On 23 September 2026, the Royal College of Paediatrics and Child Health (RCPCH) published new Scotland-focused findings from its State of Child Health 2026 report. The findings paint a concerning picture of children’s health across Scotland, highlighting persistent and widening inequalities linked to poverty and deprivation. Children living in Scotland’s poorest communities continue to experience significantly worse health outcomes than their peers, with inequalities evident in oral health, obesity, early childhood development, vaccination uptake and, most concerningly, child mortality.
At Children’s Health Scotland, we welcome the publication of this important evidence. As an organisation committed to promoting children’s healthcare rights, we have worked alongside RCPCH and other partners to ensure that the voices of children and young people are heard within national conversations about health and healthcare. These findings reinforce what many children, young people, families and carers have been telling us for years: where a child lives, how much money their family has, and how easily they can access services continue to shape their health and wellbeing.
A Rights Issue, Not Just a Health Issue
The statistics published by RCPCH are concerning. Scotland recorded the highest child mortality rate among the UK nations in 2024, while nearly a quarter of children aged four to five were overweight or living with obesity. The report also highlights stark inequalities in oral health, with 40% of children living in the most deprived communities experiencing tooth decay compared with 16% in the least deprived areas. Vaccination uptake remains below national targets, with children in the poorest areas less likely to receive routine immunisations.
These are not simply health outcomes. They are indicators of whether children’s rights are being realised.
Under Article 24 of the United Nations Convention on the Rights of the Child (UNCRC), every child has the right to the highest attainable standard of health and access to healthcare services. Since the incorporation of the UNCRC into Scots law, public bodies have a strengthened duty to consider, respect and protect these rights.
When children experience poorer health outcomes because of poverty, delayed access to support, or unequal access to services, it raises important questions about whether their rights are being upheld equally across Scotland.
Looking Through the EACH Charter Lens
The findings are also significant when viewed through the lens of the European Association for Children in Hospital (EACH) Charter, which sets out the rights of children and young people in healthcare settings.
The EACH Charter emphasises that all children should have access to healthcare that meets their physical, emotional and developmental needs, regardless of background or circumstance. It recognises the importance of equitable access to services, participation in decisions, age-appropriate information, and care delivered in a way that supports the whole child and family.
For many children living in poverty, barriers to healthcare extend far beyond the hospital or clinic door. Long journeys to appointments, difficulties taking time off work, digital exclusion, waiting lists, and challenges navigating complex systems can all affect access to care. As highlighted in the RCPCH findings, inequalities often begin early and accumulate over time.
This is why a rights-based approach remains so important. Improving child health requires more than treatment. It requires services and systems that actively work to reduce inequality and ensure children’s rights are realised in practice.
Listening to Children’s Voices
At Children’s Health Scotland, one of the strongest messages we hear through our Health Rights Defenders is that children and young people want to be listened to.
Over the years, our Health Rights Defenders have contributed to national reports, consultations and discussions led by organisations including RCPCH. Their experiences provide a vital perspective on what it is like to navigate healthcare, education and daily life while living with a health condition.
Children and young people consistently tell us that delays in accessing services, long waiting times, inconsistent support and poor communication can have a significant impact on their health, wellbeing and opportunities. Many understand the links between poverty, health and access to support because they see these challenges affecting their own communities.
The latest RCPCH findings demonstrate why these lived experiences matter. Data tells us what is happening. Children’s voices help us understand why it is happening and what needs to change.
On Our Way, But Not There Yet
Children’s Health Scotland published On My Way, a report capturing the experiences and priorities of children and young people with health conditions across Scotland. The report highlighted the importance of accessible services, clear information, participation in decisions, mental health support and tackling barriers to care.
The RCPCH findings reinforce many of these same themes. While Scotland has made important progress in recognising children’s rights, significant inequalities remain. Children’s experiences continue to vary depending on where they live, their family’s circumstances and how easily they can access support.
As Scotland continues its journey towards becoming a nation where children’s rights are fully realised, these findings provide a timely reminder that progress must be measured not only by policies and commitments, but by the everyday experiences and outcomes of children and young people.
A Call to Action
The RCPCH report calls for urgent action to reduce child poverty, strengthen prevention and invest in the child health workforce. These recommendations are essential if Scotland is to reverse current trends and ensure every child has the opportunity to thrive. Children’s Health Scotland supports these calls and believes that a rights-based approach must remain at the heart of future action. Improving health outcomes means listening to children, addressing inequalities, strengthening services and ensuring that children’s rights are embedded across healthcare, education and public policy.
Michelle Wilson, Head of Children’s Services, Children’s Health Scotland
The findings from RCPCH should concern everyone who cares about children and young people’s futures. Through our Health Rights Defenders, we regularly hear from children and young people whose experiences reflect the inequalities highlighted in this report. Their voices remind us that statistics represent real lives, real families and real barriers to accessing the support they need.
The publication of the On My Way report showed that children and young people know what good care looks like and have clear ideas about what needs to change. We are on our way towards getting it right for every child, but these findings show there is still significant work to do. Children’s rights, including the right to the best possible health, should never depend on a child’s postcode, income or circumstances. We must continue working together to ensure every child in Scotland can access the care, support and opportunities they need to thrive.
As we reflect on these findings, the challenge is clear. Every child has the right to the best possible health. Realising that right means tackling inequality, listening to children’s voices, and ensuring that no child is left behind.
Want to talk about our On My Way Report?
You can contact Michelle on CYPHRS@childrenshealthscotland.org to find out more.
