Early Years Family Support

Lucy Powell Excerpts

Tuesday 16th July 2019 Commons Chamber

[Lucy Powell (Manchester Central) (Lab/Co-op)]

I for one, Mr Deputy Speaker, am pleased that you allowed the right hon. Member for South Northamptonshire (Andrea Leadsom) the time she needed to give such an excellent and outstanding speech about why the 1,001 critical days are so important. When she asked me to co-sponsor this debate, I did not hesitate to say yes. As she has said, she and I have worked together on this issue for many years. In fact, she was the first Government Member to approach me when I first got elected, and she asked me to get involved with her work on this important area. She sought me out and we have worked very closely ever since. As we heard in her outstanding opening speech, her personal commitment to this agenda is completely without exception. She has done a fantastic job and we really miss her drive and leadership in government on these important issues. I will say more about that later.

I will not try to emulate the right hon. Lady’s excellent speech, but, as she has said, all the evidence tells us that the most important time in the life not just of a child but of a human being is those first 1,001 critical days. The fact that we do not give enough attention to that is, in my view, immoral, because we know how important it is, yet it does not get the attention it deserves.

The science has already been outlined, but I want to highlight another aspect. Deprivation is still a really key issue for outcomes in the first 1,001 critical days and thereafter of a child’s life. We know from all the evidence that the single biggest indicator of how well someone will do in their GCSEs is their developmental level at the age of five. We also know that children from better-off backgrounds hear 30 million more words than those from less advantaged backgrounds. The developmental gap between the less well-off and their better-off peers is significant before a child even starts school. It can be as much as 18 months or more in some cases. The Government, services and others seem to spend a huge amount of time and money on trying to address those gaps later in life, when we could do a lot more earlier and save a lot more money in doing so.

That is why we are here today. If we spent on this issue even a fraction of the amount of resources and time that we spend on health, education, criminal justice, home affairs, the Department for Work and Pensions and all the services they support—and instead of focusing on the consequences of not getting the first 1,001 days right, focused on the root causes and those early years—not only would we save a huge amount of money for Government and the country, but we would create a much happier and better society.

We are here today because, unfortunately, the ambitious work that the right hon. Lady began and almost concluded in government has not yet come to light. Like her, I have asked questions, both written and oral, about what is happening. It would not take a huge amount. The Under-Secretary of State for Education, the hon. Member for Stratford-on-Avon (Nadhim Zahawi), who will respond on behalf of the Government, is a fantastic Minister. He and I have worked very closely on a number of issues, and I do not doubt his commitment. I hope he will soon be in the Cabinet, and I believe that this issue needs Cabinet oversight.

What needs to happen? We have already heard some of the issues. I am going to focus on three things that I think need to happen. Some of my comments are based on my role leading on an outstanding piece of work that the Mayor of Greater Manchester, Andy Burnham, asked me to do on school readiness across Greater Manchester.

We do not need lots of new initiatives and new programmes. We know what works, largely, and we know what we need to do. We are just not doing it as well as we should or making it reach as many babies and parents as it should. I do not want the Government to take the message from this that we want lots of whizzy new action plans. We just want to get the nuts and bolts, and the agenda and the importance of that agenda, right, because if we steer this oil tanker in the right direction, we can make great strides. It is not rocket science, and that makes it even more immoral that we are not doing some of these things, because we know what works in the early years.

The first thing we need, I am afraid, is more cash. We cannot have this conversation without discussing funding, and particularly funding for local government. As we have heard, many of the early help and intervention support services—including, critically, Sure Start children’s centres—are funded via local government, which has seen some of the biggest cuts across Government. Action for Children has published a really good report which shows the real value that Sure Start centres can provide in narrowing the attainment gap. The recent Institute for Fiscal Studies report on Sure Start children’s centres showed how much money was saved in just one area—hospitalisation of infants—for the NHS by reducing the number of unnecessary visits to hospital by parents.

We need more cash, and we need that cash to be allowed to be spent on early help and intervention. That includes the troubled families programme, which, as the right hon. Member for South Northamptonshire said, should be extended to the early years. The troubled families programme is due to end soon. That would be a travesty, because it has done more to break the cycle of deprivation that we have heard so much about than many other joined-up programmes.

I want to make a small plea on funding. The Minister will know that I would not let this opportunity go without mentioning our valued maintained nursery schools, which in many cases act as hubs for children’s centres and the holistic, place-based, integrated support services that we need to change lives for the better. Their funding is at risk. The Minister has been an outstanding champion for them. He has done a great deal of work with the all-party parliamentary group on nursery schools, nursery and reception classes and others to secure funding. If he leaves office for a higher position under the new Prime Minister, which I am sure he will and which he deserves to do, I hope he will leave a firm handover note to his successor. The sector will miss him greatly if he leaves the Department for Education. He is the most popular Minister we have had in this Government.

[Tracy Brabin (Batley and Spen) (Lab/Co-op)]

We’ve had quite a few.

[Lucy Powell]

Indeed, and he is definitely top of the list by a long shot—I mean no disrespect to the others, but he has been very good.

The second thing we need to do is break down the barriers to joined-up services and commissioning. Key to that, as we have seen in Manchester, is the value of place-based, integrated services working together. In Greater Manchester, the early years delivery model acts as the core of the service. Every child, from pre-birth to the age of five, is seen at least eight, if not nine, times, with fully integrated service delivery, and intervention, support and advice can be put in place at any stage in the child’s upbringing. It is already paying real dividends. The innovative work we are doing with the BBC on communication and language and other work is starting to have real results, especially for the most in need. It cannot just be at a local level—it needs to be joined up with Whitehall too, but that is not the answer. It is about place-based, integrated services.

The third and final area—just to conclude, because I know lots of people want to speak—is workforce development. A real challenge in this space is to make sure we have a workforce right across the piece—from health visitors to midwives, but also outreach workers and those who work in childcare, social services, health, schools and education—who are valued and paid well for a job that is the most important job they could do and who also have the ongoing career training and development to understand the root causes of poor child development and the impacts that can have, so that the whole body of people who ever come into contact with a family and child are all working with the same agenda, vision and understanding of what needs to happen. That is not a whizzy initiative or a press release; it is the hard yards and the real focus on developing a whole workforce around families that will really get us the step change we want. That is why we are setting up the Greater Manchester early years workforce academy, and we hope this will be a beacon for the rest of the country to look at best practice.

In conclusion, as I have said a number of times, this is not rocket science. We know what we need to do, but it needs proper funding, leadership and drive across Government through the country into places, homes and families. As insurers do when they are looking at insurance policies, we could all probably work out who the families most likely to need help are—we can get names, not just numbers attached to these issues—and there really is no excuse for us not to do it. It is immoral for us not to try to help break the cycle of deprivation and really tackle those early and important 1,001 critical days. I want to thank the Minister and particularly the right hon. Member for South Northamptonshire for the leadership they have both shown, and I hope they will continue to have the opportunity to do so in government over the coming months.

--- Later in debate ---

[Wera Hobhouse]

rose—

[Lucy Powell]

rose—

[Tim Loughton]

Hold on a minute. I will give way first to the hon. Member for Bath (Wera Hobhouse) and then to the hon. Member for Manchester Central.

--- Later in debate ---

[Lucy Powell]

I am grateful to my friend, because he has given me an opportunity to do what I did not do earlier—which was hugely remiss of me, because it was in my notes—and express my huge respect for his leadership and all the work that he does on Sure Start, children’s services and education in the all-party parliamentary group for families in the early years. I thank him for that. He is, of course, absolutely one of my favourite Members on the opposite Benches, and he will long remain so, even if I am no longer one of his.

[Tim Loughton]

I am completely recharged and relieved by that. The hon. Lady is my absolute favourite Member of Parliament for Manchester Central, and many things besides. But this debate is getting far too consensual, so I shall return to the points that I was trying to make.

The phrase “1,000 days”—or, for those whose glass is half full, “1,001 days”—is almost becoming common parlance as well, and it needs to. It needs to be almost a brand. People need to understand that those 1,001-ish days of life from conception to the age of two are the period that will have the most impact on a child’s future life. If we do not invest in the right support then, the cost of picking up the pieces later will be so much greater, both financially and, as I think everyone here recognises, socially.

I should declare an interest, in that I chair PIP UK—the Parent Infant Partnership—which was set up by my right hon. Friend the Member for South Northamptonshire. I became chairman of the trustees, and am proud still to be so. Our most recent report is “Rare Jewels”. I pay tribute to Sally Hogg, who works for PIP and who did a great deal of research on the scarcity of parent and infant mental health specialist support. That was a false economy.

I shall now be slightly unconventional, and talk about the motion. The motion is about the inter-ministerial group, and I want to talk about some of the experiences of that group. As I found during my few years as a Minister, joined-up government is a complete myth. What the group almost uniquely did, because of the vim and force of my right hon. Friend the Member for South Northamptonshire, was bring together key Ministers from half a dozen key Departments to try to create joined-up solutions. A child’s mental health, and those early years affecting the child and his or her parents, are not just the preserve of the Department for Education and of children’s social care. They touch on the work of so many other Departments

I am glad that my right hon. Friend the Member for Basingstoke (Mrs Miller) is still here. She will remember that some years ago, when I was the Children’s Minister and Sarah Teather was also an Education Minister, we tried to put together the early intervention fund, which was largely intended to bring together different interests with a pooled budget so that we could work together on smarter solutions. However, that did not really fit the way in which the civil service worked.

We struggled for some months to pull together a plan that would involve various other Departments, and we were being frustrated at every turn; so we formed a pizza club, well before my right hon. Friend the Member for South Northamptonshire was on the scene. My then colleague Sarah Teather and I rang other colleagues—Housing Ministers, Health Ministers and others. I think that my right hon. Friend the Member for Basingstoke was then a Minister in the Department for Work and Pensions. We got together in “The Adjournment” restaurant, had a pizza, agreed what we wanted to do, and all went back to our Departments in the following days and told our civil servants what we wanted to do. The response was “Well, I’m sorry but that’s not the way we do things around here, Minister”, to which our response was “Tough, we’re now doing it.” That was the only way we could actually get through an important joined-up policy because the system just did not work. I do not think things have improved much at all.

Another innovation I set up then was the Youth Action Group. Again, there were problems and I tried to youth-proof all Government policy, which is something I still bang on about. There were many problems that transcended different Departments, and yet if there was a problem, it would go from one Department to another in a vicious triangle, as it were. So I got together six major charities led by The Prince’s Trust and Barnardo’s. I co-chaired it and, at one stage, I think we had nine Ministers from nine different Departments. Invariably most of those Ministers would turn up to those meetings and the children’s charities and youth charities would bring particular problems to us. One problem was about housing benefit for looked-after children who were care leavers, which was the responsibility of the Department for Education for care, the Department for Communities and Local Government—whatever it was called in those days—for housing and the Department for Work and Pensions for benefits. We got the three Ministers together with the three lead officials and said, “Here’s the problem; can you please take it away and solve it and come back with a solution that the children and youth workers can then take away?” Alas, that group no longer exists, but we need far more of that sort of rationale and mentality in Government. The inter-ministerial group showed how it could be done, and it is so important that the work continues. I hope that the recommendations that have been made are taken up and run with.

We need a Minister for early years children and families at Cabinet level. It should not just be left to civil servants to people those committees when what we need is a co-ordinated ministerial response. This needs to be led by a high-profile Minister who has the clout, enthusiasm and drive to bring all the relevant Departments together and come up with a cross-departmental solution. I am afraid that we are still a long way from that in common practice, and that is partly what is wrong with Government and with our civil service. So that is my main plea.

On the investment equation, I am not going to repeat everything that has been said, but we know that healthy social and emotional development in the first 1,001 days means that individuals are more likely to have improved mental and physical health outcomes from cradle to grave and children will start school with the language, social and emotional skills they need to play and explore and learn. Children and young people will also be better able to understand and manage their emotions and behaviours, leading to less risky and antisocial behaviours and the costs that these bring to individuals and society, and they will have the skills they need to form trusting, healthy relationships—something we heard about in the Chamber earlier. If they had that, we would not have to spend such a lot of time teaching it to them at school because it would come naturally, and they would know what a proper quality, trusting relationship actually is. And if they know, they are much more likely to be able to hand it on and nurture their own children as they become parents in the future.

The cost of getting this wrong is huge. Some years ago—although it is still as true and important today—the Maternal Mental Health Alliance calculated the cost of getting perinatal mental health care wrong for the one in six women who will have some form of perinatal mental illness. The cost of that was £8.1 billion each and every year, and the cost of child neglect in this country is £15 billion each and every year; so £23.1 billion is the price of getting it wrong. A fraction of that spent on early intervention—well-targeted, well-timed, well-positioned by well-qualified and trained professionals—could save so much personal grief and so much financial and social grief later on.

It is not rocket science, as I constantly say; it is technically neuroscience, but it really is something we should have been doing so many years ago. The troubled families programme is the model here, and it is essential that the troubled families programme is not just retained, but expanded in the comprehensive spending review. I have always said that we need a pre-troubled families programme, because in the troubled families programme we are dealing with the symptoms of getting it wrong earlier. If we prevented those symptoms in the first place, working in those very early years, so that we have a well-balanced parent or parents with well-balanced children, they are more likely to arrive at school eager and able to learn and be contributing members of society. That is so vital. Some 28% of mothers with mental health problems report having difficulties bonding with their child. Research suggests that this initial dysfunction in the mother-baby relationship affects the child’s development by impairing the baby’s psychomotor and socio-emotional development.

Postnatal depression has also been linked with depression in fathers, and with higher rates of family breakdown. We forget the impact on fathers of not knowing how to deal with a mum—a partner—who all of a sudden has some form of postnatal mental illness. A lot of fathers are affected by this. I know that my hon. Friend the Member for St Austell and Newquay (Steve Double), who chairs the all-party parliamentary group on fatherhood, is going to talk about this. It is essential that we look at all parents, when both parents are on the scene, and give support to the family as a whole.