Mental Health (Infants)

Emily Thornberry Excerpts

Tuesday 26th October 2010 Westminster Hall

[Emily Thornberry (Islington South and Finsbury) (Lab)]

I congratulate the hon. Member for South Northamptonshire (Andrea Leadsom) on the great passion, and knowledge of the subject, that she has shown us all today, and on securing this debate. I pass on my best wishes to OXPIP—the Oxford Parent Infant Project—for its good work. I hope that it will continue to go from strength to strength. I am today also speaking as a mother of three, and as the former chair of the all-party group on maternity. I have listened with great interest to the debate and to the thoughtful contributions from the hon. Members for Mid Dorset and North Poole (Annette Brooke), and for Southport (Dr Pugh). At times, I thought that I must have strayed into the House of Lords, given the level of expertise that we have heard.

I do not agree with some of the points raised. I do not agree that all parents are amateurs; I believe that the vast majority of parents are experts, but only in their own children. Of course, there are some catastrophic failures, but I believe nevertheless that it is important for parents to develop confidence in their ability to look after their child. I remember beginning parenting with an understanding that I needed to love the child, but with little further understanding. I still remember holding a copy of a book by Penelope Leach in one hand, the baby in the other hand, and looking up how to hold the baby. One struggles on, and that did not make me any less of a mother. I learned quickly on the job and was committed to it. I quickly became an expert, to such an extent that I remember showing off to my mother because my baby did not have a bald patch on the back of his head. My mother pointed out that that was because I had never put him down. Perhaps that was my own version of the application of the attachment theory.

The importance of the attachment between parents—or an adult—and a child in the first two years of life has been greatly highlighted by child psychotherapists. Those years are when the prefrontal cortex develops, which brings awareness of our emotions and those of the people around us. The infant mind is not born, but builds like a muscle over the first two years in response to parental attention and attachment. That theory has been around for some time. Attachment is considered to be a bond that develops from a child’s need for safety, security and protection. Positive attachment experiences stimulate feel-good chemicals and help build pathways in the brain that support the development of higher-level functioning and help with things such as attention, memory and impulse control. Missing attachment can give a sense of insecurity, suppress neural development and stimulate stress hormones in the brain. The weight of research has been brought to the attention of policy makers and the public by people such as Sue Gerhardt, who founded OXPIP, and who has built consensus for the view that we must focus on intervening earlier than we had thought.

The importance of early intervention was recognised by the Department for Children, Schools and Families in its report, “Early intervention: Securing good outcomes for all children and young people”, which made a strong case for expanding early intervention policies. According to the Prime Minister, the new Government will be the most family-friendly ever, so perhaps expectations are high that increased support will be available to new parents. Unfortunately, as the Institute for Fiscal Studies has pointed out, families with children seem to be the biggest losers in the comprehensive spending review.

The fierce debate about the long-term detrimental effects, or not, of day care has been fuelled by superficial and irresponsible reporting in the media. The question is whether the day care is good day care. What plans do the Government have to ensure that day care remains of a high quality, so that those parents who choose to put their child into day care do so in a way that benefits the child and assists in their development?

As highlighted today, maternal depression is an important issue. Under the previous Government, there was the introduction and great expansion of psychological therapies. Do the Government have any plans to target new mothers who have post-natal depression? There is also the problem of parents and substance misuse.

Another policy issue that has been raised is that of health visitors. I welcome the Government’s announcement that the number of health visitors will increase by 4,200. They will give support and encouragement to new parents, which, from my own memories, is invaluable. When will those new health visitors be in place? Will they receive specific training in mental health, and if so, what sort of training? Where will the funding come from? I understand that it is likely to come from Sure Start, and although the Government have said that Sure Start is safe in cash terms, if a large amount of money is taken out to pay for health visitors, how much will Sure Start be short?

Sure Start has an important role in bringing together cross-disciplinary services and providing an atmosphere of trust. In areas such as my constituency of Islington, Sure Start services are interesting because we have the very rich living next door to the very poor. If the Government’s new policy is to target Sure Start services on the poor, the concern is that there could be some form of stigma attached to getting involved in Sure Start.

Alison Ruddock, the head of Islington’s early years programme, fears that Government plans could set such services back 20 years in a borough such as mine, which ranks as the sixth most deprived in the country, despite there also being great wealth in it. She says:

“The fact that we have a mixed population is hugely to our advantage…We haven’t got rich centres and sink centres. So the most disadvantaged children are shoulder to shoulder with the most advantaged. If you have a service for poor children, it’s very difficult to prevent that from becoming a poor service.”

If one says to a parent, “There’s a stay-and-play centre on your estate; it’s really fun, why don’t you come?”, they will often say yes. However, if one says, “Let’s sit down and fill in a massive form, and you can tell me all your problems,” the parent is likely to say no. The problem will be the effectiveness of Sure Start, which over the past few years, as far as we are aware, has given huge support to parents.

Action for Children estimates that for every £1 of public money spent on Sure Start, we save £4.60 in the long term. Ofsted only began inspecting Sure Start in April, and it may be too early to judge matters technically. However, in our heart of hearts we know that Sure Start has been a good policy lever. If it is to be changed, we must be confident that it will not be undermined. I understand that there will be early intervention grants. Can the Minister provide any further details about those? I am sure that she has heard concerns from councils that that might not be enough, and that early intervention projects might close, as opposed to expanding.

I would also like to highlight the issue of GPs. Although health visitors are important for new mothers, GPs are important, too. However, up to half of GPs have no formal training in paediatrics and child care, despite a quarter of their patients being children. In many terrible tragedies, some of which have been mentioned today, we see an involvement of GPs that has simply not been up to the mark. I echo the question from the hon. Member for Mid Dorset and North Poole about whether the Minister can provide an assurance that funding for child and adolescent mental health services will not be cut. If the Government go ahead with the proposed abolition of primary care trusts, will they have the policy handles to ensure that such vital services are not cut?

I conclude by congratulating the hon. Member for South Northamptonshire on raising this issue. The quality of the debate this morning has been high, and it is a great shame that there are not more people in the Chamber to contribute to it.