Evidence-based Early Years Intervention

Tracy Brabin Excerpts

Thursday 21st March 2019 Westminster Hall

[Tracy Brabin (Batley and Spen) (Lab/Co-op)]

It is a pleasure to serve under your chairmanship, Mr Davies. I, too, thank the right hon. Member for North Norfolk (Norman Lamb) for securing the debate. I am grateful to have the opportunity to debate early intervention. We have heard some fantastic contributions.

I particularly note the experience of my hon. Friend the Member for Stockton South (Dr Williams) with the Health and Social Care Committee. As a GP on the frontline, he understands the impact that early intervention can have on the outcomes for the most vulnerable. I was blown away by the startling statistic of 1 million brain connections being made every second.

My hon. Friend the Member for Bristol North West (Darren Jones) made a good contribution about partnership working, which is certainly something we need to look at from all angles. My only concern is that, in my constituency, there is the ambition for partnership working but it does not always happen. For example, if a child has seen domestic violence the night before, the school is not told. We need to ensure that there is great partnership working across the board. I will certainly steal his idea for the event, so I thank him for sharing the information about that.

My hon. Friend the Member for Stroud (Dr Drew), who is no longer in his place, talked about mental health. We need to get on with the Green Paper and see where we are. My hon. Friend the Member for East Lothian (Martin Whitfield) said that this was about the data, which is the point of the report. Once we have the data, we can respond.

I thank the hon. Member for Linlithgow and East Falkirk (Martyn Day) for his contribution. He spoke about child poverty and said that we needed to ensure that combating it is at the forefront of everything we do, because how can we improve a child’s life chances if they go back to terrible housing, unemployment, debt concerns and so on? We absolutely need to tackle child poverty, and there are some excellent pilots and ideas coming out of Scotland and Wales that England and the Government should look at very carefully.

Having heard the contributions, I think it is fair to say that early intervention is a diverse matter and a cross-party concern; it is of great importance to politicians and families. I put on the record our appreciation of the Science and Technology Committee for its work in producing this report. It is thorough and informative, and makes a number of interesting points. In particular, the idea of using data more efficiently—a theme that runs through the report—is certainly food for thought for me, for local authorities and hopefully for the Government, because without the data, nothing will change. That certainly proved true when we were looking at the gender pay gap; only with data, so that we know where we are falling behind, can things change.

Adverse childhood experiences are often linked to an increased risk of health and social problems as adults. Early intervention seeks to resolve problems as early as possible, to stop them happening before they become too difficult to resolve. Although I was very happy to see money going to the police and fighting knife crime, as it should, so many of the problems of the young people affected by knife crime could have been addressed much earlier—when they were under five, even. If we get things right under five, so much else will fall into place for those families and those children.

While it is generally accepted that high-quality early intervention improves a child’s outcomes, programmes are entirely the responsibility of local authorities, and effective national data does not exist. The overall thrust of the Committee’s report about gathering local evidence to support nationwide strategies is welcome, but we must also be sensitive to local authorities’ unique knowledge of their communities and build on that knowledge to create a national strategy.

I will speak to some of the Committee’s proposals that really stood out for me, and will note the response received from the Government. The numbered paragraphs quoted will be from “Evidence-based early years intervention: Government’s Response to the Committee’s Eleventh Report of Session 2017–19”.

In the strongest possible terms, I would like to associate myself with the Committee Chair’s remarks about Sure Start in the report, which are cited in paragraph 10 of the response. The lack of clarity from the Government on Sure Start is nothing short of an outrage. We have been holding on for a consultation, or even an announcement that the consultation has been cancelled, for far too long. Instead of the Government providing that answer at any stage—there have been plenty of opportunities for them to do so through written questions, oral questions, Select Committee questioning and even in their response to this report—they have still not given us a clear, definitive answer.

Today we are joined by the Minister for Universities, Science, Research and Innovation, who is probably the only Minister in the Department for Education whom I have not asked about this issue. Perhaps he could let us know if it is still the policy of the Department to hold an investigation. Was one ever started and, if so, when was work last done on it?

The loss of so many children’s centres and Sure Start centres is truly devastating for so many communities, and the way that this issue has been bundled and passed around the Department for Education is indicative of its overall attitude towards children’s centres. When I challenged the Minister for School Standards, whom I shadow, he emphasised that this issue should not just be all about buildings. My hon. Friend the Member for Bristol North West made the point that sometimes the building is the point, because people can go in to find a multitude of services on offer to them. Women in crisis, for example, can go to a centre on the pretext of getting their baby weighed, but use the opportunity to talk about domestic violence. Buildings are important.

As for early intervention, these centres had open doors and they were at the heart of their communities, and staffed by professionals. Their ability to ensure that families were aware of childhood experiences and to signpost services, where necessary, was so important. I was very lucky to spend a whole day at a number of the Sure Start centres in the constituency of the right hon. Member for North Norfolk, and I heard for myself about the impact that those centres have had on the outcomes of the children attending them.

I have said before how moved I was by hearing from the people who used the Sure Start centres. There was one woman in particular who was illiterate, but was taught to read by workers at a centre, so that she could read to her children. We know that literacy has a massive impact on the outcomes of young children; it improves their confidence, their articulacy and so on. I weep for the many closures in North Norfolk, and I hope that, under a Labour Government, perhaps that situation will be reversed. These centres do incredible work.

Regarding Ofsted inspections, I would be interested to know why the responsibility for maintaining and ensuring the quality of children’s centres is an issue for local authorities. Why is that appropriate for children’s centres, but not, say, nurseries or colleges? What distinguishes children’s centres from everything else that comes under Ofsted’s remit is not completely clear.

Paragraph 13 suggests:

“The Government should work with researchers and practitioners to examine how new specifications on the free childcare it funds could increase the use of evidence-based programmes”.

That is an interesting point and it deserves further investigation. Funding for childcare hours has been generally very simple; eligible parents apply, and the providers receive the money from local authorities. However, there has been very little obligation on the provider, having provided the hour of childcare, to disclose anything about the families or the children going there. This is an interesting point: is there an obligation on nurseries to collect data on their children and their outcomes?

I caution that the budgets for delivering free hours are already very tight, and having worked with practitioners for some years, I know that training opportunities are reducing, so staff capacity to capture data is potentially limited, so further thought would have to be given as to where the funding would come from to upskill the staff in these centres. Also, at what stage would that training be carried out? I would suggest that it is quite complex and sensitive training. Is it level 3, degree level or somewhere in between?

We need to be honest with ourselves: successful early intervention happens when local authorities are strategic and resource programmes properly. However, we cannot hide from the fact that the climate has been made far more challenging in recent years by savage local authority budget cuts. Early intervention programmes have been cut so severely that often children are referred multiple times before help is offered. Parents who reach out for help go round in circles, desperately asking for support, only to be disappointed.

This firefighting approach is costly; dealing with a crisis is obviously far more expensive than taking preventive measures. Addressing the issue when it first appears would save the Government money in the long term. However, local authorities are under increasing pressure to slash budgets after a decade of austerity.

The National Children’s Bureau has reported that more than one in three councillors are warning that cuts have left them with insufficient resources to support children, and it was recently revealed that 41% of children’s services are now unable to fulfil their statutory duties. These cuts have consequences. Early intervention grants—the very grants that keep children from entering care—have been slashed by up to £500 million, with almost £200 million of cuts still to come. Early intervention budgets are down by £743 million in the last five years. Over 1,200 Sure Start centres have been closed, and other children’s centres have had their offers reduced and hollowed out. The budgets for children’s centres across England have decreased by 42% in the last five years.

In my constituency of Batley and Spen, headteachers have told me how cuts to their school budgets—a part of cuts of 8% across the country—have meant that the staff who would normally do early intervention and spot children’s needs have had to go in staff cuts. The most highly paid member of staff in the building, which is often the headteacher, is the one who has to do the early intervention—who sits with the child who has anorexia to make sure they eat their lunch; who takes the disabled child swimming; or who even helps to get a child out of bed and ready for school. That cannot be right and is obviously not sustainable. We need to reverse these cuts to our school budgets, to support teachers in doing their job.

That is the reality of the situation that local authorities and schools face. For all their talk about local leadership, the Government need to accept that no matter how good that leadership is, funding cuts are tying one arm behind their back. As the right hon. Member for North Norfolk said in his opening remarks, this issue is about political will, and the incentive and commitment to turn around the lives of the most vulnerable.

In conclusion, this report is broad and far-reaching, cutting across many Departments and ministerial responsibilities. I commend the Science and Technology Committee for its tenacity in pursuing this issue, and I am sure that we will all use its report as a basis for our parliamentary questions and interventions. The data in the report is excellent, and I congratulate the Committee on it. It has certainly had an impact on me, and I hope it will have an impact on the Government as well.

--- Later in debate ---

[Chris Skidmore]

I thank the hon. Gentleman for raising that issue, which I am happy to raise with the relevant Minister. I am meeting the Minister with responsibility for mental health shortly to discuss mental health issues surrounding students, and I will make sure the issues are placed on the agenda for my discussion with her.

[Tracy Brabin]

Although we welcome the recent announcement of 5,000 additional health visitors, can the Minister say whether there will be an opportunity to collect data on how many visits a child has? To increase the number of visits from the statutory five, we need the data to enable us to know whether the extra health visitors are having the impact that I know the Government want.

[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.

[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.

[Tracy Brabin]

The Minister probably will not be able to answer this, but is there a timeframe for the consultation on What Works? Is it a two-year strategy? How long will local authorities have to wait to get something out of the Government for their children’s centres?

[Chris Skidmore]

I will talk later in my speech about issues around evaluation, What Works and the Education Endowment Foundation. As for the timeframe that the hon. Lady asked about, if I am unable to provide an answer in this debate, I will ensure that the Department writes to her and the Committee about it.

On the free hours provision that the hon. Lady mentioned, the proportion of disadvantaged two-year-olds taking up a Government-funded place continues to increase and has risen to about 72%—higher than ever before—so the entitlement is still successfully reaching the families who need it most. The 30 hours provision continues to help a wide range of families, and a lone parent has to earn only around £6,500 a year to access the 30 hours of free childcare. Parents are also eligible if they are self-employed or on a zero-hours contract. We will continue to provide local authorities with lists of potentially eligible parents in order to support them and directly target hard-to-reach families. It is important to reflect on that when we look at the evidence. There is an opportunity for positive data sharing and using data to inform local authorities.

[Tracy Brabin]

The Minister is being incredibly generous with his time, and I am grateful. I know that this is not necessarily his brief, but I want to flag up that I hear from maintained nurseries that eligibility for access to the 30 hours for two working parents is resulting in a widening of the disadvantage gap between children who access 15 hours as statutory and children whose parents work. Although it is a positive step to provide childcare for working parents, the disadvantage gap cannot be allowed to continue.

[Chris Skidmore]

The Government’s independent evaluations of early delivery showed that with 30 hours of free childcare about 78% of parents report greater flexibility in their working life, and a quarter of mothers can now work more hours. That is one aspect of the evaluation, but it is important that we continue to monitor all areas of the policy’s impact. We will continue to monitor the impact of the offer closely. I will ensure that the Department reflects on the comments that the hon. Lady has made about the 30 free hours issue.

On the question of protecting vulnerable children through effective children’s social care, we know that many children in need have experienced adversity and trauma, which is why we are strengthening children’s social care to ensure that it is effective and that it protects vulnerable children. The Department for Education children’s social care innovation programme has invested almost £200 million in 98 projects to develop, test and scale new approaches to supporting children in the social care system. We have also committed £45 million to the partners in practice programme, where we are working with 20 of the best local authorities to deepen our collective understanding of what excellent children’s social care services look like, while providing practical support to the sector. We are spending around £3.5 billion in total on our early education entitlements this year alone—more than in any previous year under any Government. We are supporting parents to improve the quality and quantity of adult-child interactions, as positive adult-child relationships are key protective factors against adversity and trauma. Following our successful home learning environment summit in November, we continue to work with businesses and other partners and are developing a campaign to launch later this year.

Looking beyond parents, we know that a skilled early years workforce is also key. Alongside our training for health visitors, we are investing £20 million in our early years professional development fund, which will offer training to practitioners in disadvantaged areas, particularly for the support of early language, literacy and numeracy outcomes. As I have already outlined, local areas have a key role to play in commissioning and delivering effective early intervention services to meet complex and specific needs locally. The Government want to support them in that task, as they should. I will give three examples, the first of which is the troubled families programme, where a multi-agency, whole family approach is advocated, in work with local areas to transform the way services are delivered. We committed £920 million to the troubled families programme between 2015 and 2020; we achieved significant, sustained progress with 130,000 families; and we aim to achieve a similar improvement for 400,000 families by 2020. Forty-nine per cent. of families on that programme have at least one child under the age of five.

The second example is the reducing parental conflict programme, which works with councils across England to integrate approaches and services to address parental conflict. It is supported by £6 million that we are investing to improve the outcomes of children of alcohol-dependent parents, because we know that alcohol misuse has a severe impact on parental conflict and childhood adversity.

The third example is the Department’s early years local government programme, which I mentioned earlier, which will focus on how local services work together across health, education and early help, to improve outcomes at age five. As part of that work, multidisciplinary peer reviews will support councils to identify reforms to services and to our early outcomes fund, which will provide £6.5 million of grants to local authority partnerships to improve the delivery of services. That programme will also look at what works, including effective models of service provision, and spread that learning across the sector.

As I have said, the Government remain strongly committed to the What Works initiative, embodied in three What Works centres—the Early Intervention Foundation, some of whose data analysis the right hon. Member for North Norfolk has mentioned, the Education Endowment Foundation and the centre for children’s social care. To improve the way organisations create, share and use high quality evidence for decision making and implementation, those centres are already producing a diverse range of important materials and support for local commissioners. Part of Government’s funding for the Early Intervention Foundation is being used to establish an early years transformation academy, which will provide a framework for sharing learning, including events and online material for leaders, commissioners and other stakeholders. More intensive academy work will begin in June 2019 and provide further opportunities to pool learning.

The Government will also, as we refresh individual Departments’ areas of research interest, consider including further research into early intervention methods for addressing childhood adversity. Some of the Departments’ published research aims for 2018 and 2019 already seek to tackle issues raised in today’s debate. For example, the Department for Work and Pensions will continue to investigate how best to support families in distress to reduce parental breakdown and separation. The Ministry of Housing, Communities and Local Government is taking forward work to support effective local government, which is key to delivering effective early intervention strategies. The Department of Health and Social Care is focusing on research on mental health. I have outlined the work that is being done to support children’s mental health and wellbeing in schools, which will help to build resilience to adversity and trauma. Interventions in the health system more generally will be tested to maximise effectiveness and cost-effectiveness. Finally, the Department for Education investigates the early years and seeks to foster childhood development for those with disadvantaged backgrounds, who are at higher risk of experiencing adversity and trauma in childhood.

Separately from departmental research budgets, UK Research and Innovation funds research and innovation across all disciplines and sectors, including disciplines directly relevant to this area. Funding for the Economic and Social Research Council has included co-funding a project with the Early Intervention Foundation. UKRI will continue to consider what future funding is most appropriate in that research area.

The right hon. Member for North Norfolk raised the issue of national data collection. There are currently two separate data collection and national reporting systems for universal health visitor review data. Data is collected via Public Health England’s interim process, which is a voluntary submission of aggregate data provided by local authorities that covers universal health visitor service delivery metrics and outcomes. However, that method of data collection is due to be superseded by a record-level collection through the community services dataset, for which NHS Digital has published the information standards and established the technical infrastructure.

It is also important that we reflect on the use and sharing of data at a local level. I mentioned the troubled families programme in connection with co-ordinating local approaches; the programme has also taken forward an early help service transformation model and toolkit, which provide practical advice on service transformation, explaining what it means, how it can be developed and how to measure and monitor progress locally. That will be shared with local partners. The local government programme will also allow local authorities to spend on digital advancements in data collection. As part of the peer review programme, best practice on data collection and sharing will then be disseminated nationally.

As to increasing the use of evidence-based programmes in free childcare, the Government are supporting early years settings to put in place high-quality evidence-based provision. I mentioned the £20 million professional development fund; the Government are also investing £4 million in trials focused on interventions that improve the home learning environment, delivered by the Education Endowment Foundation. Results from the trials will be available over the next two years and will be used to inform future policy for commissioning decisions.

[Tracy Brabin]

I am very interested in staff training. To return to a question that I asked in my speech, at what point—level 3, university, or whatever—would the relevant training be included? I would be very interested to hear the answer, because high-quality staffing is certainly at the heart of closing the disadvantage gap. It is about not just childcare, but education, so we need to ensure that all staff have all the tools at their fingertips.

[Chris Skidmore]

I have touched on some of the Government programmes that have been taken forward for staff training. The hon. Lady is absolutely right that we need to ensure that staff training takes place at every level, from those starting off in the early years workforce right through to continuous professional development for early years workforce leaders. I will have to write to her on her specific point about timing, as well as on the points she raised earlier. I hope that that is satisfactory.

As I mentioned, the Department for Education is reforming the early learning goals at the early years foundation stage. The first stage of these reforms will be followed by an external evaluation of the pilot, helping to generate learning in this area and allow reforms to be refined ahead of full roll-out.

The Government are absolutely committed to What Works and improving how the Government and other organisations create, share and use high-quality evidence for decision making alongside the What Works centres, including the Education Endowment Foundation and the What Works centre for children’s social care.

The Early Intervention Foundation has an important role to play in testing and communicating what works to improve outcomes through early intervention. The EIF has played a key role in bringing evidence and rigour to the early intervention debate. The Government have provided funding of £7.3 million to the EIF until 2020, and the Government will review funding for the EIF in the forthcoming spending review. The right hon. Member for North Norfolk mentioned the Chancellor of the Exchequer’s spring statement, and I am sure he will make representations to the Chancellor. I will ensure that this debate and its text are communicated to the Treasury so that it is aware of the points raised by the Committee in its report and by the debate today about the importance of continuing funding for the EIF going forward into the spending review.

I assure Members that the Government take the Committee’s report and the issues it raises incredibly seriously. I have set out our approach to childhood adversity and trauma, which includes the actions taken through programmes that are run and funded centrally. It is also about supporting local areas to ensure they are commissioning and delivering evidence-based early intervention services.

I have mentioned the specific issue of the strategy. The Government do not consider the formal publication of a national strategy to be the best approach at this time, and I have set out our current approach through the various programmes. The Government are confident that those programmes will bear fruit, but we will seek to review that 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, which I set out earlier.

I have also mentioned that the early years ministerial group on family support will add to the Government’s current approach. I am sure that the Leader of the House, given her passionate commitment to this specific area and to taking forward cross-Government work, will take a keen interest in reviewing the contributions made in this important debate.

It is the role of Government to provide guidance on local approaches to early intervention, but there is a fine balance to be struck between local direction and central Government oversight. The Government believe that it is fundamentally for local authorities to determine how their services best meet the complex demands of their areas, not central Government, but we will nevertheless continue with our responsibility to support What Works initiatives and ensure that local systems are working well. The Government will also consider including further research into early intervention methods for addressing childhood adversity as we refresh individual Departments’ areas of interest. The issues that make up childhood adversity and trauma, such as verbal, physical and sexual abuse, parental separation, mental illness and alcohol abuse, are at the core of the work of numerous Departments and major programmes.

We want to ensure that we build long-lasting protective factors against adversity and trauma in the early years. The Government have invested in the early years. By 2019-20, we will be investing around £6 billion a year in early education and childcare support to cover free entitlements, tax-free childcare and the childcare element of universal credit. The Government see effective early intervention as essential to our work to bring about cost efficiency in public services and, above all, to ensure that the human factor is there to improve people’s lives and that children are not put at risk. The factors that Members have mentioned help to ensure that children have strong and healthy lives. As I have already outlined, the Government are putting research funding investment into early intervention initiatives.

Finally, as Members can probably see, I am the Minister for Universities and Science, so I wish to put on record the apologies of the Minister for Children, my hon. Friend the Member for Stratford-on-Avon (Nadhim Zahawi), for being unable to speak in the debate. He will happily meet the hon. Member for North Norfolk to reflect on the report and take forward any issues of concern that have been mentioned in the debate.

The Government are keen to continue to engage fully, as I do—wearing a different hat, as Science Minister—with the Science and Technology Committee. We are very grateful for the conclusions the Committee came to in its report.