Giving Every Baby the Best Start in Life

Sarah Olney Excerpts

Tuesday 9th November 2021 Commons Chamber

[Sarah Olney (Richmond Park) (LD)]

I beg to move,

That this House has considered the matter of giving every baby the best start in life.

I am grateful to the Backbench Business Committee for giving us time for the debate. Among all the turbulence created by the pandemic and the lockdown, I am pleased that we have the opportunity to debate at length the impact of those events on those who are likely to live with its after-effects the longest.

The building blocks for lifelong emotional and physical health are laid down in the period from conception to the age of two. Those first 1,001 days are a critical time for development, but they are also a time when babies are at their most vulnerable. Babies do not yet have the language skills to advocate for themselves, so carers and services must be equipped to do that on their behalf. During the first 1,001 days, babies are also uniquely susceptible to their environment. Chronic stress in early childhood, whether caused by maternal depression, poverty or ill health, has a negative impact on a baby’s development.

Early intervention and prevention to support the wellbeing of babies during this time is strongly linked to better outcomes in later life, including educational achievement, progress at work and mental health. Failing to invest in giving babies the best start in life delivers not only a human cost but an economic one. The total known cost of parental mental health problems per year’s births in the UK is estimated to stand at £8.1 billion.

[Chris Elmore (Ogmore) (Lab)]

I thank the hon. Lady for securing the debate on an issue that is close to my heart, having had a lockdown baby at the end of January—he is just over nine months now, and he is very happy and causing all sorts of chaos in my and his mother’s lives. The hon. Lady mentioned mental health, and my constituent Mark Williams has spent many years speaking publicly about the mental health issues he experienced after having his first child. It is extremely important that we wrap care around the mother and the baby after birth, but does the hon. Lady agree that we should also do more to allow fathers to get support with their mental health and to realise that becoming a father is a deeply profound thing and that there is nothing wrong with talking about our mental health as a father after having a child?

[Sarah Olney]

I congratulate the hon. Member on the birth of his baby, and I hope that all is progressing well. I am grateful to him for raising that point about fathers, and I will come to it later in my speech.

My interest in this topic arose from conversations I have had with constituents who gave birth during lockdown. They told me about the isolating experience of not being able to have their partners in the delivery room with them, not being able to share their new babies with the wider family and not being able to meet up with other new parents to support each other and share their experiences. Thinking back to my own experiences of early motherhood—12 years ago—I remember how much it meant to me to have all those people around me as I recovered from the birth and got used to my new life as a parent. My heart goes out to all those who struggled in isolation during those early months, and I am determined that young families should be prioritised for support as we emerge out of the other side of the pandemic.

The UK Government’s recent focus on investment in the first 1,001 days in their “Best Start for Life” vision and funding is very welcome and will undoubtedly make a significant difference to families. I pay tribute in particular to the efforts of the right hon. Member for South Northamptonshire (Dame Andrea Leadsom), who has been unsparing in her work to bring the needs of our very youngest citizens to the forefront of public policy and funding.

One of the most important sources of support for new parents is a health visitor. Even for those who enjoyed the most robust mental health, having sudden responsibility for a tiny and vulnerable new baby who is entirely dependent on them is a source of great anxiety. Having a visit from a trained health care professional who can give them advice, answer their questions and, above all, reassure them is enormously helpful and can make all the difference to their early experience of parenthood.

Although the UK is no longer in lockdown, both access to services and working patterns have changed. Some support services, such as playgroups, have not survived, and some have closed altogether. Children’s centres have reopened, but numbers are limited and places need to be booked in advance, which may mean that the families with the least time on their hands will lose out. The co-ordinators and volunteers at Home-Start Richmond, Kingston & Hounslow have told me about the high levels of anxiety experienced by new mothers unable to access health visitor advice and reassurance. That is impacting new mothers’ confidence and their ability to meet their baby’s needs.

Health visitors are a skilled workforce of specialist public health nurses who have the expertise to provide holistic care to families. As the only professionals positioned to reach every young child before they start school, health visitors play a crucial role in child safety and early childhood development. They identify and manage developmental delay, as well as common and serious health problems. They also provide support around childhood immunisations and advice on infant feeding, safe sleeping and mental health, all of which relieves pressure on NHS emergency departments and specialist services.

However, there is currently no national plan to address falling health visiting workforce numbers. The Government's spending review stated that it

“maintains the Public Health Grant in real terms, enabling Local Authorities across the country to continue delivering frontline services like child health visits.”

In fact, the Government are maintaining the public health grant at a level that is too low for many local authorities to resource health visiting services that can deliver face-to-face visits and the support described in the healthy child programme and other national guidance.

Ahead of the spending review, 700 leading children’s sector organisations were united in their call for investment for 3,000 more health visitors over the next three years. However, I am concerned that £500 million over the next three years will not deliver the Government’s pledge to rebuild health visiting. It is of the most urgent importance that we restore face-to-face health visiting to every new mother as the most essential building block of support to families as they welcome their new babies.

The importance of early home visits by skilled healthcare professionals was highlighted to me by one constituent who wrote to me last summer. She said:

“My baby is now 6 months old and soon after birth he was diagnosed with SMA type 1. If you are not familiar with it, the full name is Spinal Muscular Atrophy and it’s a muscular wasting illness. There isn’t a cure for it and without treatments and proper care the life expectancy of a baby is less than 2 years. He is currently under treatment but, and here is the reason for this letter, every possible centre specialised in physiotherapy, hydrotherapy or other physical activities for disabled people is shut due to Covid-19.

My husband and I were the ones who had to notice something was not right with Peter because, due to Covid, no one came for home visits after birth to see the baby or me. I almost died in child birth and because we were left alone I had to endure 1 month bed ridden due to further complications, once again noticed by me. Only once I was able to walk again we saw something wasn’t right with the baby. If after 2 weeks the health visitor had been able to come home, my son would have started treatment sooner without losing the mobility of his legs.”

I want to talk a little more about the importance of diagnosing and treating perinatal mental health. Maternal suicide is the leading cause of direct deaths within a year of pregnancy. An estimated one in four women experience mental health problems in the first 1,001 days after pregnancy. While depression and anxiety are the most common perinatal mental health problems, other conditions include eating disorders, psychosis, bipolar disorder and schizophrenia. One in 10 fathers is also affected by perinatal mental health problems. Of the 241 families that Home-Start Richmond, Kingston & Hounslow supported during the most recent year, 66% were experiencing mental health difficulties, including post-natal depression, anxiety, depression and chronic mental health conditions.

I was privileged to be able to visit Springfield University Hospital in Tooting recently to meet the perinatal psychiatry team for the South West London and St George’s Mental Health NHS Trust. I was extremely pleased to hear about the work the trust is doing in successfully supporting new mothers who struggle with their mental health, and particularly that it was able to maintain its services during the lockdown and after. Akvinder Bola-Emerson, the clinical services lead for perinatal psychiatry, stressed in particular the need for peer support but also the importance of health visitors, whom she described as the “eyes and ears” of perinatal mental health services.

The visit highlighted for me that we also need better provision for new and expectant fathers. Currently only mothers can be formally diagnosed with a perinatal mental health problem. Springfield provides services for fathers, but it is currently able to identify mental health issues in fathers only when they accompany a mother who is attending the hospital for perinatal mental health issues.

[Jonathan Edwards (Carmarthen East and Dinefwr) (Ind)]

I am extremely grateful to the hon. Lady for securing the debate, and she is making some very important points. Does she agree that one of the worst situations expectant parents can find themselves in is when there is a miscarriage and that parental leave for such parents would be a welcome reform?

[Sarah Olney]

I am grateful to the hon. Member for his intervention. He is absolutely right that there are a large number of events and incidents surrounding pregnancy and birth—as I know from my own experience—that can cause huge distress, and it is right that mothers and the people supporting them, and fathers as well, get the support they need, including statutory leave from employment for the time it takes to come to terms with the miscarriage. That is certainly something we should be looking at.

We know that impending fatherhood can be a cause of great anxiety for men, and more services need to be developed to support them. We also know that over a third of domestic violence starts or gets worse when a woman is pregnant. I would speculate that some of that is attributable to undiagnosed and untreated mental health conditions in expectant fathers, which underlines the need to do more to support them.

In addition to health visiting and perinatal psychiatry, support for children and their families throughout their early years is vital for enhancing children’s prospects at school and beyond. Evidence shows that effective integration of services in the earliest years can bring broad benefits. For example, Sure Start children’s centres are shown to decisively reduce hospitalisations during childhood. However, 1,300 children’s centres have closed since 2010, and recent research has shown that 82% of parents of young children have struggled to access early years services. I am pleased that the Government have now committed £80 million to introducing family hubs to 75 local authorities across England, and £50 million for parenting programmes. However, we need more information on what family hubs can provide, and I would particularly like to ensure that health visiting and mental health support are included.

The importance of the right support in the early years was brought home to me after a recent meeting with primary headteachers in my constituency. I heard about how difficult it is for nursery and reception-age children to settle into class and to get used to spending time with other children and not spending all day at home with their parents. For adults, lockdown has been 18 months of inconvenience, after which we expect to be able to pick up the threads of our former life. However, some young children who started nursery this term will have spent up to a third of their life in lockdown, and we cannot yet know what the long-term impact will be.

[Wera Hobhouse (Bath) (LD)]

Is my hon. Friend alarmed, as I am, by the fact that domestic violence has increased during lockdown, which has particularly affected young or very young children? The Government need to look at the backlog of cases that have arisen through the lack of attention to domestic violence, or inability to look at it, during lockdown, as it did not really come to our attention.

[Sarah Olney]

My hon. Friend is absolutely right, and incidents of domestic violence during lockdown are a matter of grave concern. We know there is a clear link between domestic violence starting or worsening and a pregnancy in a family. That issue needs a huge amount of attention; more mental health support for both partners would help a great deal.

The lockdown will have increased disparities in educational outcomes between those from poorer backgrounds and their richer classmates, and I call on the Government to do more to provide catch-up funding to our schools, and allow them to spend it on a greater range of services. Local headteachers tell me that funding can be allocated only to academic tuition, and that they have identified many children, including the very youngest, who need mental and emotional support to help them in school.

I will conclude by saying thank you to everyone who has talked to me about their experiences in this area, but particularly our health visiting and perinatal mental health teams, who do so much good and valuable work for new families. I also acknowledge the huge contribution made by the voluntary sector in supporting new families, in particular the work of Home-Start, which provides an excellent network of support. It takes only a small amount of encouragement, a little word of advice or a sympathetic listening ear to give a new parent confidence, but it can make a world of difference to their children. A small investment in the beginning of life can reap huge rewards, not just for individual children and their families but for whole communities, and the right start can enhance not just individual educational achievement and wellbeing but reduce risky and antisocial behaviours. Few pounds could be better spent, or yield a more valuable return, than those invested in our youngest citizens.

--- Later in debate ---

[Sarah Olney]

Thank you, Madam Deputy Speaker. I thank all hon. Members who have spoken in our debate, which has been really interesting. I particularly thank the right hon. Member for South Northamptonshire (Dame Andrea Leadsom) for all her work.

It was great to hear from the Minister about how much has already been delivered and the spending that has been announced. I thank the hon. Member for Newcastle upon Tyne North (Catherine McKinnell) for all her support in getting the debate together. She made some very interesting points about employment discrimination. I also want to pick up on what the hon. Member for Washington and Sunderland West (Mrs Hodgson) said about the importance of climate change.

The hon. Member for Penistone and Stocksbridge (Miriam Cates) made some very interesting comments about the economic impacts of motherhood. I was particularly struck by her comment that children are not an economic inconvenience; I agree 100%. I thank the hon. Member for East Worthing and Shoreham (Tim Loughton) for sharing his personal experience, which was really thought-provoking. I also thank my hon. Friend the Member for Bath (Wera Hobhouse) for mentioning trauma and adverse childhood experiences.

All hon. Members have added a really interesting dimension to the debate. I thank them all.

Question put and agreed to.

Resolved,

That this House has considered the matter of giving every baby the best start in life.