Giving Every Baby the Best Start in Life

Andrea Leadsom Excerpts

Tuesday 9th November 2021 Commons Chamber

[Dame Andrea Leadsom (South Northamptonshire) (Con)]

It is a pleasure to follow the hon. Member for Richmond Park (Sarah Olney) in this important debate, and I congratulate her and the hon. Member for Newcastle upon Tyne North (Catherine McKinnell) as fellow co-sponsors and tireless fellow campaigners for giving every baby the best start in life.

Despite the rough and tumble of politics, there are times when colleagues from all parties in the House come together. Early years is one such cross-party issue. Over the past 11 years in Parliament, I have been proud to work with many colleagues on the early years. The hon. Members for Manchester Central (Lucy Powell) and for Washington and Sunderland West (Mrs Hodgson), my stalwart and long-standing hon. Friend the Member for East Worthing and Shoreham (Tim Loughton), and my hon. Friends the Members for Eddisbury (Edward Timpson) and for Winchester (Steve Brine) have all been amazing campaigners for the earliest years, as has the hon. Member for Glasgow Central (Alison Thewliss). The former Member for Birkenhead, Lord Field, and the former Member for East Dunbartonshire, Jo Swinson, have been great allies, as have all those Members who supported the all-party group conception to age two: first 1,001 days, and Ministers on the inter-ministerial group on early years family support from 2018-19.

It is fantastic that since the 2019 general election, the early years agenda has received fresh support from new colleagues such as my hon. Friends the Members for Penistone and Stocksbridge (Miriam Cates), for Stroud (Siobhan Baillie), for Cities of London and Westminster (Nickie Aiken), for Truro and Falmouth (Cherilyn Mackrory), and for Ruislip, Northwood and Pinner (David Simmonds). I also pay tribute to the late Baroness Tessa Jowell. She and I worked together on the 1,001 critical days agenda, and she campaigned for it to be introduced as part of the sustainable development goals at the United Nations. I must also mention the superb work of the Royal Foundation and its Centre for Early Childhood. The commitment from Her Royal Highness the Duchess of Cambridge and her team has generated fresh attention for ensuring that every baby gets the best start in life.

This subject has been my personal passion for more than 20 years, from chairing the Oxford parent-infant project, to setting up the parent infant partnership UK, and the Northamptonshire parent infant partnership, establishing the 1,001 critical days manifesto and the all-party group conception to age two: first 1,001 days, and chairing the inter-ministerial group in the Government of my right hon. Friend the Member for Maidenhead (Mrs May). July 2020 marked a huge opportunity when the Prime Minister commissioned the early years healthy development review and invited me to chair it. Since then, we have been able to build on years of cross-party support, and a wealth of knowledge and expertise from the early years sector, to create a new vision for the 1,001 critical days initiative that was launched in March this year. The review has put the baby’s needs at the centre of all our work. Through meetings with parents and carers, virtual visits to local areas, and detailed discussions with parliamentarians, practitioners, academics and charities, we heard about the experience of early years services and support, and about what is going well and where change is needed.

First and foremost, we learnt from every parent and carer of their strong desire to be the best parent they can be, but we also learnt that new prospective parents often struggle to find the support they need. We heard from many parents who had deep concerns about their own or their partner’s mental health, and struggled to get timely support. We heard from many mums who desperately wanted to breastfeed but gave up because the support was not there. Parents told us how frustrating it was to keep telling their story over and over again to different people. Their cry was, “Why don’t you people ever speak to each other?” Equally, we heard from professionals and volunteers who said it would have been so helpful for them if they had known before meeting a new parent or carer about previous trauma or health challenges.

We heard from many dads about how excluded they felt from what they saw as “mum-centric” services. Some felt that they should not ask for any support for themselves, while others just felt sidelined and, in some cases, traumatised by what their partner had gone through in childbirth. We heard from foster carers of babies how little information came their way when caring for a vulnerable baby. More specifically, in 40 cases of babies who went into foster care, only two arrived with their red book. Those carers had no formal information about that baby’s early traumas that had caused them to be taken away from their birth family.

We heard from same-sex couples about unhelpful assumptions by early years professionals about their relationship and parenting roles. We heard from black mums about how particular cultural and health issues can be overlooked by busy staff. We heard from single mums and single dads about how they can feel isolated, and sometimes stigmatised, at such a life-changing time. We heard from many parents with particular challenges, such as not speaking English well, concerns about possible disabilities, experiencing violence in their lives, or other significant challenges. We heard that support is inconsistent and sometimes hard to access.

It comes as no surprise that the covid pandemic has been an extraordinarily difficult time for new families who, through no fault of their own, have not been able to access services or support in the normal way. The “Babies in Lockdown” report from the Parent-Infant Foundation, Best Beginnings and Home-Start reveals that nearly seven in 10 parents felt that changes brought about by covid were affecting their unborn baby, their baby, or their young child, and that 35% of parents would like help with their concerns about their relationship with their baby. The report also found that nine out of 10 parents and carers experienced higher levels of anxiety during lockdown.

Despite the many stories of difficulties, we also heard fantastic examples of good support for families. Many health visitors went the extra mile to keep in contact with families who were struggling, and many families found it incredibly reassuring to be able to text or Zoom their health visitor at short notice. Parenting programmes have been a huge support to many families, and we virtually visited Camden’s Bump to Baby programme, where classes continued online throughout the pandemic, and have proved incredibly popular with new parents and carers who are also helped to make friendships outside the programme. Dads gave us positive feedback on services that gave them space to share their experiences, without worrying about whether they were taking the focus away from the other partner’s health and wellbeing.

In lockdown, we also heard about excellent online and virtual services, and how they came into their own. One such service, Parent Talk, provided by Action for Children, reported a 430% increase in the number of parents seeking advice online during the pandemic. The Baby Buddy app, produced by Best Beginnings, has seen a huge take-up of its digital and virtual advice for everything from breastfeeding to nappy changing, and from sleep management to mental health concerns. Many local authorities are now determined to improve their joined-up offer to new parents and carers, so I certainly feel that we are pushing against an open door.

Our report, “The Best Start for Life: A Vision for the 1,001 Critical Days”, was launched by the Prime Minister in March this year. It contains six action areas. The first is that every local area should publish its own joined-up set of start for life services so that every parent and carer knows where to go for help.

The second is a welcoming hub for every family, in the form of family hubs. Those will build on the excellent work done by the late Baroness Tessa Jowell and others on creating Sure Starts, but the benefit of family hubs is that they will be the place where every family goes for support and advice, including from midwives, health visitors, mental health support workers and breastfeeding advisers within their walls. Not only will those services be physically available but they will be virtually available through the family hub model.

The third action area is a digital version of the red book, which will provide parents and carers with a record of their baby’s earliest life, from lovely moments such as their first tooth and their first steps, all the way to records of immunisations and professional support interventions.

The fourth action area is about the workforce. We all know that health visitors provide critical support for new parents and carers, but we also know that their case load can be very heavy, and parents and carers have told us that they really want more continuity of care and more frequent contact in the earliest years. We are therefore working with health visitors and local areas to consider resourcing levels and training needs, and whether a mixed-skill workforce can provide that greater continuity of care.

The fifth action area is to continually improve the start for life offer. A key action will be to establish parent and carer panels in every local area to ensure that the voices of families are heard when services are designed and improved. We are looking at improving the collection of data, at the evaluation of different interventions and at the need for proportionate inspection of the start for life offer in each area. A final but critical action area is to ensure that there is sound leadership, both locally and nationally, to drive the ambition to give every baby the best start for life.

I want to say a huge thank you to the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Erewash (Maggie Throup), and to all the review’s sponsoring Ministers, past and present, for their support for the review. I am sure that it was their commitment, combined with the support of the Prime Minister and the Chancellor, that ensured such a positive spending review settlement for the earliest years, with £82 million for family hubs, £50 million for parenting programmes, £10 million for the start for life offer, £50 million for breastfeeding support, £100 million for infant and perinatal mental health support, £10 million for new workforce pilots, and a £200 million uplift for the supporting families programme. I believe that £500 million is a transformational sum that will allow many more parents and carers access to the vital help they need to give their baby the best start for life.

Why does this matter so much to our society? Well, we know that it is in the period from conception to the age of two when the building blocks for physical and emotional health are laid down. Babies born into secure and supportive homes will usually go on to become happy children who do well at school and grow into adults who cope well with life’s ups and downs and are more likely to hold down a job, have better health outcomes and form healthy relationships themselves. On the other hand, we know that in families under pressure, particularly where there is partner conflict, substance misuse, poor mental health or deprivation, the consequences for a baby’s developing mind in that critical early period can be far-reaching and very harmful.

Prevention is not just kinder; it is also significantly cheaper than cure. For example, the NHS has estimated that for every one-year cohort of births in England, the long-term cost of lack of timely access to quality perinatal mental health care is £1.2 billion to the NHS and social services and more than £8 billion to society. That is for every year’s cohort. We also know that up to 30% of domestic violence begins during pregnancy, and that health issues such as tooth decay and childhood obesity cost hundreds of millions of pounds every year in health-related expenses. We believe that those things could be significantly reduced by better education and support for new families.

With these six action areas, I think we can transform our approach to early years support and services, improving the health outcomes and life chances of the youngest in our society. Just as we need to level up economic opportunity across the country, we must also focus on where it begins—that critical period of human life from conception to the age of two.

[Jonathan Edwards]

The right hon. Member is giving a very comprehensive speech. Does she also agree that the Government should look at the issue of shared parental leave? The stats seem to indicate that fewer than 4% of eligible fathers take up the Government’s current policy. The Government need to look at that, and the forthcoming employment Bill may be an opportunity to strengthen those provisions.

[Dame Andrea Leadsom]

I completely agree with the hon. Gentleman that it would be fantastic for families and babies if more dads took up shared parental leave. Of course, as he will know, that has been legislated for. Unfortunately, as he points out, far too few fathers have taken it up to date. I certainly wish that more would have the confidence to do so.

I believe that all colleagues across the House would agree that the world in which we all want to live is one where every baby is nurtured to fulfil their potential, where good lifelong emotional wellbeing is the norm, where our society is productive and co-operative, and where every one of our citizens has the chance to be the very best that they can be.

--- Later in debate ---

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

I would like to start by thanking the hon. Member for Richmond Park (Sarah Olney), the right hon. Member for South Northamptonshire (Dame Andrea Leadsom) and my hon. Friend the Member for Newcastle upon Tyne North (Catherine McKinnell) for securing this debate at this incredibly important time. I also offer my thanks to the right hon. Member for South Northamptonshire for her tireless campaigning on this issue over many years, for her recent leadership of the early years review and for her success in securing funding for the sector in the recent Budget. All those are to be welcomed. It is not easy getting money out of a Chancellor, as we all know. She also knows my dismay at the short-sighted cuts that preceded this funding, making it all the more necessary. I know she agrees that we need to ensure that no Government cut valuable services such as Sure Start or family hubs ever again.

I stand here as a former shadow Minister for children and families, a role now most ably held by my hon. Friend the Member for Hampstead and Kilburn (Tulip Siddiq). It has been said that once anyone has been a children’s Minister, like the hon. Member for East Worthing and Shoreham (Tim Loughton), or a shadow, they can never quite leave the issue alone. It is sort of like an “Order of the Babies” maybe, or a ministerial Hotel California.

Covid-19 has had a profound impact on all of us, but the effects of the lockdown restrictions and social distancing measures were keenly felt in the early years sector. I welcome the “Babies in Lockdown” survey report published today by the Parent-Infant Foundation, Home-Start UK and Best Beginnings. The pandemic is, sadly, far from over, and the report offers signs that the early years sector has developed a form of long covid, if you like. The survey found that nearly a third of mothers questioned reported that health visitor drop-in clinics that existed before the pandemic were no longer operating. I urge colleagues to read the report.

But let me take Members back to 1970, well before Zoom and Teams. Back then, fewer than a quarter of mothers worked; society expected a full-time mother. Without a central focus on the early years, and no talk of the 1,001 critical days or adverse childhood experiences, the education of very young children was neglected. Baroness Blackstone, writing in 1974, highlighted the fact that only 10% of three and four-year-olds attended state nursery schools or classes in 1971, with some areas receiving no service at all.

To combat the lack of state nursery education, the mothers did it themselves. Belle Tutaev set up a playgroup with her neighbour which eventually bloomed into the Pre-School Playgroups Association. This has since become the Early Years Alliance. But the state should have taken up this mantle, rather than the already burdened mothers. Not everyone was convinced of that principle, however. In 1980, George Young, then the Conservative Secretary of State for Social Services, said that he did not

“accept that it is the state’s job to provide day care to enable the parents of young children to go out to work”.

Listening to the debate today, 40 years on, we can see how far we have come from that thinking.

It was the last Labour Government who finally addressed this problem. I have spoken before, as others have today, about the late Tessa Jowell’s Sure Start programme being a beacon of early years policy. Sure Start brought children’s services together under one roof, uniting healthcare with wellbeing, education with childcare, babies with other babies, and parents with other parents. There were 3,620 Sure Start centres in 2010 under Labour. That has fallen, as we heard from the hon. Member for Richmond Park, by more than 1,300 in the past decade or more of Conservative Governments. Those that remain have been effectively hollowed out, offering only skeleton services with minimal opening hours. While the Government’s pledge to fund 75 more family hubs is obviously welcome, it does little to make up for that loss. I know the hon. Member for East Worthing and Shoreham said it is not all about the buildings but, when we have lost 1,300 and replaced them with 75, it is trying to get a quart into a pint pot, as they used to say.

[Dame Andrea Leadsom]

It has been such a pleasure to work with the hon. Lady on this topic for so many years. I just want to put on the record that it is not 75 family hubs, but 75 upper-tier local authorities; it will be for them to decide, but it could be hundreds or thousands of family hubs. The hon. Member for Newcastle upon Tyne North (Catherine McKinnell) drew the same conclusion, so I really want to set the record straight on that point, if the hon. Lady will forgive me.

[Mrs Hodgson]

I am very grateful to the right hon. Lady. That is an important clarification, and we must ensure it is out there that maybe it will not just be 75, but that they can make it many more. Let us hope it is 1,300; I am sure she will agree with that. That said, I warmly welcome what I think is the Government’s tacit admission that they got it wrong when they defunded the Sure Start programme, even though, as we all remember, on the eve of the 2010 election, David Cameron promised it would be safe in his hands.

However, we are where we are. Earlier this year, I also co-chaired a cross-party early years commission alongside the hon. Member for Eddisbury (Edward Timpson), who, as a former children’s Minister, is also a member of the “Order of the Babies” and a resident of the ministerial Hotel California. The commission heard from a wide range of stakeholders, including educators, academics and policy professionals. I will take the House through some of the recommendations in the comprehensive report.

First, there should be integration of health and education support for children, ensuring that every child receives the health visitor appointments they are entitled to and a new health visit when the child is 18 months old. Secondly, because too few families have access to essential services, a locally relevant and dedicated parent support service is needed in every community in every area. Thirdly, we should upskill early education practitioners by investing in continuing professional development, so that the workforce stay fit to face the challenges of the future. Those proposals could easily be made reality. I sincerely hope that, as part of the £500 million brought forward in the Budget, the Government will deliver all of what we seek in this debate.

As we take part in this debate, we are mindful that the babies and children themselves will not be listening. They will not be tweeting their agreement or penning letters to our offices. I will spare a moment to mention how, beyond their value on their own terms, reforms to the early years offer can be instrumental in improving the lives of those without children, via the economy.

The Early Intervention Foundation found that the cost of late intervention in 2016-17 was £17 billion, owing to the need for services to help with mental health issues, youth crime and exclusion, including a £5.3 billion spend on looked-after children. Early intervention can offset that cost. The Carolina Approach to Responsive Education programme provided intensive, high-quality childcare for ages 0 to 5 in the United States of America and delivered a 13% return on investment per child each year. It netted IQ gains, higher wages, increased likelihood of home ownership and higher scores on achievement tests.

For the family unit, the economic returns are clear too. As the hon. Member for Richmond Park said, parents in areas with Sure Start local programmes moved into paid work more quickly than those without, reducing the benefits bill to the taxpayer and increasing tax receipts for the Treasury. But that is not the full picture: the economic benefits are often only modelled on specific, targeted interventions, whereas the benefits of intervention fan out across a range of factors, such as reducing the later burden on the public purse— the whole point of early intervention—and greater participation in the economy over many years. As such, it is practically very difficult to model the effects of a web of measures applied at once. So just imagine the results we could achieve if those interventions were provided simultaneously, with wholesale improved outcomes delivered via intensive early years support. Britain’s early years offer has the potential to be much greater than the sum of its parts.

To conclude, I would like to look to the world we are creating as legislators in this place. As we speak, delegates from around the world are discussing the means of preserving the planet and protecting the environment in Glasgow at COP26. It is incredibly important that we limit climate change to an increase of 1.5°. Missing, I believe, is leadership for those who will grow up into these environments. The pursuit of climate justice is in no small part to ensure that our children and their children’s children do not face an uninhabitable, hostile world. As those at COP26 work for the future of the planet, let us, here and now, seize this golden opportunity to help those who will inherit it.