In defending the nanny state, Keir Starmer walks right into the objections that are often raised against it, which is that governments should not try to change behaviour, such as eating the right food and cleaning your teeth (Starmer to embrace ‘nanny state’ with plan for toothbrushing in schools, 10 January). Where in these worthy proposals is an understanding of how children develop? Most of us know in our hearts that the better you are looked after, the better the result. This is not from instruction but through attentive care, the capacity for which is undermined by poverty and insecurity. So why is Labour not restoring its most inspired social provision for under-fives, Sure Start? This was set up in 1998 with Treasury funding under the brilliant Irish-born civil servant Norman Glass, who made sure that Whitehall colleagues from different departments collaborated in its design and that parents became active partners in the communities thus created. As long as children’s centres were centrally funded, they were successful, but this was not convincingly demonstrated until a decade after Conservative austerity had begun closing them, while laying waste the rest of the social fabric on which families rely. Starmer’s proposal to end the mental health crisis, mentioned in his article (Britain has suffered terribly under these Tories, especially our children. The only word for it is neglect, 10 January), is “8,500 more mental health staff in the system”, but this is already too late. By studying rates of mental and physical hospital admissions, the Institute for Fiscal Studies showed in 2021 that the poorest preschool children in Sure Start areas made the greatest gains in health, right into their teens. Besides saving more than a third of the costs of the whole programme, this outcome is just the tip of an iceberg of socially promoted resilience; nothing to do with a nanny state. A children’s centre is more than a location for doing things for families. It also a micro-neighbourhood where they – and the staff – do things for each other. As the former shadow early years minister Kate Green put it in 2021, “those mums that got to know one another at Sure Start are still the bedrock of our community”. Dr Sebastian Kraemer London I read Keir Starmer’s article with increasing dismay. While he acknowledges that the dire state of British children’s mental and physical health requires a range of fresh initiatives across a broad variety of fields (health, dentistry, education, the food and drink industries are some he mentions), there is not a single word about housing. It’s as if the Beveridge report had never happened. Expecting the NHS or schools by themselves to tackle the now desperate state of affairs caused by what amounts to decades of neglect by both the Tories and New Labour of children’s everyday living conditions is no longer tenable. Our health and theirs (physical and mental) depends on many things, but most essentially on the homes we live in. It is central. Leaving such a crucial matter to the tender mercies of the private sector has proved a betrayal of more than one generation now with predictable results. Yet there are too many stories, recently, of social landlords also betraying their tenants. Housing has to form one of the central features of any manifesto seeking to promote and protect the health of the nation’s children. It is a field in dire need of serious attention. John Anderson London We read with interest the announcement from the Labour party about their new child health action plan, designed to tackle child health inequality. The plan contained several policies that chimed with our own campaign for the next UK government to put babies, children and young people at the heart of government policy-making. In particular we welcomed the recognition that a child’s wellbeing is shaped by their mental health as well as their physical health. Cutting NHS waiting times for mental health treatment and providing specialist mental health support in all schools would be transformational. We were also pleased to see a pledge to create a cross-departmental delivery board prioritising child health. We now want to see all political parties and leaders, including Labour, commit to an ambitious cross-government strategy and outcomes framework that will drive improvements for babies, children and young people across all areas of their lives in a properly joined-up way. Underpinning this must be a commitment to end child poverty once and for all – a harm that damages and destroys many children’s lives. Paul Carberry CEO, Action for Children, Lynn Perry CEO, Barnardo’s, Mark Russell, CEO, The Children’s Society, Anna Feuchtwang CEO, National Children’s Bureau, Sir Peter Wanless CEO, NSPCC Discussion of supervised toothbrushing for young children makes me ponder on whatever happened to the school dental service. In the 1950s, dental checks were provided in school, with follow-ups at the school clinic. The school clinics were still functioning into the 1970s, when my own children benefited, including from orthodontic work and fluoride gel application. All free, of course. That service has gone the way of school nurses, eye tests for all and so on. What an economic and welfare disaster. Janet Lail Nottingham Many of the public figures who rail against the “nanny state” were brought up by nannies. Is there a connection? Gabrielle Palmer Cambridge