Sure Start: IFS Report

Anne Milton Excerpts

Wednesday 5th June 2019 Commons Chamber

[Lucy Powell (Manchester Central) (Lab/Co-op)]

(Urgent question): Thank you, Mr Speaker, for granting this urgent question. To ask the Secretary of State to make a statement on the Institute for Fiscal Studies report on Sure Start children’s centres.

[The Minister for Apprenticeships and Skills (Anne Milton)]

The Government very much welcome the recent report by the Institute for Fiscal Studies on the effects of Sure Start. It is crucial that, in our pursuit of better outcomes for children and families and in making spending decisions, we are guided by high-quality evidence. The report gives us more of that.

The report shows very clearly that children in disadvantaged areas benefit most from services. Indeed, those in the richest 30% of neighbourhoods saw practically no impact at all. The policy framework we have in place reflects that evidence. In 2013, the Government introduced a new core purpose for children’s centres, focusing on families in the greatest need of support. While we have seen local authorities remodel services, there are now more children’s centres than at any other time prior to 2008—in fact, since Tony Blair was Prime Minister. This is at a time when the Government are making record investment in childcare, with more than 700,000 of the most disadvantaged two-year olds having benefited from 15 hours’ free childcare since its introduction in 2013. In addition, under the Government’s healthy child programme, children and families now receive five mandatory health visitor checks in the early years. The statutory framework also contains important protections so that outcomes for children and families, particularly the most disadvantaged, will not be adversely affected by the proposed changes to children’s centre provision.

The IFS concludes that policy makers must

“consider which types of services and models of provision can most effectively help this group”.

The Government agree. Indeed, we already have work under way to do exactly that. As part of our £8.5 million early years local government programme, we announced in April that the Early Intervention Foundation will look at children’s centres and other delivery models to find out what works well, so that local authorities have more evidence to help them to continue to make the best decisions for their communities.

[Lucy Powell]

I thank the Minister for her reply, but I think it bears little relation to reality.

Sure Start is a proud Labour legacy. It has a proven track record of transforming lives, yet it has been allowed to wither on the vine by this Government. The Institute for Fiscal Studies, in its significant report yesterday, highlighted that austerity has hit Sure Start hard, with budgets falling by two thirds. We have seen over 1,000 centres close since 2010. The report also shows that Sure Start saved the NHS millions of pounds by significantly reducing hospitalisation of children, especially those from the most disadvantaged backgrounds. There is a clear lesson here for Government: investment in early intervention saves money later on. Closing Sure Start centres is a false economy.

Will the Minister use the report as ammunition, with the Tory leadership contenders and the Treasury ahead of the spending review, for a new commitment to revitalise Sure Start? What is happening to the Government’s review on the first 1,001 critical days, which was led by the former Leader of the House, the right hon. Member for South Northamptonshire (Andrea Leadsom)? I pay tribute to her work and her focus on this issue. Will the review be published before we get a new Prime Minister—I understand that it was ready to go—and will renewing Sure Start be central to its recommendations? Will the Government match Labour’s commitment to save Sure Start and invest £500 million in resurrecting it? Given the clear benefits of children’s centres in creating social mobility, will she properly fund local authorities so that they can do everything possible to keep children’s centres open?

The decimation of Sure Start has been a travesty. It flies in the face of all the evidence that early intervention is key to tackling disadvantage. It must be reversed.

[Anne Milton]

I pay tribute to the hon. Lady. This has been a passion of hers and she has worked very hard across the House to gain support. She is absolutely right that investment in early intervention is important. I should point out that, in the first paragraph of the executive summary, the report makes it clear that

“the UK is now one of the highest spenders on the under-5s in Europe”.

Those are OECD figures from 2014. I would just say to her that what matters is to have a universal offer, but it is also about the way services are delivered. That is not necessarily always most effective through centres. They definitely have a role, but it is about services and making sure that we get the services to those who need them the most.

[Robert Halfon (Harlow) (Con)]

I congratulate the hon. Member for Manchester Central (Lucy Powell), a member of the Education Committee, on her urgent question. In Essex, we have an extraordinary family hub that the Children’s Minister, the Under-Secretary of State for Education, my hon. Friend the Member for Stratford-on-Avon (Nadhim Zahawi), has visited. It is a one-stop shop for mentoring, health support, education support and counselling services. Our manifesto commitment was to have family hubs across the country. Will my right hon. Friend commit to having such hubs and roll them out across the United Kingdom?

[Anne Milton]

I thank my right hon. Friend for his comments and congratulate Essex on its work on its family hubs. The point he makes is important. It is not just about one-stop shops; it is also about ensuring that, for families who never go near family hubs or children’s centres, we can deliver services in their own homes. On the quality of children’s centres, in 2010, 68% of early years providers were good or outstanding. Today, the figure is 95%. On outcomes, in 2013, 52% of children left reception with a good level of development. Today, 72% of children do so. It is about making sure that we get the services that are appropriate for a local area to those who need them the most.

[Tracy Brabin (Batley and Spen) (Lab/Co-op)]

Thank you for granting this urgent question, Mr Speaker, and I thank my hon. Friend the Member for Manchester Central (Lucy Powell) for asking it.

The IFS report showed that Sure Start reduces the hospital admissions gap between rich and poor children by half. Put simply, thousands of children are ending up in hospital because of cuts to Sure Start. Sure Start was the jewel in the crown of the Labour Government, and politicians, policy makers and the public have long understood its benefits. Even back in 2010, the Conservative party pledged to recruit 4,200 Sure Start health visitors for exactly that reason. It was a Conservative election manifesto promise, but what is the reality? A cut of two thirds in funding and over 1,000 Sure Start and children’s centres have been lost since 2010.

Will the Minister join me in welcoming the report and commit to responding in detail to each of its recommendations before the summer recess? However, it should not be the IFS that marks the Government’s homework. In 2015, the then Conservative Government promised a consultation on Sure Start, but nothing has materialised. When will that work be completed and will the Minister commit to a publication deadline today? At a time when NHS budgets are stretched, should we not be investing in preventive measures such as Sure Start to keep children from ending up in hospital? Will she make that point forcefully in the spending review?

Tory leadership candidates are scrambling over themselves to make pledges to reverse their cuts, but if they are genuinely serious about social justice, now is the time to show that by pledging to reverse the scandalous cuts they have made to Sure Start.

[Anne Milton]

I thank the hon. Lady for her comments. Being fixed in a dogmatic way on Sure Start children’s centres is not necessarily—[Interruption.] Perhaps she will let me finish. It is important that anything we do is evidence-based. As the report makes clear, statistically the IFS cannot necessarily be confident that the effects that it highlighted on hospitalisation are not due to chance. We need to make sure that we get the right services in the right place, in the right setting, for the families who need them most. Public Health England is currently looking at the healthy child programme, which is 10 years old. It wants to modernise that, focusing it on the first 1,000 days, and she has been involved in that. Looking at the team around the child and at solutions to make sure that vulnerable children and families get the help they need means that we need universal reach and a targeted response where it is needed most.

[Lucy Allan (Telford) (Con)]

I, too, pay tribute to the hon. Member for Manchester Central (Lucy Powell) for her excellent and long-standing work on early years, and I very much enjoy being a member of the Education Committee alongside her. With increasing numbers of children being taken into care, what is the Minister doing to help the most vulnerable families to stay safely together?

[Anne Milton]

It is important that families who can stay safely together—the critical word is “safely”—are supported to do so. A number of initiatives are going on: I talked about Public Health England looking at the health child programme and my right hon. Friend the Secretary of State is looking at home learning environments. There are a number of initiatives and this involves children’s services, education and the NHS all working together—[Interruption.] The hon. Member for Batley and Spen (Tracy Brabin) is shaking her head. If she thinks differently, she should say so, but this will not be solved, and families who need help will not be helped unless we have an integrated approach to make sure that, as my hon. Friend the Member for Telford (Lucy Allan) said, families can stay safely together.

[Thelma Walker (Colne Valley) (Lab)]

I congratulate my hon. Friend the Member for Manchester Central (Lucy Powell) on securing this really important urgent question, and I enjoy working with her on the Education Committee. As the former head of a school with a phase 1 Sure Start, I welcome the recent IFS report, which acknowledges the life-changing work that Sure Start centres deliver for the most vulnerable families in our most deprived areas. Can we have a guarantee that there will be a full commitment and funding from the Government to Sure Start centres and early intervention projects now and in future?

[Anne Milton]

The hon. Lady has a wealth of experience in this field. I can guarantee that our interventions will be evidence-based, which is the critical thing. She talks about cuts, but as the IFS report states, the UK is now one of the highest spenders on the under-fives in Europe, so we are spending money. What matters is making sure that we get the help to those who need it most.

[Tim Farron (Westmorland and Lonsdale) (LD)]

I congratulate the hon. Member for Manchester Central (Lucy Powell) on raising this incredibly important issue. The Minister talks rightly about evidence-based decision making. The evidence shows that in recent years, there has been a 17% increase in the number of children being taken into care and that the reduction in funding for Sure Start centres is a contributory factor. Some 655,000 referrals to children’s services—[Interruption.] The Secretary of State is muttering from a sedentary position that that is not backed up, but the correlation is very clear for all to see. It is both tragic and expensive to reduce funding for Sure Start centres, leading to the need for much more drastic and tragic intervention later. In rural communities such as mine, parents have to travel much further to a Sure Start centre. Will the Government commit to capital funding, so that local authorities can co-locate libraries, children’s centres and Sure Start centres so that they can keep performing?

[Anne Milton]

I point out to the hon. Gentleman that correlation and causation are not the same thing. The IFS report, which we have very much welcomed, is cautious in making that distinction. The important thing is that we can build children’s Sure Start centres in his constituency, which, as he says, is very rural, but what has always mattered to me—I am a former Public Health Minister—is this: what about the families who do not go there?

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

On the eve of the election in 2010, David Cameron, who became Prime Minister, promised that Sure Start would be safe in his hands, yet here we are nine years later and over 1,000 Sure Start centres have closed, the rest have been hollowed out and two thirds of the budget has gone, and still the IFS has said that they are doing some powerful work with the poorest in our communities. Like me, does the Minister wonder what amazing achievements there could have been from these centres if they had not been decimated and savagely cut in the way that they were?

[Anne Milton]

The hon. Lady has always been a champion of early years in all the work that she has done. It is not just the budget spent on Sure Start centres that matters; it is the budget coming in, and the visits from health visitors, which are so crucial—[Interruption.] The hon. Lady is shaking her head. It is not just that budget. As the report makes clear, we are the highest spender in Europe. What matters is the universal offer and making sure that we target the support to those who need it most and possibly to families who are not attending the centres—what about them?

[Helen Goodman (Bishop Auckland) (Lab)]

I invite the Minister to come to my constituency and see the communities that were being served by the five Sure Starts that were closed. She can see whether they were the best off in the country—I think she will find that they were not. Surely she understands that there is a connection between those closures and the 30% increase in the number of children going into care in County Durham.

[Anne Milton]

I am going to sound very repetitive, but this needs to be evidence-based. Sure Start centres—[Interruption.] Read the IFS report and read the wealth of evidence out there. This is part of the problem, but I think the hon. Lady will find that there are more places giving 15 hours free childcare than there ever were Sure Start centres.

[Mr Barry Sheerman (Huddersfield) (Lab/Co-op)]

I have some sympathy for the Minister, only because the evidence she is not looking at is the evidence she can do little about—the fact that the dramatic cuts from the Treasury to these services and to local authorities have resulted in many local authorities, very reluctantly, having to close children’s services. She says she does not think the model works, but the evidence shows that investment in early years is the best investment we can make. Without it, we have to make good the damage later on. I suggest that she ask parents whether they are satisfied with the present level of support. The evidence suggests that they will say no.

[Anne Milton]

The hon. Gentleman is a doughty champion of all things to do with education. As the Minister responsible for post-16 education not at university, I see the results of children having suffered from poor educational backgrounds and possibly insufficient family support. He mentioned the word “model”. That is the key. It is not one model we need to reach the most vulnerable families. I point again to the 700,000 of the most disadvantaged two-year-olds who have benefited from the entitlement to 15 hours free early-years education a week. This is an important addition to what else is being done. There is no one model that works in this area.

[Ellie Reeves (Lewisham West and Penge) (Lab)]

When I held a summit on parental loneliness in my constituency, the local children’s centres made clear the vital role they played in supporting local families—often some of the most vulnerable. Despite this, 12 of the Sure Start centres in Bromley have closed since 2010. The Minister talks about universal reach, but with only six centres left in the entire Borough of Bromley—a huge London borough—and with our health visiting services cut, does she not recognise that universal reach is impossible without significant investment and an end to austerity?

[Anne Milton]

I can only refer the hon. Lady to the report that states that we are the highest-spending nation in the OECD. It is very easy for Opposition Members to throw the word “austerity” around without looking at the evidence or the other models available. She is fixated on a centre. What about the families and mothers who are too depressed to go there? I am saying we need good—[Interruption.]

[Mr Speaker]

Order.

[Anne Milton]

We need a variety of models of care and we will be led by the evidence.

[Karin Smyth (Bristol South) (Lab)]

This is becoming a very frustrating exchange. On the one hand, the Minister, who I respect greatly and work with and who we know cares, is saying that this is about families in the greatest need, but on the other hand, she is saying, “What about the families who don’t go there?” My experience in Bristol stems from when this started. I was brought in to help join up the provision on education, early years and health services. They did not work well together, so we supported measures to tackle health inequalities—measures on family things such as parenting, mental health, domestic violence, cooking, nutrition, and so on. We did that through outreach to the families who would not normally come and by supporting families in the greatest need. What we are losing now is that universality principle and the point about how it actually works—that is where the evidence is. This is a frustrating exchange because the evidence is there. If she can tell us what the Government seek to replace the model with and help us to understand those outcomes, perhaps we can have a more productive exchange for the benefit of all those families who need this provision.

[Anne Milton]

I agree 100% with the hon. Lady. In some ways, these discussions should be more consensual given that we all want the same ends. I must repeat that there are more children’s centres now than at any time when Tony Blair was Prime Minister. It is not just about having centres either. In 2010, 68% of early years providers were good or outstanding and now 95% are. The presence of a centre in itself does not necessarily answer the question. Similarly, in 2013, 52% of children left reception with a good level of development; today, that figure is 72%. That is a marked increase. It is about the quality of care as much as the presence of a centre. I go back to what I said to the hon. Member for Batley and Spen: sticking in a dogmatic way to one thing will not work. We have improved quality, which is critical, and it is important that we are led by the evidence, including the IFS report, which—I say for a third time—I very much welcome. It is one of many things. The work that Public Health England is doing on modernising the healthy child programme is also critical to ensuring universal reach and a targeted response, but so too is looking at the team around the family.

[Thangam Debbonaire (Bristol West) (Lab)]

Following on from my hon. Friend the Member for Bristol South (Karin Smyth), I visited a lot of Sure Start centres in my capacity as a domestic violence practitioner and helped them with their work. We are talking about a woman’s ability to walk into a centre, without any stigma and without anyone knowing why she is there, and get help not just with childcare but with the domestic violence she is suffering, her mental health problems, and so on, and all that in her locality from people she trusts. What is it about that that the Minister seems to object to—in, I have to say, quite a dogmatic way?

[Anne Milton]

I congratulate the hon. Lady on her work at the domestic violence centre, and she is absolutely right: women—and men, because sometimes men suffer from domestic violence—need to feel free to go to some place where they feel they can report their situation. I do not have a dogmatic objection. This is the problem with our debate. We want the same ends. I am saying only that no silver bullet answers the question we all want answered by ensuring both sufficient universal support and a targeted approach.

[Dr Roberta Blackman-Woods (City of Durham) (Lab)]

Since 2012, all five Sure Start centres in my constituency, serving the most disadvantaged areas, have closed, with devastating impacts on early years interventions in those areas. The Minister needs to visit Durham to understand that Sure Start’s multi-agency approach and access to a wide range of services has not been replaced by other services largely because of cuts to local authorities. Will she commit to coming to Durham, will she carry out a complete review of early years provision and children’s services and ensure it is funded properly, and will she agree to ring-fence money for Sure Start?

[Anne Milton]

I thank the hon. Lady for her invitation. I am not the Minister responsible for this policy area, but I will make sure that her invitation is passed to the Minister who is responsible, and I am sure that at the earliest possible opportunity he will come to Durham to see the evidence on the ground. As she said, one needs to see what it has been replaced with. I am not sure what the provision of the free childcare entitlement for two-year-olds is like in her area, but it will be important to look at that as well to see what benefit it is giving to families who might otherwise have gone to the children’s centre.

[Paula Sherriff (Dewsbury) (Lab)]

I remember a conversation with a constituent who said her Sure Start centre literally saved her life. She was suffering from post-natal depression but she went to the centre and spoke to other mums and dads, and it was they who convinced her that she needed professional help. Unfortunately, that Sure Start centre has now closed, along with more than half of the Sure Start centres in Kirklees, owing to savage Government cuts. Will the Minister publish figures for the number of designated centres across the country so that we can know exactly what damage has been done and—crucially—will she demand that the new Prime Minister undo that damage by reversing the cuts in full?

[Anne Milton]

The right hon. Lady raises an important issue—she is the first to have specifically raised it—and that is maternal mental health, which is a significant problem for many and is not limited to those from disadvantaged areas. I think that is important. Paternal mental health is now getting slightly more attention than previously. I cannot comment on Kirklees specifically, but if there is any information that we can send her, I will make sure she receives it.

[Mr Speaker]

With typical generosity, the Minister has elevated the hon. Member for Dewsbury (Paula Sherriff) to membership of the Privy Council. As far as I can discern or guess, it can only be a matter of time.

[Dr David Drew (Stroud) (Lab/Co-op)]

One of the great successes of Sure Start was that it reached out to rural areas. We saw that particularly in Dursley and the Top of Town in Stroud. The problem with the cuts is that they have come along with other cuts in, for instance, the number of health visitors. All the increases that were put in place by the Government post-2010 have gone. We also see all sorts of problems in the private and voluntary sectors. Will the Minister agree at least to look at the impact on rural areas? There may not appear to be great areas of deprivation, but to people in those areas who are suffering as a result of deprivation, this matters just as much.

[Anne Milton]

Perhaps, Mr Speaker, that was because I believe that all women should be Privy Counsellors. They are very under-represented on the Privy Council.

The hon. Gentleman raises an important point about rurality. As I said at the outset—and I did not make the comment flippantly—we will ensure that all that we do is evidence-based, and that our evidence is robust.

[Vicky Foxcroft (Lewisham, Deptford) (Lab)]

Has the Minister any plans to look into the impact of centres providing early-years support on reducing youth violence? I ask because last year the cross-party Youth Violence Commission published a report that, as well as suggesting we should take a public health approach to tackling youth violence, said that early childhood centres should be revitalised.

The Minister refers to the need for evidence. Our report was written in partnership with Warwick University, and a great many academics gave evidence, including a representative of the Open University. Edward Melhuish is one of the leading academics analysing the impacts of Sure Start and early childhood centres. Will the Minister agree to read our report and respond to it, and will she also look into the material published by Edward Melhuish on Sure Start and early childhood centres?

--- Later in debate ---

[Anne Milton]

The hon. Lady rightly raises the issue of youth violence, which is behind much of the work done by Members on the first 1,000 years. [Hon. Members: “1,000 days.”] I mean 1,000 days. “The First 1000 days of life” is based on the premise that many life chances are set in those early years. I think that both the Department of Health’s healthy child programme and our Secretary of State’s focus on improving home learning, particularly family learning, are important. However, I shall be delighted to look at Edward Melhuish’s report when I am able to do so.

[Ruth Cadbury (Brentford and Isleworth) (Lab)]

I was Hounslow’s Cabinet lead for children and young people when the Tories, who were in opposition in this place, shifted their view and came round to fully supporting the Labour Government’s roll-out of universal Sure Start provision as a multi-agency service. They did so because of the vast body of credible evidence of the real benefits provided by fully funded Sure Start centres, not just in health and mental health—which are covered in the IFS’s report—but in, for instance, social mobility, educational outcomes, and the provision of domestic violence services. Where is the evidence that informs the Government’s change of policy, as a result of which Sure Start centres are withering on the vine—or is the Minister struggling to justify it in the light of the effects of Government austerity on her Department?

[Anne Milton]

No. Let me remind the hon. Lady that the report makes it clear that we are one of the highest spenders on early years—[Interruption.] It is in the report, on the first paragraph of the executive summary.

I can only reiterate that, while words like “austerity” can be thrown around, this is about the money we are putting into, for example, the free childcare entitlement. It all matters. It all goes towards giving young families and children the early years support they need.

[Anneliese Dodds (Oxford East) (Lab/Co-op)]

With all due respect to the Minister, she has misrepresented the research, which showed that universal, multi-functional services—not residualised services—had a positive relationship with outcomes for disadvantaged children. In my city of Oxford, children’s centres are anything but that: they are just shells for private or voluntary services, or for residualised services such as contact centres or social services. The access is not there.

The Minister keeps talking about health visitors. Is she aware that under her Government the proportion of children receiving those visits at the right time is appallingly low in many parts of the country? Is she aware that it has fallen under her Government?

[Anne Milton]

The hon. Lady refers to universal, multi-functional services, and to health visitors. There are five statutory health visits. Well over 90% of contacts are made with children in the first few months of their lives, and 80% are made with those aged between two and two and a half. I think that that is welcome, but we always need to know what underlies such figures. I know that Public Health England is looking at the healthy child programme, and I am sure that it will look at those figures as well.