Healthcare Support Services: Conception to Age Two

Andrea Leadsom Excerpts

Tuesday 15th December 2020 Westminster Hall

[Andrea Leadsom (South Northamptonshire) (Con)]

I beg to move,

That this House has considered provision of healthcare support services in the period between conception and age two.

It is a pleasure to serve under your chairmanship, Sir Christopher. Today’s debate takes place against the backdrop of such a disruptive and damaging year. This year, as ever, it is the very youngest, the very oldest and the most vulnerable in our society who suffer when times are tough. It is timely that we are having the debate today, as the early years healthy development review, which my right hon. Friend the Prime Minister asked me to chair, is now gathering together its phase 1 recommendations.

Personally, I am grateful for the chance to highlight what has been my real passion in politics for more than 20 years. The first chapter in my early years story begins with OXPIP—the Oxford Parent-Infant Project—a charity in Oxford providing psychotherapeutic support for families struggling to cope with their new baby. I got involved as a banker, writing a business plan and successfully applying for a substantial lottery grant. I very soon found myself chairing the charity, and that was when I learned the vital importance of the period from conception to the age of two.

I was introduced to OXPIP by my mum, who was a midwife and a trauma therapist and had seen at first hand how so many new parents have unspoken and appalling birth experiences or traumas in their personal lives that leave them unable to focus on their baby and that precious early bond. Having had my own brief experience of post-natal depression in 1995, with my first born, I could empathise with how hopeless and helpless someone can feel as a new mum. Even with a loving partner and family around, those first few weeks can be frightening, sleep-deprived and, in many ways, overwhelming. Statistics show that up to one in seven women has that sort of experience after having a baby, so it really is an invisible epidemic.

Therefore, when I became the parliamentary candidate for South Northamptonshire in 2006, my family moved to the constituency and I set up NorPIP, the Northamptonshire Parent Infant Partnership, which is the Northamptonshire sister charity to OXPIP. I then established PIP UK, Parent Infant Partnership UK, a national charity that would lobby for better support in the early years and oversee a programme of building new PIPs around the country. I chaired PIP UK until I became a Minister in 2014 and had to leave the role overnight, whereupon my very old friend, my hon. Friend the Member for East Worthing and Shoreham (Tim Loughton), picked up that work. I want today to pay tribute to him for all that he has done for the PIP movement and on the first 1,001 critical days.

During my early years as a Back Bencher, from 2010, I became chairman of the all-party parliamentary group on Sure Start Children’s Centres and set up the APPG for conception to age two—first 1,001 days. With cross-party support from colleagues such as Lord Field and the hon. Member for Brighton, Pavilion (Caroline Lucas), I launched the first “The 1001 Critical Days” manifesto in 2013.

Under the leadership of my hon. Friend the Member for East Worthing and Shoreham, PIP UK has become the Parent-Infant Foundation and the “The 1001 Critical Days” manifesto has become a movement with the support of more than 160 charities and professional organisations. There is no doubt that there is overwhelming support from the early years sector for significant Government action, and the opportunity for that is now, as we build back better. This has personal backing from the Prime Minister himself.

How do the first 1,001 days shape a baby’s lifelong potential? From conception to the age of two, a secure and loving relationship between baby and carer literally shapes the way the baby’s brain develops. It is where the building blocks for lifelong physical and emotional health are laid out and, like a sponge, the developing brain will soak up the sense that the world is a good place and that problems can be solved. Humans are unique in the animal kingdom in the extent of their underdevelopment at birth. What other animal cannot walk until it is a year old and cannot fend for itself in any other way until it is at least two years old? The physical underdevelopment is only a small part of the story. The human brain is only partially formed when we are born, with billions of undifferentiated neurons, and parts of the brain that are yet to exist. At birth and in the precious months that follow, a baby has no cognitive skills; it can only cry, sleep or look around. Its neural connections are stimulated by the loving attention of its carer and the world around it, which makes those things so important for the baby’s future development and secure attachment.

Those people who have children will all remember walking up and down the landing in the middle of the night with baby in their arms, saying, “Go to sleep, go to sleep”. We wind them, we change them and we feed them, all of which comes naturally to most parents. The baby whose basic needs are met learns that the world is a good place and they retain that instinct throughout their life. The baby who develops secure attachment will grow up able to cope with life’s ups and downs. They will develop speech skills and they will be able to pay attention in school, make friends, hold down a job and then go on to become a good enough parent themselves.

On the other hand, a baby who is ignored, neglected or abused will find life much harder, and in the most extreme cases of abuse there will be a severe impact on the developing brain. A baby cannot regulate his or her own feelings. If their needs are not being met, they will cry, and that cry will get more and more persistent. If no help comes, that baby will eventually take refuge in sleep.

We know that a baby left to scream continually for days and weeks on end will experience raised levels of the stress hormone cortisol. We also know that excessive amounts of that hormone can damage the baby’s immune system, with lifelong implications for their physical and emotional health. Such damage can happen in the womb itself and there is strong evidence to suggest that high-risk behaviours evidenced in adults have a link to a high tolerance to raised stress levels that started in the earliest years.

We know that a pregnant woman who suffers from stress produces more cortisol, and the more stressed the mother, the more the foetus is exposed to higher levels of that chemical. This exposure can lead to modifications in gene expressions while the child’s brain is still developing. A baby’s brain development has deep implications for society, and we know that a human being without a properly developed social brain will find it difficult to empathise with others and to regulate his or her emotions, which will make it harder to cope with life’s stresses, as well as with building and keeping relationships in later life.

We have seen the lack of human connection at its most extreme, particularly in the case of the Romanian orphans under Ceauescu’s regime. Their minimal physical and emotional contact left them profoundly and permanently damaged. Sadly, we know that long-term violence, self-harm, poor mental health and substance misuse have roots stemming back to the earliest experiences in childhood.

What we do with a baby from conception to the age of two is about building the human and emotional capacity of that infant, and what we do after the age of two will be about trying to reverse damage that has already been done. In the words of the Royal Foundation, the early years are the most important time of life to set out the building blocks for a human being’s future development and success, and I truly applaud the Duchess of Cambridge for her passion to ensure that every baby gets the best start in life.

It is utterly indisputable that the first 1,001 days is the most crucial period of human development, and I want to set out where we are now. Between 2018 and 2019, I chaired an inter-ministerial group on the early years, under the premiership of my right hon. Friend the Member for Maidenhead (Mrs May). That group made some key recommendations, the main one being that the Government should set out and identify a vision for the critical first 1,001 days.

Our current Prime Minister has always been a supporter of greater help for new families. During many Cabinet meetings and conversations over several years, his commitment has always been clear, so I was delighted earlier this year when he asked me to chair the early years healthy development review on behalf of the Government. The review has three advisory groups—parliamentary, practitioners and academics—using the knowledge, experience and passion of colleagues across both Houses and across the early years sector. Lockdown has prevented any physical visits, so instead our group has taken part in a series of virtual visits, meeting parents, health professionals and service providers in Camden, Devon, Stoke, Leeds, Essex, Newcastle and other places. We had a series of deep dives looking into and hearing from professionals and stakeholders on everything from breastfeeding to parenting apps to parental mental health. We have engaged with parents and carers through a questionnaire that has gathered over 3,500 responses. A personal favourite has been the Mumsnet thread that I have logged into every week to chat with new mums.

We are now at the point of bringing together the review’s recommendations with a view to communicating them at the end of January. I do not want to spoil that by talking about them now, but I want to raise a few key learning points today, because, I am sorry to say, during the lockdown there has been much suffering that has come to the review’s attention. We have heard troubling stories of isolation with partners unable to be at health checks and even unable to stay with mum and baby after the delivery. Parents have experienced limited face time with health visitors and disastrously there has been a rise in cases of domestic violence.

Half a million babies were born during the first lockdown alone, with 1,800 babies born every day in England. Far too many have entered a world of isolation and limited social contact. There have been few cuddles with granny and grandad, much less support for mums and dads, and barely any time spent with other babies. If a baby’s potential for good life-long health and wellbeing is derived from their earliest experiences, surely we need to make sure that every new family is now getting the best possible support. That is why it is vital that once the vaccine is rolled out and we start to get our lives back to a sense of normality, we improve and increase the care given to new families who have had such a tough year.

Despite the troubling stories, there are some silver linings. We should not lose sight of them. I would particularly like to highlight the use of digital and remote support. Many parents have said that during lockdown they really valued being able to text or have a Zoom call with their GP or health visitor on a much faster timescale than an in-person appointment. Some mums told the review that they preferred remote breast-feeding support to a physical group setting. Those who have taken advantage of mental health therapies online have felt it has been a positive step forward. This rapid adaptation to change has pushed open the door for the possibilities of technology in backing up good face-to-face support for new parents.

Another silver lining is the better joining up of services. From family centre workers to health visitors, from midwives to mental health therapists, professionals have found getting together on a Zoom call to discuss how better to support a family has been a vast improvement to their working practice and one that they do not want to lose.

Although the pandemic is not yet over and therefore until the vaccine has been rolled out sufficiently there will still be the need to remember hands, face, space, I call on the Minister to think about what more can be done for those 1,800 babies born every day. One in seven women and up to one in 10 new dads suffer post-natal depression. That was even before lockdown. We can only begin to imagine how many more families are struggling today. I urge the Minister to consider allowing new families at least two other supporting family members to bubble with them, or two other individuals if they are a lone parent. I also encourage her to make sure that health visitors and early years health services remain available and accessible face-to-face for everybody.

The strength of feeling of those here today, of sector stakeholders and, importantly, of parents, gives me the confidence that we can create real change in the early years and make sure that every baby gets the best start in life. For me it has been a long journey—more than 20 years—to reach this point, and I thank colleagues in both Houses who have committed themselves to this agenda. I also want to thank the hundreds of thousands of people across this country who, through their professional careers or through volunteering, are supporting the next generation day in, day out.

Finally, I want to end my remarks with a thought from Nelson Mandela, who is a bit of a hero of mine. He said,

“Our children are our greatest treasure. They are our future.”

The actions that we take in the present will help to shape not only the future of the youngest in society, but the outcomes of generations to come.

--- Later in debate ---

[Andrea Leadsom]

The extent of cross-party support is apparent in today’s debate, and it is going to be essential. I will pick up on a couple of points.

The hon. Member for Glasgow Central (Alison Thewliss) talked about the vital importance of infant feeding. She is exactly right: it will be a big feature of our recommendations. My hon. Friend the Member for East Worthing and Shoreham (Tim Loughton) spoke particularly about the crucial importance of health visitors. I join him in paying tribute to Cheryll Adams, who has done a brilliant job. He also talked, as did my hon. Friend the Member for Congleton (Fiona Bruce), about the importance of leadership. That will be one of the recommendations that we will look at carefully in our report.

The hon. Member for Strangford (Jim Shannon), whom I have worked with many times, talked about his own grandchildren—how lovely to hear about them. He also talked about how it takes a village to raise a child, and I absolutely agree. My hon. Friend the Member for Congleton was right to talk about family hubs. They are the absolutely proper place for better support in the early years. I thank my hon. Friend the Member for Truro and Falmouth (Cherilyn Mackrory) for her bravery in talking about her own story. She has been a critical member of the parliamentary advisory group. I thank all colleagues for a very helpful and useful discussion to inform the review.

Motion lapsed (Standing Order No. 10(6)).