Affiliate Contributors to Primary Care for Children

Abstract

There is more to primary care than solely medical and nursing services. Models of Child Health Appraised (MOCHA) explored the role of the professions of pharmacy, dental health and social care as examples of affiliate contributors to primary care in providing health advice and treatment to children and young people. Pharmacies are much used, but their value as a resource for children seems to be insufficiently recognised in most European Union (EU) and European Economic Area (EEA) countries. Advice from a pharmacist is invaluable, particularly because many medicines for children are only available off-label, or not available in the correct dose, access to a pharmacist for simple queries around certain health issues is often easier and quicker than access to a primary care physician or nursing service. Preventive dentistry is available throughout the EU and EEA, but there are few targeted incentives to ensure all children receive the service, and accessibility to dental treatment is variable, particularly for disabled children or those with specific health needs. Social care services are an essential part of health care for many extremely vulnerable children, for example those with complex care needs. Mapping social care services and the interaction with health services is challenging due to their fragmented provision and the variability of access across the EU and EEA. A lack of coherent structure of the health and social care interface requires parents or other family members to navigate complex systems with little assistance. The needs of pharmacy, dentistry and social care are varied and interwoven with needs from each other and from the healthcare system. Yet, because

Potentially over 3 million children in EU Europe believed not to be receiving needed medical and dental treatment—and parents' reasons why

“…Reported reasons for this non‐treatment are only published for a subset of mainly larger countries and vary considerably by country, but in most cost is almost the sole barrier. This is perplexing as virtually all EU countries claim to have a free service of inspection and basic treatments for children (Alexander et al, ), so these may be non‐health costs of attending with a child. Poland, followed by the Czech Republic, Estonia, France, and Latvia have waiting list problems, suggesting lack of workforce or capacity.…”