The NHS is stepping up for care leavers – because health is where inequality begins

Throughout my career, I have seen just how deep the disadvantage is that faces young people growing up in the care of the state. I saw this first as a school teacher working with children who were doing well in the classroom but who faced huge obstacles beyond the school gate. As chair of the independent review of children’s social care, I was confronted with stories and statistics that left a permanent mark.

Young adults who were languishing on a waiting list for mental health support despite having experienced repeated and serious neglect. Statistics that showed that care leavers are more likely to struggle to register with a GP, to miss appointments, and to lose access to support as they move into adulthood.

That they face higher risks of unemployment and homelessness, and poorer physical and mental health outcomes than their peers. These are not failures of aspiration or resilience. They are the predictable result of systems that are failing too many.

And here’s the most shocking: those who’ve grown up in care are 70% more likely to die prematurely. Let that sink in.

When I was elected as an MP last year I jumped at the chance to work with the Department of Health and Social Care to push for changes, because statistics like this have remained stubbornly unchanged. Now, as children’s minister, I’m delighted to share that government is implementing the changes I pushed for to address appalling health inequalities facing those in and leaving care.

Thanks to ministers at the Department of Health and Social Care, we can announce a package of NHS changes that will not just tackle one the starkest health inequalities but will improve employment and the quality of relationships for care leavers too.

From the end of 2026, we will remove practical barriers to care, by introducing free prescriptions, eye care and dental care for care leavers. These costs can act as a barrier to basic health care that care experienced young people too often don’t have the resources to overcome. I recommended this change in my 2022 care review and government is now acting.

Secondly, we are testing a model of shifting mental health support for children, care leavers and families with children’s social care support, out of the health service and into local family help services. 

This model has the potential to make a big difference because it will end the referral merry-go-round and put clinicians who can provide direct support close to those who need it. Without waiting. 

But the NHS’s role does not stop at healthcare. As one of the largest employers in the country, it also has a responsibility to open up routes into work for those who need more intensive support. That is why we are launching a paid, supported internship scheme for care leavers in the NHS.

Supported internships offer intensive support for people who might need a lot of extra help to get into and stay in work. The NHS will also extend its guaranteed interview scheme to care leavers. This is exactly the kind action we need for care leavers given that nearly 40% of them are currently not in education, employment or training.

Finally, we are going to make changes to data sharing in 2026 to help keep more children safe and ensure that health service can provide extra support for those in care. We will make changes so that GPs are automatically notified when they have a patient who is on a child protection plan or is a young person in care. It is a sign of how outdated our approach to information sharing is that this hasn’t previously been fixed.

Alongside these health measures, we are bringing forward changes through the Children’s Wellbeing and Schools Bill to strengthen how government works together to protect children before they ever reach crisis point. This includes introducing a register for children not in school, new data sharing powers and £2.4bn of extra investment to get support to families earlier. 

We are extending Staying Close housing support up to age 25 for those who need it. And we are introducing corporate parenting responsibilities across government departments so that this action by the NHS can be mirrored by government bodies across the board in future.

As we approach Christmas, it is worth remembering that this can be an especially isolating time for care-experienced young people. While others gather around family, many feel the absence of support most sharply.

We are working on every front to change that – to ensure those in and leaving care have stronger networks around them, and that public services step up, rather than step back, as care-experienced young people move into adulthood.

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Josh MacAlister is MP for Whitehaven & Workington and children’s minister.

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