One of Scotland’s leading public health figures has made the case for greater use of early adoption and residential care, warning of a “bleak” future for Scotland’s vulnerable young people.

Dr Laurence Gruer OBE, Director of Public Health Science in the national health improvement agency NHS Health Scotland said that in light of recent cases of child neglect there is a greater case for early adoption and residential care.

Speaking at Holyrood’s More Choices, More Chances conference in Edinburgh last week, he said: “There’s no doubt that young people who are not in employment, education or training are at the highest risk of health problems.

“It’s a tragic loss of potential.

Many end up being trapped in addictions of various sorts, in damaging relationships – both those they’ve been brought up in and those they develop themselves – lots of chronic health problems and compared with people who are in more fortunate positions, much less likelihood of reaching old age.

“Things start right at the very beginning of life. Indeed even before conception. I think one can look at many cases and see young people who are starting off as parents and think ‘well, this isn’t the best start for this child to have; it’s almost a disaster waiting to happen’.

“Things really become increasingly problematic in the kid’s early years.” Outlining the problems in a child’s early life that lead to such poor outcomes, including bad parenting, physical and emotional abuse and poor accommodation, Gruer said there is now a greater argument for early adoption and a new type of residential care.

“I think many people would feel given a lot of the cases we’ve seen in the last few years that there is a greater case for early adoption. There have obviously been many bad experiences of residential care but I think there’s a case perhaps for a new type of residential care looking at some of the Scandinavian models. That’s obviously an expensive solution,” he said.

The public health chief’s comments follow a number of high profile cases of child protection failures including that of Baby P and Brandon Muir.

With less public funding available in the years ahead, Gruer warned the outlook for this group of young people in Scotland is “bleak”.

“This conference is clearly bringing together people who are doing a huge amount to help young people in the later stages of their teens and in their 20s. It clearly does help some but we shouldn’t kid ourselves.

There are also many young people who aren’t getting the help they need. Often it’s too late and we do have to bear in mind the growing tightening on resources that the recession is inevitably going to bring over the next few years and how we can cope with that and minimise the damage,” he told delegates.

“I think that in terms of the future prospects this is Scotland’s greatest health and also greatest social challenge, affecting the fabric of our society. Despite what we would like to think, unfortunately my experience is, seeing people going through this over many years, that the future prospect for them is bleak, although we can do a lot to reduce that bleakness.

“It may not go away entirely but we can certainly mitigate it to some extent. Undoubtedly early intervention is preferable where we can but we must not give up even when things are difficult in the teens and later life because we have plenty of examples where a very unpromising situation has been turned around by inspiring work of people like you yourselves.”