Early Years Family Support Debate
Full Debate: Read Full DebateAndrea Leadsom
Main Page: Andrea Leadsom (Conservative - South Northamptonshire)Department Debates - View all Andrea Leadsom's debates with the Department for Education
(5 years, 1 month ago)
Commons ChamberI beg to move,
That this House believes there is now overwhelming evidence of the importance of the first 1,001 critical days of a new baby’s life in determining his or her lifelong physical and emotional wellbeing; notes the work of the Inter-Ministerial Group led by the Rt. hon. Member for South Northamptonshire, the Thirteenth Report of the Health and Social Care Select Committee, HC 1496, on First 1000 days of life and the Eleventh Report of the Science and Technology Committee, HC 506 on Evidence-based early years intervention; and calls on the Government to take strong and decisive action immediately to ensure that every baby gets the best start in life.
I am delighted to have the chance to speak today on a subject that is a real passion for me, and one of the reasons that I got into politics. I thank the Backbench Business Committee, particularly the hon. Member for Gateshead (Ian Mearns), for finding time for me to hold this important debate.
It is a great pleasure to see good friends from across the House here to support the motion this afternoon. I am looking forward to hearing some excellent speeches on an issue that, if we get it right, has the potential to be truly life-changing for so many in our society. We are here today to share the overwhelming evidence of the importance of the 1,001 critical days of a new baby’s life in determining his or her lifelong physical and emotional wellbeing, and to call on the Government to take strong and decisive action right away to ensure that every baby gets the best start in life.
I want to pay tribute to some recent work that has been undertaken in this important area by the Select Committees chaired by the right hon. Member for North Norfolk (Norman Lamb), my right hon. Friend the Member for Harlow (Robert Halfon) and the hon. Member for Totnes (Dr Wollaston). I know that the right hon. Member for North Norfolk was keen to speak today and I am sorry that his duties elsewhere mean that he cannot be with us this afternoon.
As many right hon. and hon. Members will know, until recently I was chairing a cross-Whitehall inter-ministerial group at the request of my right hon. Friend, the Prime Minister, to look specifically at how the Government can best improve support in the earliest years, for families and their newborn babies. I pay tribute to the Prime Minister for her prioritisation of this key issue—I believe it can provide a vital part of her legacy.
I am told that the inter-ministerial group I chaired was the only significant piece of cross-departmental work under way, with the obvious exception of Brexit. I am so grateful to the Prime Minister for tasking me with the enormous responsibility of contributing my own experience and knowledge in this policy area to fundamentally change our society for the better. I was proud that one of the last things I did before stepping down from my role as Leader of the House was to sign off on the detailed recommendations of the group.
Before we turn to the recommendations, I want to take a few minutes to set out the science behind the importance of the 1,001 critical days. From conception to the age of two—the period that is now referred to as the 1,001 critical days—it is the existence of a secure and loving relationship with a key adult carer that literally shapes the way a baby’s brain develops. It is amazing that, in the first year of life, more than 1 million new neural connections per second are being created in the brain. Secure attachment to a loving adult carer has a lifelong beneficial impact on the baby’s developing emotional health, and the developing brain will literally learn that the world is a good place and that problems can be solved.
Not only that, but secure attachment in the earliest period of life can have a positive impact on our entire social fabric. It is not about the impact on the individual; it is the positive ripple effect that secure attachment creates. It is the emotionally capable adults that those children become, able to make friends, learn, hold down a job, find a good partner and then become good parents themselves. It is the society that we could create if we fully address this issue.
Although it would be an exaggeration to claim that insecure or, worse still, disorganised attachment leads to all of life’s problems, at one level there is no doubt that it severely limits a person’s ability to cope with life’s ups and downs, and we know that in the most extreme cases a person’s earliest experiences can totally wreck their life. Negative early experiences create new generations of troubled and insecure young people and are often passed down to their babies by parents who themselves suffered insecure attachment. This is known as the cycle of deprivation. I well recall discussions with Dame Louise Casey when she was the troubled families tsar, who became convinced that intervening much earlier would be vital to prevent the later behavioural challenges that she was seeing, and the many discussions with my local police and crime commissioner, who recognises on the street every day the impact of a person’s earliest experiences on their tendency towards later criminality, addiction and violence, as well as depression and suicide.
It is clear that the science of brain development matters not just in our early years, but is a cradle-to-grave public health issue, the symptoms of which are evident in the years and decades that follow poor early experiences, which can cost the individual and society so much.
Before the right hon. Lady moves on, let me say that I chair a multi-academy trust. We are trying, without additional expenditure, to use midwives and health visitors to work from schools, so that any feeling that they are hostile places might be lessened, and to seek funds for home visiting during the first two years, so that mothers and fathers can learn skills that are good for them and even better for their young children, as the right hon. Lady has highlighted. Does she agree that one of our pleas to Government should be to look at how they spend existing budgets, as well as to give this subject the priority it deserves?
The right hon. Gentleman and I have worked together on this subject for many long years. I pay tribute to him for his amazing contribution in recognising the importance of secure early interventions and everything we can do to make people’s lives more successful and secure. I am sure that some of his ideas will be, and are being, taken forward by Government.
I congratulate my right hon. Friend on securing the debate and the work that she has done. She or the Government might wish to consider the Imagination Library, an initiative that we have started in North Lincolnshire which signs up every child for a free monthly book gifting scheme from birth, so that parents and carers read with their children from an early age. Health visitors and the maternity units in our local hospitals are involved, so that when people register their child’s birth they are automatically enrolled in this incredible scheme, which is funded by North Lincolnshire Council. Over 95% of children in the North Lincolnshire part of my constituency are now signed up. The scheme is having a really impressive impact, which is following through to our literacy rates in school, and is something that the Government could consider expanding elsewhere in the country.
My hon. Friend is absolutely right. One of the so-called “Five to thrive” is cuddling up to your baby, reading with them and looking at pictures with them. That engagement, which develops the early brain of the infant, is vital, and I pay tribute to him for his work on that.
I congratulate the right hon. Lady on securing this very important debate. It is vital that we get this right, and she has mentioned the troubled families programme. Bath and North East Somerset Council has a successful project, but I understand the funding is not secure. Does she agree that, where this has been an important part of a local authority’s intervention, it should continue and the Government should make funding available?
The hon. Lady is right, and it is, of course, part of the upcoming comprehensive spending review. I will return to that later because, at the moment, the troubled families spending does not specifically pick out the 1,001 days, but I think it will in future.
I congratulate the right hon. Lady on her work on this issue. I do not want to be negative or political, but it strikes me that, where a troubled family have an additional child, that additional child often does not develop as we would want. That happens for a variety of reasons, and it could be economic or the lack of a second parent. Has she looked at that? If so, does she have any solutions?
The hon. Gentleman tempts me to launch off in a completely different direction. He is right that, all too often, troubled families who have further children go on to have further problems, but the whole point of early intervention is that it can turn around the outcomes for all the family’s children, not just the new one. The programme is vital.
Insecure attachment in the early years has a cost to society in terms of not only human happiness but the financial cost to individuals, families and the public purse. As Professor James Heckman, a winner of the Nobel memorial prize in economics, has demonstrated, the return on every dollar invested in the 1,001 critical days delivers an exponential financial benefit in later life. Not only is early years intervention good for human happiness; it is also good for the public purse.
There are two profound areas of impact on the foetus and, then, the infant during the 1,001 critical days. The first is the level of cortisol, the stress hormone, and the second is the extent of the development of the infant’s prefrontal cortex. We know that a pregnant mother who suffers from stress produces more cortisol, which is easily transmitted via the placenta to the unborn child. The more stressed the mother, the more frequently the foetus is exposed to higher levels of cortisol.
The mother’s stress levels could be due to insecure employment, financial instability, the worry that her partner might leave her or the difficulties of being a single mum living in temporary or unsuitable housing, and so on. We know that exposure to high levels of cortisol can lead to modifications in gene expression while the foetus’s brain is still developing. Even in the womb, the potential for lifelong emotional and physical health is being determined.
We also know that maternal stress can lead to low birth weight, which can lead to all sorts of later complications, including diabetes, obesity and congenital heart disease. Once he or she is born, a baby left endlessly to cry themselves to sleep, or who is neglected or abused, will experience higher cortisol levels, which can over time lead to a lifelong higher tolerance of stress and an increased likelihood of being attracted to high-risk behaviour such as drug abuse, violence, criminality and so on.
We also know the critical role that the prefrontal cortex plays in developing the social and empathetic capacity of human beings. The prefrontal cortex is hardly present at birth, with the greatest growth spurt happening between six and 18 months, largely stimulated by the attention of a loving adult carer. Games like peekaboo, gazing into the baby’s eyes, smiling and mimicking them, and saying, “I love you. Aren’t you gorgeous?” [Interruption.] That is not directed at you, Mr Deputy Speaker. [Hon. Members: “Ah.”] I take that back, as it was mean. You are gorgeous. It is just that you are not in my arms. All that, in those 1,001 critical days, acts to jump-start the growth of the prefrontal cortex and the development of that vital human empathic capability.
However, if mum or dad is depressed, or if the baby suffers adverse childhood experiences, such as witnessing domestic violence, sexual abuse or substance misuse, that can have a significantly damaging effect on the development of the prefrontal cortex and the baby’s ability to regulate their own emotions. That, extraordinarily, can affect the ability in later years to cope with life’s challenges and opportunities, to form strong relationships and even to hold down a job. At the extreme end, the impact will be disastrous for that baby’s own future life and therefore for society at large. So love—a secure early bond—is what we want for all babies, although that is far from what is happening today.
The right hon. Lady is giving a powerful speech on why early intervention is so important. One of the things I most regret from the past few years is the demise of children’s centres and of their ability to reach out into families—help educate parents about all the positive things that she is talking about. Saving money in the long term could well mean a small investment up front in these families, and children’s centres could be an easy way of achieving that. Does she agree with me on that?
Of course on one level the hon. Lady is right: having a safe place for families to meet and receive particular interventions is important. But it is not the whole picture. I will expand on that in my remarks.
Let us look briefly at some of the facts we know. First, 67% of the UK population has had at least one adverse childhood experience—one in eight people have had four or more. Secondly, this predicts certain risks for those one in eight, such as a three times greater risk of lung disease through smoking; an 11 times greater likelihood of intravenous drug use; 14 times the number of suicide attempts; and a four and a half times greater chance of developing depression. Thirdly, people with six or more adverse childhood experiences can die as much as 20 years earlier than those who have none.
Fourthly, where domestic violence is present in the home, there is an increased risk of child maltreatment. In one study, families where domestic violence takes place were shown to be 23 times more likely to abuse their under-five-year-olds than families without. Research shows that about 30% of domestic violence begins during pregnancy. Fifthly, it is understood that conduct disorder in young children leads to adult antisocial personality disorder in about 50% of cases, and is associated with a wide range of adverse long-term outcomes, particularly criminality.
Of course, we are all aware, every day, of growing levels of mental ill health among young people, as well as the self-harming and eating disorders that are blighting too many young lives. So it is pretty obvious to all those with a passion for the earliest years why this issue matters—not just to the individual, but to society as a whole. For all the good that a free education can do, for all the good of quitting smoking, for all the benefits of rehabilitation programmes, we will never truly turn society around and break the cycle of deprivation until we prevent those acute problems that begin in the 1,001 critical days.
I should give a “health warning” about all this. Let me say that I am in no way suggesting that insecure attachment always leads to disastrous outcomes. It is possible for a baby who was insecurely attached in infancy to grow up to lead a perfectly normal and happy life, but there is also significant evidence that a troubled early life makes that so very much harder.
Does my right hon. Friend agree that evidence shows that there is a small window in early adolescence when much that has been done to a child can be put right? Does she agree that we need to focus on these times when a brain is most plastic?
My hon. Friend is, of course, right to say that it is possible to turn around these outcomes, but the ideal time to do it is during that first, critical 1,001 days, when the baby’s brain is still developing. Although we will always seek to turn things around later on, if necessary, the best chance is during the 1,001 critical days.
As my hon. Friend says, it is possible for a baby insecurely attached in infancy to grow up to lead a perfectly normal and happy life, but there is significant evidence that a troubled early life makes that so very much harder. Sadly, disorganised attachment, in which the person one turns to for love and support is also the person who sometimes abuses or neglects one—and in some cases, terrifies one—can lead to the worst sorts of outcomes in later life, including socio-pathological behaviour and a later cycle of abuse. In short, those who go on to become abusers in 20 years’ time are all too often the vulnerable babies who are themselves being abused today.
The right hon. Lady is making a powerful point and we all appreciate her bringing this issue to the House. It all seems to stem from the cycle that we need to break. Does she agree that what we had with Sure Start centres and children’s centres was so important in enabling a change of behaviour and the breaking out of that cycle?
The hon. Gentleman is absolutely right that there is a cycle of deprivation, which I will come on to discuss, but, as I said to the hon. Member for Oxford West and Abingdon (Layla Moran), although Sure Start centres are a vital part—having that safe place—in the work that I shall come on to talk about, this is about much more than that. That is just one of many services.
Order. Let me just help a little. The opening speech on a Back-Bench debate is meant to be 15 minutes and we are now at 20 minutes. I am worried about that. Although of course it is a very important debate and I will allow some time, Members should bear in mind that we have time limits that we try to work to. But it is too important an issue to curtail at this stage.
I am grateful for your guidance, Mr Deputy Speaker.
Those who go on to become abusers in 20 years’ time will all too often be vulnerable babies who are themselves being abused today. The question that really matters is how we even start to tackle this issue.
Having had my own brief experience of post-natal depression, I can certainly attest to how difficult it can be to cope as a new parent. Colleagues might have heard me speak before about my own memory of sitting in my kitchen with a crying baby, in the middle of winter, with snow on the ground outside, looked at through dirty windows, feeling totally unable to call a window cleaner or even just to make a cup of tea. That feeling of helplessness and hopelessness is a vivid memory—and it is now 23 years on.
This is not my sob story, though: I was lucky enough to have a great husband, a strong network of support and a job to go back to, which snapped me out of it, but, thinking back, it could have been so much worse. Many parents who are struggling to cope are dealing with that reality each and every day. I really do understand how debilitating depression is and how unexpected and horrible the feelings are.
It was when my mum, herself a trained midwife and therapist, asked me to go along and help with a charity she was working with—the Oxford Parent Infant Project —that I realised just how vital secure attachment in those first years really is. After 10 years as chairman and a trustee of OXPIP, I went on to set up NorPIP, the Northamptonshire Parent Infant Partnership, into which my hon. Friend the Member for Banbury (Victoria Prentis) was dragged—although not kicking and screaming; she was delighted. I then set up PIPUK, the fabulous national charity that is setting up PIPs throughout the country to provide specialised parent-infant relationship support, including parent-infant psychotherapy, to families and their babies. PIPUK’s aim is not only to address the immediate problems in the relationship between the baby and their parent, but to support a more positive and secure attachment for the long term.
I brought my passion for early years with me to Westminster when I was elected in 2010. I have since met so many brilliant people in the world of infant and maternal mental health, some of whom are present in the Chamber today, and many more of whom are following proceedings on TV. So many people have generously given their time and expertise. In 2011, with support from colleagues from every political party currently represented in Parliament, I launched “The 1001 Critical Days” manifesto, which called for a rethink of how we approach early years intervention at a policy level.
I particularly recognise the early commitment of the right hon. Members for North Norfolk and for Birkenhead (Frank Field), and of the hon. Member for Brighton, Pavilion (Caroline Lucas), in getting the work off the ground. I pay special tribute to the hon. Member for Manchester Central (Lucy Powell) for her dedication to the “The 1001 Critical Days” campaign. She and I promised each other years ago that we would remain committed to achieving real and long-lasting positive change. I am delighted that she is present. We can definitely achieve much through cross-party collaboration for the greater good, and this work is the perfect example of it.
“The 1001 Critical Days” campaign has received the support of more than 100 different organisations, including the National Society for the Prevention of Cruelty to Children, Barnardo’s, Best Beginnings, the Royal College of Midwives, the Royal College of General Practitioners and the Royal College of Obstetricians and Gynaecologists. There are just too many esteemed charities, royal colleges and foundations for me to list here. I also had the pleasure of working closely with Dame Tessa Jowell on her interest in bringing early years support into the UNICEF millennium development goals.
With cross-party colleagues, we set up the all-party group for conception to age two. I wish to mention the hon. Member for Washington and Sunderland West (Mrs Hodgson), with whom I very much enjoyed working on the all-party parliamentary Sure Start group.
I am very grateful to the right hon. Lady for giving way. I just wanted to commend her on her work at OXPIP and PIPUK, which she mentioned a moment or so ago; I visited myself to see the work being done. It is really quite outstanding to see what can be achieved. I also thank her for mentioning a number of us, as she has done so generously.
I am grateful to the hon. Lady. It has been a great experience. When I became City Minister, I was so sorry to learn that I had to drop all trusteeships and the all-party groups overnight. I cannot thank my hon. Friend the Member for East Worthing and Shoreham (Tim Loughton) enough—I have known him for the many years since we were at university together—for picking up the ball and continuing to drive these important issues forward to this day with his amazing dedication, focus and care.
Let me fast-forward through my more recent roles as Energy Minister, Environment Secretary and Leader of the House. On the face of it, there was little scope for me to continue the push on early years, but with the continued collaboration between the right hon. and hon. Members whom I have mentioned and many others, the excellent work has continued, culminating in the Prime Minister herself committing to support the early years agenda and asking me to set up the IMG in the summer of 2018.
The IMG itself comprised my hon. Friends the Members for Louth and Horncastle (Victoria Atkins), for North Swindon (Justin Tomlinson), for Richmond (Yorks) (Rishi Sunak), for Stratford-on-Avon (Nadhim Zahawi) and for Thurrock (Jackie Doyle-Price). I pay real tribute to all of them for their hard work on the group, as well as to the dedicated civil servants who supported us. Our remit was to consider the individual, the family and the wider societal risk factors that affect child development in the conception-to-age-two period and the long-term impacts, as well as the issues with central and local government’s approach.
The Prime Minister had asked the IMG to make recommendations to the relevant Secretaries of State that would support local areas in improving the co-ordination of early years services and in spending their current funding more effectively and more efficiently. I am so grateful to the Prime Minister for her continued support for, and interest in, the IMG, which my ministerial colleagues and I felt demonstrated the high priority being placed on that work.
I was delighted to be told that the Cabinet Secretary, Sir Mark Sedwill, has already prepared a cross-Whitehall civil service team to take our recommendations forward once signed off by the various Departments. We met as a ministerial group several times and undertook a great many visits to learn from examples of best practice right around the country. We visited Manchester children’s centres, the Lambeth Early Action Partnership, a parent-baby drop-in group in Peterborough and an outreach group in Devon. We held roundtables with charities and families, including parents within the civil service. We had consultations on Mumsnet and spoke to so many passionate and dedicated people working within the sector who want to make a clear difference for parents and babies. It was a wonderful and thoroughly rewarding experience. Out of those visits, meetings and consultations, we quickly began to identify a number of common issues that clearly need attention.
First and foremost is the postcode lottery across the country of the availability of perinatal mental health and specialised parent-infant relationship support, particularly around parent-infant psychotherapy services. In some areas, the provision is fantastic, but in others it is almost entirely non-existent. We heard from parents and professionals wanting health visitors to provide greater levels of support to new parents and their babies, particularly where parents are struggling to form a secure bond, with better levels of breastfeeding support and post-partum care. We also had detailed evidence of the need for greater support for dads, greater support for same-sex parents, better availability for couple counselling and for targeted services for new parents, such as debt and housing advice.
One particular issue that we identified was the need for greater support for non-English-speaking parents. The incredible work of children’s centres was highlighted everywhere we visited, and there is no doubt that parents and professionals want to see family-centred spaces such as these protected. There is a great amount of need out there, and it is clear that we have the opportunity to bring about a huge step change in how we deliver early years family support right across the country, if we seize on the recommendations of the inter-ministerial group.
What did we recommend? First and most importantly, getting the 1,001 critical days right can put children on course for good social, economic and physical outcomes later in life. Getting it wrong creates inequalities and significant costs later for Government and society. Secondly, better focus on both universal and targeted services needs to be a priority in this period.
I will not go into all the key recommendations because Mr Deputy Speaker is looking impatient, but I will mention some of them. First, using the wealth of research and evidence taken by the IMG, Departments should work together to create a clear and cohesive Government vision for the 1,001 critical days. That should be published in the autumn after the spending review. Local authorities should be invited to set out their own service models that work for their local communities, and should be properly measured on that.
The right hon. Lady has made an excellent speech and I commend her on the great work that she has done. However, she must also recognise that all the suggestions and ideas that have been put forward to deal with this situation require proper funding and new funding: new moneys for local authorities and for different groups to be able to carry out the suggestions. Is that money being promised?
Before the right hon. Lady responds, let me just say that I am not impatient—far from it. We have time on our hands. Unfortunately, I do not make the conventions of the House. As a former Leader of the House, the right hon. Lady will be well aware that the opening speech should last 15 minutes and that the Minister will have 10 minutes. I did not make the rules. I am just trying to ensure that hon. Members have enough time to discuss a very important subject that matters to us all.
I am grateful for your advice, Mr Deputy Speaker, and I absolutely do understand your point. I know that you are very sympathetic, and I will hurry up.
The second key recommendation I want to mention is that Departments should work together to develop a spending review proposal for a fund that would support local authorities in rolling out best practice and innovation in the delivery of the 1,001 critical days services. Thirdly, Departments should work together to ensure that the successor to the troubled families programme has a specific focus on the 1,001 critical days.
The IMG set out many other recommendations, including investing in maternal and paternal perinatal mental health and ensuring that support is available to address issues in parent-infant relationships. We recommended that the NHS expands access to evidence-based parent-infant psychotherapeutic services within specialist service provision. We also felt that a website should be created to support parents to make informed choices and decisions at key points in their parental journey, including the information that people need about parental leave, childcare support, family-friendly policies and the 1,001 critical days.
Given that breastfeeding boosts a baby’s ability to fight illness and infection and supports emotional bonding in the early months of life, and given that the UK has one of the lowest rates of breastfeeding in Europe, we also recommended that further action must be taken to continue to focus on reforms that enable and support breastfeeding in England, including the recommendations of the “Becoming Breastfeeding Friendly” review. The IMG made many other recommendations, and I do hope that the Government pick these as soon as possible. One recommendation that I personally made very strongly is that there should be a specific ministerial responsibility for the 1,001 critical days.
As Members may know, I raised the work of the IMG with the Prime Minister during PMQs earlier this month, and I have tabled several written parliamentary questions to ask what progress has been made on addressing the IMG’s recommendations. I truly believe that we are on the threshold of something very exciting for our country—a real opportunity to deliver long-lasting and positive change in our early years family support policy that would make a huge difference to individuals and society as a whole. I call on the Minister to commit that the Government will report back before the House returns from summer recess, and I ask him to make a statement about that response on the Floor of the House as soon as possible after we return, so that we may debate it further.
It is fantastic to see you in your place for the final bit of the debate, Mr Speaker. I can paraphrase what it has been about as “all you need is love”, and I know that you would subscribe to that yourself. It has been an incredibly positive and optimistic debate.
The hon. Member for Manchester Central (Lucy Powell), my hon. Friend the Member for East Worthing and Shoreham (Tim Loughton)l and I have worked on this for years. Members throughout the House are determined to see every baby get the best possible start in life, and ultimately that is all about love. It is about attachment, about good early years services, and about the Government working in a joined-up way. My hon. Friend the Minister has made huge strides in showing his personal commitment to progress in that regard, but I urge him, and the Government, to demonstrate that final commitment to getting the excellent work done by the inter-ministerial group over the line, so that we really do give every baby the best possible start in life.
Question put and agreed to.
Resolved,
That this House believes there is now overwhelming evidence of the importance of the first 1001 critical days of a new baby’s life in determining his or her lifelong physical and emotional wellbeing; notes the work of the Inter-Ministerial Group led by the Rt. hon. Member for South Northamptonshire, the Thirteenth Report of the Health and Social Care Select Committee, HC 1496, on First 1000 days of life and the Eleventh Report of the Science and Technology Committee, HC 506 on Evidence-based early years intervention; and calls on the Government to take strong and decisive action immediately to ensure that every baby gets the best start in life.