Looking out of the hospital window: reflections on 50 years of paediatrics in the community

2026 marks not only 100 years since the first edition of <i>Archives of Disease in Childhood</i>, but also 50 years since the Court Report which marked the beginning of a process to extend the practice of paediatrics from the hospital to the community. I've spent much of my life staring out of windows, wondering what was on the other side. As a junior doctor, from the hospital windows, I wondered where the children came from, where they went back to after discharge and why some ill, and some not so ill, children seemed to be admitted again and again. The hospital toolkit did not seem to have a remedy for poor parenting or the excess morbidity from disadvantaged areas. Starting in the 1970s, a number of articles caught my attention-these papers, written by paediatricians, expressed similar questions, concerns and frustrations to those that preoccupied me as I gazed out the window. What's more, these papers went on to suggest possible answers to these problems. In this article, I have selected three seminal papers published at the time when the first consultant community paediatric services were being planned. The three studies highlight the identification and the need to respond to those factors in the family and environment that have such a powerful influence on morbidity and mortality in childhood.