Public Health Model to Reduce Youth Violence

Vicky Foxcroft Excerpts

Thursday 13th December 2018 Commons Chamber

[Victoria Atkins]

I thank the hon. Gentleman, who contributes a great deal through the serious violence taskforce, which is chaired by the Home Secretary and brings together colleagues from across the House and people from local government, Whitehall Departments, the police, health and so on to try to tease out ways of tackling serious violence. I understand his point. It is of course for each Member of Parliament to decide which debates to attend. However, looking at the colleagues who are here, I know that they have all paid particular attention to this issue in their constituencies and in conversations with me and other Ministers. I hope that there will be more people in the Chamber for future such debates, but anyone watching should rest assured that, although the Benches may not be as full today as the hon. Gentleman and I would like, a great deal of work is going on outside this Chamber.

[Vicky Foxcroft (Lewisham, Deptford) (Lab)]

How many times has the serious violence taskforce met? Where can we find the details of what it has discussed?

[Victoria Atkins]

The taskforce has met five times—it meets pretty much every month, although there may have been a period of five weeks between one or two meetings. There was a meeting only last week that I was unfortunately unable to attend because I was required for a debate in the House, but the next meeting is on 9 January. We do not publish the minutes of the meeting because we want people to be able to exchange full and frank views. I am grateful to hon. Members throughout the House who take part in the taskforce, which has pushed on a programme of work across Government, including on exclusions and social media activity. I plan to move on to that later in my speech.

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[Victoria Atkins]

I pay tribute to the right hon. Gentleman for his work on this subject over the years, and I join him in paying tribute to the work of the Youth Violence Commission. I absolutely agree about adverse childhood experiences. He will know there is a new inter-ministerial group, chaired by the Leader of the House, focusing on the first two years of life. I invited myself on to that group because it is of such interest to my portfolio.

When I speak to young people who are involved in gangs, and to their youth workers, the prevalence of domestic abuse is sadly a theme that runs through these young people’s lives. That is why I hope the forthcoming domestic abuse Bill will have an immediate impact not just on violence committed in people’s homes but on the longer-term consequences of ensuring that children do not witness such violence and abuse in what should be their ultimate place of safety—their home. That can have long-term adverse impacts in their adult and teenage years.

The serious violence strategy sets out our understanding of recent increases in serious violence, our analysis of the trends and drivers, as well as the risks, and the protective factors that can help to tackle them. As a result, it places a new emphasis on early intervention and prevention, and it aims to tackle the root causes of the problem, alongside ensuring a robust law enforcement response.

The strategy sets out our response under four key themes: tackling county lines and the misuse of drugs; early intervention and prevention; supporting communities and local partnerships; and the law enforcement and criminal justice response. The strategy is very clear that tackling serious violence is not a law enforcement issue alone and that it requires a multi-agency approach involving a range of organisations, partners and agencies, including education, health, social services, housing and youth services. It supports a public health approach to tackling serious violence, which I suspect has the support of the House.

[Vicky Foxcroft]

Does the Minister share my disappointment that we do not have Ministers here listening to the debate from all those other Departments, which are so integral to delivering a public health approach?

[Victoria Atkins]

I always enjoy the company of my colleagues on the Treasury Bench. In fairness, those Ministers may not be here today, but they are there at meetings of the serious violence taskforce, the inter-ministerial group on serious violence and the inter-ministerial group on the first two years of life. There is a great deal of Whitehall involvement, and there has to be, because we have to ensure that all relevant Government Departments, at both national and local level, are involved if we are to provide a wrap-around approach to tackling violence.

The trends and analysis show that this violence is based around male-on-male offending, alongside a shift to younger offenders. Young black men are disproportionately represented as both victims and perpetrators, and although the rise in violence is national, particular communities are being disproportionately hurt by this terrible violence. The strategy is clear that a range of factors are likely to be driving the rise in serious violence, but the most notable driver is the drugs market.

Crack cocaine markets have strong links to serious violence, supported by the growth in county lines, which is also strongly linked to violence. The latest evidence suggests that crack use is rising in England and Wales and that county lines drug dealing, which is associated with hard class A drugs, has spread.

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[Vicky Foxcroft (Lewisham, Deptford) (Lab)]

I will start with what motivated me to speak in this debate. I was first elected in 2015, and in September of that year I had to deal with losing two young men in my constituency. I saw the impact it had on the whole community. Since then we have lost 10 young people in Lewisham, Deptford. With 130 lost in London and 263 lost across the country this year alone, this clearly is not something we can simply tackle in Lewisham, Deptford alone.

If that many people had died in a football stadium, a music arena or a workplace, we would be having a national inquiry. From my conversations with experts and young people, I quickly realised that anything we do needs to be cross-party—we cannot play politics with young people’s lives—and evidence-led. That is why we established the cross-party commission on the root causes of youth violence. Warwick University joined as our academic partner, and academics from elsewhere, including the Open University, have supported our work. A public health approach was the key recommendation of our interim report.

In talking about a public health approach, people far too often, and particularly politicians and commentators, say the words but do not understand what they mean or where they come from. In 1996, at its 49th annual conference, the World Health Organisation declared violence

“a major and growing public health concern around the world”

and in 2002 it advocated tackling violence as a public health problem. The World Health Organisation identified that violence acts and spreads like a disease.

The focus is on dealing with violence just like any other disease. The World Health Organisation’s evidence shows that violence spreads like a disease and, as such, we need to treat the disease and prevent it from spreading. Across the world, from Chicago to Scotland, there are numerous examples of successful public health programmes aimed at tackling violence. I could name loads of them, but I have had to cut down my speech dramatically to stay within the time limit.

Cure Violence, founded in Chicago in 2000 under the name CeaseFire, runs projects all over the world, including in England at Cookham Wood young offender institution. The project at Cookham Wood resulted in a 50% reduction in violent incidents, a 95% reduction in group attacks and a 96% reduction in youths involved in group violence.

Cure Violence maintains that violence is a learned behaviour that can be prevented using disease control methods. The Cure Violence model has five required components, three core components and two implementing components. Put briefly, the model involves, first, detecting potentially violent events and interrupting them to prevent violence through trained, credible messengers; secondly, providing ongoing behaviour change and support to the highest-risk individuals through trained, credible messengers; thirdly, changing community norms that allow, encourage and exacerbate violence in chronically violent neighbourhoods to healthy norms that reject the use of violence; fourthly, continually analysing data to ensure proper implementation and to identify changes in violence patterns and levels; and fifthly, providing training and technical assistance to workers, programme members and implementing agencies.

In Scotland, the violence reduction unit established in 2005 has reduced the number of homicides by 39% and the number of violent crimes by 69%, which is huge. I could talk for hours about the unit’s work, but I will not. I will simply say that I have nothing other than total respect for the unit’s work and for the magnificent people I have met.

Karyn McCluskey and John Carnochan, who set up the unit, are two of the finest, most dedicated people I have ever met. It has never been just a job to them. They drafted the violence reduction unit’s first plan and they would say that they had lots of dedicated people who worked with them, and I know that to be true. What would be the main things they would say to me if they were here? They would say, “It is about relationships.” I interpret that to mean breaking down barriers, pulling people together on a common aim and enthusing people to do something that is going to work. It is also about the importance of individual relationships. They would also say, “Follow the evidence. Don’t do things that don’t work. Do things that work.” That might sometimes mean trying something, realising it is not working and binning it, and then trying something else that will work. They would also say, “ Listen. Listen to what you’re being told and what the evidence shows you. Listen to our young people and recognise they are so, so often so very vulnerable, even if they put a super-hard act on.” One of the most important things they would say is that our approach must be long term. They had a 10-year strategy, but when we speak to them, they say it could and probably should have been 15 or 20 years long.

I am glad to see that Sadiq Khan, the Mayor of London, has announced the establishment of a violence reduction unit in London, which will establish a public health approach to reducing violence, learning the lessons from Scotland, but appreciating we may need some different approaches in London. Local authorities need to have the legal duty—this is not just about having a consultation on a legal duty—to underpin a public health approach in tackling violent crime. I hope the Home Office can update us on that soon.

Turning back to what the Government can do, we need to learn lessons from what works. We need to be brave and follow the evidence, which can be difficult when the Government do not store data on crucial sources of information. Can the Minister tell me why the Government do not centrally hold data on the time of knife attacks, especially as recent research has shown that young people are especially vulnerable between 4 pm and 6 pm on school days? Data on the number of knife aggravated murders in each city or local authority is also not held centrally, which makes it far harder to compare the efficacy of different local authority approaches over time. The number of prisoners that were excluded at school is also not regularly recorded. Many victims of knife crime do not report their injuries to the police, so should we not be looking for this information in other areas, such as the NHS? The Government do not cross-reference ambulance service dispatch data for knife injuries and police records for knife attacks. Many people believe there is a link between deprivation and levels of violence, so why do the Government not hold this information? Finally, but extremely importantly, why do we not record the number of young people who applied but failed to meet the threshold for child and adolescent mental health services treatment?

Those are all extremely important areas—and I am sure there are many more—where we should hold data, as a minimum to ensure that the Government can successfully deliver on their public health approach. I have asked numerous questions of the Government and others in order to try to find this information, but, sadly, I know the Government do not hold this data. Why is that? Will the Government commit today to seeking to hold this data?

Why do we invest in programmes that we know do not work? For example, there is no evidence to suggest that programmes in schools that say, “Do not use drugs” or, “Do not carry a knife” have any impact. We should analyse the efficacy of these programmes and if they do not work, we must stop them. We know that programmes investing in social development, home visitation, training in parenting, mentoring programmes and family therapy work. We also know that the earlier the intervention, the more effective it is.

I will skip through what I have on adverse childhood experiences, because I know that other Members have gone through it, but ACEs is an extremely important area of work and we need to do a lot more on it. I encourage all Members of Parliament to do the survey on ACEs and get their scores, as I intend to do in the future. I understand that the Government are due to publish a report on ACEs; when will it be published?

I will skip through my comments on schools, but in previous speeches on education I have said a lot about what happens in schools. It is really important that we look into whether school finishing times are right and whether we should stagger them. Should we think about closing down all pupil referral units? Should we look into expulsion? We could absolutely invest that money in our children’s lives far earlier.

Let me conclude my remarks with an important quote from a Member of the Youth Parliament, Ciya Vyas, who spoke about the importance of tackling knife crime in the recent UK Youth Parliament debate on the subject. She said:

“More young people voted for this issue than any other…If there is a will for change on this issue among young people, there is a political will for change here at Westminster. Whether we see the need for a violence reduction unit and a public health approach, as pioneered so successfully in Scotland and endorsed here by London’s Mayor, or the Home Secretary’s recent proposals to increase levels of stop-and-search, this debate is happening now, and we cannot neglect our duty to bring young people’s voices into it.”

After that debate, and following a ballot of more than 1 million young people throughout the nation, the Youth Parliament and the British Youth Council chose knife crime as the subject of their national campaign. Let us make sure that as politicians we do not let them down.

[Several hon. Members rose—]

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[Sarah Jones (Croydon Central) (Lab)]

I start by congratulating my hon. Friend the Member for Lewisham, Deptford (Vicky Foxcroft) on the work she has done on the Youth Violence Commission and on securing this debate against all the odds. I do not know whether she asked for the debate nine, 10 or 11 times—

[Vicky Foxcroft]

Thirteen.

[Sarah Jones]

Thirteen! She was incredibly persistent.

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[Chris Stephens (Glasgow South West) (SNP)]

I am very grateful, because of my sore throat. that the time limit has been reduced. When I heard it was originally nine minutes, I was going to encourage interventions.

I am a member of the Youth Violence Commission, alongside the hon. Member for Lewisham, Deptford (Vicky Foxcroft). I want to spend my allotted time making it clear that the recommendations in its report are very much evidence-based, and in particular are based on the evidence of the work we saw in Glasgow and in Scotland. When we launched the Youth Violence Commission, I said that one of the first things we need to tackle as a society is the cycle of low expectation in young people—I think we need to raise young people’s hopes—and also that youth violence is a preventable public health problem, but it does require resources and constant commitment.

That was seen when Swayed, a youth organisation that does street outreach work in my constituency, visited the London Assembly. Young people and youth workers met in London to discuss the work that is done both in London and in Glasgow, and I know that both organisations found that very beneficial.

[Vicky Foxcroft]

Will the hon. Gentleman give way?

[Chris Stephens]

I will give way to save my throat.

[Vicky Foxcroft]

I just want to point out for the record that my hon. Friend the Member for Streatham (Chuka Umunna) is also on the Youth Violence Commission. I had forgotten the name of his seat when I was making my speech.

[Chris Stephens]

So noted—and it has been good to work with the hon. Gentleman.

On the Youth Violence Commission’s visit in October last year, we went to a school. In my intervention on the right hon. Member for Hackney North and Stoke Newington (Ms Abbott), I mentioned the visits to schools that are made to give young people the skills to deal with challenging, threatening and abusive behaviour.

We visited an after-school club, which at that time was run by Sergeant Danny Stuart. We made an evening visit to Govan to see Johnny Hendry of YouthLink Scotland, a street outreach worker. He provided the commission with insights and a tour of some of the areas he goes to in Govan to engage with and support young people. Points were made earlier about gangs taking over, as well as about drug dealers and all the rest of it. Johnny tells me that what is happening in Scotland is that the violence reduction unit is dealing with the schools, but the drug dealers are after the ones playing truant.

We also visited another organisation in my constituency that has been praised in Parliament, the South West Arts and Music Project, to see its magnificent work. I am a great believer in providing young people with a creative outlet, such as video making or music. Young people can do so much to help the creative industries in our country, and it helps them with their health as well. I think that is one of the keys going forward.

The public health model adopted in Scotland has demonstrated that violence has significant social, structural and environmental root causes that need to be tackled. If a young person is subjected to harsh physical punishment or has seen physical punishment in the household, they are more likely, as others have said, to engage in violence. If we are to support the public health model across these islands, we need to have consistent funding; to provide opportunities, whether educational, recreational or economic; to promote social inclusion; and to enhance social cohesion between parents, young parents and communities. I will be doing all I can while I am a Member of Parliament to make sure that we tackle youth violence across these islands.