Committee publication · Report · 22 January 2026 · HC 802
5th Report - First 1000 days: a renewed focus
From: Health and Social Care Committee
Inquiry: The First 1000 Days: a renewed focus
Government response deadline: 22 March 2026
Summary
This Health and Social Care Committee report examines progress on early childhood services since 2019, focusing on Family Hubs, health visiting, workforce, vaccinations, and service integration. It finds health visiting numbers have fallen 43% since 2015, vaccination coverage remains uneven, and Family Hub access is inequitable. The committee welcomes government expansion plans but calls for ring-fenced funding, workforce rebuilding, and better data integration across early years services.
Key findings
- Health visitor numbers have fallen by 43% since 2015, creating a shortfall of 5,000 posts with dangerous caseloads sometimes exceeding 750 children; committee calls for immediate recruitment of 1,000 additional health visitors.
- Over 35% of parents from low-income households cannot access Family Hubs compared to 23% of parents on average incomes, indicating proportionate universalism principle has stalled since 2019.
- Family Hub funding of under £600 million annually is significantly below Sure Start's £2 billion (2010), despite expected to serve broader age range; government announced £500 million between 2026–2029 for expansion to all local authorities.
- Vaccination uptake has declined steadily since 2012 with stark regional and ethnic disparities; committee recommends reinstating 95% coverage target in NHS planning guidance.
- Perinatal mental health support in Family Hubs is often unclear and limited to peer support; mothers from ethnic minority backgrounds experience 13% higher rates of postnatal depression.
Recommendations
- Expand Family Hub network to provide access in every community, backed by sustained ring-fenced funding, and confirm funding arrangements for new areas with guidance on 0–2-year services.
- Create dedicated roles within Family Hubs to support parents of children with additional needs and similar roles for other disadvantaged groups.
- Urgently rebuild health visiting workforce with funded plan to recruit at least 1,000 additional health visitors immediately; develop safe staffing tools and commit to increasing mandated visits from five to six.
- Ensure NHS 10 Year Workforce Plan includes specific funded targets for early years professionals with updated modelling and publish child's health workforce strategy covering NHS and non-NHS professions.
- Reinstate 95% vaccination coverage target in NHS planning guidance with commitment to achieve by end of Parliament; accelerate health visitor-led vaccination delivery pilots and ensure Integrated Care Boards have named vaccination leads.
- Improve perinatal mental health access in Family Hubs with specific targets for ethnic minority women and set out actions to enhance mental health care within Hubs.
- Revise Department for Education guidance on early language and home learning funding to allow support for 0–2-year period.
- Produce data sharing toolkit to address practical challenges providers face; work toward greater data disaggregation to enable monitoring of waiting times for under-twos.
Tone
CriticalTopics
Key actors
Layla Moran (Health and Social Care Committee Chair), Minister Dalton, Dame Andrea Leadsom (Chair of Early Years Health Development Review), Christine Farquharson (Institute for Fiscal Studies Associate Director), Jane Harris (Speech and Language UK CEO), Saskia Jenkins (Senior UK Policy Advisor at UNICEF)
Notable line
“Health visitors are the backbone of early years care, yet their numbers have fallen by 43% since 2015, leaving a shortfall of 5,000 posts.”
Key Quotes
“The ambition for family hubs is that they will be like a supermarket or a GP clinic; everybody goes there, so there is no stigma associated with going.”
“… even taking a "maximalist approach" to counting, the annual expenditure on Family Hub funding was less than £600 million a year …”
“It just depends on whether there are people in those family hubs who see this as a priority.”
“Yes. This is the beginning of our ambition to deliver the healthiest generation of children ever. […] This is a decade of renewal.”
“Perinatal mental health is as important as physical health, with poor mental health outcomes having potentially significant long-term consequences for both the mother and child.”
Source · parliament.uk record ↗