Conception to Age 2: The First 1001 Days

Debate between Justin Madders and Graham Allen

Thursday 17th December 2015 Commons Chamber

[Justin Madders (Ellesmere Port and Neston) (Lab)]

First, I commend and congratulate the hon. Members for East Worthing and Shoreham (Tim Loughton) and for Dwyfor Meirionnydd (Liz Saville Roberts) on securing this debate. I also pay tribute to the members of the all-party group for conception to age two—the first 1001 days for developing the manifesto and raising the profile of these important issues. All the Members who have spoken today have done so with great eloquence on these issues.

Let me go through some of today’s contributions. The hon. Member for East Worthing and Shoreham, in his opening remarks, correctly said that this is about challenging the mindset and going beyond the troubled families programme, which has proved to be a success around the country. He rightly highlighted the shocking statistics on suicide among new mothers and rightly said that much of it is preventable. He gave us a volley of statistics and they all point towards this manifesto as being something on which there should be widespread agreement, and I think that agreement has been apparent from today’s contributions.

It was also a pleasure to hear from my hon. Friend the Member for Nottingham North (Mr Allen), whose work in this area I was a keen reader of before entering this place. I was glad to hear his contributions today. He rightly said that this is about investment in individuals, that a consistent approach has to be taken across changes of Government and that this is about a philosophy in the way we do things. He made an interesting point when he said that, if we proposed spending £17 billion on an early intervention programme, we may have a little difficulty in getting that past the Treasury, but that is actually the potential saving that might be realised if this is done correctly. Of course, this is about so much more than simply making savings. He said that early intervention should mean that late intervention is consigned to the dustbin of history, and we would all welcome that.

[Mr Graham Allen]

Like the hon. Member for East Worthing and Shoreham (Tim Loughton), and many others who spoke, including the hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron), I did not have a chance to speak about a broad policy area in this field—social investment. There is now a way of monetising and finding out how much we can save ourselves, and the many social instruments and social investments out there are growing by the day. I hope my hon. Friend will consider that in his remarks, because massive savings can be made in this area—indeed, money can be made in order to reinvest in new services.

[Justin Madders]

I am grateful for that intervention, and my hon. Friend is right to say that this can be monetised. I recall that when my local authority carried out an examination of the early intervention scheme, a figure of about £100 million was mooted. There are challenges in getting different Departments to buy into that, because they are all quite protective about their own sources of money, but if we take a holistic approach, we can see that there will be savings right across Departments. I hope that we can begin to develop that approach.

The hon. Member for Congleton (Fiona Bruce) rightly highlighted the staggering and shocking statistics about alcohol intake during and indeed before pregnancy, and rightly said that a clear message needs to be sent out about the risks. She rightly paid tribute to the work of my hon. Friend the Member for Sefton Central (Bill Esterson) with his all-party group on foetal alcohol spectrum disorder. The group took a great deal of evidence in preparation for its report, which has been released today. It is unambiguous in its recommendations about the need for clear and consistent advice to be given on the dangers of alcohol during pregnancy and the need to improve training and education across the board. He has laid down a clear challenge for the Minister in this area and I look forward to hearing what his response will be.

The hon. Member for Foyle (Mark Durkan) spoke with his usual passion and sincerity on the subject. He gave us the memorable phrase, “What happens in our early years stays with us throughout our years.” I am not sure what he meant about the goings on in Las Vegas. Perhaps he will enlighten me outside the Chamber. He rightly pointed out the academic research that is set out in the manifesto. Clearly, an evidence-based approach is welcome, because the evidence is there and it is clear.

The hon. Member for East Kilbride, Strathaven and Lesmahagow spoke with great personal experience on this area. She rightly pointed out that early experiences can affect a child’s relationships throughout their lives. We have heard from a number of Members about how difficulties in relationships can perpetuate the cycle of despair that we currently see and have been discussing today. She made a valid point about early assessment of development disorders, especially autism. At the moment, that assessment does not happen quickly enough. She also talked about this idea of a named person being the point of contact for the families, and saw it as a positive development. I am certainly aware of a number of similar initiatives that have shown the benefit of such an approach.

We have had a great many informed, respectful and consensual contributions today. I will try my best in this season of goodwill to maintain that. I am speaking here as a member of the shadow Health team. The NHS is really where my focus is. It was first conceived to be a responsive treatment-based service that supports everyone in society from the cradle to the grave. It is only in recent years that we have begun to understand how that short time in the cradle—those very first few months—can ultimately decide how long, healthy and happy a newborn baby’s life will be.

I will keep my remarks quite brief as we have been squeezed out by other business today. Let me just touch on a few areas that highlight why this period is so vital and a few areas where we should be doing a little better.

As we know, the manifesto takes its title from the period from conception to age 2 when a baby’s brain is developing at its fastest. We know that the earliest experiences have a lifelong impact on mental and emotional health. We also know that, when a baby’s development falls behind the norm during the first years of life, rather than catch up with those who have had a better start, they are actually more likely to fall even further behind in subsequent years. More than a quarter of all babies in the UK are living in complex family situations that present heightened risks to their wellbeing. The sad reality is that babies are far more likely to suffer from abuse and neglect and up to seven times more likely to die in distressing circumstances than older children. We have a duty to give every child an equal opportunity to lead a healthy and fulfilling life.

“The 1001 Critical Days” manifesto is the best chance for us to make that happen. Not only is it the right thing to do for our children, but it is the right thing for the public purse. According to the Royal College of Paediatrics and Child Health, there is increasing evidence to show that spending on early years intervention can yield a return on investment as high as 6% to 10%. My hon. Friend the Member for Nottingham North eloquently showed how that could be translated into significant savings across Government.

[Mr Allen]

I sense that my hon. Friend may be coming to the end of his remarks, so I am going to squeeze in one more intervention, if I may, and it is in respect of the next Government. There may be a change of Government in 2020. My hon. Friend has an opportunity to spend some time developing an early intervention philosophy across, as I mentioned, not only health and children’s services, but the economy and even international affairs. That preventive view, rather than attempting to cure, could be fundamental to the next Government, as it should be and increasingly is to the current Government. Will he give us an assurance that this will be in his thoughts as he develops policy in his area?

[Justin Madders]

I thank my hon. Friend for his intervention. I am certain that I will be able to take those comments on board. As I said, it is a subject in which I took an interest before I entered this place. I believe that is the right approach and I am confident that in four and a half years’ time we will have the opportunity to put it into practice. [Interruption.] Some may disagree about that. In the season of good will, a little latitude is surely permissible.

If it is done in the right way, early intervention can save money, save lives and improve the wellbeing of parents and children. The former Scottish Health and Finance Minister, Tom McCabe, summed it up perfectly when he said,

“We have heard evidence, stacked from the floor to the sky, that this is the right thing to do.”

Focusing on the first 1001 days is not just about ensuring the healthy development of future generations of children, but about making our NHS and many other public services sustainable.

I want to say a few words about perinatal mental health, as I know this is an issue that many Members feel passionately about, not least the shadow Minister for mental health. Perinatal mental health problems affect up to 20% of women at some point during pregnancy or in the year after childbirth. We heard from the right hon. Member for North Norfolk (Norman Lamb), who pointed out the impact not only on the mother, but on the child and the wider family. About half of all cases of perinatal depression and anxiety go undetected and even those that are detected fail to receive evidence-based forms of intervention. This is important because severe perinatal mental health problems are bad not only for the women affected, but for the development of the children involved, as the right hon. Gentleman highlighted.

In particular we need to ensure that all women affected have access to appropriate treatment, and that variation in access is addressed. The right hon. Gentleman referred to a map which starkly highlighted that. It is worrying that 41% of maternity units have no access to a trained mental health worker, 30% are unable to offer psychological support, and on a wider but connected issue, about a third have no overnight accommodation. It is also regrettably the case that under this Government there has been a reduction in the number of specialist in-patient mother and baby units. The Government’s pledge to spend £15 million on perinatal mental health was extremely welcome, but we need to see that pledge put into action. I would be grateful if the Minister could update the House on what he has been doing in that respect.

We will tackle the problems that parents and children might have in this period, and spot the problems early enough, only if we have joined-up multi-agency working between health services and local family support services. Children’s centres have a critical role to play in this mix in many areas. As a former member of the advisory board of the Stanlaw Abbey children’s centre in my constituency, I have seen at first hand what a welcoming and safe place it is for families to visit, as indeed are all children’s centres. In addition they have a wealth of experience and knowledge, and trained staff who have the skills to identify problems at an early stage, whether in bonding, the mother’s mental health or child development, so that that disadvantage can be tackled.

I have heard from Stanlaw Abbey the great strides made by children coming into the centre and how much progress they make, as well the support given to the parents, many of whom have re-entered education and the world of work, thanks to the help of the centre. The one challenge that continually remains, though, is how to engage with those families who do not come through the door. We know that they are out there. They will not all need support, but some will, and despite extensive efforts to reach out to these families, they simply stay outside the system for too long, missing out on the crucial support that this debate is trying to highlight.

For me children’s centres have to be the cornerstone of a successful early years policy. That is why it is so concerning that under this Government we do not appear to have any strategy for children’s centres. The Prime Minister famously promised to protect such centres, but there are 700 fewer designated children’s centres than there were in 2010.

Alongside that, many of the local government services that families used to rely on are taking a massive hit. The transfer to local authorities in October this year of the healthy child programme for children up to five years of age presents an important opportunity for local authorities to integrate health, education, social care and wider council-led services and to focus on improving outcomes for children from birth. But I find it difficult to square the circle of this announcement alongside the £200 million in-year cut to public health that this Government have introduced.

There is a real risk that the decision could cost more money than it saves and that the good intentions behind passing responsibility to local authorities could be stymied from the off as a result of the short-term approach to funding that the cuts represent. I would therefore be grateful if the Minister updated the House on what support he is giving to local authorities to ensure that commissioning is properly resourced when they assume this new responsibility. What steps is he taking to ensure that the cuts do not affect front-line services?

As we know, many local authorities have been forced to pare back to the statutory minimum, which is totally against the grain of what we are trying to achieve. Taken together, the failure to invest in early help services and the lack of priority the Government give to this type of provision mean that Ministers will fail to support adequately all children and families in those critical 1001 days. The cross-party agreement we have heard about today needs to be matched by cross-departmental harmony across Government.

In conclusion, the evidence is overwhelming. It is so obvious that it should have underpinned Government policy decades ago. Anyone who is a parent will recognise the intensity of feeling when observing how their child is developing. That innate desire for one’s offspring to grow up to be happy, healthy and wise should be all the encouragement we need to support this incredibly important document, not just for our children but for everyone’s children. On that note, I would like to wish everyone in the House a very merry Christmas.