Health: Children and Young People

Baroness Stedman-Scott Excerpts

Tuesday 7th July 2015 Lords Chamber

[Baroness Stedman-Scott (Con)]

My Lords, I congratulate the noble Baroness on securing this important debate about children and young people’s physical and mental health. I hope I am not at risk of repeating some of the things that she said, but I hope she will take it as significant endorsement. I am not an expert on physical or mental health, but I have a lifelong interest in these issues, not least because I am a fellow of the Centre for Social Justice, which has spent more than 10 years researching the root causes of poverty and disadvantage.

These overlap to a very large extent with the root causes and effects of poor mental health. The National Audit Office has documented how young people who should be poised to make their mark on the labour market yet struggle with pronounced depression and anxiety are much more likely instead to be unemployed. Conversely, early episodes of unemployment can have lifelong effects not just on wages but on mental health. Working with Graham Allen MP, the Centre for Social Justice blazed an important trail in social policy by emphasising prevention rather than cure. The concept of early intervention when it is clear that deep and potentially intractable problems are brewing in a child or young person’s life is not rocket science but common sense, yet much government spending has been focused in the past on late intervention.

I am encouraged that there is cross-party consensus that that needs to change. Take the troubled families programme, for example, which built on Labour’s family intervention project pilots. The coalition Government estimated that £9 billion was spent per annum on disruptive and highly distressed families, but only £1 billion of that spend was helping them to turn their lives around and prevent further harm. The other £8 billion was used to mop up the mess: over three-quarters of a billion pounds was spent on health, for example, over £2.5 million on criminal justice and almost £4 million on safeguarding children and behavioural interventions in schools. And that was a conservative estimate: for example, the health spend did not take into account domestic violence and other A&E admissions, yet violence is a factor in around three-quarters of so-called troubled families.

While families in that category are in a small minority, the Government have recognised that many of the problems affect a large number of families, hence they have expanded the programme significantly. Surely they were influenced in doing so by the Riots, Communities and Victims Panel’s estimate that at least half a million families were teetering on the brink of considerable difficulties that were not simply financial.

All this is a preamble to my main point that if any Government are to safeguard the health and well-being of children and young people, they would do well to start with parents, strengthening and stabilising families and helping to prevent the relationships within them from breaking down. Government research shows that the poor outcomes of many children who experience family breakdown include poor mental and physical health, particularly depression, smoking, drinking and drug use in teenagers.

We know that a high number of under-18s cannot get local help when they experience a mental health crisis, further compounding their loneliness and difficulties. Either they are treated on adult psychiatric wards or they have to travel hundreds of miles across the country to receive hospital treatment. The Government and local health commissioners simply have to address this, but they also need to do far more to prevent mental health problems from arising in the first place.

Addressing our epidemic levels of family breakdown is vital. This is not an argument for families to stay together however abusive or conflictual the relationships within them, but it is a plea for recognition that adverse childhood experiences, many of which could have been prevented by working early with families, are like a child’s footprint in wet cement—they last a lifetime.

Standing back for a moment, it is important to acknowledge that families can greatly benefit society and boost a nation’s economic competitiveness, and to acknowledge the profound social and financial consequences when, for whatever reason, families fail. Family breakdown costs £48 billion per annum and disproportionately affects people in the poorest communities, where two-thirds of children do not grow up with both their parents, compared with two-fifths of children in more affluent areas, although that is still a high proportion.

So while I applaud the Government’s launch of a task force to improve the mental health and well-being of children and young people, I also want them to develop a robust and comprehensive range of family policies, and to appoint a family champion who will drive and sustain this agenda—a Secretary of State with clear accountability for families who has the resource and clout to drive through a programme to strengthen families, boost stability and uphold fatherhood and its importance. This range of family policies must support all the main functions of families: family formation, and separation when that is inevitable; relationships between parents; and economic support for child-rearing and caring for older people. The family test introduced in 2014 is a great start but, while this views all departments’ policies through a family impact lens, it reacts to what other departments propose rather than being proactive in strengthening families.

A lot is being done already in terms of childcare: the CANparent programme; the troubled families programme; 4,200 extra health visitors and the doubling of family nurse partnerships; shared parental leave; family-based arrangements in child maintenance; an additional 10,000 family mediations; the marriage allowance, which recognises interdependence within couples; and funding for relationship support. Coming down the tracks, this Government have promised to increase income tax thresholds, provide better mental health support in pregnancy and introduce better measures to eliminate child poverty by recognising the root causes of poverty, including family breakdown.

However, a truly comprehensive approach to strengthen the family and prevent relationship breakdown requires ensuring that a family strand runs though practically every area of government. For example, the MoJ should encourage parenting and relationship support in prisons. Robust research shows that when offenders leave prison and are in a good relationship, that can help them turn away from crime, and their children are less likely to suffer bereavement and loss if they come back into their lives with a better idea of how to be good parents. BIS needs to look closely at what Lloyds and other employers are doing with regard to employee webinars on parenting and couple relationships. Helping employees cope with family worries reduces absenteeism, so the Government should be encouraging employers to help pick up the tab for relationship support.

There are many other examples across government, hence the family champion need not be someone heading up a department for families but could be like the Cabinet Minister for Women and Equalities. Alongside their main departmental role they would spend time on this responsibility, with the necessary governmental structures in place to ensure that adequate attention was given to it. For example, there should be a statutory duty to report on the extent to which family stability has improved or worsened on their watch.

Adequate and appropriate healthcare services are essential, but the welfare society begins in the home, and in children’s earliest years. It is essential that we focus our efforts on families and take a preventive approach to reduce demand—and deep human misery.