Children: Parenting for Success in School
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Baroness Hollins
My Lords, it is a real pleasure to be able to welcome the noble Lord, Lord Ahmad of Wimbledon, and to congratulate him on his maiden speech. I want to mention that we share not just Wimbledon in our title but a great love for Wimbledon and Merton, where he is very well known. The noble Lord has already had a stellar career in the financial sector and is an expert in marketing, but we have also heard about his contributions to the voluntary sector. He has also made a huge contribution to local government. I know too that the noble Lord has a lot of international connections and I look forward to getting to know him and seeing something of his youthful energy applied to the work of this House in the future.
I am grateful to my noble friend Lord Northbourne for introducing this debate. The topic is close to my heart as I originally trained as a child psychiatrist. My daughter is also a consultant psychiatrist and psychotherapist working in the field of perinatal mental health and infant development. I am going to focus on the role of specialist mental health services in enabling vulnerable parents to be successful in preparing their children for school.
Graham Allen’s report brings something to our attention that I am particularly pleased about. On page 40 he mentions the impact that unresolved trauma in youth can have on later parenting. He also draws attention to the importance of early intervention in leading to permanent improvements in a child’s health and developmental outcomes, but he stresses that this must happen in the first months and years of life, and even during pregnancy.
Research has increased our understanding of the importance of early experience for later child health and development. The evidence is strong. The emotional and physical environment and relationships during pregnancy and infancy are crucially important in enabling a child to be successful in school and in later life. This applies equally to children with learning disabilities, whose parents must also come to terms with their disability.
The evidence tells us that the first relationships in life are central to healthy development. Professor Schore, from UCLA, says that,
“the child’s first relationship, the one with the mother, acts as a template, as it permanently molds the individual’s capacities to enter all later emotional relationships”.
This profound statement has been understood within the psychoanalytic and psychotherapeutic traditions for decades, but now this has been recognised on a neurobiological level. He explains that the architecture of the growing baby’s brain will reflect the quality of the relationships that it has adapted to. The circuits formed during these early years, when the brain is most plastic, may last a lifetime. A baby needs a mother who can help him by responding sensitively to his distress, so the baby feels understood and can begin to manage his own physical and emotional experiences, both now and in later life. This is the foundation of communication, and when communication is absent the health of this emotional attachment needs attention.
Margot Waddell’s book Inside Lives: Psychoanalysis and the Growth of the Personality gives some excellent examples—which I do not have time to share with your Lordships now—which show well how a parent helps a small child to develop a capacity for learning by helping to manage their emotional experiences. Waddell explains:
“Something happened … which enabled the child to feel understood … Inseparable from this, no doubt, is an experience of being loved and of loving, and the deepening expectation of similar feelings to, and from, others”.
Without a stable early emotional development, children will be less able to form relationships and communicate with others, to learn or to take advantage of their school experiences. The early relationship with mother impacts on peer relationships at nursery and at school, and this can further affect the child’s ability to enjoy school and to be able to share in and learn from group activities.
So what early intervention programmes or treatments can help those who are struggling? An effective intervention recommended in Graham Allen’s report is the family nurse partnership. This programme was developed in the United States over 30 years ago but it has also had impressive results here in the United Kingdom—for example, by improving educational achievement and parenting practices, and by reducing child abuse and crime.
However, some women need more specialised mental health interventions to improve outcomes for their children and will not be able to respond to social or community-level interventions alone. Serious problems can affect women of all ages, cultures and socio-economic groups—for example, parents who themselves have experienced abuse and neglect are more likely to need health-led interventions—and there are other special cases.
Research is clear that mental health problems such as depression, psychosis and anxiety during pregnancy not only carry significant risks for mother and baby but can have long-lasting effects on cognitive, emotional and behavioural development. The complexity of attachment difficulties can be better understood by carrying out psychiatric and psychotherapeutic assessments. Health-led interventions are needed to address these complex and painful situations.
Perinatal and parent-infant psychotherapy can treat distressing experiences such as depression, anxiety and terror by understanding the cause of the difficulties and by focusing on improving the relationship between mother and baby from pregnancy onwards.
Tertiary centres such as the Cassel Hospital are also needed. Sadly, the future of the Cassel is under question. I hope the Minister will recognise the importance of providing specialist mental health services for mothers and their infants rather than waiting for child psychiatry services to intervene at a later stage when problems have already become established.
Baroness Verma
I remind noble Lords that this is a timed debate and that they have five minutes.
The Parliamentary Under-Secretary of State for Schools (Lord Hill of Oareford)
My Lords, I congratulate the noble Lord, Lord Northbourne, on securing this debate and on setting out the issues so clearly and with his customary thoughtfulness. I thank him for the courtesy of sharing his speech with me, which helped me prepare for today’s debate.
Like the noble Baroness, Lady Crawley, I congratulate the right reverend Prelate the Bishop of Oxford and my noble friends Lord Ahmad of Wimbledon, Lord Lingfield and Lady Stowell of Beeston on their excellent maiden speeches. I cannot add much to the comments made by the noble Baroness, Lady Crawley, but I am clear that, different though they were, they were united in their quality, and we all look forward very much to the contributions that they will make in years to come.
I knew that we would have a good debate, and so it has proved. It has been a broad debate that has raised a large number of issues, and I will do my best to respond to the broad themes that have been raised. I associate myself strongly with the remarks of the noble Lord, Lord Northbourne, at the outset. This Government, like the previous one, want to improve educational outcomes in our schools and to reduce inequality in our society. I hope that it is also fair to say that this Government, like the previous Government, recognise the importance of the early years in children’s lives and development.
In headline terms, there has been a lot of agreement in this debate—first, that good parenting in the early years matters; love, communication and order are some of the themes that have been picked up repeatedly. Secondly, it has been agreed that, despite most parents doing a very good job, there is clearly a group which needs support. Thirdly, there is a cross-party consensus on the need to tackle those issues. Fourthly, we need to find a way of co-ordinating the efforts that are being made, of sharing good practice and of trying to approach the issue in the round rather than in silos. That is particularly the case when one is talking about families with multiple problems.
Today’s debate is timely, as we have heard, because the Government are considering or have commissioned reviews in four separate but interrelated areas: a review into poverty and life chances by Mr Frank Field; a review into early intervention by Mr Graham Allen; a review into the early years and foundation stage by Dame Clare Tickell; and a review into child protection by Eileen Munro. This is a reflection of the priority being given to this whole area. It is the Government’s intention, as we have been urged by noble Lords, particularly by the noble Lord, Lord Northbourne, that we will respond to the reviews by Frank Field and Graham Allen and set out a new policy statement later in the spring.
We know that what happens in a child’s early years is critical to that child’s future attainment, behaviour and happiness. Those points were set out persuasively by the noble Baroness, Lady Massey of Darwen, and my noble friend Lady Walmsley. That is why, in a difficult financial situation, the Government consciously made decisions to try to protect funding as much as possible for the earlier years, keeping spending on schools flat in cash terms, introducing a pupil premium, extending 15 hours of free early education to disadvantaged two year-olds and providing an extra 4,200 health visitors.
I want to say in passing that what we do in schools is important as well. While I fully accept the contention that the early years are crucial, it is equally not the case that a child labouring under some of the disadvantages that we have been discussing is doomed to failure. We can all think of wonderful schools that have high expectations and provide an orderly, caring environment where their pupils achieve at least as well as, or better than, pupils from more affluent backgrounds. I am thinking of schools like Mossbourne Community Academy, which has a very high number of children on free school meals but has outstanding results, or King Solomon Academy, which I was fortunate to visit last week, which is giving the structure, support, engagement and aspiration that those children well might not have been receiving at home.
We have heard a lot of convincing evidence today for why early intervention matters. I was particularly struck by the figures provided by the noble Lord, Lord Ramsbotham. I listened with care to what he had to say about assessment. It is true to say that, as part of the universal healthy child programme, all children are assessed by a health visitor or a member of their team at two and a half years, and we hope that the expansion of the number of health visitors will make the quality of that assessment better and ensure that it is carried out.
I also learnt from the noble Lord, Lord Winston, that I apparently have 100 billion neurones, which is about 100 billion more than I thought I had and probably 100 billion fewer than the noble Lord, Lord Winston. We know from research that 94 per cent of children who achieve a good level of development at age five go on to achieve expected levels of reading at key stage 1, and are five times more likely to achieve the highest level, level 3, than those who have not reached a good level of development at age five. The National Literacy Trust, of which I was fortunate to be a trustee for many years, has also shown that parental involvement in a child’s reading has been found to be the most important determinant of language and early literacy.
There may be a utilitarian argument there for reading with one’s children. I actually have far more selfish reasons for wanting to read with my children: I never found anything nicer to do. I will probably be attacked for saying this by my daughter, who is now at university, but she asked me the other day to read her a Just William story again, so I must have done something right. We also know that parental support for education continues to be important as children get older. Parental involvement in a child’s schooling between the ages of seven and 16 is a more powerful force than family background, size of family and level of parental education. The Government therefore accept fully that the quality of care and support for early learning that young children receive, and their positive engagement with parents, can make a real difference to later outcomes in life.
Quality childcare and practitioners play a crucial role in supporting the children’s learning and development and engaging with their parents, and it is important that we support the sector to continue that role. The early years foundation stage has helped to promote a consistent approach to early learning and development for children aged nought to five across the sector, and has done much to raise standards and engage parents. We have asked Dame Clare Tickell to undertake a full review of the early years foundation stage, and to look at how best to protect young children’s safety and welfare and support their development and learning. Her review covers four main areas: scope of regulation, learning and development, assessment, and welfare. Underpinning all of this, we will aim to reduce burdens on providers, prepare children for learning at school and better support parental engagement in the foundation stage. We look forward to receiving Dame Clare’s report in the spring.
I accept fully the point made by the noble Lord, Lord Winston, and the noble Baroness, Lady Crawley, about the importance of Sure Start services. I recognise the work done by the previous Government in getting that network up and running. We know from stories, some of which we have heard today, that Sure Start services can make a real difference to families’ lives. That is backed up by the 2008 and 2010 reports from the national evaluation of Sure Start, which show improved outcomes in a number of areas, including better behaviour, more positive parenting skills and home learning environments, and better physical health of children living in an area with a Sure Start programme.
Sure Start children’s centres remain at the heart of the Government’s vision for early intervention. That is why we have put resources, in a difficult financial situation, into the system to maintain the network of Sure Start children’s centres and have provided the new investment I have already mentioned to pay for extra health visitors.
Last week, the Government published their response to the Education Select Committee report on Sure Start children’s centres. That response sets out more detail about our vision for children’s centres being accessible to all but with a clear role in identifying and supporting the most vulnerable and disadvantaged, with a commitment to be more accountable for the services which they deliver. We will further set out the key role of Sure Start when we publish an early years policy statement, which I mentioned earlier, in the spring. We will develop this in partnership with the sector to set out a new vision for Sure Start children’s centres, and the practical steps for achieving it. Our aims will be to increase voluntary and community sector involvement with children’s centres, a point made by the noble Baroness, Lady Sherlock, to try to improve accountability arrangements, to increase the use of evidence-based interventions, and to see whether we can introduce greater payment by results.
I accept the point made by the noble Baroness, Lady Crawley, about the issues being faced in some local authority areas as local authorities are looking at their budgets and addressing the future of Sure Start centres. Local authorities are looking at their budgets and are working hard to make the right decisions. Section 5D of the Childcare Act 2006 places a duty on those local authorities to consult before opening, closing or significantly changing children’s centres, and to make sure that there is sufficient children’s centres provision to meet local need so far as is practicable. However, we know that in some local areas families are concerned about whether this will alter their local services. I do not dispute that people have that concern. My honourable friend Sarah Teather, the responsible Minister, is monitoring the situation carefully. Although it is raising difficult issues, which I accept, our basic position is that decisions which affect local families should be taken locally so that services can be managed in ways which best meet local needs.
The Government has announced a national recruitment drive to appoint the 4,200 new health visitor posts I have mentioned. The number of health visitors working with families will increase by almost 50 per cent. The Government have committed to doubling the capacity of the local nurse partnerships. The increase in health visitors will, we hope, reinforce the importance of the relationship between Sure Start children’s centres and health visiting provision. Each children’s centre should have access to a named health visitor. Health visitors have great expertise to deliver universal child and family health services through children’s centres; to lead health improvement on subjects such as healthy eating and accident prevention; to help families stay in touch with wider sources of support, including from the community and other parents; and to be leaders of child health locally, including trying to build partnership between GPs, midwives and children’s centres.
Some of the broad issues that have been raised include families with multiple problems. In December, the Prime Minister set out his ambition to address the concerns of troubled families. I fully accept the point that there is financial sense in doing that, but there is also of course a strong moral need. Successive Governments have grappled with the problem of coming up with approaches that deal with the needs of these families in the round rather than the traditional Whitehall way of dealing with it by department or institution. Central to the Government’s ambition, therefore, will be the development of new approaches to supporting these families, underpinned by freedoms for local authorities to establish community budgets. We are hoping to set these up in 16 local areas to pool budgets for families with complex needs and roll them out to local areas across the spending review period.
The noble and learned Baroness, Lady Butler-Sloss, raised the importance of adoption, which we have debated before in this House. Like the noble and learned Baroness, the Government are keen to see more adoptions with less delay in all aspects of the system. The noble and learned Baroness spoke eloquently about particular problems with the courts system. My honourable friend Mr Loughton is taking the lead in addressing adoption, to speed it up and find more suitable people who are able to adopt, including looking at the role of voluntary adoption agencies.
Relationships and marriage is another theme that was discussed today. All noble Lords recognise that strong and stable families of all kinds are the bedrock of a strong and stable society, a point made very persuasively by the right reverend Prelate the Bishop of Oxford. They are the key to ensuring that children grow up in a loving and nurturing environment, and develop into healthy, happy and successful adults. The coalition Government are committed to helping parents to build strong relationships and supporting families through difficult times. We therefore have plans to put funding for relationship support on a stable, long-term footing to try to make sure that couples are given greater encouragement to use existing relationship support.
The Green Paper Strengthening Families, Promoting Parental Responsibility: the Future of Child Maintenance, was published on 12 January. It places a strong emphasis on signposting separating parents to support, including relationship support. Funding of £30 million for relationship support for the spending review period was announced by the Prime Minister in December. That is an increase on current funding levels and I hope it will make some contribution towards helping couples stay together. As all noble Lords have said, the more one is able to do that, the greater the chances a child has of a fulfilled and happy life.
We have also talked today about the role of fathers. The noble Lord, Lord Alton, particularly stressed that; I very much share the views that he set out. One aspect which the Deputy Prime Minister has addressed is proposals on work and parental leave to make the load more equally spread between the mother and father. That is one way in which, in a more difficult situation for many parents today, we can help give fathers more opportunity to be involved in their children’s upbringing.
It has been, as I thought it would be, a helpful and stimulating debate. If I have failed to respond to any particular questions that were put to me I will follow those up outside this debate. I am thinking in particular of the noble Earl, Lord Listowel, and I will of course speak to my noble friend Lord Howe as he asked me to.
In closing, I cannot do better than quote from the recent report, already referred to today, by Mr Frank Field. The following sentences in particular struck me:
“The things that matter most are a healthy pregnancy; good maternal mental health; secure bonding with the child; love and responsiveness of parents along with clear boundaries, as well as opportunities for a child’s cognitive, language and social and emotional development. Good services matter too: health services, Children’s Centres and high quality childcare”.
As is so often the case, Frank Field puts things extremely concisely. He has summed up our whole debate in those sentences. I share those sentiments; the Government share those sentiments. I am extremely grateful to the noble Lord, Lord Northbourne, for providing us with the opportunity to explore these issues today.