Health Visitors (England)

Debate between Karen Lee and Tim Loughton

Wednesday 23rd October 2019 Westminster Hall

[Tim Loughton]

That is a serious point; my hon. Friend is absolutely right. Health inequalities are still a big problem in this country, and those professionals on the ground, not least health visitors, are the first to come face to face with them and have the practical means, in many cases, to do something about them.

[Karen Lee (Lincoln) (Lab)]

Will the hon. Gentleman give way?

--- Later in debate ---

[Tim Loughton]

I am happy to take interventions, but it will mean that hon. Members will have to make shorter speeches, as I am sure Mr Bone will point out.

[Karen Lee]

The Royal College of Nursing’s briefing for the debate says that the number of health visitors with caseloads of more than 500 children rose from 12% to 21% between 2015 and 2017, so it will have risen even more in the two years that have elapsed since. The caseload is really worrying, in terms of people being missed.

[Tim Loughton]

The hon. Lady pre-empts a point I was going to make on page 5 of my notes, so I will take that bit out.

Unlike some other public service professionals, health visitors are non-stigmatising and usually welcomed over the threshold into homes, enabling them to give early advice and support to prevent later problems, encourage healthier choices, detect problems early and, in some cases, act as an early warning safeguarding alarm. Often when social workers are the ones to knock on the door, it may be too late, and that professional has a completely different sort of relationship with the family.

Maintained Nursery Schools

Debate between Karen Lee and Tim Loughton

Thursday 31st January 2019 Commons Chamber

[Tim Loughton (East Worthing and Shoreham) (Con)]

I start by declaring an interest and by congratulating the hon. Member for Manchester Central (Lucy Powell) on securing this debate. I supported the application and will certainly be supporting the petitions next week, with one from the nursery school in my constituency that I mentioned earlier.

Thursday afternoons are becoming like a “children’s hour” session, which is fantastic. I said two weeks ago when I opened the debate on children’s social care that we do not have enough time in this place to talk about important issues such as those facing children. We have a lot of childish debates on other topics, but we should be doing more on children and young people. A few Thursdays ago, we had an important, well-informed, emotional debate on baby loss. These are the issues that resonate with and are important to our constituents and their children on a day-to-day basis. It is to be applauded that we have strong interest in this afternoon’s debate and that we have a degree of consensus.

I am disappointed, however, with the politicisation in some Opposition Members’ speeches, because the Government want quality education for all. We can only pay for that quality education by having a strong economy and taxpayers who are in a position to pay tax. Hounding some out of the country does not provide resources to invest in education at any level and we need to balance that. Trying to make this into a political issue or to suggest that there is some ulterior motive—

[Karen Lee]

Will the hon. Gentleman give way?

[Tim Loughton]

I will not. Trying to suggest that the Government have some ulterior motive to run down what we all absolutely acknowledge is an essential part of the education system does not help anyone, frankly. I want to carry on with a more consensual approach about how to find a solution to the looming problem of sustainability of funding for these excellent nursery schools, which is the subject of this debate.

My hon. Friend the Member for Chichester (Gillian Keegan) and I each have a maintained nursery school in our constituencies. West Sussex only has four, so we have 50% of the county’s maintained nursery schools between us. What the schools share is quality and engagement with the local community. Boundstone Nursery School, which has been in existence for many years in one of the more deprived parts of my constituency and is run by an inspirational, exceedingly hard-working, determined headteacher in Jim Brannan, is co-located with other children’s centre services. The services have recently been rationalised into a new single service that provides an aged zero-to-25 prevention and early help service, integrating specialist county council teams with health visitors, school nurses and others. The site provides a one-stop shop for many of the services wanted by my constituents who use and need a maintained nursery school. Long may that continue.

I pay tribute to West Sussex County Council. We have many arguments about how many children’s centres have closed, but no children and family centres in West Sussex have closed. However, this is not a numbers game. This is about the quality of the services that are offered in children’s centres, the success of the level of engagement with the people who most need it, and the outcomes for those children and the families who engage with such services.

We still have many children’s centres that are often closed for too much of the week. The most successful centres, whether they are co-located with nurseries or whatever, need to be open in the evenings and at weekends. They need to be more father-friendly, and we had a debate on a similar topic in Westminster Hall yesterday. We need to make centres more welcoming, flexible and amenable so that, wherever possible, fathers can bring their kids to the nurses and engage with them, the support services and extracurricular activities that are on offer just as much as mums can. This is not about quantity, but quality, the extent of the engagement and the level of the outcomes. We need to make centres busier. In West Sussex we have also integrated them with what we call “Think Family,” which is one of the country’s best versions of the troubled families programme. The Minister has a strong interest in these areas, and he appreciates the importance of getting it right, so I re-emphasise the need to make sure that the Treasury rolls over the funding for the troubled families programme, which comes to an end in 2020. The programme has been a template for how joined-up, sensible preventive thinking prevents an awful lot of problems later on.

Maintained nurseries are an important part of the jigsaw at an important and impressionable stage of a child’s life and a new parent’s life. This can be a lonely and daunting time, and a nursery can be part of a new parent’s support network. I pay tribute to the immense amount of work and investment the Government have put into the free childcare offer, although not without problem; not enough fully to remunerate the cost of this in the independent sector. We are seeing the impact in the maintained sector, too.

Maintained nurseries are the gold standard, which is why so many more of them are rated outstanding, including the Boundstone nursery in my constituency. That is not to undermine the independent sector, but the standards of maintained nurseries are consistently higher. Maintained nurseries have to invest in provision for special educational needs and disability support because, as many hon. Members have mentioned, they are effectively schools, and they take on many of the kids who cannot be adequately catered for in alternative provision elsewhere. Maintained nurseries are doing a more universal job than many other high-quality players in the sector are able to perform.

I declare an interest as chair of the all-party parliamentary group on conception to age two—the first 1,001 days. I am also the chairman of trustees at Parent Infant Partnership UK, and we run professional services in children and family centres across the country to work with new parents, often single parents, who have attachment problems with their children. Those first 1,001 days from conception to age two are where we can have the maximum bang for our buck in giving the support that has not come, for whatever reason, between a parent/carer and his or her child.

The more we can do to get it right then, the bigger the savings financially and, much more importantly, socially in how that child will consequently become a contributing, balanced, stable member of society later in life. That work is crucial, and it is a false economy not to do it. The cost of getting perinatal mental health wrong is estimated at more than £8 billion a year, and the cost of child neglect is estimated at £15 billion a year. That is one hell of a bill for getting it wrong. Maintained nurseries are part of the solution and can prevent some of those children from ending up in those other ancillary services.

That is why I asked whether a proper audit has been done. If we reduce the places or the quality available in maintained nurseries, because some of them might have to consider their future if the funding is not confirmed and maintained, there will be a knock-on effect on safeguarding services. Maintained nurseries can act as an early-warning system where there are safeguarding problems or parenting problems within a family. Good nurseries are not just for the children who attend each day; they support the parents as well. Nurseries reduce the costs for health, wellbeing and disability services.

As I mentioned earlier, nurseries offer respite for parents looking after profoundly disabled children. Those parents can be confident that their children will be safe and properly looked after, and the nurseries provide a strong respite facility that may be the difference in whether a child is able to stay in the family home.

Madam Deputy Speaker, you are looking at me with concern, so I finish by saying that we need to do our best to make sure that these maintained nurseries continue as they are. For that, we have to give them certainty. When this protected funding comes to an end in 2019-20, some difficult decisions will have to be made if that funding has not been guaranteed, and we need to get that indication sooner rather than later. We need urgent clarification from the Treasury about the funding outcomes for these schools in pretty short order, otherwise they will be making these difficult decisions early, and what has been described as a beacon of early years education will be burning a little less brightly because we have not got it right. We will be reaping the consequences of that in years to come and those children will be reaping the consequences of the false economy that not doing that represents.