Children: Maternal Care

Baroness Barker Excerpts

Thursday 17th March 2016 Grand Committee

[Baroness Barker (LD)]

My Lords, I thank the noble Earl for securing this debate today and for introducing it in such eloquent fashion. Early years, the early start in life and maternal support were a key priority for the coalition Government. It is good to have the opportunity to return to this issue. We do so in the week that a new all-party group has been set up. I am not really a fan of new all-party groups because there are thousands of them already, but this is the All-Party Parliamentary Group for Conception to Age Two—The First 1,001 Days. That shows the consensus which now exists around the importance of the first 1,000 days of a child’s existence. Throughout the mother’s pregnancy and up until the age of two, approximately, is the key formative stage in any person’s life, physically, mentally and socially. I am glad that we now have that consensus about the importance of interventions during that time to make sure children grow up happy, healthy and well adjusted.

Needless to say, midwives have a key role in assisting mothers. This House, under the repeated instruction of the noble Baroness, Lady Cumberlege, has over the years come to understand the continuing importance of midwives, not just in the support and information that they give to women during pregnancy but also in their ability to prioritise post-natal care plans with women so that they, once they come out of hospital, have in place a way to see them through what is sometimes the most demanding not to say frightening time in a parent’s life.

It is recognised by all parties that continuity in midwifery is extremely important. Quite often, one hears women talking not about the fact that they could not see a midwife but that they had to see different midwives. On each occasion they had to start from scratch and go through all sorts of details, so that by the time they got to the end of a short consultation they had had very little time in which to have a proper discussion about the issues bothering them. In the light of the recent report by the noble Baroness, Lady Cumberlege, what impact does the Minister believe that the introduction of personal budgets, as she proposed, would have on the availability of midwives? What is his assessment of the impact that it might have on the training—and access to that training—of midwifery students, who are so important for the future?

On 1 October 2015, services for children aged under five were transferred from the NHS to local authorities, which are now required to make provision for maintaining the universal health visitor reviews as part of the healthy child programme—specifically, the antenatal promotion review; new baby review; six to eight week assessment; one year assessment; and two to two and a half year review. We know, because there is a lot of evidence now both from this country and abroad, that early intervention with disadvantaged families can have a profound effect on the life chances of a child. We know that the public health interventions that are needed have to be integrated at a local level with the NHS to ensure that the healthy child programme and family nurse partnerships can identify and work with those families who are most in need. We know that investment in health visitor programmes pays off in terms of the benefits that they bring to families and the way in which they enable children to thrive and not to need far more expensive interventions later on. The transfer of powers to local authorities is well founded in evidence. How will the programme’s implementation be monitored and evaluated in practice and when can we expect to see the initial results? When will we be able to see figures, particularly in relation to the eradication of child poverty, which is a target by which this and all previous Governments are judged?

I touch briefly on mothers, work and childcare, which the noble Earl, Lord Dundee, alluded to. According to the Department for Education survey of parents in 2014-15, two-thirds of mothers—about 66%—were in employment and one-third of mothers were not working. About half of those non-working mothers agreed that they would prefer to go out to work if they could arrange good-quality childcare that was convenient, reliable and affordable. Among the mothers who had returned to work in the previous two years, the most commonly reported factor that had influenced their return to work was finding a job that enabled them to combine work and childcare. The availability of not just childcare but of suitable childcare is the single biggest problem for working parents. It is quite often the case that it is impossible to find childcare for half a day. Yet, when children start at nursery schools, sometimes they go for only half a day, which leaves parents desperately trying to juggle work around the time they have to get back to pick up the kids. Equally, some parents have to work part time but can only arrange with their employers to work for, say, two full days. If they cannot find childcare to fit around that, their chances of moving back into work—as the majority wish to do—are severely hampered.

We in the Liberal Democrats supported the extension of free childcare, particularly to parents who were not in work: free childcare is a very early-stage intervention and makes a big difference to children in deprived communities. We also recognise the importance of the role of fathers and believe that shared parental leave should be the aim of all Governments, so that individual families can arrive at solutions that work best for them and their children. Will the present Government continue the work of the coalition in trying to work with employers to improve the availability of affordable high-quality childcare, so that those parents who wish to can continue to work while giving their children the best start in life, which is what the vast majority of parents in this country want?