ABSTRACT
There is overwhelming evidence to suggest that all types of abuse and neglect will potentially have a long-term negative inuence on a child’s physical, intellectual and emotional wellbeing (Lazenbatt 2010). Accordingly, article 24 of the UN Convention on the Rights of the Child (UNCRC) states that children should have access to the ‘highest attainable standard of health and to facilities for the treatment of illness and rehabilitation of health’. Additionally, there is a responsibility for states party to ensure that ‘no child is deprived of his or her right of access to such health care services’ (United Nations 1989). The centrality of health as a key component of safeguarding is recognised in British law within section 31(9) of the Children Act 1989, which states that ‘harm’ means ill-treatment or the impairment of health or development, further acknowledging that ‘health’ means physical or mental health. The requirement for a child to ‘be healthy’ was also enshrined as one of the ve Every Child Matters outcomes (DfES 2003a), and is currently being delivered through the ‘Healthy Child Programme’ (DH 2009a). In my previous role as a health visitor I was often faced with some very difcult dilemmas around whether professionals should intervene if they consider parents are not fully supporting their children to achieve what they believe to be positive health and wellbeing. The question of whether parents have the right to make their own health and lifestyle choices may pose an ethical dilemma, but as adults they have the right to make their own informed choice. It could be suggested that by adhering to the guidance set out by the Children Act 1989 to respect parental autonomy and responsibility, there may be occasions when we are inadvertently putting children at risk. When the wellbeing of the child is at risk, then the decision becomes a professional judgement, using knowledge of current policy around child protection as well as consideration of the risk of ‘signicant harm’. This chapter considers what being healthy is, exploring where responsibility lies in relation to children being supported to be healthy. Discussion then moves to the possible dilemmas that may be encountered, with examples
from practice used to demonstrate the importance of considering children’s holistic wellbeing, particularly keeping them safe from harm. By the end of this chapter you will:
N be able to outline the differing concepts of what ‘being healthy’ means; N understand the role of the practitioner in relation to supporting children to
be healthy; N be aware of some of the current issues and debates around supporting and
empowering children and families to be healthy; N identify a number of dilemmas and their consequences when children are
not given the opportunity to achieve optimum health and wellbeing.
