Childcare and Early Years

Debate between Steve Brine and Andrea Leadsom

Wednesday 8th March 2023 Commons Chamber

[Dame Andrea Leadsom (South Northamptonshire) (Con)]

May I say what a huge pleasure it is to see you back in the Chair, Madam Deputy Speaker—and what better day to be discussing this topic than International Women’s Day? I wish all the women—and men—in the Chamber a happy International Women’s Day. Is it not wonderful that there are so many of us now? It is indeed wonderful to see so many women in politics, making a contribution and debating these issues. On behalf of all of us, I want to encourage every young woman, of whatever party, who has political interests and ambitions to get stuck in. We will help you. Come and join us; you will be most welcome.

Let me begin by paying tribute to my hon. Friend the Minister, who has been such an advocate for what, as I think everyone in the House knows, I am so passionate about: giving every baby the best start in life. The lovely thing about that is that I am, so far, not alone. Every Member I talk to, in every party, is incredibly supportive, because we all know from bitter experience of constituency cases, from what we have read, and from what we have learned as politicians and in our own lives, how critical it is for every single baby to have a chance of the best start in life.

Let me give the House some statistics. We know from a study conducted by the Early Intervention Foundation in 2016 that the cost to our economy of late intervention is about £17 billion a year. Almost a third of that is the cost of looked-after children. The children who have some of the worst outcomes in the country are those who are removed from their families and taken into care, and it is shocking that so much money is spent on achieving such poor outcomes. Huge parts of that £17 billion are spent on dealing with domestic violence, and young people who are not in employment, training or education and whose life chances have been hampered by their not being given the best start.

My hon. Friend the Member for Worcester (Mr Walker) has already mentioned the work of Professor James Heckman in analysing the rates of return on human capital investment. It says very clearly, “If you do not care about human happiness, just look at the money—follow the money!” A pound, or a dollar in the professor’s case, invested during the antenatal period will pay exponentially more, in terms of the return, to the human potential of the child—and will lower the later cost to society—than a pound, or a dollar, spent further down the line, when that child is already in the realms of youth crime or perhaps mental illness. Financially, prevention is not much kinder but so much cheaper than cure. Across our United Kingdom, and indeed across the world, there is a growing wealth of evidence for that.

I pay tribute to the Princess of Wales for her amazing work through the Royal Foundation Centre for Early Childhood, observing the struggles of parents and the number of parents who do not feel confident about knowing what their baby needs. I have talked to consultant paediatricians as part of my work as the Government’s early years healthy development adviser, and one of them said to me, “I am supposedly an expert in this field, but when my wife and I had our baby, we were like, ‘Aargh! What do we do with this?’” That is the challenge. It is not about the nanny state, or about interfering; this can happen to any us. I had three babies, and by the third time I thought I had it sussed, but my 19-year-old still gives me hell!

When you first have a child, you do think, “What am I supposed to do with this?” You take that beautiful, squeaky new baby home, and once you have got over the stitches and the other horrific unspeakable things that befall women in these circumstances, you find yourself trying to focus on the fact that you have had no sleep, which is an effective torture, is it not, Madam Deputy Speaker? We all know what it is like if we have had no sleep, and your baby, like my first, does not sleep for more than two hours at a time. In the one antenatal class that I just vaguely recalled, I was asked, “What is your 24-hour clock like now?” We all said things like, “Between 11 pm and about 7 am, I am fast asleep.” Then we were asked, “What do you think it will be like once you have had the baby?” We all said, “Well, I don’t really know, actually.”

It is so difficult, having a baby. You can be as rich as Croesus, you can be happily married, you can have all the support and the nannies in the world, you can have maternity nurses, and it is still difficult. Actually, I pay tribute to the Netherlands, where 95% of babies are born at home and you get a free maternity nurse, on the state. I would do that trade any day of the week—hands up those who would not! To have someone who will take the baby off you so that you can get a few hours’ sleep—that is extraordinary. However, I hope I am not freaking out anyone who is thinking of having a baby: it is the most glorious thing we ever do, and I welcome the fact that so many of our colleagues in the House have young children. I was proud as Leader of the Commons to introduce proxy voting for baby leave, because, oh my goodness, we cannot just sit at home and watch everyone voting and hope that our slip is going to be adhered to. We need to continue our lives.

So, for many women, and men, this is the most difficult thing they ever do, but what is so appalling is that we are really not allowed to say that. When I had my first child I was working at Barclays and I had just been appointed senior executive—one of only eight women; it was an absolute badge of honour—and they said, “We will do this appointment if you will come back after 10 weeks.” I know that seems extraordinary. They could not legally do that now, but in those days they could. And I said yes, which was really stupid. In hindsight, why on earth did I say yes? Anyway, there ensued two miscarriages, postnatal depression and awful trauma, and I left. It was not a happy experience. I say that because we are never allowed to say when things are difficult and we are really struggling, but we really want to keep our career. We do want to have it all, and that is understandable, but at the moment we really cannot.

We absolutely have to focus on the incredible investment in the early years. Again, I pay tribute to the Under-Secretary of State for Education, my hon. Friend the Member for East Surrey (Claire Coutinho); to the Prime Minister who, as Chancellor, funded this incredible project; and to the Chancellor, who as a Back Bencher and Chair of the Health and Social Care Committee was absolutely supportive of the best start for life. I also pay tribute to Opposition colleagues. One of my earliest friends in this place was the wonderful Lord Frank Field—if I may use his name since he is no longer an MP—and the even more wonderful, if that is possible, Dame Tessa Jowell, both of whom have been such advocates for giving every baby the best start in life.

What the Government are seeking to do is to provide support. My hon. Friend the Member for North Dorset (Simon Hoare), who is no longer in his place, talked about the importance of early years settings to build families’ capacity to be parents. In those settings, parents can chat to others and ask, “What size nappies are you using? Have you weaned yet? What are you feeding your baby?” We do not get a manual, do we? We should, but we do not. Another thing we do not get, which we should, is an on/off button. Don’t you agree, Madam Deputy Speaker? I am sure Matthew would agree. When Madam Deputy Speaker’s son used to sit in his sitting room opposite mine and play my music in my flat from his Bluetooth, I wanted an on/off button then. He was a bit older.

That is one of the challenges that we have as parents: there is no manual. So how do we get that information? We have the Government’s programme of rolling out family hubs across England. I wish we could roll them out across the UK, and we will be working with our colleagues in the devolved Administrations to make that the case. In Scotland, they have got parenting mental health absolutely sorted but they do not have family hubs. Talking to some colleagues who are Scottish parliamentarians, I know that they would be keen to follow what we are doing here. I think we can learn from each other all around the world. In Chile they have the most wonderful support for new mums that we do not currently have here, but we are starting to roll out the family hubs across England.

Most importantly, we are rolling out the best start for life, which involves six universal services. People who go to a family hub will be able to get antenatal midwifery checks, to chat to a health visitor, to seek support for their mental health issues or those of their partner or any member of their family, or for their relationship with their baby. They will also be able to get breastfeeding support. This is another ridiculous thing: we are all expected to know how to do that, aren’t we? How on earth do you breastfeed a baby? Who knows? Hands up, any of the men? No. We do not get a manual for that either, and actually women need a lot of support. You would not give your five-year-old a two-wheel bicycle and say, “Right, off you go, darling.” You hold the back of the seat until they have got the hang of pedalling. Our breastfeeding rates are among the worst in western Europe and that is because no one gets any help—

[Steve Brine]

On that point, will my right hon. Friend take an unlikely intervention?

[Dame Andrea Leadsom]

My colleague is going to tell us how to breastfeed, ladies!

--- Later in debate ---

[Steve Brine]

I have never name-checked them in this House, but Auntie Jane and Auntie Jenni ran the BABIES breastfeeding support group at Lanterns nursery, which still exists in Winchester, and I remember going to them one morning after we had had a dreadful night with our first, Emily—who is 15 now and still a challenge—and we were just desperate. The only thing that got us through to daylight was knowing that we were seeing Auntie Jane and Auntie Jenni in the morning. I remember taking my wife and Emily down to see them, and they provided amazing support, as do support groups all over this country. So, Auntie Jane and Auntie Jenni, thank you.

[Dame Andrea Leadsom]

That is lovely, and I pay tribute to the thousands of volunteers who provide breastfeeding support. My hon. Friend highlights perfectly one of the great challenges of becoming a new parent. When we are really struggling, there is a high correlation with mental health issues. When there is not enough support for women who want to breastfeed their babies but find they cannot do so, they suffer from feelings of guilt and feeling that they have failed and they are not good enough, and that lends itself to the problems of postnatal depression that are only too prevalent right across England.

So, to recap: midwifery, health visiting, mental health support, breastfeeding support, safeguarding support and disability support will be universally available in family hubs to help every family to give their baby the best start in life. Not only that, there will be universal-plus support for the most tricky and challenging issues such as the prospect of domestic violence. We know that up to 30% of domestic violence starts in pregnancy because of the partner’s feeling, “This person is going to love the baby more than they love me.” All these challenges that are brought out by pregnancy are quite desperate to be solved. We know that if we can get the hang of giving every baby the best start for life, that will transform our society.

I mentioned that the cost to our economy of late intervention is about £17 billion a year. The Maternal Mental Health Alliance’s study has shown a cost of around £8 billion a year for every new cohort of births as a direct result of the cost of poor maternal mental health in the perinatal period. The all-party parliamentary group on conception to age two—the 1,001 critical days—has demonstrated that school readiness results in a reduction in later problems such as the propensity of children to get into gangs, to have poor mental health and to fail to learn and do well at school. The 1970 cohort study showed, significantly later on, that only 18% of children in the bottom 25% academically at age five get one or more A-levels, compared with 60% of those in the top 25% at age five. What happens to a child in their earliest years follows them throughout their life, and the more we can do in that earliest period, the better, so the Government are totally on the right lines.

Early Childhood Development

Debate between Steve Brine and Andrea Leadsom

Thursday 30th January 2014 Westminster Hall

[Andrea Leadsom (South Northamptonshire) (Con)]

I am delighted to have secured this debate, and I am grateful to the Backbench Business Committee for selecting it. Mr Weir, did you know that 36% of all case reviews into deaths or serious abuse involve a baby under the age of one, and that a quarter of all babies in the UK have a parent affected by domestic violence, mental health or drug or alcohol problems? Furthermore, if one asked most local authorities how much they spend on specialist parent and infant mental health services, the answer would be, “Nothing.”

I am proud of the fact that with three cross-party colleagues, I have launched the manifesto “The 1001 Critical Days” to propose specific ways that the Government can better support the needs of new families. The 1,001 critical days is the period of time from conception to the age of two. In our cross-party manifesto, the right hon. Members for Birkenhead (Mr Field) and for Sutton and Cheam (Paul Burstow), the hon. Member for Brighton, Pavilion (Caroline Lucas) and I seek to recognise the overwhelming evidence now available that a secure early relationship between baby and key carer is vital to the infant’s lifelong emotional and physical well-being.

We are grateful for the strong interest that the manifesto has received from Ministers and shadow Ministers, particularly the Under-Secretary of State for Health, my hon. Friend the hon. Member for Central Suffolk and North Ipswich (Dr Poulter), and the hon. Members for Manchester Central (Lucy Powell) and for Washington and Sunderland West (Mrs Hodgson). We have also been delighted by the amazing number and range of endorsements for our manifesto, from the chief medical officer for England and Wales to UNICEF UK, the National Society for the Prevention of Cruelty to Children, the Centre for Social Justice, Barnardo’s, the Royal College of Midwives, the Royal College of General Practitioners and the Institute of Health Visiting. The list goes on and on.

Mr Weir, you might be wondering what on earth is left to debate if the topic is such a love-in, but the truth is that there is an enormous amount to be done if we are to seize the opportunity to change our society radically for the better. An NSPCC study shows that only 64% of NHS trusts have a perinatal mental health strategy. Other recent research shows that 42% of GPs feel that they have very little knowledge about the specialist services available for severe mental illness. Nearly a quarter—23%—of all maternity professionals say that they have received no education on maternal mental health, and the Royal College of Paediatrics and Child Health estimates that the annual short-term costs alone of emotional, conduct and hyperkinetic disorders among children aged five to 15 in the UK are £1.58 billion, and the annual long-term costs are £2.53 billion.

The Institute of Health Visiting is delighted by the Government’s commitment to significantly increasing the number of health visitors, and progress in training new health visitors is on target. However, in a recent survey by the institute, 87% of midwives said that their work loads had increased and that they were seeing the following worrying trends: 65% were seeing increased child behaviour problems, 61% reported seeing an increase in the prevalence of speech delay, 73% were seeing an increase in poverty that was having a bad influence on families, 82.5% were seeing an increase in domestic violence and abuse and 70% reported an increase in the incidence of perinatal depression. Perinatal depression includes antenatal depression—that is, before a woman has her baby—as well as the depression that can arise during birth as a result of a traumatic birth experience and, of course, post-natal depression, which is the main subject that people talk about when they talk about depression in the perinatal period, if they ever talk about it.

Everyone would agree that prevention is better than cure. Everyone, or pretty much everyone, would agree that many of our society’s greatest problems stem from alcohol and substance abuse and mental illness. But too few people realise that in a vast number of cases, those in our society who cause the most damage and cost the most money have been permanently set up for disaster from their own infancy. The absence of a secure bond between baby and carer in the 1,001 critical days has profound lifelong consequences for the baby. I am convinced that once the strong link between experiences in the earliest years and whole-life outcomes becomes more widely accepted, we will start to make huge progress in tackling society’s most intractable problems.

The efforts of 20th-century politics achieved great strides in tackling the physical health of our nation. The challenge for our 21st-century generation must surely be to secure sound mental health that will lead to a stronger and happier society. Imagine how wonderful it would be if we were to shut down prisons, not because of overcrowding or poor conditions but because we did not have enough criminals to fill them. Imagine if we could close psychiatric hospitals due to a lack of need for them.

[Steve Brine (Winchester) (Con)]

I congratulate my hon. Friend on this debate. I know that she is achieving quite a reputation in this area. The Select Committee on Justice, of which I am a member, held an inquiry recently into youth justice and the drivers of youth justice. As she will probably know, just 10% of children and young people in the general population have a speech and language difficulty, but in the prison population the figure is somewhere between 60% and 65%. Does she agree that delayed language development leads to issues at school, exclusion from school and many of the problems that cost our society so heavily?

[Andrea Leadsom]

My hon. Friend is absolutely right that delayed speech is a key contributor to later problems for the infant who does not reach the right level of speech capability in the first critical years.

Think of walking through any big city in the UK without seeing teenagers living rough in the streets. Finally, imagine a society where the number of babies and children being taken into care and removed from their families was falling, instead of rising as it is at the moment.

[Andrea Leadsom]

I completely agree, and I will discuss that in a moment. It is called the cycle of deprivation, and my hon. Friend is absolutely right to raise it.

I honestly believe that it is possible to change our society for the better, but it needs a concentrated focus on the mental health of our nation. I want us to build a third pillar to our great universal services. Alongside the achievements of free and universally available health care and education, I want a free and universal service focusing on the mental health of our people. It must start at the very beginning—the period of 1,001 critical days between conception and age two—and it must ensure that every child can build the emotional capacity and resilience to cope with life’s ups and downs.

I make the case that what we do with a baby from conception to age two is all about building the human and emotional capacity of that infant. Supportive interventions with a child after the age of two are often too much about trying to undo damage that has already been done. I would never advocate giving up on anyone, but it is an incontrovertible fact that if we want to change our society for the better, we must focus on the crucial period between conception and age two.

Human babies are unique in the animal kingdom in the extent of their underdevelopment at birth. What other animal cannot walk until it is nearly a year old and cannot fend for itself in any way at all until it is at least two years old? However, the physical underdevelopment is only a tiny part of it. The human brain is only partially formed when a baby is born. The billions of neurones in the brain are largely undifferentiated at birth, and parts of the brain are simply not there. Humans are born with only the fight-or-flight instinct and the earliest experiences of the human baby literally hardwire his or her brain and have a lifelong impact on the baby’s mental and emotional health.

What are a baby’s earliest experiences? It is quite simple. When a baby cries, he does not know that he is wet, tired, hungry, bored or too hot; he just knows that something is wrong, so he relies on a loving, adult carer to soothe his feelings. Most parents will remember, as I certainly do, long nights spent walking up and down, hugging a baby, saying, “Go to sleep, go to sleep,” desperate for sleep ourselves and determined to try one thing after another to sort the situation out. The baby whose basic needs are met learns that the world is a good place, and he or she will retain that sense as an instinct for life. That baby will be more emotionally more robust than the baby who does not have his needs met.

For the baby who is neglected or abused, there are two critical impacts on development. First, a baby cannot regulate his or her own feelings at all. If the basic needs are not met, he or she will simply scream louder and louder, and eventually take refuge in sleep. The first impact is that a baby who is left to continually scream night after night will experience raised levels of the stress hormone, cortisol. Excessive amounts of that damage the baby’s immune system permanently, and evidence suggests that a baby left to scream for hours at a time, day in and day out, will develop a higher tolerance to their own stress level, meaning that in later life, they will have more of a predisposition to high risk-taking behaviour than a baby who has only a normal level of cortisol. A lot of evidence shows that violent criminals have a high tolerance to their own stress levels. However, it is not only that—for a mother who is very stressed during the time that her baby is in the womb, the outcome is that the baby can physically be very desperately damaged. For example, maternal stress during pregnancy can lead to a thinning of the baby’s arteries, which has profound consequences later in terms of congenital heart disease, diabetes and obesity.

There is also a very real physical impact on the brain. The pre-frontal cortex—the social part of the brain—only starts to develop at about six months, and the peak period for that part of the brain to develop is between six and 18 months old. Growth is stimulated by the relationship between the baby and carer, and peek-a-boo games, gazing into each other’s eyes, singing songs, saying, “I love you, you gorgeous little thing!” and lots of cuddling all play a really strong role. Love literally shapes the baby’s brain. The brain develops millions of neural connections during that period and the pre-frontal cortex physically grows in size.

[Steve Brine]

Although I appreciate that saying, “You beautiful, delightful thing” is clearly the thing to do, at 3 in the morning, especially as a brand-new MP with a vote at 10 pm the next night, saying, “The Prime Minister really needs to be on my game” does not cut much ice with a newborn baby—I say that from bitter experience. My point is that parents have to learn how to be parents and how to give that love and care. Will my hon. Friend take a moment to recognise the amazing work of organisations such as Home-Start? They do brilliant work in teaching parents how to be parents.

[Andrea Leadsom]

Yes, Home-Start does a fantastic job, as do other volunteer organisations, peer-support groups and so on; there are many around the country. It is true to say that becoming a parent is the most difficult thing that someone ever does. There is no on-off button for a baby and no rule book, guidebook or handbook, so we all struggle on in our own way, with better or worser results—[Interruption.] Probably not “worser”—worse, thank you. The Secretary of State for Education is not responding to the debate, so we are all right, but the point is about being a good enough parent, and if a baby knows that he or she is loved, a parent does not have to say it at 3 o’clock in the morning when they are at their wits’ end. However, a baby does have to learn that their parent loves them.

When a baby does not receive attention from a loving adult carer, the pre-frontal cortex does not grow and may never grow. Many will remember the tragic story of the Romanian orphanages, where the minimal physical and emotional contact with babies left them profoundly and permanently brain-damaged. Some of them died literally from a lack of love.

It ought to be natural and automatic for families to form a loving and secure bond with their babies, but post-natal depression, problems with conception, trauma during childbirth, domestic violence and issues of poverty and deprivation all get in the way. Insecure attachment is no respecter of social class or wealth. One of the biggest obstacles to forming that crucial secure bond is when mum did not have a secure relationship with her own mother. As my hon. Friend the Member for East Worthing and Shoreham (Tim Loughton) pointed out, it truly is a cycle of deprivation that is all too often passed down through generations.