YET another health study finds Scotland performing badly and, even more dishearteningly, it is our children who are suffering – from poverty and, more particularly, from smoking among the poor. In a landmark report providing comprehensive comparisons, both within Scotland itself and with other European countries, the Royal College of Paediatrics and Child Health (RCPCH) found that more pregnant women smoke in Scotland, compared to England and the Continent. This was most notable in our most deprived areas (nearly 30 per cent, compared to 4.5 per cent in the least deprived).

Fifteen per cent of mothers were recorded as smokers during their first health visitor review after giving birth, compared to 11 per cent in England. Other findings by the RCPCH include: more than 210,000 children living in poverty; 28 per cent overweight or obese; around 400 deaths a year, with a significant number of these avoidable; lower rates of breastfeeding in Scotland.

The RCPCH offers recommendations which we readily support: extending the smoking ban to school grounds, sports fields and playgrounds; raising awareness of the benefits of breastfeeding; measuring child health rates more regularly; and making sure children are considered in all areas of policy. If the first of these seems breathtakingly obvious, it is only because existing legislation on smoking refers only to enclosed spaces. However, while little in the way of rational excuses can be made for smoking, particularly during pregnancy, underlying all the statistics is the understanding that poverty is the main driver of ill-health among our children. Very often, in other words, poor health is caused by being poor. And tackling poverty requires a major operation rather than sticking plasters. The Scottish Government’s somewhat weak response to the RCPCH report is that it is committed to producing a child health and wellbeing strategy. That sounds like a plan to have a plan.

More substantially – we hope – there is the Child Poverty Bill, which proposes protecting families’ income by law, and has the inevitable worthy targets; in this case, fewer than 10 per cent of children living in relative poverty, and five per cent in absolute poverty, by 2030.

This, of course, would be a welcome achievement. Beyond targets and hopes, meanwhile lies the reality of poverty: lack of heating or medicines or healthy foods or decent sleep. And all of these can affect health and indeed performance in class, which leads to poor qualifications, which leads to low-paying jobs, and so the cycle continues. The Scottish Government can rightly claim there is only so much it can do in the face of a storm of welfare cuts, freezes, sanctions and deliberate delays, which together form one half of the UK’s Government approach to poverty: punishment. The other half is blind belief that the market will provide work (most of it at welfare levels of pay). They have a Victorian apprehension that the poor will always be with us. That it is natural. But child poverty and concomitant ill-health in a materially rich society is not natural. It is political.