Healthcare Support Services: Conception to Age Two

Fiona Bruce Excerpts

Tuesday 15th December 2020 Westminster Hall

[Fiona Bruce (Congleton) (Con)]

It is always a pleasure to follow my friend, the hon. Member for Strangford (Jim Shannon). I commend my right hon. Friend the Member for South Northamptonshire (Andrea Leadsom) not only on securing this debate and on her excellent speech, but on the many years of work that she has undertaken in support of nought to three-year-olds. I very much support that.

The Early Intervention Foundation’s new report, “Planning early childhood services in 2020,” states:

“It is difficult to think of a more effective way in which the government might realise its vision to ‘level up’ Britain and ensure equality of opportunity than through ensuring access to high-quality local family services which start in maternity and run throughout childhood.”

It goes on to say:

“There is a logical case for more holistic and joined-up approaches to delivering area-based family services, which respond to concerns about a lack of service integration and artificial service boundaries.”

Recently, in making the levelling-up fund announcement, the Chancellor spoke about the opportunity to upgrade the centres of our communities:

“This is about funding the infrastructure of everyday life”—[Official Report, 25 November 2020; Vol. 684, c. 831.]

As vulnerable children and their families struggle with isolation, relationship conflict, poverty, addiction, death and many other problems during this pandemic, we need now more than ever to strengthen our community infrastructure so that every family needing support can access it locally and easily, when they need to. Many of us here are aware that the most pressured point in family life is often when the children are aged nought to three.

It will come as no surprise to colleagues that I want to use the rest of the two short minutes I have today to talk about family hubs. To put it bluntly, family hubs’ time has come. My hon. Friend the Member for East Worthing and Shoreham (Tim Loughton) made an excellent speech in which he said that sometimes it is difficult to find something new to say about something one has been speaking about for years, but I should say that family hubs are local centres that ensure that families with children and young people can receive help to overcome a range of difficulties, and get the face-to-face support that, as we have heard this morning, is so necessary.

Recently, calls for progress in supporting family hubs have grown louder. The Children’s Commissioner wrote in July:

“Some parents may want help to find work, or deal with the new strains on their relationship, or on their mental health, that can come with having a baby—and those stressful issues may also be making it harder for them to give their young children the loving attention they need. The Hubs would also have these more targeted services—including perinatal and infant mental health teams, JobCentre advisors, Speech and Language Therapists and housing teams—co-located within the service.”

Recently, family law practitioners have got on the case as they see far too many—40%, in fact—separating couples using fractious court proceedings to determine child contact and residency. Last month, the Family Solutions Group concluded that

“Crucially, the Family Hub…could provide the signposting and gateway to the range of other direct support services for children which are so sadly lacking at present.”

Thankfully, the Government are now on the same page. Their manifesto commitment says that they will

“champion Family Hubs to serve vulnerable families with the intensive, integrated support they need to care for children – from the early years and throughout their lives.”

Recently, the Family Hubs Network was established to share best practice and drive the family hubs movement across the country. The movement is characterised by an understanding of the importance of early help and provision; by a relational approach, adopted by everyone who works in the hub; and by a whole-family approach, so that families have somewhere they know they can go to get information, advice or guidance. Parents can get help for difficulties in their own relationships, and there can be integrated health and public health priorities, including health visiting and maternity, with social services and, if necessary, troubled families programmes.

This month, the Department for Education is taking the first steps in establishing a national centre for family hubs, which will not only develop the evidence base but share good practice on how best to support families in the early years. There is no time to lose.

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[The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)]

It is a pleasure to serve under your chairmanship, Sir Christopher. I thank the right hon. Member for South Northamptonshire (Andrea Leadsom) for securing the debate. I know that her passion for this subject runs deep and has done for some considerable time, and she always speaks with great authority. That is why I was so pleased that the Prime Minister appointed her to lead the review. I am really looking forward to the results of that come the new year, because as so many right hon. and hon. Members have said, the time for change is here. Being able to deliver for families over those first 1,001 days is a responsibility that we should all share; we need to make sure that we not only speak about it, but actually deliver it.

I would also like to thank all hon. Members present, starting with my hon. Friend the Member for East Worthing and Shoreham (Tim Loughton)—or, as I now like to refer to him, the hon. Member for health visiting, that very unsung part of our health ecosystem. I thank the hon. Member for Glasgow Central (Alison Thewliss), and commend her on the work that she does with her APPG on breastfeeding, which is such an important start to life. I also thank my hon. Friend the Member for family hubs, or for Congleton (Fiona Bruce), and the hon. Member for Strangford (Jim Shannon), who looks after the strength of the family in this place. Finally, I thank my hon. Friend the Member for Truro and Falmouth (Cherilyn Mackrory) for her plea for continuity of caring, but also for the fine work she does with the APPG on baby loss. I am following in some big shoes: those of my hon. Friend the Member for Colchester (Will Quince), of the former Member for Eddisbury, and of my hon. Friend the Member for Banbury (Victoria Prentis).

There is such power in this room for change, and it is both right and important that the Government have a care for the nation’s health. Just as we say about retirement, we should be investing in our health from the beginning: from early years through to older age. It must start from conception to be as effective as it can be. The period between conception and the age of two is absolutely critical in a child’s development, as we have heard. It is during this time that the important foundations are laid, creating that strong and healthy start that can see children through their life: to school, to work, to parenthood, and to better parenting themselves, as my right hon. Friend the Member for South Northamptonshire said, which very much struck me. This is a cycle that we really do need to get right.

Thankfully, most babies do have a fantastic start in life. They benefit from the support of loving parents and carers, as well as dedicated early years professionals. However, there are unacceptable variations across the country, both in different parts of the country and within regions, and both in terms of geography and population groups. We know that just over 66% of children in Bolton achieve a good level of development at age two to two and a half, but that rises to over 93% for a child born in Cambridgeshire. That differential should be unacceptable to us. Risk factors, often family based or socioeconomic, make our children—they are all our children—more vulnerable to poorer outcomes going forward.

The coronavirus has created enormous pressure, not only on services but on individuals. For many new parents, coronavirus has meant feeling isolated and losing that support mechanism, and my heart goes out to them. I think it was the hon. Member for Strangford who spoke about the importance of just meeting friends; just being able to have that little bit of “Does your baby do this? My baby does that.” They do not come with a manual, and I remember all four of mine, all under five at the same time, all being completely different: they all had completely different eating habits, and so on. Very often, I could not work out why. I thought, “I did a proper job before I had these children. Why on earth is this so difficult?” Some days, it was a real achievement to get the breakfast pots washed and go out with my pants on the right way around.

[Fiona Bruce]

The Minister is making such an important point. Does she agree that we so often undervalue how important mothering, parenthood and ensuring children have that best start in life is? As a society, we should value that much more highly, because it is not an easy job.

[Jo Churchill]

I agree wholeheartedly with my hon. Friend. We are in a different time as regards parenting. Many couples choose that the father will stay at home. Often they do an excellent job at raising their children, as that part of the family unit. It is about communicating, sharing responsibility, and the services that wrap around families. My hon. Friend the Member for East Worthing and Shoreham used a lovely phrase when he talked about supporting, not supplanting, parents: holding hands to make sure that there is help there when someone struggles with breastfeeding or to understand the right thing to help a child sleep, or when there might be conflict in the house and they reach out. I take the point made by my hon. Friend the Member for Truro and Falmouth about a trusted carer giving people signposting. I asked my sister, who recently became a grandparent, what the most challenging thing was, and she said it was definitely the isolation and separation, which did not even allow her to hold her new granddaughter for six weeks after her birth.

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[Fiona Bruce]

I thank the Minister for that comment. Will she also comment on the point made by my hon. Friend the Member for East Worthing and Shoreham (Tim Loughton) about the need for a dedicated Minister for families, ideally at Cabinet level? Within just a few minutes we have referred to many different Government Departments—the Department for Education, the Department of Health and Social Care, the Ministry of Housing, Communities and Local Government and others—all looking at family hubs. There needs to be one Minister who can really pull the thinking together and drive it forward.

[Jo Churchill]

I know that the Education Secretary has been given a leadership role for families, and £2.5 million to research and develop best practice on how we integrate family services. I know that my hon. Friend the Member for East Worthing and Shoreham has often called for a families Minister, and in the last Parliament my hon. Friend the Member for Congleton also made such a plea. Joined-up cross-Government working in many areas is always a challenge. I leave the plea of my hon. Friend the Member for East Worthing and Shoreham resting there. It is something else that will probably come out in the review.

The Department is taking important steps to improve the healthcare outcomes of babies and young children to give them the best start in life, including the most ambitious childhood obesity plan in the world. The Minister for Mental Health, Suicide Prevention and Patient Safety has done a lot of work on transforming children’s mental health and maternity services to identify those mothers and members of the broader family who are struggling. We also have a world-leading immunisation programme, which I will come back to.

All those policies are informed by the guiding principle of prevention, which I totally agree is better than cure. We want to identify and treat problems from the earliest stage and help parents to care for their children, change and improve behaviours, and protect against preventable diseases. We know that if parents and babies are well supported in the vital period from conception to age two, they are set up for a lifetime of better mental and physical health. Attachments, stimulation and foundations really are the backbone of their lives. While my right hon. Friend the Member for South Northamptonshire was talking, I thought of it as an emotional reservoir on which we can spend our lifetime drawing to ensure that we live healthier and more sustainable lives.

We are doing everything we can to help the NHS to improve outcomes for babies and children, and we are building that into the NHS long-term plan. The pandemic has made the public rely on new methods of accessing childcare. Information has been accessed from conduits such as 111 to an extent that we have never seen before. I am keen to explore how that can be used further to support parents and children going forward.

We are embracing opportunities presented by technology and pleased that the personal child health record, better known as the red book, is being digitised and made available. There are enormous opportunities here. We are also making sure that the modernisation of the healthy child programme is universal and personalised in response to every child’s needs. We remain committed to improving perinatal health. My hon. Friend the Minister for Patient Safety, Suicide Prevention and Mental Health is making sure this is at the top of her agenda.

I ask Members to encourage parents in their constituencies to ensure that their children are vaccinated. As my hon. Friend the Member for East Worthing and Shoreham said, vaccination rates are falling, and we lost the World Health Organisation status for measles. It is vital that parents use the free vaccination service to protect their children from measles. The actual disease is much worse than the second it takes to get vaccinated. I would really like us all to push to make sure that we regain the WHO status. The flu vaccination programme rolled out to school-aged children has been a phenomenal success this year, but if parents are worried about anything to do with vaccinations, they should go to their GP or a health professional and ask questions.

Before I finish, I will quickly comment on support bubbles. I hear my right hon. Friend the Member for South Northamptonshire. In all tiers, single adult households can form a bubble, and we have expanded this provision because we understand the pressure that they are under. Specifically, households containing a child with only one adult, and adult households with a child under one, or a disabled child under five who requires continuous care, can now also form a support bubble. In addition, households with one or more people who have a disability and require continuous care, as long as there is no more than one other individual over 18 who does not have a disability, can also form a support bubble. As my right hon. Friend knows, it is a challenge in the current pandemic to make sure that we balance the safety of everybody with access to support, in this case for young parents or perhaps people with needs arising from terminal illness.

The Duchess of Cambridge’s report was mentioned by several hon. Members. I am keen to understand whether the five recommendations are woven into the review, when it finally comes to us in January.

I recognise the impact of domestic violence on families. It has been incredibly difficult, and it is unseen. I pay tribute to the Under-Secretary of State for the Home Department, my hon. Friend the Member for Louth and Horncastle (Victoria Atkins), for her work in this space and on the Landmark Domestic Abuse Bill. We all need to be aware of the issue, and highlighting services and support for families is key.

On that note, I hand over to my right hon. Friend the Member for South Northamptonshire. I look forward to receiving the review in the new year and discussing the outcomes with her.