the UN Convention on the Rights of the Child by the UK government in 1991 and specifically Art 12 — which supported and strengthened the movement towards a fuller involvement of children and young people in decision-making — there has been tremendous amount of legislation that eventually concluded with the passing of the Children Act 2004.
For example, the five outcomes exemplified in Every Child Matters, include ‘make a positive contribution’ which assimilates the concepts of involvement and participation. The value and implication of listening to young people, and taking their views seriously, is likewise mirrored with the recent appointment of the first Minister for Children in England. Moreover, each nation in the UK now has a statutory Children’s commissioner and one of the more important functions this person has to perform is to listen to, represent, and respond to the views of children and young people.
Governmental departments have been made responsible in taking this participation agenda to move on and move fast and the Children’s and Young People’s Unit described how “the Government wants children and young people to have more opportunities to get involved in the design, provision and evaluation of policies and services that affect them or which they use” (CYPU, 2001).
The challenge is being faced and there are now countless manifestations of how models of participation are being, and can be, effectively executed (Kirby et al, 2003; Mason and Fattore, 2005) to be ‘meaningful, efficient and sustainable (Sinclair, 2004). Participation has also turned to become a vital component of many new national frameworks for youth action (Russell, 2005).
Various schemes and proposals in the health and health care domains are growing, and it is highly probable that the agenda has considerably changed Hart and Chesson contended in 1998 that although children are chief users of health services, they are hardly ever consulted as healthcare consumers. Their needs were, certainly at that time, given insufficient priority by policy makers and health service professionals despite a recommendation by the British government’s health committee that changes in attitudes were needed to encourage greater heed of children’s voices and views.
Lately, initiatives in this direction, the Royal College of Pediatrics and Child Health (2005) came up with a strategy to foster participation of children and young people in pediatric activity which, very aptly, draws on the findings from consultations with children and young people as well as members of the Royal College of Pediatrics and Child Health committees and RCPCH staff. It was also propped up by a young person’s advisory group. And as part of the development of a single inspection framework following the Every Child Matters Green Paper, there is a commitment to the involvement of children in the inspection process.
In like manner, the Department of Health came out and published Listening, Hearing and Responding, an action plan to involve children and young people and has since updated this by describing key achievements and setting new and immediate priorities. Further government activity in the area of adolescent health is obvious in the ‘You’re Welcome’ Quality Criteria for Young People that have been set up to enable health services to become young-people- friendly. Likewise, there have been significant steps to seek young people’s views on these matters.
One that is specifically pertinent is the Children’s Voices Project from the Commission for Health Improvement (Boylan, 2004), which gathered and organised feedback from children and young people about their experiences and expectations of healthcare. The project was a product of a request by CHI commissioners for information on children and young people’s views that could influence the development of future inspection methodologies. In 2003, CHI compiled reports of young people’s views on health services, and drafted these to become a database with online search facilities.
There was felt to be potential for this database to become a continuing resource, and it was agreed that CHAI, (currently the Healthcare Commission) would take responsibility for the project when CHI was abolished. Another welcome development is the first Young Patients Survey, carried out in 2004 for the Healthcare Commission. This was a major survey, carried out in 150 NHS acute and specialist trusts, and gathered opinions from over 62,000 children and young people who had used these services.