Early Years Intervention

Debate between Lord Winston and Lord Giddens

Thursday 8th January 2015 Lords Chamber

[Lord Winston (Lab)]

My Lords, I will refer to two groups of experiments. First, in the 1960s, there was a classic neuroscientific experiment where newborn kittens were blindfolded for various lengths of time. After a short time of complete darkness, once the blindfold was removed, there were permanent changes in the visual cortex of the brain. That could not be fully corrected by any subsequent exposure to light. Although I completely agree with my noble friend Lord Giddens about the early years not being a special part, none the less, there are key experiences that we need during development which are not entirely ruled out by the arguments being made.

Secondly, I point out that that is exactly why I take issue with the noble Lord, Lord Storey. I do not believe that it is as simple as he makes out. This is a very competitive area. I think that I can demonstrate that by the most amazing report done in 2001 by Lars Bygren of Sweden, who looked at a village in the far north of Sweden, near the Gulf of Bothnia. He showed that of males aged nine who were subjected to a good harvest during the period that he studied in the late 1800s and early 1900s, their paternal grandchildren, the sons, had a shorter longevity than any other members of the family. That is an extraordinary finding and suggests that there is programming. At the time, the report was not taken seriously, but since then a number of interesting epigenetic experiments have been carried out which show that many things that we inherit not directly through our DNA but through the way that the genes function make a massive difference.

For example, Gregory Dunn, in Pennsylvania, has recently published a study in which he shows that an obese great-grandmother mouse passes on a trait through only her male children which causes their grandchildren, if they are female, to be obese. Obesity is a very complicated issue. This will apply to all sorts of areas of inheritance—it could well apply to cognition as well. The field of epigenetics is extremely confusing. That is why we need to be very careful not to make snap judgments about the complexity of early childhood learning. That is borne out by all sorts of other experiments which I do not have time to address.

With regard to environment, I am surprised that the millennium cohort study has not been mentioned already; your Lordships will be aware of it, I am sure. It has looked at 19,000 children born since 2000-01. That study, funded by the ESRC, and a very good example of British cohort studies—one of the reasons why we want to support British research—has been a mine for all sorts of overseas investigators in France and elsewhere who have used those data. For example, it looked at parenting, childcare, school choice, behaviour, cognitive development and health. It looked at those children at nine months, three years, five years, seven years and nine years. It bears out some of the things that my noble friend Lord Giddens said. Although there may be serious evidence of undoubted changes in cognition in early years—certainly between three and five—by the age of seven, that can often be adjusted by other factors.

[Lord Giddens]

I point out that we are not a team and it is coincidental that we are sitting next to one another.

[Lord Winston]

I thought that in a time-limited debate the noble Lord would not interrupt me, but I forgive him as he is a noble friend.

My point is that a whole range of claims are made by all sorts of authorities about maternal health and how it affects cognition, breastfeeding, socialisation, social recognition and play. Undoubtedly, when there is severe deprivation—for example, in Romania—there is clear evidence of massive changes. Nelson and his group at Harvard University have shown clearly that good fostering makes a massive difference when a child has been in institutional care for a long period but, sadly, most of those children never recover completely—certainly, in their ability to deal with emotion, stress, some aspects of cognition and so on.

Although I argue that we certainly need to do more about early years learning, it is very important that successive Governments focus this work in the best possible way to have the key access to those most at risk. That is one reason why the Sure Start programme was a good start in trying to do that.

Medical Innovation Bill [HL]

Debate between Lord Winston and Lord Giddens

Friday 24th October 2014 Lords Chamber

[Lord Winston]

I do not think that it restricts anything at all but actually makes the Bill of the noble Lord, Lord Saatchi, workable. We need some kind of definition of what an innovation is. That is all the amendment tries to achieve. It is not in any way restrictive. Of course, if one decides to put a plastic tube that is normally used to infiltrate the trachea into another organ, this amendment will permit that to happen, when currently it would not be allowed.

[Lord Giddens]

My Lords, the noble Lord, Lord Saatchi, knows that I support the thrust of the Bill but there are issues around some of these amendments that the noble Lord might at least listen to.

As I have mentioned previously, one of the core things about this legislation, given its sensitive nature, is that we have to comb through it all the time for possible perverse consequences. At the risk of sounding like sociology 101, unintended consequences are different from perverse consequences. Unintended consequences can be good or bad; perverse consequences undermine good intentions and reach the opposite result of what an individual needs to achieve. For example, strong rent controls were introduced in New York City to help poor people; in fact, they adversely affected them because they could not find places to live. The noble Lord says that the Bill is crystal clear in its intent, but that is not enough because there is a massive difference between intent and consequence. I therefore feel that as a general principle we should comb through the whole Bill to try to spot possible perverse consequences.

On the whole, with the reservations that have been noted, I support Amendment 6 because it might help to block off some of those reservations. We surely must know what innovation actually means in the context of clinical practice. Without such specification, one can see that various perverse consequences could occur. What would happen, for example, if a doctor was accused in court of failing to innovate because he or she did not try some eccentric form of treatment that was available? One could block off that perverse consequence by specifying, in the way that Amendment 6 tries to do, what actually counts as innovation.

I feel strongly that as the Bill proceeds through Parliament we must tighten every loophole that could lead to a situation in which, to some degree, the Bill undermines what it is actually supposed to achieve—helping vulnerable patients in a situation in which they are often desperate by bringing innovations to them that they would not have had available before. However, I fear that some of those things could happen if one was not aware of the minefield of perverse consequences. If we do not examine it all carefully, there could be consequences that, to some degree, undermine the purest of intentions with which the legislation is introduced.