(13 years, 9 months ago)
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Baroness Walmsley
To call attention to the cost-effectiveness, and impact on quality of life, of early intervention in the first few years of a child’s life; and to move for papers.
Baroness Walmsley
My Lords, I am grateful for the opportunity to debate this very important topic and look forward to hearing from the star-spangled cast assembled in the Chamber. In particular, I look forward to the maiden speeches of my noble friend Lord Storey and of the right reverend Prelate the Bishop of St Edmundsbury and Ipswich.
The successful development of our children is one of the most crucial responsibilities of government, both for their sake and for the sake of society and the economy as a whole. There are about 12 million children in the UK, of whom about 1.5 million are growing up in “at risk” situations. However, only 25,000 were on the “at risk” register when it was discontinued. Practitioners have had to raise the bar for intervention because of lack of resources. For example, if one or even both parents are drug addicts, that is no longer sufficient cause to act.
Each child has rights under Article 19 of the UNCRC which compels Governments to intervene on their behalf. It states:
“Governments should ensure that children are properly cared for, and protect them from violence, abuse and neglect by their parents or anyone else who looks after them”.
That is why, although in our culture government intervention in family life is a sensitive issue, we must respond to the evidence that is stacked up so high about the importance of the early years.
It is parents who should bring up their children, and we must help them do it well. In his recent report, Graham Allen states that,
“if we could equip parents to optimise … maternal responsiveness and their impact on their 0-3 year old children, we would be laying secure and strong foundations for all the work that the public sector did thereafter … Crucially, it would enable public expenditure to become developmental and not just remedial”.
The WAVE Trust states:
“The evidence overwhelmingly indicates that dysfunction strongly correlates with adverse experience in early life”.
The relationship with the mother or first carer is the most crucial in the whole of life. Unless there is attachment and attunement, the child will find it very difficult to form future relationships. Unless she feels warm and safe, is rocked and stimulated, has eye contact and a lot of love, her brain and the rest of her body will not develop to its full potential and may become very damaged. Damaged brains mean damaged people, damaged lives and damage and cost to society. To coin a popular phrase, it is a “no-brainer” that investing in that crucial relationship and the early years is money well spent.
There are multiple reasons why I was anxious to have this debate at this time, in the hope of influencing the Government. The Budget is next week. The Government have emphasised their firm intention to improve social mobility during their term of office, and their strategy will be published soon. We also await the child poverty strategy, which will no doubt respond to the report by Frank Field. Graham Allen produced last December his report entitled Early Intervention and its equivalent in Scotland, the Deacon report, has already had a major influence on the policy of the devolved Government. There has been a report on children's services from Professor Eileen Munro, and the important Green Paper on special educational needs. Dame Clare Tickell's review of the foundation years will be out soon. All these government-commissioned documents demonstrate the determination of this coalition Government to get things right for children. What we need to know now is how the Government are going to respond to all this well-evidenced advice, and I look forward to hearing about that from my noble friend the Minister.
There is an enormous amount of evidence which shows that the prenatal and first three to five years of a child’s life are the most important. This is because of the biological fact that the human brain is so complex and so large that we have to be born three years premature. In other words, our brain is not fully developed at birth. It reaches 85 per cent of its potential at age three, and development goes on into the teenage years. During this development, the brain is extremely vulnerable to trauma and responsive to the child’s experience.
Several studies show that it is possible to predict things about a child’s future from as early as 22 months. The Prime Minister himself is clearly aware of this. He said to the Local Government Association in 2007 that if you,
“ask a primary school teacher with a class of 5 year olds, which ones are likely to be in trouble”—
with the law—
“in 5 or 10 years’ time—and chances are, the teacher will be able to tell you with total accuracy”.
It is not just the law where effects will be seen. Education, health, working life and relationships will all be affected. A number of important longitudinal studies all point to the fact that, if we get things wrong in the early years, the results will be long-lasting and expensive.
So what do we mean by early intervention? The word “early” can be ambiguous. It can mean intervening early in a child’s life or early in the genesis of a problem that develops at any stage. All the evidence shows that, if you do enough of the first kind, you avoid the need to do a great deal of the second kind. It is also more cost-effective, bringing returns of £7, £9, £12 or even £19 for every pound invested in various programmes. A £600 family programme can save £45,000 to keep a child in custody for a year.
Some countries are leading the way—notably Sweden, where they start very early indeed with prenatal care. Nearer home, in Scotland, the Finance Committee of the Scottish Parliament has concluded a six-month investigation into preventive spending. It ended with the unanimous cross-party conclusion that a shift to investment in early-years preventive spending should be a priority for action by the Scottish Government, and that it should be carried forward in a non-partisan, all-party manner not just during the next Parliament but over the next 20 years. I believe that we should do the same in the rest of the UK because the problem extends well beyond today’s generation of children. Graham Allen said:
“Those who are dysfunctional have to be assisted not only because of the problems they create in the here and now for themselves and society, through their involvement in crime, drugs and violence. Even more importantly, they also need to be assisted because in their role as parents such problems will impact adversely on newborns and be perpetuated intergenerationally”.
Therefore, we need to take action now for the sake of future generations.
The economic costs of falling behind are enormous, and we are falling behind other countries. UNICEF’s Report Card 9 has a league table of inequalities in child well-being, which shows the UK in 21st position among other OECD countries. The consequences of this include the risk of poorer health and nutrition, more frequent visits to health services, impaired cognitive development and educational under-achievement, reduced linguistic ability, lower skills and aspirations, reduced productivity and adult earnings, higher rates of unemployment and welfare dependence, increased behavioural difficulties, crime and antisocial behaviour, and a greater likelihood of teenage pregnancy and drug or alcohol dependence. The significant costs are borne by business and the economy as a result of lower rates of return on investment, greater expenditure on social services and the justice system, and lower productivity and tax revenues. There is also a price tag on social cohesion and the overall quality of life.
Our Government are relying on growth to improve our economic situation, and growth relies on the abilities of the workforce. A recent report by the Nobel prize-winning economist, James Heckman, on the crucial importance of the pre-school years for skill formation, and the critical role of skill formation in programmes to reduce inequalities, shows that gaps in achievement are primarily due to gaps in skills; skills determine success; families are major producers of skills; gaps emerge early; and investment in the early lives of children in disadvantaged families will help to close achievement gaps. He points out, too, that the skills needed for success require more than cognition and IQ; also important are soft skills such as conscientiousness, perseverance, motivation, ability to work with others, and so on.
Frank Field has outlined the link between child poverty and achievement. He acknowledges the massive amounts of money that the previous Government spent on trying to get families out of poverty but accepts that they had limited success. He now believes that the spending was not sufficiently targeted at the early years and recommends that Governments concentrate not just on supplementing incomes but on providing services to support families. Poverty contributes to educational failure, family stress—which in its turn leads to poor child development—mental health problems, family separation and often violence, so its effects are not just about how big a television you can afford or even whether you can buy good, simple food.
So when and how is it best to intervene? The Chief Medical Officer for Scotland, Harry Burns, concluded that there are four key periods when one can make the greatest difference—pregnancy, age zero to one, pre-school, and the transition from primary to secondary school—and that we should focus investment on interventions for each of these periods based on the strongest evidence.
The Graham Allen report talked about a virtuous circle of interventions: a prenatal package, a postnatal programme, Sure Start children’s centres, primary school follow-on programmes, anti-drug and alcohol programmes, and pre-parenting education through PSHEE in schools for teenagers before they become the next generation of parents. He is right to start with the period before birth. Professor Michael Meaney from McGill University recently explained the important physical changes that take place in the brain as a result of early life experiences and that some of these changes persist throughout life. He did this via the science of epigenetics, which explains how the early life environment changes the function and structure of our very genes, such that twins with identical parental DNA could end up with very different effective DNA. He claimed that early family environment is correlated strongly with many health problems. He said that the child’s experiences affect messenger RNA—a substance through which DNA has its effect on our cells—and that the effects of various chemicals produced during abuse and stress affect the development of the brain and the personality. He emphasised the critical importance of protecting mothers from stress during pregnancy. Pregnancy is the peak period in relationships when domestic violence occurs. Whereas outside pregnancy men mainly hit their partners on the face, during pregnancy the principal target is the woman’s stomach. Therefore, in the argument between nature and nurture, nurture wins and it is the only one that Governments can affect.
All the evidence leads to the importance of fathers as well as mothers and the benefits of investing in parenting programmes. However, there is compelling evidence from the charity Relate that programmes that do not include work on the relationship between the parents are not as effective or enduring in their effect. It tells us that 70 per cent of relationships deteriorate in the first year of a child’s life and that 20 per cent break up. However, trained counsellors and health visitors can and do offer help, so Relate is calling for all health visitors to receive training on the importance of the parental relationship to child development and on how to identify and address the problems.
We can have effective early intervention only if we identify problems early. Here, I should like to mention my concern at the reduction in posts for educational psychologists, who play such an important professional role in identifying not just educational problems but many other mental and emotional problems. There are many effective interventions. Other colleagues will speak about the importance of early intervention in autism, speech and language therapy, child safeguarding, special educational needs, children in care, literacy and counselling in schools.
Getting children into high quality early education is vital, especially for the disadvantaged two year-olds who are now about to receive free early years provision. I am proud to tell the House that, even during all the budget cuts that local authorities have had to endure recently, not one Liberal Democrat authority has closed a single Sure Start centre. It is a matter of priorities and they have made the right decisions. When children get to school it is important that there are follow-on programmes which involve their parents. School Home Support and the FAST programme from Save the Children both help parents to get involved with their children’s learning. Programmes which help children to develop emotional resilience and relationships are also essential. I believe that the SEAL programme and a high quality PSHE come in here.
Where do we go from here? Graham Allen proposes a national assessment centre to do research and evaluate initiatives. Personally I feel that we already have plenty of evidence and need to get on with it. There is, of course, the need to measure the value for money of programmes so that local authorities have a good evidence base to help them to choose on what to spend their money, but that evaluation must be done well. There must be a political will, such as now exists in Scotland and Wales, and there must be money up front. But Graham Allen is talking to the banks about that.
In conclusion, we cannot affect the genes that a child receives—that is up to his parents. However, we can affect how his mother is treated and supported when she is pregnant. We can affect the information that parents receive about what babies need. We can set up a system to identify and work with families that need extra help and support. We must do all that or continue to fail our children.
Baroness Ritchie of Brompton
My Lords, I thank my noble friend Lady Walmsley for bringing this important topic to the House for us to debate again. I know that the coalition Government take early intervention very seriously, and I am sure that they will be listening to our contributions—the Minister is with us. I know that they want to ensure that effective strategies are put in place throughout the country.
Early intervention has been proven to work by numerous anecdotes, individual programmes and—as my noble friend Lady Walmsley said—a lot of research both in Britain and overseas. However, as I said in my previous contributions on this topic, I am concerned that the effect of early intervention can only be seen in the very long term, and often it is quick results and short-termism that attract continued finance. Therefore, we must ensure that long-term funding, support and monitoring are all put in place for all early intervention programmes to ensure their effectiveness. It is difficult to prove the positive impact of early intervention as many of the projects have been funded for too short a time although they are showing excellent results. As the National Children’s Bureau has commented, the real research findings on the outcomes of Sure Start tend to show that results really become evidenced many years down the line. I declare an interest as president of the NCB.
Perhaps I may bring to the House’s attention the latest report from the Centre for Excellence and Outcomes in Children and Young People’s Services, also known as C4EO, which collates much of the work on outcomes for children and families, including work on early intervention. Grasping the Nettle is a joint report with the Association of Directors of Children’s Services and makes the very good point that although targeted approaches tend to be judged more cost-effective than universal approaches, there is little comparative evidence to determine which approach might be the right course of action. Indeed, the report concludes that it is likely to be a combination of both and that a range of interventions would support different levels of need.
However, one outcome is clear. It is far more cost-effective to put in place rigorous early intervention schemes than to have to deal with the cost of problems later on. A long-term scheme in the United States called the Nurse Family Partnership found that $9,000 spent per child had the average benefit of more than $26,000 per child in later life, and also that crime reduction was an important contributor to that benefit. The scheme is replicated in the UK as the Family Nurse Partnership, but a long-term evaluation has not yet been completed.
My second point is that parenting programmes, to which my noble friend Lady Walmsley referred, are an essential part of any early intervention support. International studies and effective local practice in the UK have shown very clearly that good parenting, regardless of background, is crucial to good outcomes for children and young people Effective parenting support leads to improved outcomes for children, parents and families. Parenting is one of the most difficult jobs and yet there is no training or recognition for this vital role in our society.
Again, I believe that we need properly funded long-term projects. It is not fair that some parents get support while a three or five-year project being run before closure possibly due to a lack of funding leaves other parents with no help. When resources are scarce we need to ensure that we have the vision—which I believe that this Government have—to lead the commissioning of good, evidenced-based, multi-agency targeting of parenting and other early intervention support. Evidence by the NCB suggests that multi-agency approaches are the most effective in complex families.
The OECD suggests that expenditure on children should be regarded as if it were an investment portfolio, with a continual process of evaluation and reallocation to ensure that child well-being is actually improved. I welcome the model that C4EO has developed to help assess the cost of effective interventions at a time of reducing resources, as the methodology up to now has been weak. I hope that local authorities will make use of it. All the international evidence suggests that spending more intensively earlier is cost-effective, particularly for children in disadvantaged families, and we need to ensure that we roll out successful early intervention support throughout the United Kingdom.
Baroness Morris of Yardley
My Lords, I very much welcome the opportunity to contribute to this debate and to join others in congratulating the noble Baroness, Lady Walmsley, on initiating it. The noble Baroness has a long history of interest in this subject and it is good to hear that her passion has survived moving from opposition to government—and long may that be the case.
There is probably unanimity about the importance of this issue. I suspect that had we been discussing this 20 years ago, there would have been a debate about whether it was right for government to comment on or intervene in what happened in families. That battle has been won. If we are to move forward, it is important not only to stand on that as a basis but to realise that we have to sustain and protect that belief. I do not necessarily want to go through the evidence of how early intervention works; I believe in it passionately and have enjoyed listening to the evidence so far, and no doubt there will be other contributions on it. However, having won that battle, we need to be very careful about any government action that would take us back to where we were before.
I do not want to dwell on this for too long, but I also remember that, in 1997, parts of this country were a waste field as regards early intervention. Some local authorities had no provision for nursery education. However, the infrastructure has been built up over the past 15 years, and we now have more than 3,000 Sure Start centres covering 2.7 million people. The provision of a £2.2 billion budget just for Sure Start and early years intervention has led to a massive change. It has provided more than simply the fabric and the bricks; it has brought about a change in culture in this country, such that it would now be unimaginable for a politician from any party to say that they did not believe in early years intervention and support. That is how far we have moved and it is very important that we do not risk it. It is still early days and it may not be as rooted as I hope that it is.
I want to look forward on the two fronts by which I will judge the extent to which we are likely to build on the progress, or to throw it away. I shall consider, first, the amount of provision and, secondly, the quality of that provision in the coming years.
On both those issues, the Government’s record so far does not give me confidence that they will build on the past 15 years of investment and progress. There are three main threats to the amount of provision. First, there is the 13 per cent cut in cash terms to the intervention budget, which is real money out of the service and will have real consequences. Secondly, there is the un-ring-fencing of the budget, and, thirdly, the diminishing of our nation’s ambition for a universal service to a targeted service. I do not want to go into all of those in great depth, but this was a Government in which both parties went to the election promising to protect the early years and protect Sure Start. Now the Minister who is now responsible for that has said to people that if they want Sure Start to continue they must lobby their local council to let it happen. That is not government responsibility; the public have made clear their view about Sure Start and early intervention. They have done their lobbying and voted for parties at the general election that promised to keep Sure Start and the amount of investment in that sector—and that was all three of the major parties. I worry that what the Government have done in their early months is to give away every single lever they had to ensure that this work continues. That is what happens when you un-ring-fence a budget and say to local authorities, “Here is a smaller budget—you decide how it will work out”. I am left wondering where the Government’s levers are to deliver the pledges that they made before the election.
The next thing that I wanted to look at was the quality of provision, because there are some fairly ineffective things happening in this sector. It is bound to be the case. In education, we are quite good at carrying on doing ineffective things; we are not as good at actually changing our practice so that we build on the evidence of what works.
I shall talk about one error that the Government have made and then comment on one opportunity that they have. Frankly, it was a mistake to remove the requirement that at least one person with qualified teacher status or early years professional status should be in our children’s centres. I admire the Minister for his commitment to the quality of teaching and praise him for having made it clear in this House that the Government are committed to that at school level. I just cannot understand why he can care so passionately about the qualification of those who work with our children at five and above but less so about those who work with our children at five and below. We have the irony of a situation in which you can teach children only when you have a degree level of 2.2 or above but do not need a qualification to work with our under-fives.
The last point that I make is about evidence. I join the noble Baroness, Lady Walmsley, in saying that the work that Graham Allen has done in talking about an evidence base is crucial. However, I disagree with her in that I am not sure that we have the evidence. There is some lousy research around, and we do not write it down and equate it as we should.
I want to take from Graham Allen’s comments in my last few seconds. He talks about the need to evaluate programmes by randomised control trials and other things of really good quality. I declare my interest in that as a member of the Institute for Effective Education at the University of York. We must then classify those programmes by quality, impact and caste and only then allow the professionals to make wise decisions on behalf of the interventions they make.
Lord Storey
My Lords, I first thank noble Lords for making my entry into the House so welcoming. Indeed, the generosity of that welcome and the support from attendants and staff has been truly remarkable. I am a city councillor forged in the political council chamber of Liverpool. Coming to the House and seeing respect, reflection, support, concern and friendship is quite remarkable.
I am a head teacher. I have been a teacher for 40 years and a head teacher for the past 25 years. My current school, of which I am head teacher, is a large three-form entry primary school, with 332 children at the last count and a 100-place nursery, in Knowsley on the outskirts of Liverpool. I am grateful to my noble friend Lady Walmsley for this opportunity to give my thoughts about early intervention as a practitioner. As she rightly says, the most important intervention for any child is made by the child’s parent or parents. The love and support that the parents give to that child is crucial. But we should also be supporting parents, particularly those parents who find themselves in vulnerable situations that perhaps are not of their own making. I note the comment made by Iain Duncan Smith a few days ago when he said, rightly in my view:
“Unless something changes in the adult's life, nothing changes for the child”.
How true those remarks are.
I know that we are talking about intervention in early years, and I shall come to that in a moment, but intervention in my view has to happen throughout the life of the child or young person. Those interventions cannot just be a fad which one minute we pick off the shelf because it is the in-thing to do. They have to be thought through very carefully and, when we know they are right, we have to make sure that they are consistently given time and resources to make them work.
I am glad to say that one of the most important interventions that the last Government made was with the Sure Start centres. They have made a huge difference, particularly in deprived communities, and especially in inner-city areas, to the lives of children and young people. I regret that in some local authorities those important Sure Start and children’s centres are being closed down. I have also scripted in my mind a comment that my noble friend Lady Walmsley made—that I am proud that in my party’s control of local authorities, not one Sure Start centre has closed down.
I shall spend a few minutes talking about the Graham Allen report, Early Intervention: The Next Steps. First of all, I commend this report as it is one of the best pieces of writing about early intervention that I have read. It is hugely important, and I commend those who had the foresight to ask for it and work on it. In this report Allen makes the comment to which I alluded a few moments ago:
“This is not to say that development stops at age … We need to keep supporting them throughout childhood in ways which help them reach the key milestones of social and emotional development”.
That is very important indeed.
In this report, Allen also identifies 19 possible intervention strategies. It is sad to reflect that of those 19 interventions nearly all originate in the United States of America and only one in the UK—reading recovery. I wonder why, and what happened to UK interventions. The other point made in the report is about the use of the private sector, and I caution concern about that because, although the private sector is important, we must be careful that we do not in some people’s minds subject our most vulnerable and needy to profit and loss. That might be something that we need to consider.
I know the support mechanisms that are around to help children. While I listened with interest to the comments of the noble Baroness, Lady Morris of Yardley, one of the most important steps now, as a head teacher, would be to use the pupil premium to decide how my teaching staff will target that money to help the most needy as well as those who need intervention in my school. I have seen my school budget increase, so I will be able to use my own resources to target the interventions, which we think will make a difference to the lives of children.
I end by saying that schools make a real difference to children’s lives, but they cannot do it alone. They need the support of other interventions. I thank noble Lords for having the patience to listen to me on my first very nervous speech in the House of Lords.
Baroness Sharp of Guildford
My Lords, it gives me enormous pleasure to follow my noble friend Lord Storey, and I congratulate him on a really excellent maiden speech. As he made clear, he has been a headmaster for 25 years, and he is a great expert in early childhood development. As well as guiding the development of many a young person in Knowsley, he has also been instrumental—he did not really say very much about this—in regenerating the proud city of Liverpool. He became a councillor in Liverpool in 1973 at the age of 23, and he has been a councillor for 37 years, becoming leader of Liverpool City Council in 1998 and lord mayor in 2009-10. It was during his leadership of Liverpool City Council that the city was transformed, becoming one of the best performing local authorities, having been one of the worst.
It was at my noble friend’s stimulation that the city bid to become the European capital of culture, and he was part of the team that delivered that most successful year of culture in Liverpool. He subsequently secured world heritage status for Liverpool. He brought to Liverpool, and Liverpool won, the largest leisure and retail development in Europe, as well as the new arena and conference centre which those of us who are Liberal Democrats enjoyed at our annual conference last September. He has also brought the cruise liner terminal and the science park to Liverpool. Indeed, under his leadership, Liverpool has emerged as one of the leading cities in the UK, and he has been very much responsible for its wholesale regeneration. We are delighted to have him here in this House; he will contribute a great deal to it and we look forward very much indeed to his further contributions.
I pay tribute to my noble friend Lady Walmsley and must say how grateful I am to her for bringing this important topic to our attention yet again. We have had a number of debates on this subject in this House recently, but it is certainly a subject that is worth debating. As the noble Baroness, Lady Morris of Yardley, said, not many of us need convincing of the importance of early intervention. The evidence is increasingly overwhelming; the noble Baroness, Lady Ritchie, has already mentioned some of it. One has only to look at some of the work quoted by Graham Allen in his report and in Feinstein’s work on the cohort studies here in the UK to see how important it is that we intervene early and help children at the earliest possible stage. Indeed, as my noble friend Lady Walmsley mentioned, we have had a series of reports—the Allen report, which I mentioned, and the Munro report—and we will have reports from Clare Tickell and Frank Field.
I was much influenced by the meeting on shared parenting held by the APPG on Family Law and the Court of Protection on Monday 14 March, at which Dame Clare Tickell stressed that what young parents need to be taught about parenting is actually very simple and very basic: the importance of talking to babies, communication and language, learning how to manage conflict, the difference between right and wrong, and above all showing love and affection. As she said, all those can be taught very quickly, and young couples of men and women, or of teenage boys and teenage girls for that matter, are immensely receptive in the run-up to the birth of the child and in the year that follows. They want to know and to help their children to be successful. Their aspirations at this point are sky high, and that is the time to catch them and teach them. Sadly, until now, we have failed to do this, and still far too many children slip through the net.
I, like others, pay tribute to the previous Government, who turned the spotlight on the importance of the early years and began the rapid rollout of such programmes as Sure Start, but still far too many people arriving at school are unprepared and unready for the experience. As a reception class teacher in the school of which I am a governor told me, “It’s no good trying to teach children to read if they don’t know how to talk”. In essence, getting them to talk and communicate with each other is a very important part of the whole programme. It is therefore important that intervention happens not just with very young children and babies but at this early stage when they are learning to read in primary school.
In the little time that I have left I will mention just two initiatives for which I have enormous admiration. One is the reading recovery programme, which came to this country from New Zealand and was picked up and developed in the early part of this century. It has shown enormous gains for the young people involved. It involves one-to-one teaching. The noble Lord, Lord Adonis, was in the Chamber earlier but is no longer here. I remember asking a question three or four years ago about reading recovery. He said:
“it is a very expensive programme—it costs about £2,500 per child”.
I replied:
“My Lords, does the Minister not agree that it is well worth spending £2,000 on a six year-old if you are not going to have to spend £60,000 on him when he is 16?”.—[Official Report, 4/12/06; col. 960.]
The second programme that is thoroughly worth while is The Place2Be, which has allowed 172 primary schools to enjoy the services of a trained child psychologist as a counsellor in the schools, helping the children with all kinds of problems. It is vital for schools to be able to serve deprived areas by having the services of a counsellor. I recommend this programme to the Minister, and I very much hope that it will be extended.
Lord Northbourne
My Lords, I thank the noble Baroness, Lady Walmsley, for introducing this debate and for the brilliant way in which she explained the problem. I am extremely happy to be on the same side as her on this occasion.
The classic research of Bowlby, Ainsworth and others—indeed, almost all modern published work—confirms the importance for the child of secure loving attachment during the early years to a mother or surrogate mother. During the first year of life, infants learn to love, to feel confident and to deal with stressful circumstances and negative emotions in an organised manner. As an illustration of the importance of an appropriate environment in the early years of brain development, the noble Lord, Lord Winston, in an earlier debate on this subject, told the House that kittens are born blind, and that if you put a blindfold on one for no more than 21 days the cat will be blind for life.
Similarly the synapses in a child's brain are developed by that child's experiences. Key emotional and social development takes place in the early weeks and months. The human child needs regular positive interactions with nurturing adults in order to develop the complex networks of brain connections that they will need to form healthy relationships. I have been aware of this research and this story for some time, but I must admit that the full force of it has come to me only very recently when watching my daughter care for and play with her beloved first child. That child knows that she is safe and that she is valued more than anything else in the world. She is learning how to love and be loved.
Given that the emotional and social development of the nation's children depends so much on the quality of secure attachment to a mother or another secure attachment figure in those first months and years, does it not seem logical to argue that we as a society should be doing more to optimise the chances of child/mother relationships being secure and loving? This is the basic point which the noble Baroness and others have already made, but successive Governments have shied away from this proposition because intervention in the child/mother relationship can be intrusive. Indeed, the word “intervention” sounds just a little too much like interference. I would rather change the word, focusing in the opposite direction, and talk about prevention. I was extraordinarily happy to hear the noble Baroness and other speakers talking positively about prevention. In those terms, there are many things that we can do. I do not have time to go into them this afternoon, but one is better preparation for parenthood, starting perhaps in schools and certainly elsewhere too. There should be more support for first-time parents before and around the time of birth of the child, and in the first year of the child’s life. Also, we need to think about trying to create a society which more greatly values and encourages long-term parental commitment. There are also obvious elements that we must not forget, involving the improvement of the environment in which some parents are obliged to bring up their child. These include poverty, debt, ill health, violence, addiction and many more things that your Lordships know about.
I want to turn to the subject of grandparents. In all this work, there is a very important role for grandparents. In particular, they often have key roles as supporters of parents, as carers and often as surrogate parents. I was therefore most concerned recently to hear that before the end of April The Grandparents’ Association will have to close its helpline, manned mainly by volunteers but none the less costing money, because their financial support is to be withdrawn from 31 March. This helpline has been dealing with more than 8,000 calls a year, many involving legal advice or deeply complex and emotive problems faced by grandparents.
We all have to accept that cuts are necessary, but I cannot help wondering whether this cut will not cost a great deal more than it saves. In this context, I should be grateful if the Minister could give me an answer to three questions of which I have given him notice. First, do the Government recognise the important role which grandparents can play in supporting their grandchildren during their early years? Secondly, is the noble Lord aware that each year some 8,000 grandparents have been contacting The Grandparents’ Association helpline for advice and help, and that the association has been working with grandparents for more than 23 years? Thirdly, will the Minister please ask his right honourable friend to find some way at least to provide essential short-term financial support to The Grandparents’ Association helpline at least to give it time to seek other sources of funding for the helpline or, if necessary, to try to transfer its services in an orderly manner to some other provider?
The Lord Bishop of St Edmundsbury and Ipswich
My Lords, it is a great privilege to be a Member of this House and to be addressing you for this first time. I, too, would like to express my gratitude to those noble Lords who have already generously welcomed me. I would also like to acknowledge with gratitude the kindness and efficiency of the officers of the House in helping and supporting my introduction. It was a particular delight to meet Black Rod, whom I had last seen in his previous incarnation within the borders of my diocese when, as Colonel Commandant of the Royal Tank Regiment, he presented campaign medals to a squadron of the regiment on its return from Afghanistan.
I want also to pay tribute to the former Bishop of Lincoln, whose retirement was the reason for my Writ of Summons to this House. John Saxbee combined a refreshingly down-to-earth personality with a sharp intellect, which certainly enlivened bishops’ meetings and, I am sure, the proceedings of this House.
All those with Irish connections will know well that this is St Patrick’s Day. But I was introduced to the House on 8 March, which for a bishop whose diocese covers nearly all the county of Suffolk was particularly appropriate as it is the day on which we commemorate St Felix. While perhaps not the best known of saints, St Felix was the very first bishop to be recorded as exercising ministry in East Anglia in the 7th century. He established his See at Dunwich, in what is now the county of Suffolk. Dunwich was once a major east coast port, but has long since been reclaimed by the North Sea; however, Felix’s name is of course attached to the modern Suffolk port of Felixstowe that is of major significance to this country as a container port.
Suffolk is a county that attracts many visitors. It has many historical attractions, not least in the legacy of medieval churches, some of the finest in the country, built in times of local prosperity through the wool trade. These lovely buildings are of course an asset and a huge responsibility, but I assure your Lordships that often I find that these churches are at the centre of the life of the many small communities that make up rural Suffolk. They are certainly a major part of what attracts visitors to Suffolk. But this is of course not just a place of tourism. There is a significant contribution to the food production of the country from the farmers of Suffolk, and in these days of ecological awareness the county works hard to reduce food miles in the marketing of local produce. Indeed, the Greenest County programme attracts support from a very wide cross-section of the community.
However, this is not a static community. There are significant areas of new housing which the church seeks to serve, and there are likely to be more. But a place of historical and rural beauty is not immune from the challenges of modern society. Deprivation can be found in rural areas as well as some of the urban parts of the county. There have been many fine examples of both statutory and voluntary agencies seeking to break some of the cycles of deprivation and addiction which so often lead to tragic consequences, some of which we have been hearing about. These are areas where the church seeks to offer support across all denominations and indeed faiths.
The subject of this important debate that the noble Baroness, Lady Walmsley, brings to the House is those significant implications for human flourishing about which we have been hearing. I have read closely the proceedings of the debate last month, instigated by the noble Lord, Lord Northbourne, “Children: Parenting for Success in School”. That made clear to me that this House is able to draw on much expertise. The debate, together with the reports by Frank Field MP and Graham Allen MP, that have already been referred to, have left no doubt about how the development of children in early years has a crucial effect on human life and flourishing. That was recently underlined in the interim report of Professor Eileen Munro in her review of child protection.
In the debate last month, the right reverend Prelate the Bishop of Oxford spoke of the need to support stable and loving-couple relationships, support for volunteers who contribute to child well-being, and a commitment to continuity of provision. I note that in the county of Suffolk there are 48 children’s centres. While I am aware, as has already been referred to, that there are significant changes to the funding of these centres, these will remain open. Suffolk has, from the start, adopted a multiagency approach, and quite rightly seeks to work with families rather than doing things to them. That approach is reinforced in Professor Munro’s report. As of 1 April, 300 health visitors and school nurses will be transferring from health to children’s services in order to integrate provision further.
What I really want to plead for is an integrated approach of services, both statutory and voluntary. In a minor way, I was affected in my family when my youngest son was picked up in his early years as not developing certain speech patterns. It turned out to be a classic case of what is known as “glue ear”, which a minor operation could correct so that higher pitched sounds could be picked up and he could then develop normal speech patterns with the help of some speech therapy.
In responding to recent reports, I see that the chief executive of the Royal College of Speech and Language Therapies has emphasised the importance of early intervention, describing communication as,
“the foundation life skill and the single most significant factor in determining a child’s life chances”.
She also significantly says:
“With over 60 per cent of young people in custody demonstrating difficulties with speech, language and communication, the importance of early intervention to address communication needs cannot be ignored”.
There in itself is an area which speaks of the cost-effectiveness of early intervention.
Once again, my Lords, I thank you for your welcome, and I look forward to contributing to the work of this House.
Baroness Warnock
My Lords, it is an enormous pleasure to follow the right reverend Prelate the Bishop of St Edmundsbury and Ipswich. I congratulate him on his excellent and most interesting maiden speech. He is a man of extremely wide experience and, obviously, deep humanity. I am particularly delighted by the fact that he was introduced to this House on St Felix’s Day—Felix being the name of both my grandfather and my eldest son—and my having spent a very happy time just before the birth of my eldest son at Dunwich, no less, which now hardly exists but then was still a recognisable place, not taken over by the sea, as the right reverend Prelate said. Apart from that, we have every reason to be very glad that he is now a Member of our House and look forward to his contributions over a wide field, not just what we have heard him talk about today. I need hardly make the speech that I was going to make now that he has made his.
I shall concentrate for a few minutes on the question of communication, as the most crucial field for early intervention in childhood. I have been mildly encouraged by the recent Green Paper on special educational needs, because the Government have treated education, health and the social circumstances of the child as a seamless whole. That is, as far as it goes, encouraging. My only question is whether any concrete changes will come from the fine words in the Green Paper. The battle to treat those three areas as one in the life of the child has been fought for a very long time. As the noble Baroness, Lady Morris, said, it seems to have been fought a great deal for the past 30 years and will, I hope, change in the right direction hereafter.
It struck me that, thinking back to the 1970s when the report of the Committee on Special Educational Needs, which I was privileged to chair, was published, we were charged by the then Government with what now seems a completely absurd and impossible task, which is to recommend what such children need without mentioning a deprived background as part of the problem from which many of them suffer. That now seems ridiculous, but at the time, we were still in the days when being educationally subnormal, as it used to be called, or handicapped, put you into a class apart, a separate race of people. It seemed that we had to rule out mentioning deprivation or not having English as the first language spoken at home when talking about education, because it would put the children suffering from deprivation into the category of the handicapped, and that was known to be inferior. It would have been snobbish, at best, and racist at worst, if we had mentioned deprivation.
It is worth reflecting on what an absurd embargo was put on us at the time. It could not happen now. That is good, but it is most important to recognise the role that teachers, as well as parents, must play in identifying, and knowing what to do when they recognise, the difficulties that some children are having and the special needs that they may be demonstrating in the classroom. That means that not only specialist teachers must be prepared to intervene but that all classroom teachers must be trained to recognise such children and take the next step.
I end my remarks on a more optimistic note. This week, I was present at the launch of a new website especially designed for teachers in training and in post in the classroom. It was launched at the Chelsea and Westminster Hospital School, which is a marvellous school. The website gives information and advice on an enormous number of difficulties that children may be experiencing in classrooms, starting with severe allergies and going through every possible educational obstacle. I very much hope that that website—which, incidentally, was financed entirely by Google—will be very widely used in teacher training establishments and by teachers as individuals when they are faced with a problem that they do not quite understand. I recommend that website very highly to all teacher training establishments. That may be a good example of the big society working.
Baroness Massey of Darwen
My Lords, it is a great honour to follow that amazing campaigner, the noble Baroness, Lady Warnock. I am very happy that the noble Baroness, Lady Walmsley, has secured this debate. Like me, she campaigns for the well-being of children, and I appreciated her thoughtful speech. Indeed, all noble Lords present in the Chamber today are passionate about the well-being and achievement of children. As has been said, this is, or should be, an all-party issue. I should declare an interest as the chairman of the All-Party Group on Children. I hope that noble Lords will be able to exert their influence on the coalition Government to persuade them to look again at some of their policies on families. Children are at the receiving end of family problems, and government policies on tax, family support services, children on the edge of care, after-school services, children centres, employment, and under-fives grants will impact on families.
I am not talking just about poverty. I agree with what Frank Field said in his recent report that poverty is not the only factor to impinge on a child's quality of life. I understand that the Government will be producing a social mobility strategy, which will focus on the causes of poverty. I well understand that, but if we consider possible causes of poverty, for example, drug or alcohol addiction—I declare an interest as the chair of the National Treatment Agency—we have also to look at what causes the drug or alcohol problem. It becomes a cyclical argument. As we know, those causes are multifaceted, such as being in care, low educational achievement, low aspiration, unemployment, or inadequate early-years care, all leading to low self-esteem and feelings of worthlessness. Family poverty can contribute to that, and bring stress in relationships, as was mentioned earlier. Causes are not simple, and poverty is not simple.
The first few years of a child's life are, of course, crucial. Intervention will be, for the most part, from parents. Parents would not call it intervention. They would call it love and care through stimulus and health-giving activities. Where families do not supply such intervention, other measures are essential if the child is to flourish. Most families do not need intervention, but I agree with Graham Allen in his report that some families require specific intervention, such as with a family intervention project or a family nurse partnership. Some families need occasional help, such as from a GP, health visitor or child psychologist.
Some interventions can benefit all children, such as language enrichment, play opportunities for children, libraries, and so on. Some families have particular needs. The noble Lord, Lord Northbourne, was thinking of grandparents. I am thinking of grandparents with sole care of their grandchildren because their son or daughter is dead, in prison, or addicted to drugs or alcohol. I have raised the issue before in your Lordships' House, and some concessions have been made but, frankly, such grandparents are still in serious difficulty. Outcomes for children who go into care with family or friends are so much better, socially and academically, than those for children who go into other forms of care that such grandparents deserve more financial help and other support. They save the state millions but they sometimes have to scratch around, filling in endless forms, for a pittance. Do the Government have any plans to look at this situation again?
Maternal health, both physical and perhaps, particularly, mental, in the child’s early years, is essential, yet according to a Healthcare Commission survey more women have a more negative view of postnatal care than of any other part of maternity services. Pre-school healthcare is underfunded and tends to be a postcode lottery. Health visitors are key to all this. More than 70 per cent of parents have said that they want parenting support from a health visitor. What plans do the Government have to ensure that all families have regular access to a health visitor when they need one?
Family intervention projects are targeted and specific to the most problematic families. They have been shown to reduce the burden on other services, reduce anti-social behaviour, reduce housing enforcement action and, strikingly, reduce educational problems—for example, truancy, exclusion and bad behaviour. Family nurse partnerships focus on support for the family up to toddlerhood. They impact on the mother, for example, in birth spacing and in the take-up of education or employment. They improve parenting skills and attendance at children’s centres. To what level will such interventions continue to be funded and will children’s centres continue to thrive?
I have not yet talked about cost-effectiveness and I am not sure that we yet have enough highly rigorous cost-benefit analysis of such interventions. My noble friend Lady Morris called it lousy research. But let us hope that longitudinal studies will eventually produce more meaningful and measurable outcomes. It seems clear that encouraging people to be good parents who will look after the health and welfare of their children is bound to save money. The cost of poor literacy is, I believe, about £64,000 over a lifetime. It has been estimated that family intervention projects and family services can save £9 for every £1 spent.
We know that the costs of children in care, youth offending, preventable diseases and so on affect the economy. We know that poor self-image inculcated from an early age has a profound impact on life chances. We know what works and I ask the Government to cherish the notion that such interventions not only save money but protect the health and happiness of individuals and society.
Lord Clement-Jones
My Lords, I, too, congratulate my noble friend Lady Walmsley on initiating this debate and on her wide-ranging and extraordinarily knowledgeable introductory speech. I also congratulate our two maiden speakers, who will clearly bring enormous wisdom and experience to this House on the topics that we are debating. I declare an interest as president of Ambitious about Autism, the national charity for children and young people with autism, which through TreeHouse School provides specialist education. As so many speakers in today’s debate have emphasised, early intervention is key to securing the best possible outcomes for children with special educational needs, particularly those who have autism.
Last October, the noble Baroness, Lady Warnock, instituted a debate on special educational needs. Throughout many speeches in that debate, including my own, ran the common theme of the need for early intervention, which was also called for in the very first manifesto of the All Party Parliamentary Group on Autism, of which I was vice-chairman, in 2003. But still, even now, too many children with autism are not getting diagnosed early enough. Early intervention can result in huge financial savings for society over the course of an individual's life.
The aggregate cost of supporting adults with autism in the UK is £27.5 billion annually. Some 85 per cent of adults with autism currently are not able to access the workplace and 90 per cent are dependent on their families or the state. Early intervention is particularly crucial in education. Children with special educational needs are eight times more likely to be excluded from school than their peers. The cost of failed education placements, which end in exclusion, pupil referral units, expensive specialist provision and even more expensive residential placements, is substantial. The cost of educating a pupil in a specialist school is four times that of a mainstream school. The evidence from parents and professionals is that getting the right level of support early on in school prevents the need for this expensive exclusion route.
The most effective interventions for children with autism focus on helping them to manage their behaviour, develop communication and social skills, and “learn to learn”. A recent review of research has identified a number of approaches that can result in improvements in communication skills, behaviour and social functioning. In particular, intensive behavioural interventions, such as the applied behaviour analysis that is used at TreeHouse School, have been widely evaluated and shown to be effective. There is clear evidence to support the use of ABA.
Other countries have shown a much stronger appetite for trialling early intervention approaches, but Birmingham City Council—which is Conservative-Liberal Democrat controlled—is currently trialling four interventions. The council is spending £41.7 million on early intervention programmes over 10 years in the belief that the investment will save it around £102 million over 15 years. Projects such as this are essential if we want to ensure positive outcomes for a whole range of children while delivering substantial savings. We also need to incentivise local authorities to provide appropriate support soon after a child’s needs have been identified, rather than allow costs to escalate through exclusion to more expensive provision. This would create better outcomes for children and families and a more cost-effective solution for local authorities.
We have talked about cost but, above all, a failure to identify autism and other special educational needs early on forms a barrier to delivering effective interventions. Without timely diagnosis, it is difficult for professionals to decide on appropriate intervention. There should be screening checks for SEN built in to children’s early years. There is also a lack of understanding of autism in the early years workforce, whether in health, social care or education. A host of government and independent inquiries, including that by Brian Lamb, have recommended improved training as key to identifying additional needs early and building the skills base to meet those needs.
Much of what I have proposed is reflected in the very welcome new coalition Government SEN Green Paper, Support and aspiration: A new approach to special educational needs and disability, which has been referred to in the debate. The Green Paper makes the case for early intervention and support far better than I can, so I congratulate my honourable friend Sarah Teather both on the care with which the paper has been prepared and on its content. In particular, the paper recognises that,
“identifying children’s support needs early is vital if they are to thrive, and enables parents and professionals to put the right approach in place quickly”.
That supports the findings from Graham Allen’s review, which has also been mentioned by other noble Lords, which concluded that early intervention creates benefits for wider society as well as the individual child and family.
Having seen the experience of so many parents faced with adversarial SEN tribunals, I particularly welcome the proposal that children and young people who would currently have a statement of SEN or learning difficulty assessment will, by 2014, have a single assessment process and an education, health and care plan for their support from birth to the age of 25. I also very much welcome the fact that the new plan will afford parents the same statutory protection as the statement of SEN, and that the Government will explore how to use the voluntary and community sector to introduce much-needed independence to the process.
There are many other positive things I could say about the Green Paper, but some questions arise from it which I hope will be answered by the Minister. Will the education, health and care plan be based on a strong legal right for families to access early support? Furthermore, what will the funding and training mechanisms be to allow early years professionals and health workers to identify needs earlier? I look forward to the Minister’s reply.
Baroness Howe of Idlicote
My Lords, I join in thanking the noble Baroness, Lady Walmsley, for introducing this debate so excellently and comprehensively. We seem to have had a number of debates recently on this subject, but that merely highlights the importance of the whole issue.
Many of the costly and damaging social problems that we face occur because we are not giving children the support that they need in their early years. When we do intervene, it is often too late and less effective, as problems have intensified. Because of this, disadvantaged groups more often than not face fairly disastrous personal outcomes. Studies find that when children experience impoverished, abusive or neglectful environments, they do not develop empathy or social skills and are at increased risk of mental health problems and anti-social or aggressive behavior. Even worse, research shows that boys assessed at age three as at risk have 2.5 times as many criminal convictions by the age of 21 as a control group.
The strong economic case for early intervention and for reducing the causes of poverty is clear. A 2008 report by the Joseph Rowntree Foundation estimated the cost to public services of the consequences of unaddressed poverty. However, I follow what others have said about the range of figures. They do not always seem to add up, so there is a strong case for rather more in-depth, long-term assessment.
As well as disadvantaged children, those with special educational or disability needs require even more support in the early years. As the noble Lord, Lord Clement-Jones, said, autism is an obvious example. I was going to quote much of what he said in his remarks, but I will now leave that out, but clearly the “learn to learn” approach can save considerable sums later on as young people with autism acquire skills.
Sadly, even though for some disabilities special ring-fenced funding is available, misinformation has apparently led to lost opportunities. My example here is deaf children, for whom, in order to develop their speech and language skills, it is vital that we intervene with specialist services as early as humanly possible after diagnosis. Yet some local authorities are apparently not aware that funding is available under the designated schools grant to help deaf children under the age of two. This was apparently the case in Sheffield. The charity NDCS has since rightly explained that the grant could and should be used for the support of very young deaf children and that the school finance regulations have now been revised to remove any doubt. However, this is apparently a persistent problem with other local authorities as well.
Inevitably, there is concern that, in this current horrendous economic climate, local authorities will look to make cuts of all kinds, including funds for special needs and disadvantaged children. Can the Minister please assure noble Lords that the Government are committed to sending a strong signal, and even incentives, to local authorities that certainly designated early intervention funding should be used and that, in any case, early funding for all children with special needs should be a priority, as it is both a socially effective and cost-effective long-term investment? Thankfully, I think that there are real signs of an increased perception that it is better to identify problems early and to intervene effectively to prevent their escalation. I pay tribute to what the previous Government did in terms of Sure Start and so on, and similarly to Frank Field and Graham Allen.
In all situations, the returns on early intervention are demonstrably beneficial. Overall benefit-to-cost ratios are as high as 17 per cent. One review of the economic benefits of early intervention education programmes found that for low-income three to four year-olds the benefits were 2.5 times the initial investment.
I expect that noble Lords will agree that the challenge for the Government in adopting an early intervention policy nationally is not just deciding whether it is a good idea—I hope that that is now firmly established—but its financing, because it is no good starting on this path unless the work can be carried through. The noble Lord, Lord Storey, made that point, too, in his excellent maiden speech.
I am sure that other noble Lords will have read with interest the paper sent to us for this debate by Save the Children, particularly the details of its FAST programme, which again emphasises the importance of early intervention for the future of those groups of children and their families whom we are discussing today. There are two points that I should like to make about this. First, I congratulate Save the Children on all the excellent work that it has done over very many years. Secondly, I note the partnership that Save the Children and FAST have entered into with Lloyds Banking Group and Morrisons—here I perhaps do not agree so much with the noble Lord, Lord Storey. The FAST programme, which has been widely and successfully tested and developed over 20 years in a number of different countries including the USA, has already gained an excellent reputation. With the £2.5 million that it has raised, it hopes to establish more than 120 new children’s centres and school sites in the UK during 2011-12, with even more ambitious programmes to improve the life chances of thousands of children by 2014. I hope that the Minister will reassure us that these kinds of big society partnerships are being encouraged nationwide. If, on top of government commitment and funding, this kind of business backing can be assured, working in partnership, of course, with the third sector and local communities, we will see real results.
Baroness King of Bow
My Lords, I thank the noble Baroness, Lady Walmsley, for securing this debate and especially for her excellent speech, which summarised the benefits of early intervention. I do not believe that it is hyperbole to say that the future of this country rests on whether we implement successful early intervention strategies—certainly, the future of our children rests on it. That is why politicians need to become experts on very young children and how their brains develop; it is not enough for us just to kiss them at elections. It is also why we desperately need to exempt this subject from party-political point-scoring. I commend Graham Allen and Iain Duncan Smith on their excellent report and the example they provided. I congratulate also the two noble Lords who made their maiden speeches in this debate and thank the noble Lord, Lord Storey, for his non-party-political praise of Sure Start programmes.
Many good speeches have been made, but I draw attention particularly to that of my noble friend Lady Morris, who outlined the perils of moving Sure Start from universal to targeted provision. What assurances can the Minister give on that point and on funding for Sure Start centres?
As the noble Baroness, Lady Walmsley, pointed out, we must respond to the evidence that is stacked a mile high here. As she said, we need to move spending to the developmental stage rather than it being remedial. Just how cost-effective is early intervention? Westminster Council calculates that damage caused by an unruly family costs it £273,000 every year, a figure that includes the costs of foster care, domestic violence and ASBOs. Action for Children has estimated that for every £1 spent on Sure Start children’s centres, society benefits by between £4 and £9 in the long term and that early investment can save the economy £486 billion over 20 years. I know that we are not great at thinking long term, but surely we cannot afford not to. If anyone remains unpersuaded, I ask them to read Why Love Matters by Sue Gerhardt; in fact, every politician should read this book. I realise that, at my citing a title such as this, noble Lords could be forgiven for thinking that I want to see a communal outbreak of “Kumbaya” in the Chamber. Nothing could be further from the truth. Although it might sound quite touchy-feely, that book explains precisely how we cannot afford to wait until later in a child’s development if we want that child to flourish.
Likes others, I shall not attempt to précis the excellent Graham Allen review, but I want to say something to those who say that early intervention smacks of the nanny state. It is quite ironic that those who seem to rail most against the nanny state are usually those who enjoyed the benefits of a nanny. A nanny helps children whose parents are not available to help them. I do not see why it should be only well-off children who receive that resource or, at the very least, I cannot understand why people should recoil from extending that help to the children who need it most. It is not just about those in greatest need; it is an issue that affects us all. If people talk about broken Britain, they should realise that they are more accurately talking about anti-social behaviour perpetrated by those who most often have had broken childhoods, whether in a one-parent family, a two-parent family or any other shape of family.
In seeking solutions, I mention the work of the charity 4Children. It is a national charity that provides services within Sure Start children’s centres, nurseries, youth programmes and other family services. In its submission to the Graham Allen review, it stated that,
“early intervention is not a programme, a scheme or a project. It is an approach which should run through all work with children and families … whilst there are excellent examples of early intervention projects and programmes around the country, we have not yet changed the fundamental mindset or approach—to one based on early intervention”.
Much of the work the state does with families does not take that approach. Its proposals include putting universal services at the heart of any early intervention strategy, ensuring families and communities play an important role, recognising and building on the success of children’s centres and the critical need for a whole-family approach, as that is what makes the difference.
The noble Baroness, Lady Walmsley, reminded us that by the time a child reaches the age of three 85 per cent of their brains have developed. Let us just hope that our own minds are not too inflexible to deliver the resources that early intervention desperately needs.
Baroness Benjamin
My Lords, I, too, congratulate my noble friend Lady Walmsley on securing this debate as it deals with matters very close to my heart. I congratulate my noble friend Lord Storey on his passionate maiden speech and the right reverend Prelate on his excellent speech too.
For many years now, because of my professional and charitable work with and for children and young people, I have always advocated that early intervention is the answer as regards prevention of much pain, suffering and unhappiness later in life. Research has shown that 40 per cent of children with conduct disorders at the age of eight will go on to have repeat convictions, and 90 per cent of convicted adolescent offenders show conduct disorders. Therefore it is crucial to put early intervention in place and to work with families when difficulties first become apparent or, better still, before damaging patterns in family relationships become entrenched.
Children need to valued and loved, and not blamed, vilified or labelled. One of the ways in which we can intervene to help children to find themselves and to come to terms with fears, anxieties, death, stress and being abandoned or unwanted is play therapy. Play therapy offers a way of working with the child that is child friendly and uses the language that all children understand: play. I declare an interest as patron of the British Association of Play Therapists, which believes that filial therapy—a child-centred, non-directive play therapy—is uniquely placed to help not just children but their parents to improve their emotional well-being, and that that should be in place almost as soon as a child is born in an “at risk” situation, with parents or carers learning from the start how to have empathy with the child, how to listen, how to respond, how to set boundaries, how to discipline and how to show the child love and affection. I always say that a hug a day keeps the doctor away and there is nothing like a hug to make a child feel special.
Filial therapy is an effective therapy to help children modify their behaviour, clarify their self-concept and build healthy relationships. In play therapy, children enter a dynamic relationship with the therapist that enables them to express, explore and make sense of their difficult and painful experiences. Play therapy helps children find healthier ways of communicating, develop fulfilling relationships and increase resilience, and it facilitates emotional literacy; it allows them to express things they cannot put in words. It also allows the play therapist to have a glimpse into the child’s inner world and to gain some insight into the way forward to help that child, from as young as three upwards, with this healing process. It is one of the safest ways of working with children of all cultures. This type of therapy is so valuable because it is in the child’s control: they can move as fast or as slowly as they feel safe, stop when they feel closer to being overwhelmed and engage in repetitive play for as long as it is necessary to gain mastery over whatever the issues are.
I believe not enough consideration is given to the effects of what nowadays have become almost everyday occurrences in some children’s lives: domestic violence, alcoholism, divorce, separation, sexual and physical abuse, neglect, adoption, and fostering. They all play a part in causing conduct disorder and the craving for a loving, safe and happy parental attachment. Therefore I strongly believe that it is important to raise the status of parenting, starting in schools with helping teenagers to understand that caring for children is not just about feeding and clothing them. It is about understanding the importance of attachment and attachment behaviours, which is more than bonding—it is the ongoing relationship of the child with its primary carer. Broken attachments have far-reaching consequences for children, who find it difficult to concentrate in school and therefore to learn. Boys particularly need good role models these days, yet we have so many children growing up without a strong positive role model—they find themselves drawn into gangs, who give them that feeling of security. Parents and carers who themselves have been neglected, abused or troubled in childhood are known to be more at risk of developing difficult relationships with their own children. A lack of a secure attachment relationship can negatively affect relationships for the whole of their family life.
Research has shown that the first emotional stage in a child's life occurs during the first 12 months. This is what is sometimes called the “trust versus mistrust” stage, which is so crucial in forming attachment to parents. Neglect, abuse and emotional deprivation can all prevent a child passing through this stage, in which they can become stuck and develop lasting problems.
However, play therapy can help move a child through this stage. Filial therapy is invaluable at helping the parent or carer to understand and meet the child's emotional needs. Good attachments mean that children are more likely to form successful relationships in adult life. With the advances in neuroscience and brain scans, there is now vital information about the impact of different types of parenting on a child's brain. A newborn baby has around 200 billion brain cells but very few connections; however, when they reach the age of about 12 months, the higher brain has developed many more connections. The way these are formed is directly due to the child's experiences and in particular his or her emotional experiences with a parent or carer. It is not until around the age of seven that this process slows down and the communication and pathways between brain cells strengthen, so there is some scientific truth in the saying: “Give me a child until the age of seven and I will give you the man”. I believe—
Baroness Garden of Frognal
I apologise for interrupting but the time is up and we are right up against the clock at the moment.
Baroness Benjamin
I would like to finish. Many children are suffering. Some people believe that if we leave children like Baby P, they might go on to be abusers themselves and that the answer is to give them away. However, I believe that play therapy, delivered by highly experienced professionals, can offer a different chance for children.
While I know that we are living with cuts, will the Government seriously consider setting up a pilot scheme of filial therapy to work with at-risk children and their parents and to train more therapists to practise early intervention? That would save the Government money on NHS healthcare and the judicial system, and save money for society generally. Will the Minister also consider putting practical parenting classes on the curriculum to ensure that early intervention starts as early as possible? I always say that childhood lasts a lifetime, so let us do all we can to get it right from the start by using all the tools at our disposal. Thank you for being patient with me.
Baroness Garden of Frognal
My Lords, I respectfully remind your Lordships that we are up against the clock with this debate. When the clock goes to six, you have finished your six minutes. Thank you.
Lord Ramsbotham
My Lords, I join everyone who has congratulated the noble Baroness, Lady Walmsley, not only on obtaining this debate but on her masterly introduction to it. Perhaps I may add my admiration for her tireless championing of issues affecting children. As always, I find debates in this House on this sort of subject absolutely fascinating. I find myself nodding with agreement and learning a great deal. Every time this subject comes up I am reminded of those wonderful words of Winston Churchill, uttered in 1910, that there is a treasure in the heart of every man if only you can find it—with the urging that it is your job to find it. That is coupled with my being one of the people who believe that the only raw material which every nation has in common is its people. Woe betide a nation if it does not do everything it can to identify, nurture and develop the talents of all of its people because if it does not, it has only itself to blame if it fails.
This debate has been preceded by three weighty documents, among others. In November came the White Paper on public health, Healthy Lives, Healthy People. Then there were the two excellent documents, already referred to, by Frank Field MP and Graham Allen MP. Only last week we received Support and aspiration: A new approach to special educational needs and disability. Reading that document reminded me of my time in the Army. Whenever you were invited to do a report, you immediately looked up the previous reports on the same subject to see what had happened to their recommendations. One persistent offender, which I was always concerned about, was where people regularly checked that getting progressively less sleep meant that you worked progressively less well.
I was reminded of that because I saw that that document was a consultation document, but containing a commitment that by 2014, there would be a single assessment process and education, health and care plan which would support children from birth until 25. It went on to say:
“The plan will be clear about who is responsible for which services, and will include a commitment from all parties across education, health and social care to provide their services”.
For heaven’s sake, what on earth have we been doing for the past 100 years if that has to be said as an aim by a ministry in 2011? I then looked at the back of that document and found no fewer than 102 documents quoted, all of which contained many recommendations that seemed to have got nowhere. Why?
Here, I declare interests as chair of the all-party group on learning and communication difficulties and as vice-chair of an organisation called the Institute for Food, Brain and Behaviour. I was extremely interested that the noble Baroness, Lady Walmsley, began by talking about the developing brain because in the document that I referred to I was surprised to see no mention of nutrition and its vital role in pregnancy and the early years in helping to develop the brain. Then I looked to the list of documents and there they all were, so why has that been ignored? As chair of the all-party group, I am glad that that communication problem has come up over and over again. I am also grateful that the right reverend Prelate, in his excellent and thoughtful maiden speech, mentioned offenders.
If anyone ever wants to see the truth of the statement that is the subject of our debate, perhaps they would like to come with me into one of Her Majesty’s prisons. We could go to two places. We could go to any one of the landings, where every prisoner would be someone who had suffered from ineffective or non-existent early intervention. You see that repeated in spades and the costs cannot be quantified. Then we could go to the visiting centre and see the children of the people in prison. Those children are being deprived of one of the people who is so important in their early years, quite apart from having to go through the process of coming into that dreary place to visit the person who should be supporting them in that important process.
During my time as chief inspector I tried to get early intervention on young people, with regard to their communication skills or lack of them, properly investigated. A trial was carried out with speech and language therapists and it proved conclusively that, if they had only been able to connect with their education from an early stage, they might not have ended up there. I commend to the Minister the excellent briefing paper that has been produced for this debate by the Communication Trust, which has some very valuable information about the numbers of children who enter primary school without proper communication skills and who therefore cannot engage with a teacher. That is repeated at secondary school.
That last point has been mentioned over and again in this House in connection with legislation, which is why I conclude by asking the Minister why we have to wait until 2014 for a plan when all the evidence is already there. We do not need any more consultation; we have got it coming out of our ears. Who is actually going to be responsible for taking action rather than initiating yet another consultation?
Baroness Warwick of Undercliffe
My Lords, I thank the noble Baroness, Lady Walmsley, for introducing this timely debate. Recent debates in this House and in the other place have ensured that we are familiar with the challenging reports by MPs Frank Field and Graham Allen. As we await the Government’s response to those reports, as well as to Dame Clare Tickell’s review into the early years and foundation stage, I am particularly thankful that we continue to give significant time and thought to this hugely important area.
We know that the first few years determine profoundly how a child will be as an adult and as a citizen. More brain development takes place in the first 18 months than at any other time of life. Therefore, more damage can be done at that stage than at any other time if the environment is wrong and once that damage is done it is twice as hard to undo, so the child is hit by a double whammy.
Research tells us that by 22 months a bright child from a disadvantaged background begins to be overtaken in key abilities by a less bright but privileged child. Indeed, a child’s development score at 22 months is an accurate predictor of educational outcomes when that child is 26. Yet the public debate about life chances and social mobility often seems to pay more attention to what university a young adult of 18 should go to than to whether our three year-olds can hold a crayon or a simple conversation.
I shall focus on the importance of highly trained staff in early years education, also highlighted in Graham Allen’s report. In doing so, however, I should first like to record my support for Sure Start children’s centres in the current difficult financial climate. Giving our children the best possible start in life through improved childcare, early education, health and family support lay at the heart of the previous Government’s creation of Sure Start in 1998. Today these 3,500 life-enhancing children’s centres offer the earliest help to more than 2.5 million children and families. At their best they are hubs for community activity, offering a welcoming place to which families can turn, and, crucially, identifying difficulties before it is too late. Like many noble Lords, I am deeply concerned by reports of closures by local authorities charged with cutting budgets. The recent survey suggesting that some 250 Sure Start children’s centres could close within a year, affecting an estimated 60,000 families, is very distressing.
Of course, we cannot afford to waste money, but short-term measures mean that we risk wasting much more—what Graham Allen calls the wastage of human potential, social disruption and fractured lives. He cites the OECD in arguing that spending on young children is more likely to generate more positive changes than spending on older ones, and is likely to be fairer to more disadvantaged children. However, in the UK, for every £100 spent on the nought to five years, £135 is spent on the six to 11 years and £148 on the 12 to 17 years. As Allen points out, this is not a cost-effective way of treating society’s problems.
In championing cost-effective early intervention, I highlight the continuing need for high-quality care provided by highly trained staff. Like my noble friend Lady Morris, I am particularly concerned that children’s centres will no longer need a trained nursery teacher or early years professional of graduate status. This is a retrograde step. It goes to the heart of the call by Allen and Field to put the nought to five, or foundation years, on a par with primary and secondary education. Low-paid, low-qualified staff cannot give the expert remedial help that many families need.
I should declare an interest as my sister, an early years professional, has two nurseries in Nottingham, one rural and one urban. She sees every day the importance of an environment which is safe, secure, stimulating and loving. All these are essentials for a child’s proper development; missing any of these can be crucial. Many parents now lead unsettled, stressful, even chaotic lives. With the best will in the world, which most parents have, they are not able to provide this environment either through lack of time, money, resources or poor parenting experience themselves. Highly trained staff are, therefore, essential. High-quality childcare must be well managed and supervised. It is demanding work. Staff in children’s centres and nurseries need to be constantly aware of children, parents and each other, and vigilant about noticing change. As recent flaws in nursing care of the elderly demonstrate, the attitude of staff working in these challenging environments is critical. It must not be seen as an option for those who cannot think of any other line of work.
Training and continual professional development must be ongoing. We cannot continue with a situation whereby people can be paid more for stacking supermarket shelves than for looking after our youngest children. Will the Minister therefore endorse the schools White Paper proposal that the remit of the National College for Leadership of Schools and Children’s Services should be extended to provide training for children’s centre leaders?
We need to find a way to make the vocation attractive to more highly qualified candidates, and we need to encourage schools, colleges and universities to teach and develop resources for the future. Therefore, will the Minister consider the call for equal status and recognition for the foundation years of nought to five, on a par with primary and secondary education? In support of this, will he also seriously consider the proposal for a workforce development framework to establish training and salary structures which recognise the challenge faced by, and importance of, early years staff?
None of this can be done on the cheap—funding is, as ever, the critical question—but I believe that these steps are vital if the early years foundation stage is to deliver what we ask of it.
Baroness Brinton
My Lords, there is nothing more important than giving all our children the best start in their lives, and there is nothing more shocking than the data which demonstrate that in the UK in the 21st century a child’s long-term future success is dictated by their place of birth and the socioeconomic status of his or her parents. I thank the noble Baroness, Lady Walmsley, for instigating this important debate and congratulate our two excellent maiden speakers. I welcome both the Frank Field and the Graham Allen reports.
It seems to me that much of our public debate over the past 13 years has been about ensuring that all children get access to early education, and that there has been dissent between experts and politicians about the formality and nature of the early years foundation curriculum. It is on the nature of these formal stages of education that I wish to focus.
There is absolutely no doubt that access to proper early years support enhances and changes children’s life chances but certain elements must be in place to make that happen. In the 1980s, Tennessee state educators ran the now famous STAR project, providing detailed longitudinal research into the performance of children starting in kindergarten in a small class of one teacher to 15 children, and following them, initially as they moved through to third grade, and then over the subsequent three decades. Formal education did not start until these children were well into the first grade—rising sixes, as our parlance would have it. I will return later to the question of the age at which children start formal education.
I remember the Tennessee STAR data being released in the early 1990s. It was very much an education mantra of the time: for each dollar invested in these children, $7 of public money were saved later on, because these children graduated from high school, went on in education, were more likely to find regular employment, were significantly less likely to need public support, and were very much less likely to end up in the criminal justice system. It is interesting that similar long-term savings are beginning to emerge in the UK.
Those of us responsible for UK local government education budgets then—following the recession of the late 1980s and with major public service cuts—were struggling to make the case for increased funding for early-years education. Does that sound familiar? However, we achieved that in Cambridgeshire, where we Liberal Democrats were in coalition with Labour. We targeted our limited funds on providing support to children in the most deprived areas for whom we knew that this could be life-changing. It has been mentioned already that no Liberal Democrat council is closing Sure Start centres, which demonstrates that they can be a real priority.
Since then, work has continued on tracking the STAR cohort, and it still holds true that, as these former pupils become parents themselves, the next generation of children benefit from the experience in this scheme and that lower class sizes and having trained early-years professionals are a cost-effective way of providing an excellent start in life for young children, from which society as a whole reaps the benefit.
I want to focus briefly on the nature of that early-years interaction with children, because I worry greatly about the previous Government’s focus on starting the formal part of education early. I am with Jean-Jacques Rousseau, who said in 1762:
“You are worried about seeing him spend his early years in doing nothing. What! Is it nothing to be happy? Nothing to skip, play, and run around all day long? Never in his life will he be so busy again”.
We need to view the world from a child’s perspective, learning at their own pace and developing their social abilities. A kindergarten should be exactly that—a place to learn to play, socialise, learn to talk and discover the world.
I am pleased that there is now a focus on providing the pedagogic specialism needed for children in these early years, because the holistic approach to a young child’s well-being must take precedence for the under-fives before enforced focus on letter recognition. I fear that much of our UK focus on early formal learning brings its own problems—hence the need for intervention, such as the highly regarded Reading Recovery and the Norfolk-based catch-up schemes for literacy, numeracy and maths. Children and teachers alike love the schemes, partly because they are much cheaper to deliver, given that they are run by teaching assistants and staff trained within the school.
It is interesting to compare the UK’s standing in the PISA education rankings of the OECD. Sadly, the UK has dropped to 21st in the rankings for reading and 22nd for maths. As a nation, we should be extremely concerned about this dip in performance, which was described as “stagnant at best”, while there has been a significant improvement in many other countries. It is interesting, however, to consider those countries nearer to the top of the rankings and examining when each starts their formal education. Finland, Canada, Japan, Australia and the US all have substantial early-years provision, but children do not start formal education until the age of six, or even when they are rising sevens, because those countries believe that the informal kindergarten stage of child self-development is so important.
Let us learn from these countries overseas that understand that balance between early years provision and the start of formal education, and make it an absolutely priority. We cannot afford to get it wrong for our country and its future, socially and economically, but most importantly for each and every child growing up in the UK today, and for those tomorrow who follow.
The Earl of Listowel
My Lords, it is a great privilege to follow the noble Baroness, Lady Brinton, who gave us such well informed and wise words about children being allowed to enjoy their childhoods and not being encouraged by their parents to start reading books on planets at the age of two—as a primary school head teacher told me only yesterday evening.
In our debate we have paid much attention to raising the status of the workforce, and to recruiting and retaining the best people to work with children. There has also been some mention of the evidence base for work in this area. I will make a brief comment on getting the balance right between those two things. Of course it is right to seek the best evidence for what we do: but it is also right to give professionals the autonomy to do what they think is best. I took from the very eloquent maiden speech of the noble Lord, Lord Storey, his ability as a head teacher, with money, to make the right choices for his school. Having spoken with many primary school head teachers who have been in place for some time, it did not surprise me that he got to know his local community, he got to know what was right for that area, and he went on to become an outstanding leader of the city—as we heard from the noble Baroness, Lady Sharp—because he understood so well the people in it.
The danger with overreliance and insistence on an evidence base—particularly the sort of evidence base that Dame Clare Tickell talked about, namely a Rolls-Royce, randomised control trial—is that those in government and local government become back-seat drivers. It reminds me of the experience of being driven by my girlfriend with her parents in the back, and the terrible discomfort of listening to them telling her how she should be driving. During my time in this House there has always been a danger of insisting too harshly on an evidence base and inhibiting those who are very well placed at the front line to make the right choices and take the right actions.
I will also take this opportunity to join others in thanking the Minister and his colleagues for their strong focus on the workforce, particularly teachers, in the White Paper on excellence in teaching and delivering the outcomes we want for children. That is a fantastic emphasis to have. I admire the way that the previous Government did the same thing. This is now beginning to spread to social work; we are insisting and recognising that high-quality expertise, keeping people in the service near the front line and allowing them to become experienced and to make the right judgments for children will give us the best results, as it does in Finland, where they recruit the best teachers.
Most of the models of evidence-based policy that the noble Lord referred to came from the United States. One came from the United Kingdom. How well does the United States do in terms of child welfare? Where is it placed in the developed countries' league table, and where are we placed? Do the continentals not do far better? I remember a comment made by a pedagogue from Germany who came to this country some years ago. He said how wonderful it was to come to a country where there was such clear evidence of the outcomes of looked-after children. I almost wept when I listened to him, because in his country and in Denmark they had the right professional framework for these children, with a far better balance than we had.
I will talk briefly about the Cassel Hospital, where the family service is closing. The hospital was established in 1963. It serves families with complex needs where parents are at serious risk of harming their children. It struggled for its existence for a long time. It brings together outstanding professionals from all disciplines to work in a residential setting. It has 25 bed units. A forensic psychiatrist who gives evidence to courts said to me that she had almost decided that a child had to be taken away from their parents but, knowing that the Cassel service was available, she agreed to say to the court, “Perhaps this can work”. She followed the child and their family for two years at the Cassel Hospital. The family were reunited and succeeded. The evidence from the outcomes of this service shows that if the families pass the assessment period and are taken in for therapy, most children will be able to stay with their families. Those who are removed and placed in foster care or adopted have stable placements, and there are very good outcomes. This is also an outstanding place for training new practitioners. The daughter of my noble friend Lady Hollins is a child psychotherapist who trained at this flagship NHS hospital, working with those families.
Therefore, my question to the Minister is: what services will now be available to families such as these? Local services have worked with these families for two years but their intervention has not been successful. What other options are available? I understand that multi-systemic therapy approaches are being employed and I should like to know more. I would appreciate it if the Minister could ask his colleague at the Department of Health to write to me with details. I should also like consideration to be given to making use of the huge experience that is to be found at the Cassel Hospital.
Baroness Jones of Whitchurch
My Lords, first, I thank the noble Baroness, Lady Walmsley, for initiating this debate. It has proved to be topical, thought-provoking and controversial in equal measure. We have heard some immensely well-informed contributions this afternoon. It was a particular pleasure to hear the maiden speeches of the right reverend Prelate the Bishop of St Edmundsbury and Ipswich and the noble Lord, Lord Storey, who spoke with such authority and expertise. We all look forward to many more similar contributions in the coming years.
The noble Baroness chose the title of the debate very well, because it reflects the two strands of the argument for early intervention. First, there is the moral case, based on equality of opportunity for every child—about which more later—and, secondly, there is the hard-nosed economic case addressed in Graham Allen’s report, which says that the more society is prepared to spend on early years development, the less needs to be spent on remedial action and dysfunctional young people and adults later. It is a compelling argument but it also highlights the failings in this Government’s approach to strategic economic and social investment because, however much this Government claim to be persuaded by the arguments of Graham Allen and others, they have already shown themselves unable or unwilling to act on the logic of early intervention. The scale of the cuts that they are now imposing and their hands-off approach to local government expenditure are surely testament to that.
We all understand the need for economic efficiency, but surely the sensible approach is to focus on growth and jobs to stimulate the economy, rather than rely on major cuts to public services, which appears to be the preferred route of this Government and is already putting at risk some of the successful early intervention programmes that exist.
As we have heard from a number of noble Lords around the Chamber, the funding of Sure Start is a good illustration of that point. It is an example of successful early intervention in action. The previous Government established a nationwide network of children’s centres—more than 3,500 in total—with over 2.7 million young people and their families accessing the services. Although it will not be possible to measure their impact fully for many years, the national evaluation of Sure Start has already found better social development and behaviour among three year-olds, less negative parenting and fewer accidental injuries sustained by those who attend.
Indeed, before the election Mr Cameron and Mr Clegg made personal promises to keep children’s centres open but, regrettably, the Chancellor’s subsequent announcement that the funding would be protected only in cash terms means a real-terms cut. The reduction in the early intervention grant, which now covers Sure Start, is 11 per cent just in the first year. As a result, despite the supposed political support, a Daycare Trust survey found that 7 per cent of centre managers anticipate that their centres will close within a year and 56 per cent will offer a reduced service.
There is another reason why the Government do not appear to have the political will to invest effectively in early intervention and it is an issue that I have debated with the Minister in the past. It is also one that has been argued passionately today by my noble friend Lady Morris. By removing the ring-fencing from funding to local authorities at the same time as their budgets are cut, the Government are no longer in a position to have any control over how that shrinking pot of money is spent. The noble Baroness, Lady Eaton, the chair of the Local Government Association, has admitted that,
“councils are facing unprecedented cuts to their budgets following the toughest financial settlement in living memory, as well as an increased demand for services”.
It is an obvious worry for those in need of long-term or specialist care who do not have a local, vocal voice. It is also a worry for services such as those that we have been discussing today where, as the noble Baroness, Lady Ritchie, rightly argued, the benefits cannot be evaluated or the financial rewards reaped for many years to come.
It also strikes at the heart of the issue raised by my noble friends Lady Morris and Lady King, who made the case for universal rather than targeted provision to avoid families falling through the net. If the Minister is persuaded by the arguments in favour of early intervention, how can he guarantee that any of the initiatives taken by the Government will result in actual children’s services on the ground? If money is set aside for this work, such as in the form of the early intervention grant, how will the Government track whether it is used for this purpose? Does the Minister accept that the result of his hands-off approach will be a patchy set of unco-ordinated services which fail to bring about the benefits of the long-term cost-effectiveness that we have heard about today?
I am very aware that Graham Allen, in his report, made a virtue of saying that he would not be asking for any additional money to fund his proposals. Some might say that he had no choice in this and I wish him well in exploring alternative sources of funding. The noble Lord, Lord Storey, rightly sounded a note of caution over the use of the private sector in providing such services. As we all know, the voluntary sector is also being squeezed, with children’s charities having their grants cut. Even the newsletter of Philanthropy UK quotes a major funder as saying that it will be a challenge to find enough funding to make this initiative work, and that the Government should instead kick-start the process while encouraging match-funding from other sources over time. It is undoubtedly more of a challenge to lever in outside funding to a scheme whose very existence is predicated on the principle that the benefits will not be measurable for many years to come.
I return to the moral case for action. We have heard some inspiring examples from noble Lords this afternoon of schemes that are already making a difference to the lives of children and transforming their life chances. I cannot refer to them all but some very important points were made about the role of grandparents and the need for multi-agency interventions. A number of noble Lords highlighted the importance of communication skills at an early age. The need for autism and SEN was highlighted very successfully, and the case for play therapy and nutrition was argued well by noble Lords, as was the need for highly trained staff.
Like others, I shall not dwell on the evidence. Suffice it to say that these initiatives are supported by a wealth of academic research quoted by Frank Field, Graham Allen and others showing that, for example, the development of children as early as 22 months is a striking predictor of their ultimate qualifications and life chances. It is also clear that the Labour Government’s aspiration to abolish child poverty by 2020, which was repeated in the Conservative Party manifesto, is a crucial but challenging goal that could tackle the rich/poor attainment gap, but would also require a major investment by the Chancellor to target around 20 per cent of the population in order to lift children out of severe poverty.
Government policy initiatives on this scale really matter not only to avoid children becoming trapped in a cycle of low achievement and poverty but also to improve their broader well-being, which we know is an issue dear to the Prime Minister. I thought that the noble Baroness, Lady Brinton, made an excellent case for the importance of informal play and happiness in the role of children’s broader well-being. The Child Poverty Action Group research currently lists the UK as a lowly 24th in the European ranking on this issue. What will the Government do to address that? I have great respect for the Minister, and I have no doubt that he recognises the strength of the case for early intervention. However, does he have the strategy and funding to achieve it? How will he persuade cash-strapped local authorities, businesses and the voluntary sector to play their part, and where does this work sit in the list of priorities in his department?
We have had a good debate today, and the solution now lies in the Government’s hands. Are they prepared to act, or will we one day look back in time at a lost generation whose lives could have been transformed but who have instead had their lives blighted before they even reach the starting gate?
The Parliamentary Under-Secretary of State for Schools (Lord Hill of Oareford)
My Lords, like others I congratulate my noble friend Lady Walmsley on securing this important debate and on setting out the issues so clearly. It is a subject on which she speaks with great passion and authority, and she demonstrated both again today.
Like other noble Lords, I congratulate the right reverend Prelate the Bishop of St Edmundsbury and Ipswich on his maiden speech. I had not realised the connection at all between St Felix and Felixstowe, and I shall think of him every time I see an advertisement for a well known cat food product on the television. I also congratulate my noble friend Lord Storey, who clearly brings great experience to this House both as a teacher and as a head teacher. I was extremely interested to hear what he had to say in particular about the pupil premium, on which other members of his party have campaigned long and hard. I also agree with him about the crucial role of schools, but equally that we cannot expect schools to put everything right on their own.
Today’s debate follows the excellent debate we had five or six weeks ago led by the noble Lord, Lord Northbourne, on the importance of parenting, a point underlined today by my noble friends Lady Ritchie of Brompton and Lady Sharp. Both debates and the large number of speakers in each underline the importance that this House attaches to protecting the interests of children. As usual, today I have learnt a lot from the contributions made from all sides of the House. We have heard very clearly the moral arguments for why early intervention matters, and we have heard compelling financial ones. We have heard about academic research and we have heard about real-life practical examples. We have heard about the benefits for literacy, or tackling problems with speech, as the right reverend Prelate pointed out, and about communication more generally—a point made very forcefully by the noble Baroness, Lady Warnock. We have also heard about autism and listened with care to the points made by my noble friend Lord Clement-Jones. We have heard about development of the brain, perhaps above all from my noble friend Lady Walmsley. All those pieces of evidence underline the importance of this issue, but common sense and our own experience as parents—and there may be a few grandparents in your Lordships' House—tells that this is true.
I know that the last Government understood these points; I also believe that this Government understand these points. I agreed with the noble Baroness, Lady Morris of Yardley, on how far collectively we have travelled, and I hope to reassure her that we intend to build on that progress made in recent years. The Government agree that what happens in a child’s early years is crucial to that child’s future achievement, behaviour and happiness. That is why, in a difficult financial situation, we have put resources into the early years, extending 15 hours of free early education to disadvantaged two year-olds; providing an extra 4,200 health visitors; putting in the money to maintain a network of Sure Start centres—and I shall come back and respond to some of the concerns that have been raised about Sure Start centres; doubling up the number of places on the Family Nurse Partnership Programme from 2015; and, as we have already mentioned, introducing the pupil premium to target support in school for children on free school meals to help us narrow the attainment gap which exists between rich and poor.
While I understand the points that the noble Baroness, Lady Jones of Whitchurch, made about money, I thought that she was uncharacteristically grudging about the financial support that the Government have put in at a time when money overall is short. However, it is because this Government, like the previous Government, are committed to making progress on the early years that we are trying to look across the piece, with the aim of publishing a policy statement later this year that sets out our overall approach to early years. That work will be informed by the four reviews that have all been mentioned this afternoon: the review by Mr Frank Field into poverty and life changes, the review into early intervention by Mr Graham Allen, the review into the early years and foundation stage by Dame Clare Tickell, and the review into child protection by Eileen Munro.
I agree with the point that was made forcefully by the noble Baroness, Lady Morris of Yardley, about evaluation. I think she was saying that it is sometimes hard to get one’s hand around and pin down exactly what is being said, and, having looked at some of the research before this debate, I agree. I take the point made by the noble Earl, Lord Listowel, that there is a balance to be struck somewhere between the evidence and autonomy, and that we do not all want to become management consultant/KPI-type people, which I know would concern him greatly. However, I think there is a need to try to understand clearly what works and to learn the lessons.
My noble friend Lord Storey made the point about consistency, and I think that we can learn about that from looking carefully at what works.
The noble Earl, Lord Listowel, made a specific point about the Cassel Hospital. I will indeed talk to my noble friend Lord Howe and ask him to write to the noble Earl.
I will now try to respond to some of the concerns that have been raised about Sure Start children’s centres. The centres remain at the heart of the Government’s vision for early intervention. I accept the importance of training for early years, a point that was made particularly by the noble Baroness, Lady Warwick of Undercliffe. I will relay the points that she made to my honourable friend Sarah Teather and follow them up with her. It is because we are committed to a network of Sure Start children’s centres that the Government have, in a difficult financial situation, put resources into the system to maintain a network of Sure Start children’s centres.
We will further set out the role of Sure Start when we publish later this year the early years policy statement that I referred to earlier, and we will develop that in partnership with the sector and set out a vision for Sure Start children’s centres and the practical steps for achieving it. We are keen to try to increase voluntary and community sector involvement with children’s centres, to try to improve accountability arrangements, to increase the use of evidence-based interventions and to see whether it is possible to introduce greater payment by results.
We know that local authorities are looking at their budgets and working hard to make the right decisions. I was struck by the points made by my noble friends on the Liberal Democrat Benches about the record of Liberal Democrat councils in maintaining funding for Sure Start children’s centres. As noble Lords will know, 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 centres provision to meet local needs so far as is practical.
I do not dispute for a moment that people are concerned. This raises difficult issues, and there is a difference of opinion between the Government and the Opposition about the role of delegating responsibility to the local level. It is our view that it is better to give local authorities that discretion and flexibility so that services can be managed in ways that best meet local needs.
A number of noble Lords mentioned the SEN Green Paper. I recognise the impatience of the noble Lord, Lord Ramsbotham, for the Government to make progress, and I am sure that his words will ring in the ears of my honourable friend Sarah Teather, who is driving this work forward. I assure him, and I hope he will accept, that she is extremely committed to this area and to making progress. As has been mentioned, we published our Green Paper last week. It sets out proposals for a new approach to SEN to try to make the system less confrontational, to try to give parents more control and to try to give professionals on the front line more space. I agree with the point made by the noble Baroness, Lady Warnock, that the proof of the pudding will be in the eating. However, I hope that noble Lords will generally welcome the themes set out in the Green Paper and the direction in which the Government are seeking to move.
We hope to help professionals to identify and meet children’s needs through a new approach to identifying SEN in early-years settings in schools, and to have in place a new single assessment process and education, health and care plan. We want local authorities and other services to set out a local offer of all services available to support children who are disabled and have SEN; to consider the option of a personal budget by 2014, an issue raised in an earlier debate initiated by the noble Baroness, Lady Warnock; to give parents a choice of school, either mainstream or special; and to try to introduce greater independence to the assessment of children’s needs, testing how the voluntary and community sector could co-ordinate assessment and input from across education, health and social care as part of our proposals to move to a single assessment process.
We believe that the Green Paper marks a milestone in the development of the Government’s approach to supporting children and young people with SEN, or who are disabled, and their families. The consultation on these proposals will run until 30 June. I certainly hope that noble Lords will take the opportunity to respond to that. On the specific question about the statutory underpinning of the new SEN assessment raised by my noble friend Lord Clement-Jones, we are looking to test the key proposals in the Green Paper through local pathfinders from September 2011, and we will look to make any legislative changes that may be necessary to secure the new education, health and care plan and the offer of personal budgets, as well as any other necessary improvements to the system identified by the pathfinders from 2010.
We had an interesting discussion about the role of grandparents. I agree with the noble Lord, Lord Northbourne, about their importance, a point also made strongly by the noble Baroness, Lady Massey of Darwen. I do not believe that the Government have any plans to move on financial assistance, but I will take that point back. As anyone who has had children knows, the relationship between grandparent and grandchild is a very special one both ways, and is often far less complicated than the one between child and parent. I agree entirely about the importance of grandparents.
As regards the Grandparents’ Association, my understanding, which I will check, is that it was asking for new funding but that it was unsuccessful in its bid. I understand that it was for additional funding and that it has not been faced with a cut in existing funding. The noble Lord, Lord Northbourne, kindly alerted me to this issue and I have spoken to my officials, but having just seen him shake his head I will go back and follow up his points. Having done so, I will get back to him specifically in writing.
The noble Baroness, Lady Howe, raised the important point about funding for services for children with special educational needs under the age of two, and asked whether that could be funded under the dedicated schools grant. The short answer to that is yes. As she pointed out, there is a slightly longer, more technical answer, but I take her point about the need to ensure that local authorities are clear of that. We have written to them, but I am certainly happy to reflect again on whether there are further things we can do to ensure that her important point is properly understood.
A number of noble Lords talked about families with multiple problems. Several figures have been given, all of which have been compelling. The one I have seen is that having one professional working with a family costs on average £14,000 per family per year compared with costs to local services that could be up to £330,000 a year. There is therefore no doubt about the need for addressing these problems. In December, the Prime Minister set out his own ambition to address those concerns. As noble Lords have argued, there is a clear financial sense in that. Equally, and perhaps more compellingly, there is a strong moral need. All 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 things in silos, by department or by institution.
We will try to develop new approaches to support those families, underpinned by freedom for local authorities to establish community budgets, pulling together different streams of money and approaches. We are hoping to set those up in 16 local areas to pool budgets for families with complex needs, and then roll them out to other local areas across the spending review period.
I was asked about help and support for assessment of young children with specific needs. As I said, we plan to expand health visitor services to ensure as a priority that all families are offered the health and development review for children aged two to two and a half, so that children who need additional support can be identified. Where families need additional support, the health visitor service will have the support needed. Where parents have concerns about their child's development, they will be offered that support and, where appropriate, referred to another professional—for example, a speech and language therapist, as was mentioned.
We have talked about the Munro review of child protection. That is due to be completed by late spring. The Graham Allen review has also been mentioned. We had the first report from Mr Allen in January. As noble Lords have pointed out, he argues that we should all be actively promoting the principle of early intervention, particularly in the early years but from conception through to 18. He has given us thoughts on how to take that forward, including through evidence-based programmes and supporting reform. We will receive a second report focused more on social finance models—the point raised by the noble Baroness, Lady Jones of Whitchurch—this summer. In the mean time, the Government are carefully considering his recommendations and how we can respond to the challenge that he has set us to shift to a culture of early intervention rather than to continue late, reactive spending.
This has been a wide-reaching and thought-provoking debate. As is the whole House, I am grateful to my noble friend Lady Walmsley for giving us the opportunity to air these important issues. Listening to the debate, it is clear that there was widespread acceptance of her case; I do not think that a single voice was raised against any of her arguments.
A number of specific points have been made on which I will reflect and respond to noble Lords if I have failed to reply in the time that I have this afternoon. Overall, there has been agreement on the need to focus on the early years and to break down barriers and silos so that children and families are at the heart of early intervention, not structures and systems. A great deal of work is going on in this area on a number of different fronts. The Government look forward to pulling that work together in its early years policy statement, to which I referred earlier, which will be published later this year. When that is published, I very much look forward to the further debates that we will have then.
Baroness Walmsley
My Lords, I thank my noble friend and all those who have taken part in this debate today. Our two maiden speakers proved the truth of the saying that it is not just what you say, it is who you are when you say it, because we would not have had such respect for what they said without our knowledge of the experience that they bring to their opinions.
I take away a number of particular points from today's debate. My noble friend Lady Benjamin has given me a new mantra: a hug a day keeps the doctor away. I shall stick to that. The noble Baroness, Lady King of Bow, reminded us what 4Children has said so perceptively; the Minister reflected on the need for a culture shift. The noble Lord, Lord Ramsbotham, reminded us of the importance of food for thought; perhaps we should bring back school milk, orange juice and cod liver oil. The noble Baroness, Lady Brinton, brought us up short in a serious debate by reminding us that childhood is a time for happiness and fun.
The noble Baroness, Lady Warwick, made an important point about early-years staff and our ridiculous upside-down funding. Only this week, I was told that staff who work with the early years are paid half what teachers of five to 18 year-olds are paid. Does that not reflect the value we put on their work? There really is a need for a culture shift. I look forward very much to the statement, to which the Minister referred, in the summer of the Government’s early-years strategy when no doubt we will debate it again. With that, I beg leave to withdraw the Motion.