Becoming a parent is exhilarating but also terrifying.  Tiny bundles of joy do not come with a manual, nor with consistent levels of advice and support from public services - as this excellent report from Nesta makes clear.

For over 20 years, successive devolved Scottish Governments have committed to Getting It Right for Every Child. Yet, Scotland’s collective focus on children’s policy is weakest when it arguably should be at its strongest: before and during pregnancy, and in the first two years of babies’ lives. Indeed, the research highlights just how precarious investment in these critical years actually is, with previous Nesta reports showing that the average amount spent on each baby has remained at the same level between 2011 and 2023, whilst spending on older children has increased significantly. That finding shows that funding for our youngest children has remained static - a shocking position, especially considering the significant focus on children's policy. 

This report sets out many depressingly familiar problems: a failure to act strategically; to join up services between and among statutory and third sector organisations in particular to appropriately resource and value staff; to provide long-term funding; to gather enough of the right data and share it. Many of these stubborn challenges were identified by the Christie Commission, though  new ones  have emerged, some linked to our response to the Covid-19 pandemic.

The report’s recommendations are sound, and it makes clear that Scotland has many strengths upon which to build. But more focus on the role of the NHS, the economic implications of not acting, as well as on UK powers, not just devolved powers would have been welcome. The report rightly highlights why investing in these earliest years matters for children, their families and society. However, there is an economic imperative to improve what we do. Investing in preventative approaches reduces the need for expensive, crisis interventions, as the research makes clear, but it also benefits nations’ economies. Indeed, there is well documented research on the links between early years’ investment and high performing economies. All the arguments why we need to get it right for every baby should be deployed.

Second, the NHS has the biggest responsibility for and engagement with mothers-to-be and babies. The report references health visiting and midwives throughout but the primary role of the NHS must be acknowledged and understood, particularly as we embark on public sector reform. Anyone who has worked in this field will recognise the mercurial nature of NHS involvement with other services and supports - sometimes with devastating consequences. Its role is critical and the reprioritisation of resources to end the scandal of under investment in children’s and women’s health is key: improvement cannot happen without this, especially if we are to reduce the shamefully high levels of infant and maternal mortality.

Nesta’s goal to give every child in Scotland a fairer start is timely. We are about to embark on the largest ever period of public sector reform in our nation’s devolved history, and the shape and structure of everything in the public sector is currently up for grabs. There is a risk that the process becomes consumed with inputs and outputs and ignores the need to start with desired outcomes. Getting it right for every baby is an obvious one.

Scotland needs a reprioritisation of investment and focus to these critical months and years pre- and post-birth.  Without it, it is hard to see how we will manage to eradicate child poverty, ensure fewer children end up in care, and create equity and equality of opportunity for children throughout their lives. This research makes plain we are currently starting far too late; the question is do we have the political will to shift the dial and get it right for every baby?

Kate Higgins is a former SNP special advisor who advised on landmark family policies, including early years education, child poverty reduction, and the promise. Prior to entering government, she spent over a decade driving children’s rights and welfare across Scotland’s voluntary sector, leading policy and advocacy at Children 1st.