Table 2

Addressing inequality from outside the health system

Profession building
Lobby medical institutions	The Royal College of Paediatrics and Child Health is set up as a membership organisation with members’ interests at the forefront. We are entitled to ask what is being done about addressing the gaping holes in our training in relation to health inequality, and what action the College is taking to safeguard our ability as clinicians to meaningfully deal with these issues as clinicians, researchers and advocates.
Self-organise	Based on the idea that we can all come up with news ways of practising, whether it is how we conduct consultations, deciding who our pathways reach, or the kinds of questions we focus on in research, the Well-being and Health Action Movement (https://www.whamproject.co.uk/) arose to fill a perceived gap for paediatricians who care about health inequality. But so much more is needed and so much more is possible. We urge creativity and innovation at the margins here. Don’t wait for those in power to show the way.

Society building
Raising the alarm by:
Protest	Health workers have a responsibility to engage in all kinds of non-violent social protest. Examples include marching in protest over NHS privatisation, the health impacts of economic inequality and the climate crisis.
Shining the media spotlight	Media shapes public discourse, with the potential to highlight issues in ways conducive to political and social change. Health workers can bear witness, inform debate and speak out on injustice on behalf of children and communities.
Engaging with civil society	Health workers and their representative institutions have powerful advocacy voices which can be harnessed to demand better from civic and political institutions and build pressure for more equitable policy for children and young people.
Supporting social justice through:
Solidarity and Allyship	Health workers can engage the third sector by linking child poverty and ill health with broader social movements, requiring us to deconstruct siloes, work collaboratively across sectors and build meaningful solidarity. Some examples of organisations to get involved with: Local: Home-Start, Children North East, Everyone’s Children Glasgow National: End Child Poverty Coalition, CPAG, Trussell Trust, The Childhood Trust, The Children’s Society, Action for Children, Child of the North, Save the Children, UNICEF UK, APPG Poverty International: ISSOP, International Paediatrics Association, UNICEF, Medact, Save the Children, MSF, Joseph Rowntree Foundation, Lancet Migration, CHIFA, Doctors of the World.
Lobbying and Legal Frameworks	Health workers advocated for the introduction of child labour laws. Today’s child health professionals have provided oral testimony and submitted evidence to parliamentary groups concerning the accountability frameworks surrounding child poverty and health.
Industrial Action and Collective Organising	Health workers helped support cleaners, porters and domestic staff at Barts Health NHS trust win their struggle for pay and conditions and were brought back into NHS employment in March 2022
Political Education: (A) For Health Workers	Health workers at Medact have produced resources for political education for fellow workers concerning economic determinants of health. They cover liveable incomes, secure housing and tax justice as topics essential for a just economy and better child health
(B) For The Public	Health workers have provided political education on health justice at national political events, engaging the public in a radical re-imagining of health, through abolishing systems of violence and oppression, using health as a means of building collective power.
Voting: (A) By the Profession	What we do in the voting booth counts. We ought to choose candidates who hold policies that will support child public health and ideals for social justice at the centre of their work.
(B) By Young People	We can also help young people to use their voice, supporting them to vote by helping to lower voting age to 16 in England, and defend their political rights.

NHS, National Health Service.