Evidence-based Early Years Intervention

Martin Whitfield Excerpts

Thursday 21st March 2019 Westminster Hall

[Norman Lamb]

I welcomed the fact that the Secretary of State had identified the importance of prevention, although I noted that there was not much reference to mental health in the prevention strategy, and I have raised that with him. As I understand it, he plans to publish a Green Paper on prevention sometime in the spring, although the concept of seasons is elastic in Whitehall. I welcome that, but of course it has to have substance to it. We have to think about the social determinants of ill health, on which there generally is not sufficient focus. Poverty, poor housing and so forth are also critical factors, not only in our physical health but in our mental health.

I was going to mention that the Secretary of State has identified prevention as something that he wants to prioritise. It is up to us to guide and encourage him along a route that could reap real rewards, not only for individuals but for Government, in the longer term.

The next part of the proposed national strategy would be the collection and analysis of appropriate data. We believe that can help to identify families who would benefit from early intervention, to provide insight into how well different early intervention approaches are working, to drive continual improvement and to allow local authorities to be held to account. The national strategy should identify what data should be collected and support local authorities in delivering data-driven services. If a service is based on data and its analysis, it is more likely that evidence will be applied effectively and that we will make better use of public money. If we use public money in a way that is not based on evidence, we waste it; we cannot justify that to taxpayers, for whom the amount that they are expected to pay is often a strain. They demand that money be spent effectively in government.

The strategy should make use of the growing field of implementation science—a point that we were struck by in Dr Caroline White’s evidence. She focused on not taking an off-the-peg evidence-based programme and assuming that it will work effectively, and made the point that any programme should be properly implemented by trained staff who are supervised effectively, and that data should be used to monitor performance. Those factors are critical in ensuring that a programme can be effective in its application.

[Martin Whitfield (East Lothian) (Lab)]

I am grateful to the Chair of the Science and Technology Committee for giving way. He is right to make that point. In the report, we have provided vast amounts of evidence that the collection of data is important, but not the end. The final stage is taking the data and feeding the information it provides back to the individuals affected, so the systems that can and have been identified can be rolled out and attuned to the needs of the young people and families who will use them.

[Norman Lamb]

I thank the hon. Gentleman; it is an enormous pleasure to have him as a member of the Select Committee, when he is not tied up with High Speed 2. He is absolutely right. The point was made that when we train social workers, an understanding and an analysis of data is a terribly important part of the effectiveness of their work. We want to see a central, specialist team set up in the early intervention centre, not to impose anything, but to help local authorities to deliver the national strategy.

The strategy should shift the balance of funding from late intervention, which we know is less effective, to early intervention, which we know can be more effective. The spending review should establish how best this can be achieved. If the inter-ministerial group and the Government more generally reviewed the evidence base for early intervention and took up our call for a national strategy on these lines, it would make a massive difference to children across our country, now and in the future.

--- Later in debate ---

[Darren Jones]

The right hon. Gentleman is absolutely right. Partnership working is a phrase that we often hear in local government, and sometimes it is a bit amorphous, but that is a classic example of why it is so important. I have had cases where constituents have told me stories of when they would go to school, albeit a long time ago now, and end up being treated as if they were ill and having to sleep in the nurse’s room at the school as opposed to taking part in classes, because of the experiences they were dealing with at home. As a consequence they missed out on their education, when instead the support should have been put in place at that time to help them in the best possible way.

The involvement of Avon and Somerset police is important because we know, and the evidence shows, that for children who suffer adverse childhood experiences, especially those who suffer multiple ACEs, the outcomes associated with that cycle of harm include mental health problems and drug or alcohol misuse—criminal activity is therefore connected with that. The police have a role not only in tackling criminal activity but, as I said at the outset of my speech, in helping to deal with the causes.

[Martin Whitfield]

Does my hon. Friend agree that it is not a question of simply identifying children who have suffered or are vulnerable to suffering such experiences, but that the real importance and the real financial saving is in the interventions that follow; and that the good practice that has been shown in many areas, if it were shared across the country, would prevent this from becoming a tick-box exercise by professionals that does not address the problem?

[Darren Jones]

I agree with my hon. Friend; that was why the conference we held in Bristol was so popular—so popular, in fact, with over 400 delegates wanting to come, that they had to run the conference twice, because they could not fit everyone into the setting to do it together. More than 50 partner organisations across education, policing, probation, the voluntary sector, health, social care, public health and the Mayor’s office have signed up to our vision in Bristol.

This is also a question of political leadership, because Bristol knows that multiple ACEs lead to other factors that make for a negative environment in the communities in which we live. We know they will have an impact on problems such as knife crime and gang activity, and that they cause problems with mental health for people and therefore a lack of positive environment in the community, but also problems for economic productivity. That is why, in our “One City Plan” in Bristol, we have a clear and specific target of ensuring that children,

“grow up free of adverse childhood experiences having had the best start in life and support through their life.”

That particular strategic target for the council is linked to other targets, such as reducing knife crime and gang activity, dealing with period poverty and ensuring affordable childcare.

However, the access point is really important—returning to the comments by my hon. Friend the Member for East Lothian (Martin Whitfield). We cannot just rely on police or a school; we need a way to ensure that intervention, support or just someone being there when you need them are available. I reiterate the comments that the Chair of the Select Committee made about the lack of delivery on the health visitor programme where, as has been said, many people have no intervention or access point for much of their early years.

That is why, in Bristol, we have been able to protect all our children’s centres. The financing has clearly been cut because of austerity funding from central Government, and the services that can be made available have gone down to the bare minimum, but we have kept them all open for that reason. I pay tribute, as I have on previous occasions, to my friends the Mayor of Bristol, Marvin Rees, and the cabinet member for children and young people’s services, Councillor Helen Godwin, for ensuring that sustainability in Bristol.

In a previous debate in this place on the funding of maintained nursery schools, my hon. Friend the Member for Bristol West (Thangam Debbonaire) made a powerful point about a constituent of hers who said that she was in a domestic violence situation and the only way that she could get access to support was by taking her child to the children’s centre, because it was not seen to be going to the police or going to get intervention for the abuse she was suffering from her partner. She was taking the kids to nursery, but because the services were co-located in that environment, she was able to get support.