A Health News Letter From an Expert Commenting ON NHS and Health Related Matters

10th June 2025

Roy Lilley's eLetter, across all social media platforms and email now reaches around 300,000 in-boxes a week, throughout the UK and overseas.

It is a free digest of commentary, news and opinion... yes, it's free!.

Here is todays newsletter as an example

have news.

Something I had no idea about.

All governments keep secrets. The Horizon scandal... facts buried. The Manhattan Project in the US; not even vice-president Truman knew about it.

The Chernobyl Disaster. Radiation wafting across Europe. The USSR tried to keep it a secret.

The infected blood scandal. Only now are we coming to terms with what happened. The Hillsborough cover-up... HMG and police colluded to hide the truth.

Often, the cover-up outlived the crisis and caused more damage than the original act.

Not all secrecy is sinister. Sometimes HMG didn't cover up the facts… they are just unaware of them. They don't put two and two together.

Grenfell. HMG did not know the scale of flammable cladding used across the nation's housing stock. Windrush. British citizens illegally detained, denied healthcare and deported.

Covid… how limited our preparedness was for a pandemic. Inconsistent maintenance records and no national building inventory leading to the RAAC concrete problem.

I think there’s another disaster happening in plain sight. HMG not putting two and two together. That’s my new news.

Here it is…

… the under 1’s are the highest users of A&E.

In London there are 908 attendances per 1,000 infants… almost every child.

National figures show A&E attendances for the 0-4 year olds rose by 42% over the past decade.
Short stay emergency admission for infants rose by a third.

Last year there were 464,017 emergency admissions of children aged 0-4, Babies under 14 days saw around 45,538 admissions in the same period.

Children under five accounted for 74,400 (roughly 10%) of attendances in Type 1 & 2 emergency departments, daily.

Something is going horribly wrong with families. We need to know what it is and how to fix it... put two and two together.

Hull children aged 0-4… there are an astonishing 1,100 attendances per, 1,000 children … 46% higher than the English average. There’s a clear link between deprived areas, with 55% more A&E visits.

I tripped over this issue. It’s destined to trip-up HMG. They must act; for the benefit of families and their kids and to decongest A&Es.

What to do? Rebuild the health visitor workforce... it's urgent.

Restoring the number of qualified health visitors to just 2015 levels would mean an additional ~5,000 posts… they offer trusted advice and early intervention… and would go a long way to prevent unnecessary A&E visits.

That means;

Ring-fencing LA funding, set workforce targets, and reintroduce drop-in baby clinics.
Improve GP access for Infants … guarantee same-day or rapid access to GPs for children under 1… because lack of timely GP appointments pushes parents to A&E.

Create ‘child-first’ GP slots, protect under-5 appointments, and expand paediatric training in primary care.

Introduce 24/7 Child Health Advice Lines… paediatric-specific helplines or virtual services for infant illness and reassurance… expand NHS 111 with dedicated infant triage nurses.

Create a dedicate child-stream on the NHS app. Modern parents are tech savvy.

Talk to paediatricians; parental anxiety is a major driver of A&E use. Use NHS App, antenatal classes, Red Book app, and postnatal home visits to deliver clear, evidence-based messages.

Create Urgent Care ‘Hubs for Children’… outside of hospital… staffed by paediatric-trained teams. Co-locate in community settings... polyclinics, minor injury units, supermarkets, empty high street shops. with flexible hours.

Each of these ideas targets a different part of the system;

prevention,
access,
triage,
reassurance, and
infrastructure

… offering a balanced and achievable path to reduce attendances without compromising safety...

... could help nip-in-the-bud a dependency culture where, for families and their growing kids, A&E is their first port of call and will be for the next generation.

Families, obviously struggling with their children, is a national scandal.

It’s easy to blame the parents but the huge numbers tell us, across the board, there is a system wide issue.

Mums and dads are floundering. 'Matrifocal support networks' are what the experts call it. We'd call it mothercraft.

It's gone.

Families live farther apart. Grandparents are often still working or overburdened. There are fewer multi-generational households and there's been a decline in 'social capital'...

... the informal ties that bind communities and pass on norms and knowledge.

A quiet collapse of kinship care. The soft support scaffolding that once saw mums helping daughters raise babies and fathers quietly guiding sons. It wasn’t formal, funded, or visible... but it worked.



Once upon a time, every new mum had a health visitor they knew by name. Baby weighed every week. Advice given. Fears eased.



Now there’s been a 40% decline in HV numbers between 2015 and 2023 because of;

Cuts to the public health grant (from 2015 onwards)
Devolution of responsibility to local authorities
Broader workforce pressures and policy drift

The smallest patients are fast becoming our biggest problem and a huge warning sign.

https://ihm.org.uk/nhsm/