Healthcare Support Services: Conception to Age Two

(Limited Text - Ministerial Extracts only)

Tuesday 15th December 2020 Westminster Hall

[The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)]

It is a pleasure to serve under your chairmanship, Sir Christopher. I thank the right hon. Member for South Northamptonshire (Andrea Leadsom) for securing the debate. I know that her passion for this subject runs deep and has done for some considerable time, and she always speaks with great authority. That is why I was so pleased that the Prime Minister appointed her to lead the review. I am really looking forward to the results of that come the new year, because as so many right hon. and hon. Members have said, the time for change is here. Being able to deliver for families over those first 1,001 days is a responsibility that we should all share; we need to make sure that we not only speak about it, but actually deliver it.

I would also like to thank all hon. Members present, starting with my hon. Friend the Member for East Worthing and Shoreham (Tim Loughton)—or, as I now like to refer to him, the hon. Member for health visiting, that very unsung part of our health ecosystem. I thank the hon. Member for Glasgow Central (Alison Thewliss), and commend her on the work that she does with her APPG on breastfeeding, which is such an important start to life. I also thank my hon. Friend the Member for family hubs, or for Congleton (Fiona Bruce), and the hon. Member for Strangford (Jim Shannon), who looks after the strength of the family in this place. Finally, I thank my hon. Friend the Member for Truro and Falmouth (Cherilyn Mackrory) for her plea for continuity of caring, but also for the fine work she does with the APPG on baby loss. I am following in some big shoes: those of my hon. Friend the Member for Colchester (Will Quince), of the former Member for Eddisbury, and of my hon. Friend the Member for Banbury (Victoria Prentis).

There is such power in this room for change, and it is both right and important that the Government have a care for the nation’s health. Just as we say about retirement, we should be investing in our health from the beginning: from early years through to older age. It must start from conception to be as effective as it can be. The period between conception and the age of two is absolutely critical in a child’s development, as we have heard. It is during this time that the important foundations are laid, creating that strong and healthy start that can see children through their life: to school, to work, to parenthood, and to better parenting themselves, as my right hon. Friend the Member for South Northamptonshire said, which very much struck me. This is a cycle that we really do need to get right.

Thankfully, most babies do have a fantastic start in life. They benefit from the support of loving parents and carers, as well as dedicated early years professionals. However, there are unacceptable variations across the country, both in different parts of the country and within regions, and both in terms of geography and population groups. We know that just over 66% of children in Bolton achieve a good level of development at age two to two and a half, but that rises to over 93% for a child born in Cambridgeshire. That differential should be unacceptable to us. Risk factors, often family based or socioeconomic, make our children—they are all our children—more vulnerable to poorer outcomes going forward.

The coronavirus has created enormous pressure, not only on services but on individuals. For many new parents, coronavirus has meant feeling isolated and losing that support mechanism, and my heart goes out to them. I think it was the hon. Member for Strangford who spoke about the importance of just meeting friends; just being able to have that little bit of “Does your baby do this? My baby does that.” They do not come with a manual, and I remember all four of mine, all under five at the same time, all being completely different: they all had completely different eating habits, and so on. Very often, I could not work out why. I thought, “I did a proper job before I had these children. Why on earth is this so difficult?” Some days, it was a real achievement to get the breakfast pots washed and go out with my pants on the right way around.

[Fiona Bruce]

The Minister is making such an important point. Does she agree that we so often undervalue how important mothering, parenthood and ensuring children have that best start in life is? As a society, we should value that much more highly, because it is not an easy job.

[Jo Churchill]

I agree wholeheartedly with my hon. Friend. We are in a different time as regards parenting. Many couples choose that the father will stay at home. Often they do an excellent job at raising their children, as that part of the family unit. It is about communicating, sharing responsibility, and the services that wrap around families. My hon. Friend the Member for East Worthing and Shoreham used a lovely phrase when he talked about supporting, not supplanting, parents: holding hands to make sure that there is help there when someone struggles with breastfeeding or to understand the right thing to help a child sleep, or when there might be conflict in the house and they reach out. I take the point made by my hon. Friend the Member for Truro and Falmouth about a trusted carer giving people signposting. I asked my sister, who recently became a grandparent, what the most challenging thing was, and she said it was definitely the isolation and separation, which did not even allow her to hold her new granddaughter for six weeks after her birth.

[Jim Shannon]

The Minister is responding in just the way we knew she would, and I thank her for that. I mentioned in my contribution the importance of church and community groups, which by their nature are on hand to help and assist. Does the Minister recognise the good work that they do? Church groups are important to those of faith—and those of no faith—and the community groups are also important for what they can do, such as mother and tots provision.

[Jo Churchill]

Indeed. I think that often the role of family hubs can be support and education. However, a good health visitor can change a life, when it comes to moving on. An excellent midwife changed my journey, when I was struggling to feed my children for the first 10 days. Everyone says that those things are easy, but there is nothing easy about it, but after managing to get support people, hopefully, really feel they can fly. That is why it is vital.

Coronavirus has meant that many parents feel isolated, as I have said. They have not had access to the support of those closest to them, or other supporting work—whether that is faith-based or otherwise. That has added to the emotional pressures that many new parents face. For many babies the pandemic will represent time missed in, for example, getting to know grandparents. For some families it has meant a lack of professional wraparound support. There has been pressure throughout the system, but we have been in the middle of a global pandemic. It is just a statement of fact, not an excuse.

I assure my hon. Friend the Member for East Worthing and Shoreham and others that the advice from the chief nurse, the Local Government Association and others is that redeployment should not occur unless it is unavoidable, because it is seen as so important that families with young children get assistance. As my hon. Friend said, there are challenges with respect to health visitor numbers. Both of us have debated that issue in this place, and I have also met Professor Viv Bennett. I am looking forward to the review because some of the open sessions at which I have joined my hon. Friend have highlighted the importance of the service.

For the first set of lockdown restrictions the health professionals in question were redeployed, although I assure Members that vital safeguarding functions were still carried on. I have spoken to health visitors on the ground who said that that was a key priority, to keep children safe. We recognise that that level of support is not what people would want or expect. However, I really want us to go forward from this point to deliver into 2021 and beyond.

As the vaccination roll-out is happening and we start, hopefully, to return to a more normal, albeit covid-tinged, way of life, there is still a long way to go.

Coronavirus has shown us, if we needed more proof, how valuable data sharing can be across the services, as my right hon. Friend the Member for South Northamptonshire said. The join-up between services for the early years has accelerated out of necessity, but has brought a bit of a silver lining to what has been a very difficult time. Some of the services and support can be provided digitally. I would be the first to say that I do not want 100% of services to be on a digital platform, but there are mothers of tongue-tied babies who have been able to access immediate support, with a professional on the other end of the video conference call who is able to explain what is going on at the point when the mother is getting quite stressed about the situation. There is therefore a place not for only better data and information sharing to improve services, but for different ways of working to ensure that we get the most out of them.

The early years are not only important for health and care. Many Government Departments have an interest or play an active role, which brings me on to family hubs. They sit very much under the Department of Health and Social Care, while being integral to ensuring that we deliver properly for families. On Sure Start centres and the use of family hubs, findings from the local government programme, the Early Intervention Foundation and the review of family centres, family hubs and other delivery models will inform the next steps, including any future consultation of the role of children’s centres. I know that my hon. Friend the Member for Congleton will not cease to fight for family hubs to be at the centre of all our communities.

[Fiona Bruce]

I thank the Minister for that comment. Will she also comment on the point made by my hon. Friend the Member for East Worthing and Shoreham (Tim Loughton) about the need for a dedicated Minister for families, ideally at Cabinet level? Within just a few minutes we have referred to many different Government Departments—the Department for Education, the Department of Health and Social Care, the Ministry of Housing, Communities and Local Government and others—all looking at family hubs. There needs to be one Minister who can really pull the thinking together and drive it forward.

[Jo Churchill]

I know that the Education Secretary has been given a leadership role for families, and £2.5 million to research and develop best practice on how we integrate family services. I know that my hon. Friend the Member for East Worthing and Shoreham has often called for a families Minister, and in the last Parliament my hon. Friend the Member for Congleton also made such a plea. Joined-up cross-Government working in many areas is always a challenge. I leave the plea of my hon. Friend the Member for East Worthing and Shoreham resting there. It is something else that will probably come out in the review.

The Department is taking important steps to improve the healthcare outcomes of babies and young children to give them the best start in life, including the most ambitious childhood obesity plan in the world. The Minister for Mental Health, Suicide Prevention and Patient Safety has done a lot of work on transforming children’s mental health and maternity services to identify those mothers and members of the broader family who are struggling. We also have a world-leading immunisation programme, which I will come back to.

All those policies are informed by the guiding principle of prevention, which I totally agree is better than cure. We want to identify and treat problems from the earliest stage and help parents to care for their children, change and improve behaviours, and protect against preventable diseases. We know that if parents and babies are well supported in the vital period from conception to age two, they are set up for a lifetime of better mental and physical health. Attachments, stimulation and foundations really are the backbone of their lives. While my right hon. Friend the Member for South Northamptonshire was talking, I thought of it as an emotional reservoir on which we can spend our lifetime drawing to ensure that we live healthier and more sustainable lives.

We are doing everything we can to help the NHS to improve outcomes for babies and children, and we are building that into the NHS long-term plan. The pandemic has made the public rely on new methods of accessing childcare. Information has been accessed from conduits such as 111 to an extent that we have never seen before. I am keen to explore how that can be used further to support parents and children going forward.

We are embracing opportunities presented by technology and pleased that the personal child health record, better known as the red book, is being digitised and made available. There are enormous opportunities here. We are also making sure that the modernisation of the healthy child programme is universal and personalised in response to every child’s needs. We remain committed to improving perinatal health. My hon. Friend the Minister for Patient Safety, Suicide Prevention and Mental Health is making sure this is at the top of her agenda.

I ask Members to encourage parents in their constituencies to ensure that their children are vaccinated. As my hon. Friend the Member for East Worthing and Shoreham said, vaccination rates are falling, and we lost the World Health Organisation status for measles. It is vital that parents use the free vaccination service to protect their children from measles. The actual disease is much worse than the second it takes to get vaccinated. I would really like us all to push to make sure that we regain the WHO status. The flu vaccination programme rolled out to school-aged children has been a phenomenal success this year, but if parents are worried about anything to do with vaccinations, they should go to their GP or a health professional and ask questions.

Before I finish, I will quickly comment on support bubbles. I hear my right hon. Friend the Member for South Northamptonshire. In all tiers, single adult households can form a bubble, and we have expanded this provision because we understand the pressure that they are under. Specifically, households containing a child with only one adult, and adult households with a child under one, or a disabled child under five who requires continuous care, can now also form a support bubble. In addition, households with one or more people who have a disability and require continuous care, as long as there is no more than one other individual over 18 who does not have a disability, can also form a support bubble. As my right hon. Friend knows, it is a challenge in the current pandemic to make sure that we balance the safety of everybody with access to support, in this case for young parents or perhaps people with needs arising from terminal illness.

The Duchess of Cambridge’s report was mentioned by several hon. Members. I am keen to understand whether the five recommendations are woven into the review, when it finally comes to us in January.

I recognise the impact of domestic violence on families. It has been incredibly difficult, and it is unseen. I pay tribute to the Under-Secretary of State for the Home Department, my hon. Friend the Member for Louth and Horncastle (Victoria Atkins), for her work in this space and on the Landmark Domestic Abuse Bill. We all need to be aware of the issue, and highlighting services and support for families is key.

On that note, I hand over to my right hon. Friend the Member for South Northamptonshire. I look forward to receiving the review in the new year and discussing the outcomes with her.