Early Years Intervention

Baroness Finlay of Llandaff Excerpts

Thursday 8th January 2015 Lords Chamber

[Baroness Finlay of Llandaff (CB)]

My Lords, like others, I congratulate the noble Baroness, Lady Massey of Darwen, on having secured this debate and on attracting a large number of speakers.

I want to focus on the development of the brain. Without our brains, we cannot learn, we cannot learn language and we cannot interact. If in the next generation we do not ensure that brains are developed property, we will not break the cycle of maltreatment and failure within the social environment and every other environment in society.

It is worth noting that 90% of brain size has been acquired by the age of three, so the focus on the first 1,001 days—that is, from conception to the age of two—which has already been alluded to by other speakers, is critical. The Wave Trust has done a lot to raise awareness and to pull together the evidence in this area. The long-lasting effects of maltreatment are in the physical, socioemotional, cognitive and behavioural domains.

The consequences and costs of such maltreatment are phenomenal. As has already been said, managing it costs about £15 billion a year. As well as the physical and mental suffering of the individual and the damage to educational prospects, there are also high levels of aggression, which damages others in society. It is of note that 68% of those in the prison population have been abused or neglected in childhood. The Christie commission in Scotland estimated that 40% of public spending is necessary only because of our failure to intervene early enough. We are accumulating huge future expenditure by not looking at this very important area.

It is also worth noting that about one in five children is maltreated, the peak time being in the first year of life. Sixty-two per cent of those entering care in 2013 had been subject to abuse and neglect. In March of that year, more than 68,000 children were in care, so it is a very big problem. Five per cent of children have a diagnosable mental health condition, and 15% to 20% of behavioural problems are severe enough to cause concern. This is costing about a quarter of a million pounds per child. Interventions on parenting programmes that cover the period from birth onwards cost less than £2,000 per case. The difference in cost is phenomenal, and it seems almost madness that we have not addressed this issue on economic terms alone.

About 1 million children in the UK are suffering the long-term effects of maltreatment, with all kinds of behavioural disorders, but it is worth noting that the greatest predictor of prenatal depression is that the mother was herself abused. She has a tenfold likelihood of becoming an abuser. A third of abuse occurs when under the influence of alcohol. I urge the Government to get to grips with alcohol policy, particularly pricing and so on, because it may have a huge effect. In families with a history of domestic violence, there is a 23 times greater likelihood of abuse being perpetrated against children under the age of five. I stress the importance of domestic violence as a contributory factor.

It is worth considering briefly why this happens. As the brain develops, areas that are stimulated develop more. Those that do not receive stimulation, as the noble Lord, Lord Winston, has already pointed out, do not develop to the same extent. Therefore, even in the womb the child subject to stress develops a stress reaction, and the brain develops the ability to respond to stress. Children who have not experienced a calm environment do not develop the ability to have empathy and they cannot be expected to feel remorse for later hurting or killing somebody, because that part of their brain is not properly developed. Nor can they develop communication skills. Therefore, the child subject to hyperarousal all through those very early days and weeks will develop a state of permanent hyperarousal and response within the brain. That plasticity of the brain carries on throughout the child’s development until the age of 16, so the other educational interventions referred to by noble Lords all help in developing the areas of the brain that have not developed well.

In my last seconds I would just stress that cutting back on mental health services in the perinatal period may be the most serious adverse disinvestment that the NHS is currently undertaking.