Tuesday, August 23, 2011

The Healthy Start for School Initiative- a bogus scheme that causes nothing but stress

I was going to write a post today about growing from seed but a pressing email from Kids in Australia just popped up in my mailbox and I think its contents are more important.

Many parents and health care practitioners are shocked and infuriated by a new government initiative entitled: The Healthy Start for School Initiative. The requirement is that all parents bring their child (who turns four within this financial year) into a GP for a health assessment. Compliance with this requirement will determine whether you do or you don't get the family allowance. Letters are going out to parents this week – some have already been received.

 From his blog, entitled "Unfit Until Screening And Intervention Says Otherwise" by Dr Joe Kosterich:

"It is not often that something makes my blood boil but this has. I received a letter from the Federal Government informing me of its new Healthy Start For School “ initiative”. This is a scheme whereby any parent receiving an income support payment in the financial year that their child turns four must take the child for a “check” to ensure the child is “healthy, fit and ready to start school”.
The propaganda sheet informs me that as a doctor I can expect requests for these assessments. The check that I am supposed to do includes (and I won’t bore you with all twelve points) height and weight, oral health, and toileting. It must also include “making an overall assessment of the child and recommending appropriate interventions”.
The rationale for this as with most of these schemes is that it will “… help with the early identification of life risk factors and development delays and conditions”.  Really? Even if you could understand this double speak it is meaningless.
Now whilst on the surface it may sound well and good to want to detect problems early there are major fundamental flaws with these schemes. The primary one is that not all children develop at exactly the same rate and that does not mean they have any condition. Not all children walk or talk at exactly the same age. Not all children are the same height; this does not mean there is anything wrong with them.
The second major flaw is the assumption that children are not healthy until screened to be so. In other words all children are deemed to have something wrong with them, which requires “ appropriate intervention” unless proven otherwise.
The third flaw is the assumption that screening is actually capable of sorting out those who do have a problem (a tiny number) from those who just are developing at their own rate. For example 10% of normal ten year olds are not dry overnight. “Intervention” can be useful if sought but not if imposed.
The final howler in all this is that lots of worried well, will get shunted down the line of further assessment and intervention only to find that there was no problem in the first place. This places stress on the family, has the capacity to damage the child who feels there must really be something wrong and means that those few children who actually need help will be more likely to miss out.
The screening lobby loves this kind of stuff and will bleat about how wonderful it is. The screening lobby is the main beneficiary of this as they get more government money for their programs. And guess what, they will find all sorts of “conditions” in numbers far higher than ever thought to occur which will need even more government “funding” to solve.
The fact that most of these “conditions” will not actually exist or that considerable harm will be done to families and that those in genuine need will miss out through dilution never bothers the zealots.
And there is worse to come! In 2012 the program will extend to include “… consideration of emotional wellbeing and development in three year olds”. This is being delayed  “…to allow expert input on the assessment instrument(s) and resources for professional development”.
What absolute rubbish! There is no such thing (and nor should there be) as an unemotional three year old. Tragically there are people out there who diagnose conditions like ADHD and bipolar in three year olds and then prescribe drugs. This may increase exponentially if this “screening” of three year olds goes ahead and will end up damaging children.
You can be certain that “screening” will turn up an army of three year olds in need of emotional counseling or drugging of some kind!
Here is the bottom line. Children develop at their own pace and need to be allowed to do so.  A few genuine objective measures like sight and hearing have some value. Mass screening of this nature, medicalizes childhood on the assumption that all children have “conditions”, just waiting to be found and “treated”.
Reality is far different. Children need basics to thrive. They need nutritious food and adequate sleep. They need to be able to play outside, to be read to, and above all to be loved. Whilst not every child may get all of this, no useless government mandated screening test will replace it."
You can read about the Healthy Start for School Initiative and your requirements as a parent on the centrelink website. 
Most disturbing is this checklist which the GP is asked to fill out in order to "pass" or "fail" your child. 
Here are some of my own specific concerns and questions:
* Why and how is a GP (any GP!) able to assess whether your child is healthy or "at risk" in a 10 minute appointment?
* What if your primary care practitioner is not a GP? 
* What if your health philosophy has indicated that mainstream medicine is not in your child’s best interests? 
* What if your child is not immunised?
* What if your idea of healthy eating differs from the GPs? 
* Will breastfed babies and children be at risk because of their slower weight-gain as compared to those fed formula?
Between the ages of 0-2 I took North to all of the maternal health check-ups they encourage you to go to. Our particular Maternal Health nurse was a real shocker and put me off of the entire experience. In the two years we knew her she told me
* my children should not be vegetarian because it will be emotionally distressing for them when they are at a Sausage Sizzle (according to her an Aussie rite of passage) and can't have one with their friends
* to stop breastfeeding him when he was 1 because he didn't need it anymore, but to put him on a bottle with cow's milk
* again, to stop breastfeeding while I was pregnant or I would hurt the baby
* to stop breastfeeding because North was in the 35th percentile for weight and was drinking too much milk and not eating enough solids 
Needless to say, Indigo hasn't been to a maternal health check appointment since she was 2 months old. These are the kind of ignorant health professionals who are assessing my child and my parenting choices!
As a parent, what's your take on this initiative? Do you feel as violated, screened and belittled as I do? Doesn't it all feel a bit Big Brother-esque... or is it just me?
xo m.


madewithloveuk said...

Oh no, that's such an awful scheme to start up - there are so many similar things like that here in the UK - very much like the whole 'big brother' thing. Cannot see how the children will benefit at 3/4 yrs old?!

Green Mama said...

A bad experience with a maternal and child health nurse does not indicate an entire profession is incompetent...

Mama Mash said...

Ugh I saw this yesterday and was just as appalled as you.
I too stopped taking Harper to the maternal health nurse at 12 months... of all people I should know my child's needs best, I don't need someone else telling me what to do or what not to do when I am perfectly happy the way things are... If I do feel the need to take him to a doctor than I will do so when I feel the need.

Going off on a tangent regarding the vegetarian thing I just wanted to say that my cousin's 2 children aged 2 and 4 are both vegetarian and have been so since birth and both are happy and healthy children...

Okay I'll stop now :)

Shara said...

I was really upset and shocked when we received this letter. I don't feel it's the governments place to say when and why my children should see a doctor (in my opinion it should only be when they are sick?)But unfortunately there are some children out there who are not well cared for and maybe this will benefit them?? However I don't like bieing lumped in a category. Just another example of the Government trying to control the decisions we make, I heard recently that they are thinking of making Prep compulsory in QLD. I think it should be up to the parents who know their child best to decide when and if they should be off to school.

Rebecca said...

Having worked with vulnerable children for over 10 years, I welcome any initiative that provides another layer of support for kids who's parents who may not have the inclination or capacity to respond to their day to day basic needs. I know too many children that at 5 years of age, are still in nappies at all times, and have no teeth due to bottle rot. Although I can understand your concerns based on a bad experience with a maternal health nurse, you are clearly not the target audience in this case. You are more than capable of identifying your children's needs and responding to them appropriately. I wish this could be said for all parents, but sadly this is not the case. If this initiative saves just one child from slipping through the cracks, then I believe the 10 min 'stress' is well worth it.

Saminda said...

I got the same letter last week - and yes, felt just as you do.

We too do not vaccinate our children, and make natural health choices which are often contradictory to the mainstream advice of a GP.

I'm not sure what to do - I guess I'll need to take William along to this crazy 'health check', even though I know he is an absolutely healthy and thriving little boy!! Yes, it feels very big brother to me too. :(

ecoMILF said...

Thanks everyone for your thoughtful comments. I do wholeheartedly agree that some children and parents need more support than others. I just hope that we find other ways to support parents and to prevent problems before they occur instead of policing everyone.

xo m.

jodi said...

Che has already had this check done as we got his whopping cough booster before Poet arrived. Our GP is incredibly laid-back and basically asked us if we had any concerns (we don't) and that was that.

But I do understand your concern with placing your child on a scale. Che has always been under the 'underweight' place on the scale but look at Daniel and I - we're fine boned, slight people and I doubt we'll produce chubby babies. At poet's 2 week check the nurse was concerned she'd only gained 80grams in a week as opposed to the required 100grams. Minutes before she was weighed she did the biggest projectile poo and I happily said to the nurse: "i have no doubt that that poo weighed 20grams!"

What concerns me is that 'scales' and measurements place undue stress on new mumas - and that, above anything else, just makes me sad.x

Simone said...

I just wonder how many people expressing concern or even outrage at this new government initiative are more than happy for that same government to deposit a family allowance or income support into their bank account in the first place, no questions asked? I wonder how many people protesting this new initiative would get their knickers in a twist if an alternative or successive government threatened to take away this entitlement or, at the very least, substantially reduce it, even if it was done in the name of long term economic sustainability?

Like you and the doctor you quoted above, I am wholeheartedly opposed to this initiative, and for many of the same reasons. But this kind of governmental intrusion into the personal lives of individual citizens is hardly surpising to me. On the contrary, regulations of this kind coming from 'on high' are totally and utterly predictable. After all, isn't it true that he who pays the piper, gets to call the tune? Do people seriously expect that the person paying the piper (in this case, it's the government doling out welfare cheques of one kind or another to you and me) isn't, at some stage, going to insist on calling the tune (in this case, the imposition of an Orwellian sounding Healthy Start for School initiative?

Instead of getting all fired up about what, in effect, is simply the logical consequence of welfare dependency (i.e. increased government involvement in our lives), why not protest the root cause of the problem: welfare dependency?!

For the record, I receive a 'family allowance' on a fortnightly basis and have received two 'baby bonus' payments in the past. I guess this makes me a conscripted 'piper' and, as such, I'll just have to play the tune that I'm told to play, and hope that somehow my skinny (but perfectly healthy) 4 year-old makes the grade. Wouldn't it be better, though, if the government simply allowed families to keep more of their earnings (i.e. through lowered taxes)? Welfare payments, like the kind I receive, wouldn't be necessary, and neither would the multitude of bureaucrats and pencil pushers employed to administer said payments. Of course, if they did something as sensible as that we would no longer be beholden to the government, and we can't have people in control of their own lives now, can we?!!

Meanwhile people will keep on voting for the party which promises to spend the most on them, and the Big Government initiatives like this one will continue to be implemented.

Cass said...

Nope, I'm not at all worried about or offended by this scheme. I've seen some shocker MACH nurses too, but if a bit of inconvenience for me means that a kid who desperately needs some help gets it, then I am 100% ok with that.

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