We also know that around 80 per cent of the factors that determine good health are not within the control of the NHS and care services.
Which neighbourhood you grow up in, your home, family and people around you, your schooling, job opportunities and lifestyle – all have more impact.
So if we want to fulfil our ambitions to make Greater Manchester one of the best places in the world to grow up, get on and grow old, then we have to make improvements in all these areas.
The first 1,000 days of life – beginning at conception – are critical to the future health prospects of children as they grow up.
Our “Taking Charge” ambitions at the beginning of devolution rightly set ambitions to provide more children and young people with the opportunity of better health.
Three and a half years on we are making good progress, using our devolution principles of working together to develop solutions, sharing good practice and addressing inequalities through ensuring consistently high standards.
In the Greater Manchester and Eastern Cheshire local maternity system area the number of still births has been reduced, meaning 23 additional babies were born healthy in 2018, compared to 2016.
In addition, 19 fewer babies were judged “not healthy” soon after birth in 2018, compared to 2016.
Our programme to help pregnant women to stop smoking has been a particular success, with 90% screened and 57% successfully quitting, leading to 250 more babies born “smoke free” in 2018/19, compared to 2017/18.
Children’s personal development and readiness for school is a key indicator of their future health prospects.
Raising the numbers of children assessed as having a “good level of development” at school age was therefore one of our key goals in 2016.
It is also a target that the NHS cannot address on its own, so we are working very closely with the Greater Manchester Combined Authority and the 10 councils to focus our support on the children from more deprived backgrounds who traditionally fall behind.
Greater Manchester is also making good progress in this area, up from 62.4% in 2015 to 68.2% in 2019, although we are still behind the England average of 71.8%. And we are making even faster progress in closing the gap for children on free-school-meals.
Support for children and young people as they go through school, college or university is also critical to enabling them to fulfil their potential.
They may have to manage a health condition, they may be affected by mental health difficulties, or their health may be affected by neglect or a harmful experience.
Working across healthcare providers and together with schools, colleges, universities and the voluntary sector, we are putting in place the support that will keep children and young people well, identify problems early and prevent them from getting worse, and to avoid unnecessary emergency admissions to hospital.
The views of children themselves have been integral to developing our new approach. For example, 120 children who have long term conditions such as asthma, epilepsy and diabetes told us what would help them to manage their conditions.
These changes are showing some early successes, with the numbers of children admitted as emergencies for asthma falling by 7% between 2017/18 and 2018/19 – 153 fewer stays in hospital and children’s time instead spent at home.
Our Mentally Health Schools and Colleges programme has recently expanded because of its success and now includes 125 schools and colleges.
The investment in services is beginning to reap rewards in access and waiting times too, with the latest quarterly data showing 45.8% of children and young people with a diagnosable health condition are now receiving treatment from an NHS funded service, against the national target of 35%.
We are also just beginning to introduce our mental health support service for university students, working in partnership with the institutions to address the needs of this 100,000 strong population in our city region.
In short, our work in health and care mirrors the mission of education services in providing children and young people the opportunity to achieve their potential.
We want to provide children and young people with the opportunity of good health and, through that good health, the opportunity to lead happy and fulfilled lives.