SCIENCE AND TECHNOLOGY COMMITTEE

Norman Lamb Excerpts

Thursday 15th November 2018 Westminster Hall

[Mr Adrian Bailey (in the Chair)]

We begin with the Select Committee statement. Norman Lamb will speak on the publication of the Eleventh Report of the Science and Technology Committee, “Evidence-based early years intervention”, for up to 10 minutes, during which no interventions may be taken. At the conclusion of his statement I will call Members to put questions on the subject of the statement, and call Norman Lamb to respond to each in turn. Normally, I would say that Members can only expect to be called once to ask a question, but in view of the lack of numbers here, I may be a little more generous.

[Norman Lamb (North Norfolk) (LD)]

I suspect there may be a drama unfolding elsewhere today, which limits the numbers in Westminster Hall. Nevertheless, I rise to make a statement following the publication this week of the report of my Committee—the Science and Technology Committee—on “Evidence-based early years intervention”.

Before I explain why we conducted this inquiry and set out our key findings, I thank all the organisations and individuals—there were more than a hundred in total—who provided us with written evidence, and the 26 individuals who gave oral evidence. This is very much an evidence-based report and it would not have been possible without their input.

Around one in every two adults in the UK has suffered at least one adverse childhood experience, which could have been abuse, neglect or growing up in some other difficult situation, such as in a household where someone suffers from substance abuse problems or domestic violence. The trauma that such experiences cause the child is tragedy enough. However, there is now strong evidence to demonstrate that those who suffer such experiences as a child are significantly more likely to encounter further problems in later life—problems such as mental or physical ill health, worklessness or involvement with the criminal justice system. Risk increases with increased exposure to adversity. Paragraph 7 of our report says that,

“surveys by Public Health Wales have reported a significantly increased prevalence of problems including health-harming behaviour, poor mental wellbeing and chronic disease among those who had suffered four or more adverse childhood experiences compared to those who had suffered none.”

However, that need not be the case. Early intervention is an approach that aims to address these problems before they become significant and difficult to overcome. It can take the form of parenting programmes, behavioural classes for children, or programmes supporting early years child development, among other things. We know that it works. The Early Intervention Foundation has reviewed studies of over 118 early intervention programmes and found that 45 of them demonstrated robust evidence of positive impact. Similarly, the Children and Parents Service in Manchester has real-world evidence showing that early intervention can significantly reduce a child’s risk of neglect or abuse—in other words, it can stop the trauma from happening in the first place.

As well as transforming lives, early intervention can save taxpayers’ money. The Early Intervention Foundation has estimated that the cost of “late” intervention—in other words, not intervening early—is at least £16.6 billion every year, and that is without taking into account the positive economic impact of people living more fulfilled lives.

The Scottish and Welsh Governments and some local authorities in England have made early intervention to address childhood adversity and trauma a priority. However, the Government in Westminster have not yet seized the opportunity. Instead, local authorities in England are essentially left to their own devices, without central support or scrutiny. We know that pockets of good practice exist, but the Early Intervention Foundation told us that it experiences

“lots of examples where we see a gap between what we know from robust, peer-reviewed literature and what happens in local services and systems”.

With fragmented and variable delivery of early intervention across England, vulnerable children are being horribly failed around the country. That is why my Committee is urging the Government to draw up a national strategy on early intervention, to empower and encourage local authorities to deliver effective, sustainable and evidence-based early intervention.

In addition to providing the impetus to seize the opportunity of early intervention, the national strategy should address several major challenges that we heard that local authorities face in delivering evidence-based early intervention. Among those challenges are, first, that awareness of the impact of childhood adversity and how it can be addressed could be greater among those who work with children. So the early years workforce should be, first, defined, and then training should be reviewed to ensure that this workforce has the knowledge that they need to be effective in their work.

Secondly, the collection and analysis of appropriate data can help to identify those families who would benefit from early intervention, as well as providing insight on how well different early intervention approaches are working. The national strategy should identify what data ought to be collected and support local authorities in delivering data-driven services. At the moment, the early years are almost like a data-free zone. It is an extraordinary situation that, as children and adults grow, we collect an enormous amount of data about them nationally, including in the school system. We have an understanding of what is going on later, but in the early years there is no national data—it is fascinating. Therefore, the problem is that we are spending a lot of public money without knowing whether it is being spent effectively.

Thirdly, the strategy should make use of the growing field of implementation science to maximise the chances of success for efforts to deliver effective and sustainable early intervention. We want a central specialist team to be set up in the Early Intervention Foundation to help local authorities to deliver the national strategy and apply the evidence of what we know works around the country.

Some improvements to the delivery of early intervention in England can be made without requiring substantial new funding; no doubt that is music to the ears of the Minister for School Standards, who is present. Nevertheless, the Government should recognise the long-term cost savings available through effective early intervention and be willing to make the upfront investments now, so that we can save money in the long run. The new strategy should seek to drive a general shift in the focus of current expenditure on late interventions, which are inevitably less effective, so that we focus more on earlier intervention.

Some programmes are already in place that aim to identify families that are in need of support and that help to provide that support. Foremost among them is the Healthy Child programme, under which every child should receive five mandatory health visits before the age of three. However, Public Health England statistics show that, other than the newborn visit, only around 80% of children receive such visits. Without this interaction with health visitors, opportunities to identify families who would benefit from support are missed. The Government must set out a clear strategy to show how they intend to increase coverage of the five mandated visits to 100%. They must also make sure that such a strategy does not simply increase the strain on the health-visiting workforce, thereby diluting the impact that they can have on each family.

We also call upon the Government to state clearly their position on the future of the Sure Start programme and children’s centres. A consultation on these centres was announced in 2015, but it has still not been launched. In the meantime, Ofsted’s regular inspections of these centres have been suspended, pending the outcome of the consultation, which has not happened yet. Local authorities need clarity about the future of these centres. If the Government intend to hold a consultation, they should launch it within the next three months.

To conclude, early intervention that is used to tackle childhood adversity can transform lives and save costs to the Government—a win-win. There is now a pressing need for a fundamental shift in the Government’s approach to early intervention, targeting childhood adversity and trauma, and applying the evidence of what we know works. The Government should match the ambition of the Scottish and Welsh Governments, and build on the example set by a number of English local authorities, to make early intervention and childhood adversity a priority, and to set out a clear national strategy by the end of this parliamentary Session to empower and encourage local authorities to deliver effective, sustainable and evidence-based early intervention.

[Mr Adrian Bailey (in the Chair)]

I now invite questions. I stress that they should be questions, not speeches.

[Marion Fellows (Motherwell and Wishaw) (SNP)]

I congratulate the right hon. Member for North Norfolk (Norman Lamb). He rightly said that the Scottish Government already have a strategic plan in place. In fact, they held a conference recently on adverse childhood experiences, and that issue is at the core of what they are trying to do. The right hon. Gentleman mentioned in his speech that he did not think additional funding, or much additional funding, would be required to carry out this plan. However, at a time when so many local authorities in England are failing and overspending their children’s budget, does he think that this is actually going to happen?

[Norman Lamb]

I thank the hon. Lady for her question. I applaud the Scottish Government, the NHS in Scotland, and the Scottish schools system for grasping this nettle, understanding what the evidence shows, and acting upon it. We say in the report that there are things local authorities can do now without any additional funding, and in a way, that is demonstrated by the fact that some local authorities are doing them. Those local authorities are looking at the evidence and applying it, and using the money that they have in the most effective way. I particularly applaud Greater Manchester for that. Dr Caroline White, who leads the Children and Parents Service in Greater Manchester, acted as expert adviser to the Committee inquiry. A lot can be learned from places such as Greater Manchester.

However, the Committee also makes the point to Government that there is a prize to be won if we invest more in effective early intervention: not only transforming lives, but saving money for the state further down the track. It is a powerful case of “invest to save”, and I want to indicate to the Minister—I do not know whether he intends to say something—that I am really keen to work with the Departments on this. It is not in any way a party political issue: there is a strong consensus on our Committee in support of the sort of action we are calling for. We could achieve a real gain by applying the evidence that we demonstrate in the report to make a difference to children’s lives, and I am keen to work collaboratively to make that happen.