Evidence-based Early Years Intervention

Debate between Norman Lamb and Chris Skidmore

Thursday 21st March 2019 Westminster Hall

[The Minister for Universities, Science, Research and Innovation (Chris Skidmore)]

It is a pleasure to serve under your chairmanship, Mr Davies. I congratulate the right hon. Member for North Norfolk (Norman Lamb) on securing this important debate on behalf of the Science and Technology Committee. I know this is an area that he cares passionately about, and I pay personal tribute to the work he did in a previous Parliament as Minister of State for Community and Social Care between 2012 and 2015.

I also thank other hon. Members who have participated in today’s debate. Their contributions have shown not only clarity of thought about these issues, but real passion about what is taking place in their local areas. It is a tribute to those Members’ local commitment that they have worked with their communities to address these issues. We have heard from the hon. Members for Bristol North West (Darren Jones), for Stockton South (Dr Williams), for Linlithgow and East Falkirk (Martyn Day) and for Batley and Spen (Tracy Brabin), and there have also been important interventions from the hon. Members for Stroud (Dr Drew) and for East Lothian (Martin Whitfield). I am grateful for the opportunity to set out the Government’s approach to addressing early childhood adversity and trauma, and the actions we are taking to improve children’s life chances through early intervention.

The Government are strongly committed to effective early intervention in childhood. That means not only effective prevention, identification and support for children and families in need, but building a strong evidence base to underpin those things. The hon. Member for Bristol North West asked whether I, as Science Minister, would commit to ensuring that we take forward an evidence-led approach. I passionately believe that the investment we make in research must not only go into healthcare research, but into the social sciences.

[Norman Lamb]

I appreciate the point that the Minister is making, but does he recognise that without collection and national analysis of data, we have no idea how public money is being spent across the country and whether it is being spent effectively?

[Chris Skidmore]

I appreciate the right hon. Gentleman’s point, and I agree with what he has said about data collection; I will return to that topic later on. I am also a new Minister in the Department for Education, covering the universities sector. I recently set up a higher education data advisory committee, because I value the importance of such evaluation at both local and national level— for example, when we look at university access and participation. We have also set up the Evidence and Impact Exchange in partnership with King’s College London and Nottingham Trent University, to examine the methodology behind encouraging more disadvantaged pupils to have access to, and opportunities at, university. That is at one end of the scale, but today we are talking about what we need to do at a far earlier stage of a child’s education.

When it comes to scientific research, and early years research in particular, we must ensure that we listen to the scientific community when it comes to neuroscience and cognitive behaviour; that we are careful about how we use that scientific research to make public arguments and develop public policy; and that we work with those scientists. I am sure that they will develop new innovations and scientific research, which may even challenge our understanding of these policies. It is important that we work together as a community, understanding that evidence base and drawing on the good work already conducted at national and local level.

I welcome the recent establishment of the early years ministerial group on family support, which is reviewing how to improve the support available to families in the first two years of a child’s life, identifying opportunities for co-ordination and improving cost-effectiveness. I look forward to the valuable contribution of that group, which will provide specific recommendations to the Secretary of State. I am unable to provide a timetable for that, as the hon. Member for Batley and Spen asked me to, but I will ensure that the group is aware of today’s debate. I am sure that its members will all wish to engage with the Science and Technology Committee regarding specific issues raised in its report, and on any future work that the Committee does. The Government value the work of that Committee and recognise its place in public discourse. As we proceed, we will make sure that we engage with some of the recommendations that the Committee has made.

[Mike Gapes in the Chair]

Turning to the role of Government in early intervention, the model for adverse childhood experiences gives us a helpful focus for action on early intervention. We must also ensure that there is an overarching model for care and support. Fundamental to that is the belief that local areas are best placed to understand the needs of their local communities, and to commission early intervention services that best meet those local needs as part of a whole systems model. We have heard about some excellent examples of local innovation, such as the one given by the hon. Member for Bristol North West, who talked about the work of Bristol City Council. The fact that the council had to hold its conferences twice clearly demonstrates the demand for those services. We also heard about the work in Greater Manchester. It is important that we allow that innovation and creativity to flourish as part of future work, but, importantly, we should not expect local areas to do that work alone. The matter is a serious and complex one, and our approach, which reaches across all Departments and Governments, reflects that.

Our approach is based on a number of principles, which are as follows. First, early rather than late intervention is key; secondly, the role of central Government is to support, facilitate and work with local government and other partners to tackle these issues together; thirdly, our solutions should be focused on outcomes and underpinned by evidence; and fourthly, successful strategies should be identified and shared widely within the sector. With that in mind, we have prioritised three key areas for central Government focus to build resilience to adversity and trauma. Those are: physical and mental health in pregnancy and childhood; protecting vulnerable children through effective children’s social care; and improving social mobility, supported in the early years by high-quality early education settings and learning in the home. That is underpinned at all levels by our work to improve services and partnerships locally, and to build the evidence base for what works.

I will address each of those areas in turn. First, when it comes to supporting physical and mental health in pregnancy and childhood, the Government recognise the serious impact that adversity in early childhood can have on children as they grow up; the hon. Member for Stockton South set out some striking examples. Support must begin as early as possible, and maternity services have a central role to play. The NHS long-term plan will make the NHS one of the best places in the world to give birth by offering mothers and babies better support. It will also expand the provision of quality mental health support for new and expectant mothers and their families. The evidence shows that this is a key opportunity to improve outcomes for mothers and children.

--- Later in debate ---

[Chris Skidmore]

I will come to the question of health visitors later in my speech, but I will be more than happy to pass on the hon. Lady’s point about the collection of data and look at what evaluations might be possible. I will certainly make sure that hon. Members’ contributions are reflected in my discussions with the Department.

Local authorities are receiving £16 billion between 2015 and 2021 to spend on public health functions, which includes funding to support the healthy child programme and the mandated five health visits, which the hon. Lady mentioned, for children between the ages of nought and five. We are seizing the opportunities presented by such moments with families. A key piece of partnership working between the Department and Public Health England will see the Institute of Health Visiting train up to 1,000 health visitors in 2019 to identify and support children with speech, language and community needs early. The health visitors will then cascade the training to provide even greater reach. It is important to make sure that an evaluation takes place to make sure it is as effective as possible.

On the recruitment of additional health visitors and the quantity of visits, health visiting services are commissioned by local health authorities, and health visitors are employed by the local health service providers. However, the Government will continue to work with partners, child development experts and professional organisations representing health visitors to ensure that the healthy child programme remains an effective and evidence-based framework providing good health, wellbeing and resilience for every child.

On the wider issues around early intervention and making sure it is adversity-targeted among the early years workforce more broadly, it is crucial that early years practitioners are well trained to protect young children from the impacts of adversity and trauma. As part of the early years foundation stage statutory framework, service providers are obliged to ensure that all staff have up-to-date knowledge of safeguarding issues and are equipped to identify and address signs of abuse and trauma. We want to equip the early years workforce to deliver outstanding services, to adopt evidence-based approaches, to learn from best practice and to deliver quality outcomes. The Government are supporting that with a professional development fund and similar programmes, such as the newly established Social Work England, which will ensure that social workers receive the highest quality initial education access and continuing professional development.

[Norman Lamb]

It is helpful to hear what is happening now. Does the Minister see value in defining a national strategy—the approach taken in Scotland and Wales—to try to drive the good things that he says he wants and make sure they happen everywhere, or does he resist the idea? It is important for us to understand whether there is an opportunity to work together with the Department to try to achieve something that is greater than the sum of its parts. Is he up for that and could he persuade his colleagues, or does he positively resist what we are arguing for?

[Chris Skidmore]

The right hon. Gentleman has stolen the latter part of my speech. When it comes to the broader point, I recognise that the Committee’s work, for which the Government are extremely grateful, reflects on the development of a national strategy. Currently, the Government do not consider the formal publication of a national strategy to be necessary. However, the Government will seek to review the approach through the spending review and the upcoming prevention Green Paper, which will build on the November 2018 Department of Health and Social Care report “Prevention is better than cure”, and its priorities. Also, we will look forward to the value that the early years family support ministerial group will add to the Government’s approach. Although I cannot commit in today’s debate to taking forward a national strategy, the Government are certainly working on a future Green Paper and the approach might change.

It is important to reflect on a balanced collection of the evidence that demonstrates what works, which will then inform any future approaches as part of the future prevention Green Paper. I realise that my response does not entirely answer the right hon. Gentleman’s question, but I want to reflect on the fact that the present does not necessarily rule out a change of direction in future.

Various Members mentioned children’s centres. The Government believe that children’s centres have an important role to play in early intervention, but it is right that local councils continue to decide how to use them as part of the wider system of local services. As part of our local government programme, local authorities are looking into how early years services can be improved. The right hon. Gentleman raised the question of Ofsted inspections. When inspections of children’s centres were suspended, there was at the time an agreement that they were not fit for purpose. However, children’s social care services and all registered early years prevention, including that delivered in children’s centres, remain subject to robust and regular Ofsted inspections.

When it comes to the consultation that has been mentioned and the delay in moving forward, the Department still needs to understand how local authorities effectively use centres to improve outcomes as part of their broader strategy before we go further. That is why we will be investing in What Works, which I will talk about later in my speech, working with the Education Endowment Foundation and delivering the £8.5 million local government programme. The programmes will inform the next steps in our strategy, including any future consultation. We need to look at the evidence from the programmes before deciding whether a consultation is indeed the correct way ahead.

Oral Answers to Questions

Debate between Norman Lamb and Chris Skidmore

Tuesday 22nd October 2013 Commons Chamber

[The Minister of State, Department of Health (Norman Lamb)]

I pay tribute absolutely to that local initiative, which is exactly the sort of direction we are going in. I have made the point several times that we cannot get great care on the back of exploiting workers. The idea that people should not be paid while they are travelling from one house to another is, in my view, unacceptable. When employers and care providers breach the minimum wage legislation, we should be absolutely clear that that is completely unacceptable. To ensure great care, the Government are introducing in 2015-16 the £3.8 billion integrated transformation fund, which will pool resources between the NHS and social care to ensure that we shift the focus to preventing ill-health and deterioration, and I think that that can make a real difference.

[Chris Skidmore (Kingswood) (Con)]

T7. I and my hon. Friend the Member for Filton and Bradley Stoke (Jack Lopresti) have long campaigned for the maximum hospital facilities at Frenchay hospital, including a community hospital with an outpatients clinic—as was agreed as part of the Bristol health services plan in both 2005 and 2010. Now it seems that NHS managers are attempting to revisit these plans, something to which I am opposed, as is my hon. Friend the Member for Filton and Bradley Stoke, who has recently written to the Secretary of State to ask for a meeting to look into the situation. Will the Secretary of State agree to meet us both and investigate the situation?

NHS Commissioning Board

Debate between Norman Lamb and Chris Skidmore

Tuesday 5th March 2013 Commons Chamber

[Norman Lamb]

When the hon. Lady talks about back-door privatisation of the NHS, I am not sure of her view of the previous Government’s commitment to spend £250 million on independent sector treatment centres, whether or not they undertook any operations. I am not sure that she agreed with it, but that is what her Government did. There will be no privatisation of the NHS, and the rules we introduce will make it absolutely clear that the power lies with clinical commissioning groups to use the tools available to them—co-operation and integration, but also competition where it drives up standards, just as her Government recommended.

[Chris Skidmore (Kingswood) (Con)]

Last year, the right hon. Member for Leigh (Andy Burnham) claimed that there were less than 72 hours to save the NHS. Yesterday, when referring on his Twitter feed to the regulations, he claimed that there were two weeks to save the NHS. Does not the Minister believe that in fewer than 140 characters, the right hon. Gentleman has shredded any credibility that he might once have had? [Interruption.]

[Norman Lamb]

I think my hon. Friend makes a valuable point. [Interruption.]

Winterbourne View

Debate between Norman Lamb and Chris Skidmore

Tuesday 30th October 2012 Commons Chamber

[Norman Lamb]

I shall certainly consider the hon. Lady’s point and am happy to discuss it further with her. At the end of the day, we must ensure that people in highly vulnerable situations are adequately protected. I want to ensure that all the steps we take are aimed at that goal.

[Chris Skidmore (Kingswood) (Con)]

The Minister has mentioned raising the standard and quality of care providers. Will he consider the introduction of a starred grading system for care providers, so that we have absolute transparency on how well they are performing, and so that we know the most excellent care providers and the worst?

[Norman Lamb]

My hon. Friend raises an important point. One thing we are doing on the NHS Choices website is having quality indicators for every care home, nursing home and so on. That means that any individual looking for a care home for a loved one will be able to find out much more about the quality of the care that an organisation provides. In due course, the website will include user reviews, so that people who have experienced care in those homes will have their voices heard. That openness of information could have a transformational effect in driving up standards.