Children and Families: Early Years Interventions

Lord Bishop of Gloucester Excerpts

Thursday 27th February 2020 Lords Chamber

Moved by

[The Lord Bishop of Gloucester]

That this House takes note of the case for improved early years interventions to support children and families.

[The Lord Bishop of Gloucester]

My Lords, it is a great privilege to initiate this debate today on early years intervention. My interest in this subject comes from my experience as a paediatric speech and language therapist, then in parish ministry and now as a bishop committed to the flourishing and well-being of diverse individuals and communities. In light of that, I draw your Lordships’ attention to my entry in the register of interests.

The experiences we have as children, and in particular as young children, shape the rest of our lives. A child’s development score at just 22 months can serve as an accurate predictor of educational outcomes at 26 years. Adverse childhood experiences—ACEs—have significant public health and social consequences. Having had four such experiences is associated with poorer physical and mental health, drug and alcohol abuse and inter- personal and self-directed violence. There are stories up and down the country, including those I hear in prisons and women’s centres, about those who are now adults who were deprived of appropriate early years intervention, and about those who are turning their lives around for their children and their families as a result of receiving early intervention for their children and for themselves as parents.

My intention in tabling this debate today is to reflect on how government, both centrally and locally, can work with families and communities to support children’s well-being, particularly at the start of life—I deliberately use the word “with”. The Government have plenty of evidence that early interventions are not just good for children’s life chances, they are also sound financially. The old adage, “an ounce of prevention is worth a pound of cure”, rings true here. Despite this, the Children’s Society estimates that local authority spending on early intervention services for children and young people fell by 49% between 2010 and 2017.

Health visitors are a highly effective intervention and support for all babies and families across the social spectrum, yet their number is falling. Similarly, most areas in England have experienced a real-terms reduction in reported spending on speech and language therapy over the last three years, despite the fact that children with poor vocabulary skills at the age of five are three times as likely as their peers to have mental health problems in adulthood, and twice as likely to become unemployed.

For those in government concerned about money, it should be enough to point out that, when we provide early support and catch problems early, intervention is far less expensive. However, we have to be able to do this. The Government’s troubled families programme comes too late. The families it supports are already in trouble, not simply struggling or at risk.

Increases in government spending on children’s services have been largely a result of the increased number of looked-after children and the Government’s expansion of free childcare hours, while spending on children’s centres and provision for families has decreased, particularly in the most deprived parts of the country where they are most needed to address inequality. In the case of looked-after children, this is by far the most drastic and expensive intervention the Government can make in a child’s life. What assessment have the Government made of the causes of this rise?

On childcare, academic research shows that pre-schooling and paid childcare improve children’s outcomes only if they are of high quality. Where children are looked after by private providers, vital links with local authorities can be missed and staff may not have the specialist training required to spot early issues. Research done by the Institute for Fiscal Studies and the Joseph Rowntree Foundation suggests that the free entitlement for three and four year-olds does not effectively target the most needy and at risk. What assessment have the Government made of the quality of this provision and its effect on early years outcomes for children?

Child poverty has a strong link with child development. Children who have lived in persistent poverty during their first seven years of life have cognitive development scores on average 20% below those of children who have never experienced poverty. The Millennium Cohort Study shows that poor children are four times more likely than rich children to develop a mental health problem by the age of 11. Gaps in achievement open up early on, and by the time they start school the poorest children are already 11 months behind their more advantaged classmates. Overcrowded, poorly maintained housing can lead to children sleeping in living rooms or with parents, which has consequences for physical and mental health. Poverty puts families under pressure, and that stress can be a source of ill health and family breakdown, leading to expensive work by public authorities further down the line.

Simply expanding both entitlement to free childcare for disadvantaged two year-olds and the number of free hours that older children are entitled to is unlikely to counteract the effect of benefit changes and the two-child limit. To put it simply, incentivising single mothers to work is not a panacea for their child’s development. Can the Minister explain what analysis the Government have made of the impact of DWP changes on child poverty, particularly the two-child limit, and any impact assessment of the effect that this will have on children’s life chances and well-being?

We also know that worklessness is no longer the root of poverty. Seven in 10 children in poverty are now in a working family. Part of the problem is that families have to pay the entire cost of free childcare up front before they can claim back the 85% that the Government will cover. Many low-income families do not have the capital to pay this up-front cost or risk going into debt. Moreover, childcare support has been capped at £175 per week since April 2016, while childcare costs continue to rise. The deep irony of this situation is that most childcare workers are themselves women on low pay, and 44% of childcare workers claim state benefits or tax credits.

To paraphrase the Sutton Trust and the Marmot review published earlier this week, it is difficult to see how even well-designed policies to support parenting and ensure access to high-quality early education can have the optimal impact against a backdrop of a sharp increase in child poverty.

Furthermore, navigating the benefits in the childcare system is hugely complicated, especially as families begin to migrate on to universal credit. Anecdotally, we hear that this is something that churches and toddler groups help with around the country. Toddler groups —many provided by churches and other community-based groups—do a huge amount of early intervention and signposting work, informally across the country. It amounts to thousands of hours each year. Often, these are the only places in a community where children from different backgrounds mix and parents and care givers are provided with support. Yet toddler groups are almost invisible in impact studies and government reports. They are a tremendous asset to the country, provided by hard-working, committed volunteers. We want to encourage this sort of expression of civil society, but the Government must partner with the community to make sure that local services are joined up, holistic and sufficiently funded. This work cannot simply be outsourced to stretched volunteers.

While I welcome the Government’s commissioning of research on family hubs, surely the case for children’s centres is already well known. For each Government to have to learn the benefits of early intervention for themselves is frustrating and a poor use of resources. One of the most important parts of Sure Start was co-creation with the local community—a bottom-up approach that listened to the needs of service users. Will this happen with family hubs? What support will the Government provide for children and their families from all walks of life to ensure that parents who have concerns about their child’s welfare and development have somewhere to turn?

If I had longer, I would have liked to say something about families of children who have a disability. The long-term well-being of such children and families is about not only access to early diagnosis but appropriate early intervention. Early intervention by definition needs to be made early, and I hope that the Minister, in her reply, will explain how the Government are working across departments to improve early years policy, given that the interministerial group on the early years has been disbanded. Will the Government introduce a cross-departmental early years strategy as part of the plan to level up Britain, and ensure that every child can achieve their potential? What attention have the Government paid to the work of the Early Intervention Foundation and its analysis of what works as effective interventions? Will the Minister assure the House that local authorities have sufficient ring-fenced funding to deliver them?

There is an urgent need for join-up. At present, we do not have a single framework, even across health and education, to assess and support the development and well-being of every child. This is more than join-up across health and education—although that would be a good start. This is about every aspect of life if we are rightly to look at the whole child in the context of the family.

In this debate, we are not simply focusing on little people. We are talking about investment in the start of life, which affects the long-term well-being of individuals, families, households, communities, our country and beyond. There is a very strong case for improving early years interventions and having a clear and joined-up strategy for doing so. I look forward to hearing the contributions of other Members on this topic today.

--- Later in debate ---

[The Lord Bishop of Gloucester]

I thank the Minister for her comprehensive response and all those who participated in this excellent debate. I do not have time to mention everyone, but I thank those who shared personal and professional experiences. I am sorry that the noble Lord, Lord Mawson, feels he has heard another bishop say, “It’s all down to the state”, particularly as that was not what I was saying. I am passionate about community engagement and how we enable that, not least through our churches, our faith groups and all sorts of charities and communities. In order to enable that, we need a comprehensive, joined-up early years strategy and I am glad that that point has been clearly heard. This is about how we are investing not simply in small children but in children who grow up to be adults: we are investing in families for long-term impact, and I agree with the noble Lord, Lord Mawson, that this is about the impact on our communities in the long term.

Motion agreed.