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I beg to move,
That this House
believes there is now overwhelming evidence of the importance of the first 1,001 critical days of a new baby’s life in determining his or her lifelong physical and emotional wellbeing;
notes the work of the Inter-Ministerial Group led by the Rt. hon. Member for South Northamptonshire, the Thirteenth Report of the Health and Social Care Select Committee, HC 1496, on First 1000 days of life and the Eleventh Report of the Science and Technology Committee, HC 506 on Evidence-based early years intervention;
and calls on the Government to take strong and decisive action immediately to ensure that every baby gets the best start in life.
I am delighted to have the chance to speak today on a subject that is a real passion for me, and one of the reasons that I got into politics. I thank the Backbench Business Committee, particularly Ian Mearns, for finding time for me to hold this important debate.
It is a great pleasure to see good friends from across the House here to support the motion this afternoon. I am looking forward to hearing some excellent speeches on an issue that, if we get it right, has the potential to be truly life-changing for so many in our society. We are here today to share the overwhelming evidence of the importance of the 1,001 critical days of a new baby’s life in determining his or her lifelong physical and emotional wellbeing, and to call on the Government to take strong and decisive action right away to ensure that every baby gets the best start in life.
I want to pay tribute to some recent work that has been undertaken in this important area by the Select Committees chaired by Norman Lamb, my right hon. Friend Robert Halfon and Dr Wollaston. I know that the right hon. Member for North Norfolk was keen to speak today and I am sorry that his duties elsewhere mean that he cannot be with us this afternoon.
As many right hon. and hon. Members will know, until recently I was chairing a cross-Whitehall inter-ministerial group at the request of my right hon. Friend, the Prime Minister, to look specifically at how the Government can best improve support in the earliest years, for families and their newborn babies. I pay tribute to the Prime Minister for her prioritisation of this key issue—I believe it can provide a vital part of her legacy.
I am told that the inter-ministerial group I chaired was the only significant piece of cross-departmental work under way, with the obvious exception of Brexit. I am so grateful to the Prime Minister for tasking me with the enormous responsibility of contributing my own experience and knowledge in this policy area to fundamentally change our society for the better. I was proud that one of the last things I did before stepping down from my role as Leader of the House was to sign off on the detailed recommendations of the group.
Before we turn to the recommendations, I want to take a few minutes to set out the science behind the importance of the 1,001 critical days. From conception to the age of two—the period that is now referred to as the 1,001 critical days—it is the existence of a secure and loving relationship with a key adult carer that literally shapes the way a baby’s brain develops. It is amazing that, in the first year of life, more than 1 million new neural connections per second are being created in the brain. Secure attachment to a loving adult carer has a lifelong beneficial impact on the baby’s developing emotional health, and the developing brain will literally learn that the world is a good place and that problems can be solved.
Not only that, but secure attachment in the earliest period of life can have a positive impact on our entire social fabric. It is not about the impact on the individual; it is the positive ripple effect that secure attachment creates. It is the emotionally capable adults that those children become, able to make friends, learn, hold down a job, find a good partner and then become good parents themselves. It is the society that we could create if we fully address this issue.
Although it would be an exaggeration to claim that insecure or, worse still, disorganised attachment leads to all of life’s problems, at one level there is no doubt that it severely limits a person’s ability to cope with life’s ups and downs, and we know that in the most extreme cases a person’s earliest experiences can totally wreck their life. Negative early experiences create new generations of troubled and insecure young people and are often passed down to their babies by parents who themselves suffered insecure attachment. This is known as the cycle of deprivation. I well recall discussions with Dame Louise Casey when she was the troubled families tsar, who became convinced that intervening much earlier would be vital to prevent the later behavioural challenges that she was seeing, and the many discussions with my local police and crime commissioner, who recognises on the street every day the impact of a person’s earliest experiences on their tendency towards later criminality, addiction and violence, as well as depression and suicide.
It is clear that the science of brain development matters not just in our early years, but is a cradle-to-grave public health issue, the symptoms of which are evident in the years and decades that follow poor early experiences, which can cost the individual and society so much.
Before the right hon. Lady moves on, let me say that I chair a multi-academy trust. We are trying, without additional expenditure, to use midwives and health visitors to work from schools, so that any feeling that they are hostile places might be lessened, and to seek funds for home visiting during the first two years, so that mothers and fathers can learn skills that are good for them and even better for their young children, as the right hon. Lady has highlighted. Does she agree that one of our pleas to Government should be to look at how they spend existing budgets, as well as to give this subject the priority it deserves?
The right hon. Gentleman and I have worked together on this subject for many long years. I pay tribute to him for his amazing contribution in recognising the importance of secure early interventions and everything we can do to make people’s lives more successful and secure. I am sure that some of his ideas will be, and are being, taken forward by Government.
I congratulate my right hon. Friend on securing the debate and the work that she has done. She or the Government might wish to consider the Imagination Library, an initiative that we have started in North Lincolnshire which signs up every child for a free monthly book gifting scheme from birth, so that parents and carers read with their children from an early age. Health visitors and the maternity units in our local hospitals are involved, so that when people register their child’s birth they are automatically enrolled in this incredible scheme, which is funded by North Lincolnshire Council. Over 95% of children in the North Lincolnshire part of my constituency are now signed up. The scheme is having a really impressive impact, which is following through to our literacy rates in school, and is something that the Government could consider expanding elsewhere in the country.
My hon. Friend is absolutely right. One of the so-called “Five to thrive” is cuddling up to your baby, reading with them and looking at pictures with them. That engagement, which develops the early brain of the infant, is vital, and I pay tribute to him for his work on that.
I congratulate the right hon. Lady on securing this very important debate. It is vital that we get this right, and she has mentioned the troubled families programme. Bath and North East Somerset Council has a successful project, but I understand the funding is not secure. Does she agree that, where this has been an important part of a local authority’s intervention, it should continue and the Government should make funding available?
The hon. Lady is right, and it is, of course, part of the upcoming comprehensive spending review. I will return to that later because, at the moment, the troubled families spending does not specifically pick out the 1,001 days, but I think it will in future.
I congratulate the right hon. Lady on her work on this issue. I do not want to be negative or political, but it strikes me that, where a troubled family have an additional child, that additional child often does not develop as we would want. That happens for a variety of reasons, and it could be economic or the lack of a second parent. Has she looked at that? If so, does she have any solutions?
The hon. Gentleman tempts me to launch off in a completely different direction. He is right that, all too often, troubled families who have further children go on to have further problems, but the whole point of early intervention is that it can turn around the outcomes for all the family’s children, not just the new one. The programme is vital.
Insecure attachment in the early years has a cost to society in terms of not only human happiness but the financial cost to individuals, families and the public purse. As Professor James Heckman, a winner of the Nobel memorial prize in economics, has demonstrated, the return on every dollar invested in the 1,001 critical days delivers an exponential financial benefit in later life. Not only is early-years intervention good for human happiness; it is also good for the public purse.
There are two profound areas of impact on the foetus and, then, the infant during the 1,001 critical days. The first is the level of cortisol, the stress hormone, and the second is the extent of the development of the infant’s prefrontal cortex. We know that a pregnant mother who suffers from stress produces more cortisol, which is easily transmitted via the placenta to the unborn child. The more stressed the mother, the more frequently the foetus is exposed to higher levels of cortisol.
The mother’s stress levels could be due to insecure employment, financial instability, the worry that her partner might leave her or the difficulties of being a single mum living in temporary or unsuitable housing, and so on. We know that exposure to high levels of cortisol can lead to modifications in gene expression while the foetus’s brain is still developing. Even in the womb, the potential for lifelong emotional and physical health is being determined.
We also know that maternal stress can lead to low birth weight, which can lead to all sorts of later complications, including diabetes, obesity and congenital heart disease. Once he or she is born, a baby left endlessly to cry themselves to sleep, or who is neglected or abused, will experience higher cortisol levels, which can over time lead to a lifelong higher tolerance of stress and an increased likelihood of being attracted to high-risk behaviour such as drug abuse, violence, criminality and so on.
We also know the critical role that the prefrontal cortex plays in developing the social and empathetic capacity of human beings. The prefrontal cortex is hardly present at birth, with the greatest growth spurt happening between six and 18 months, largely stimulated by the attention of a loving adult carer. Games like peekaboo, gazing into the baby’s eyes, smiling and mimicking them, and saying, “I love you. Aren’t you gorgeous?” [Interruption.] That is not directed at you, Mr Deputy Speaker. [Hon. Members: “Ah.”] I take that back, as it was mean. You are gorgeous. It is just that you are not in my arms. All that, in those 1,001 critical days, acts to jump-start the growth of the prefrontal cortex and the development of that vital human empathic capability.
However, if mum or dad is depressed, or if the baby suffers adverse childhood experiences, such as witnessing domestic violence, sexual abuse or substance misuse, that can have a significantly damaging effect on the development of the prefrontal cortex and the baby’s ability to regulate their own emotions. That, extraordinarily, can affect the ability in later years to cope with life’s challenges and opportunities, to form strong relationships and even to hold down a job. At the extreme end, the impact will be disastrous for that baby’s own future life and therefore for society at large. So love—a secure early bond—is what we want for all babies, although that is far from what is happening today.
The right hon. Lady is giving a powerful speech on why early intervention is so important. One of the things I most regret from the past few years is the demise of children’s centres and of their ability to reach out into families—help educate parents about all the positive things that she is talking about. Saving money in the long term could well mean a small investment up front in these families, and children’s centres could be an easy way of achieving that. Does she agree with me on that?
Of course on one level the hon. Lady is right: having a safe place for families to meet and receive particular interventions is important. But it is not the whole picture. I will expand on that in my remarks.
Let us look briefly at some of the facts we know. First, 67% of the UK population has had at least one adverse childhood experience—one in eight people have had four or more. Secondly, this predicts certain risks for those one in eight, such as a three times greater risk of lung disease through smoking; an 11 times greater likelihood of intravenous drug use; 14 times the number of suicide attempts; and a four and a half times greater chance of developing depression. Thirdly, people with six or more adverse childhood experiences can die as much as 20 years earlier than those who have none.
Fourthly, where domestic violence is present in the home, there is an increased risk of child maltreatment. In one study, families where domestic violence takes place were shown to be 23 times more likely to abuse their under-five-year-olds than families without. Research shows that about 30% of domestic violence begins during pregnancy. Fifthly, it is understood that conduct disorder in young children leads to adult antisocial personality disorder in about 50% of cases, and is associated with a wide range of adverse long-term outcomes, particularly criminality.
Of course, we are all aware, every day, of growing levels of mental ill health among young people, as well as the self-harming and eating disorders that are blighting too many young lives. So it is pretty obvious to all those with a passion for the earliest years why this issue matters—not just to the individual, but to society as a whole. For all the good that a free education can do, for all the good of quitting smoking, for all the benefits of rehabilitation programmes, we will never truly turn society around and break the cycle of deprivation until we prevent those acute problems that begin in the 1,001 critical days.
I should give a “health warning” about all this. Let me say that I am in no way suggesting that insecure attachment always leads to disastrous outcomes. It is possible for a baby who was insecurely attached in infancy to grow up to lead a perfectly normal and happy life, but there is also significant evidence that a troubled early life makes that so very much harder.
Does my right hon. Friend agree that evidence shows that there is a small window in early adolescence when much that has been done to a child can be put right? Does she agree that we need to focus on these times when a brain is most plastic?
My hon. Friend is, of course, right to say that it is possible to turn around these outcomes, but the ideal time to do it is during that first, critical 1,001 days, when the baby’s brain is still developing. Although we will always seek to turn things around later on, if necessary, the best chance is during the 1,001 critical days.
As my hon. Friend says, it is possible for a baby insecurely attached in infancy to grow up to lead a perfectly normal and happy life, but there is significant evidence that a troubled early life makes that so very much harder. Sadly, disorganised attachment, in which the person one turns to for love and support is also the person who sometimes abuses or neglects one—and in some cases, terrifies one—can lead to the worst sorts of outcomes in later life, including socio-pathological behaviour and a later cycle of abuse. In short, those who go on to become abusers in 20 years’ time are all too often the vulnerable babies who are themselves being abused today.
The right hon. Lady is making a powerful point and we all appreciate her bringing this issue to the House. It all seems to stem from the cycle that we need to break. Does she agree that what we had with Sure Start centres and children’s centres was so important in enabling a change of behaviour and the breaking out of that cycle?
The hon. Gentleman is absolutely right that there is a cycle of deprivation, which I will come on to discuss, but, as I said to Layla Moran, although Sure Start centres are a vital part—having that safe place—in the work that I shall come on to talk about, this is about much more than that. That is just one of many services.
Order. Let me just help a little. The opening speech on a Back-Bench debate is meant to be 15 minutes and we are now at 20 minutes. I am worried about that. Although of course it is a very important debate and I will allow some time, Members should bear in mind that we have time limits that we try to work to. But it is too important an issue to curtail at this stage.
I am grateful for your guidance, Mr Deputy Speaker.
Those who go on to become abusers in 20 years’ time will all too often be vulnerable babies who are themselves being abused today. The question that really matters is how we even start to tackle this issue.
Having had my own brief experience of post-natal depression, I can certainly attest to how difficult it can be to cope as a new parent. Colleagues might have heard me speak before about my own memory of sitting in my kitchen with a crying baby, in the middle of winter, with snow on the ground outside, looked at through dirty windows, feeling totally unable to call a window cleaner or even just to make a cup of tea. That feeling of helplessness and hopelessness is a vivid memory—and it is now 23 years on.
This is not my sob story, though: I was lucky enough to have a great husband, a strong network of support and a job to go back to, which snapped me out of it, but, thinking back, it could have been so much worse. Many parents who are struggling to cope are dealing with that reality each and every day. I really do understand how debilitating depression is and how unexpected and horrible the feelings are.
It was when my mum, herself a trained midwife and therapist, asked me to go along and help with a charity she was working with—the Oxford Parent Infant Project —that I realised just how vital secure attachment in those first years really is. After 10 years as chairman and a trustee of OXPIP, I went on to set up NorPIP, the Northamptonshire Parent Infant Partnership, into which my hon. Friend Victoria Prentis was dragged—although not kicking and screaming; she was delighted. I then set up PIPUK, the fabulous national charity that is setting up PIPs throughout the country to provide specialised parent-infant relationship support, including parent-infant psychotherapy, to families and their babies. PIPUK’s aim is not only to address the immediate problems in the relationship between the baby and their parent, but to support a more positive and secure attachment for the long term.
I brought my passion for early years with me to Westminster when I was elected in 2010. I have since met so many brilliant people in the world of infant and maternal mental health, some of whom are present in the Chamber today, and many more of whom are following proceedings on TV. So many people have generously given their time and expertise. In 2011, with support from colleagues from every political party currently represented in Parliament, I launched “The 1001 Critical Days” manifesto, which called for a rethink of how we approach early years intervention at a policy level.
I particularly recognise the early commitment of the right hon. Members for North Norfolk and for Birkenhead (Frank Field), and of Caroline Lucas, in getting the work off the ground. I pay special tribute to Lucy Powell for her dedication to the “The 1001 Critical Days” campaign. She and I promised each other years ago that we would remain committed to achieving real and long-lasting positive change. I am delighted that she is present. We can definitely achieve much through cross-party collaboration for the greater good, and this work is the perfect example of it.
“The 1001 Critical Days” campaign has received the support of more than 100 different organisations, including the National Society for the Prevention of Cruelty to Children, Barnardo’s, Best Beginnings, the Royal College of Midwives, the Royal College of General Practitioners and the Royal College of Obstetricians and Gynaecologists. There are just too many esteemed charities, royal colleges and foundations for me to list here. I also had the pleasure of working closely with Dame Tessa Jowell on her interest in bringing early years support into the UNICEF millennium development goals.
With cross-party colleagues, we set up the all-party group for conception to age two. I wish to mention Mrs Hodgson, with whom I very much enjoyed working on the all-party parliamentary Sure Start group.
I am very grateful to the right hon. Lady for giving way. I just wanted to commend her on her work at OXPIP and PIPUK, which she mentioned a moment or so ago; I visited myself to see the work being done. It is really quite outstanding to see what can be achieved. I also thank her for mentioning a number of us, as she has done so generously.
I am grateful to the hon. Lady. It has been a great experience. When I became City Minister, I was so sorry to learn that I had to drop all trusteeships and the all-party groups overnight. I cannot thank my hon. Friend Tim Loughton enough—I have known him for the many years since we were at university together—for picking up the ball and continuing to drive these important issues forward to this day with his amazing dedication, focus and care.
Let me fast-forward through my more recent roles as Energy Minister, Environment Secretary and Leader of the House. On the face of it, there was little scope for me to continue the push on early years, but with the continued collaboration between the right hon. and hon. Members whom I have mentioned and many others, the excellent work has continued, culminating in the Prime Minister herself committing to support the early years agenda and asking me to set up the IMG in the summer of 2018.
The IMG itself comprised my hon. Friends the Members for Louth and Horncastle (Victoria Atkins), for North Swindon (Justin Tomlinson), for Richmond (Yorks) (Rishi Sunak), for Stratford-on-Avon (Nadhim Zahawi) and for Thurrock (Jackie Doyle-Price). I pay real tribute to all of them for their hard work on the group, as well as to the dedicated civil servants who supported us. Our remit was to consider the individual, the family and the wider societal risk factors that affect child development in the conception-to-age-two period and the long-term impacts, as well as the issues with central and local government’s approach.
The Prime Minister had asked the IMG to make recommendations to the relevant Secretaries of State that would support local areas in improving the co-ordination of early years services and in spending their current funding more effectively and more efficiently. I am so grateful to the Prime Minister for her continued support for, and interest in, the IMG, which my ministerial colleagues and I felt demonstrated the high priority being placed on that work.
I was delighted to be told that the Cabinet Secretary, Sir Mark Sedwill, has already prepared a cross-Whitehall civil service team to take our recommendations forward once signed off by the various Departments. We met as a ministerial group several times and undertook a great many visits to learn from examples of best practice right around the country. We visited Manchester children’s centres, the Lambeth Early Action Partnership, a parent-baby drop-in group in Peterborough and an outreach group in Devon. We held roundtables with charities and families, including parents within the civil service. We had consultations on Mumsnet and spoke to so many passionate and dedicated people working within the sector who want to make a clear difference for parents and babies. It was a wonderful and thoroughly rewarding experience. Out of those visits, meetings and consultations, we quickly began to identify a number of common issues that clearly need attention.
First and foremost is the postcode lottery across the country of the availability of perinatal mental health and specialised parent-infant relationship support, particularly around parent-infant psychotherapy services. In some areas, the provision is fantastic, but in others it is almost entirely non-existent. We heard from parents and professionals wanting health visitors to provide greater levels of support to new parents and their babies, particularly where parents are struggling to form a secure bond, with better levels of breastfeeding support and post-partum care. We also had detailed evidence of the need for greater support for dads, greater support for same-sex parents, better availability for couple counselling and for targeted services for new parents, such as debt and housing advice.
One particular issue that we identified was the need for greater support for non-English-speaking parents. The incredible work of children’s centres was highlighted everywhere we visited, and there is no doubt that parents and professionals want to see family-centred spaces such as these protected. There is a great amount of need out there, and it is clear that we have the opportunity to bring about a huge step change in how we deliver early years family support right across the country, if we seize on the recommendations of the inter-ministerial group.
What did we recommend? First and most importantly, getting the 1,001 critical days right can put children on course for good social, economic and physical outcomes later in life. Getting it wrong creates inequalities and significant costs later for Government and society. Secondly, better focus on both universal and targeted services needs to be a priority in this period.
I will not go into all the key recommendations because Mr Deputy Speaker is looking impatient, but I will mention some of them. First, using the wealth of research and evidence taken by the IMG, Departments should work together to create a clear and cohesive Government vision for the 1,001 critical days. That should be published in the autumn after the spending review. Local authorities should be invited to set out their own service models that work for their local communities, and should be properly measured on that.
The right hon. Lady has made an excellent speech and I commend her on the great work that she has done. However, she must also recognise that all the suggestions and ideas that have been put forward to deal with this situation require proper funding and new funding: new moneys for local authorities and for different groups to be able to carry out the suggestions. Is that money being promised?
Before the right hon. Lady responds, let me just say that I am not impatient—far from it. We have time on our hands. Unfortunately, I do not make the conventions of the House. As a former Leader of the House, the right hon. Lady will be well aware that the opening speech should last 15 minutes and that the Minister will have 10 minutes. I did not make the rules. I am just trying to ensure that hon. Members have enough time to discuss a very important subject that matters to us all.
I am grateful for your advice, Mr Deputy Speaker, and I absolutely do understand your point. I know that you are very sympathetic, and I will hurry up.
The second key recommendation I want to mention is that Departments should work together to develop a spending review proposal for a fund that would support local authorities in rolling out best practice and innovation in the delivery of the 1,001 critical days services. Thirdly, Departments should work together to ensure that the successor to the troubled families programme has a specific focus on the 1,001 critical days.
The IMG set out many other recommendations, including investing in maternal and paternal perinatal mental health and ensuring that support is available to address issues in parent-infant relationships. We recommended that the NHS expands access to evidence-based parent-infant psychotherapeutic services within specialist service provision. We also felt that a website should be created to support parents to make informed choices and decisions at key points in their parental journey, including the information that people need about parental leave, childcare support, family-friendly policies and the 1,001 critical days.
Given that breastfeeding boosts a baby’s ability to fight illness and infection and supports emotional bonding in the early months of life, and given that the UK has one of the lowest rates of breastfeeding in Europe, we also recommended that further action must be taken to continue to focus on reforms that enable and support breastfeeding in England, including the recommendations of the “Becoming Breastfeeding Friendly” review. The IMG made many other recommendations, and I do hope that the Government pick these as soon as possible. One recommendation that I personally made very strongly is that there should be a specific ministerial responsibility for the 1,001 critical days.
As Members may know, I raised the work of the IMG with the Prime Minister during PMQs earlier this month, and I have tabled several written parliamentary questions to ask what progress has been made on addressing the IMG’s recommendations. I truly believe that we are on the threshold of something very exciting for our country—a real opportunity to deliver long-lasting and positive change in our early years family support policy that would make a huge difference to individuals and society as a whole. I call on the Minister to commit that the Government will report back before the House returns from summer recess, and I ask him to make a statement about that response on the Floor of the House as soon as possible after we return, so that we may debate it further.
I for one, Mr Deputy Speaker, am pleased that you allowed Andrea Leadsom the time she needed to give such an excellent and outstanding speech about why the 1,001 critical days are so important. When she asked me to co-sponsor this debate, I did not hesitate to say yes. As she has said, she and I have worked together on this issue for many years. In fact, she was the first Government Member to approach me when I first got elected, and she asked me to get involved with her work on this important area. She sought me out and we have worked very closely ever since. As we heard in her outstanding opening speech, her personal commitment to this agenda is completely without exception. She has done a fantastic job and we really miss her drive and leadership in government on these important issues. I will say more about that later.
I will not try to emulate the right hon. Lady’s excellent speech, but, as she has said, all the evidence tells us that the most important time in the life not just of a child but of a human being is those first 1,001 critical days. The fact that we do not give enough attention to that is, in my view, immoral, because we know how important it is, yet it does not get the attention it deserves.
The science has already been outlined, but I want to highlight another aspect. Deprivation is still a really key issue for outcomes in the first 1,001 critical days and thereafter of a child’s life. We know from all the evidence that the single biggest indicator of how well someone will do in their GCSEs is their developmental level at the age of five. We also know that children from better-off backgrounds hear 30 million more words than those from less advantaged backgrounds. The developmental gap between the less well-off and their better-off peers is significant before a child even starts school. It can be as much as 18 months or more in some cases. The Government, services and others seem to spend a huge amount of time and money on trying to address those gaps later in life, when we could do a lot more earlier and save a lot more money in doing so.
That is why we are here today. If we spent on this issue even a fraction of the amount of resources and time that we spend on health, education, criminal justice, home affairs, the Department for Work and Pensions and all the services they support—and instead of focusing on the consequences of not getting the first 1,001 days right, focused on the root causes and those early years—not only would we save a huge amount of money for Government and the country, but we would create a much happier and better society.
We are here today because, unfortunately, the ambitious work that the right hon. Lady began and almost concluded in government has not yet come to light. Like her, I have asked questions, both written and oral, about what is happening. It would not take a huge amount. The Under-Secretary of State for Education, Nadhim Zahawi, who will respond on behalf of the Government, is a fantastic Minister. He and I have worked very closely on a number of issues, and I do not doubt his commitment. I hope he will soon be in the Cabinet, and I believe that this issue needs Cabinet oversight.
What needs to happen? We have already heard some of the issues. I am going to focus on three things that I think need to happen. Some of my comments are based on my role leading on an outstanding piece of work that the Mayor of Greater Manchester, Andy Burnham, asked me to do on school readiness across Greater Manchester.
We do not need lots of new initiatives and new programmes. We know what works, largely, and we know what we need to do. We are just not doing it as well as we should or making it reach as many babies and parents as it should. I do not want the Government to take the message from this that we want lots of whizzy new action plans. We just want to get the nuts and bolts, and the agenda and the importance of that agenda, right, because if we steer this oil tanker in the right direction, we can make great strides. It is not rocket science, and that makes it even more immoral that we are not doing some of these things, because we know what works in the early years.
The first thing we need, I am afraid, is more cash. We cannot have this conversation without discussing funding, and particularly funding for local government. As we have heard, many of the early help and intervention support services—including, critically, Sure Start children’s centres—are funded via local government, which has seen some of the biggest cuts across Government. Action for Children has published a really good report which shows the real value that Sure Start centres can provide in narrowing the attainment gap. The recent Institute for Fiscal Studies report on Sure Start children’s centres showed how much money was saved in just one area—hospitalisation of infants—for the NHS by reducing the number of unnecessary visits to hospital by parents.
We need more cash, and we need that cash to be allowed to be spent on early help and intervention. That includes the troubled families programme, which, as the right hon. Member for South Northamptonshire said, should be extended to the early years. The troubled families programme is due to end soon. That would be a travesty, because it has done more to break the cycle of deprivation that we have heard so much about than many other joined-up programmes.
I want to make a small plea on funding. The Minister will know that I would not let this opportunity go without mentioning our valued maintained nursery schools, which in many cases act as hubs for children’s centres and the holistic, place-based, integrated support services that we need to change lives for the better. Their funding is at risk. The Minister has been an outstanding champion for them. He has done a great deal of work with the all-party parliamentary group on nursery schools, nursery and reception classes and others to secure funding. If he leaves office for a higher position under the new Prime Minister, which I am sure he will and which he deserves to do, I hope he will leave a firm handover note to his successor. The sector will miss him greatly if he leaves the Department for Education. He is the most popular Minister we have had in this Government.
Indeed, and he is definitely top of the list by a long shot—I mean no disrespect to the others, but he has been very good.
The second thing we need to do is break down the barriers to joined-up services and commissioning. Key to that, as we have seen in Manchester, is the value of place-based, integrated services working together. In Greater Manchester, the early years delivery model acts as the core of the service. Every child, from pre-birth to the age of five, is seen at least eight, if not nine, times, with fully integrated service delivery, and intervention, support and advice can be put in place at any stage in the child’s upbringing. It is already paying real dividends. The innovative work we are doing with the BBC on communication and language and other work is starting to have real results, especially for the most in need. It cannot just be at a local level—it needs to be joined up with Whitehall too, but that is not the answer. It is about place-based, integrated services.
The third and final area—just to conclude, because I know lots of people want to speak—is workforce development. A real challenge in this space is to make sure we have a workforce right across the piece—from health visitors to midwives, but also outreach workers and those who work in childcare, social services, health, schools and education—who are valued and paid well for a job that is the most important job they could do and who also have the ongoing career training and development to understand the root causes of poor child development and the impacts that can have, so that the whole body of people who ever come into contact with a family and child are all working with the same agenda, vision and understanding of what needs to happen. That is not a whizzy initiative or a press release; it is the hard yards and the real focus on developing a whole workforce around families that will really get us the step change we want. That is why we are setting up the Greater Manchester early years workforce academy, and we hope this will be a beacon for the rest of the country to look at best practice.
In conclusion, as I have said a number of times, this is not rocket science. We know what we need to do, but it needs proper funding, leadership and drive across Government through the country into places, homes and families. As insurers do when they are looking at insurance policies, we could all probably work out who the families most likely to need help are—we can get names, not just numbers attached to these issues—and there really is no excuse for us not to do it. It is immoral for us not to try to help break the cycle of deprivation and really tackle those early and important 1,001 critical days. I want to thank the Minister and particularly the right hon. Member for South Northamptonshire for the leadership they have both shown, and I hope they will continue to have the opportunity to do so in government over the coming months.
What has marked out this debate already is Members’ great passion for and commitment to this subject. It is a great pleasure to follow Lucy Powell and to hear more about the work she has been doing. However, the absolute tribute has to go to my right hon. Friend Andrea Leadsom, who is quite simply the oracle on early years and attachment theory.
I will always remember the first time I met my right hon. Friend, and I had a teach-in that most people would pay for on early years attachment theory. I think that it was in the car park of a pub, but I very much appreciated that teach-in. Actually, I do not think she realised it, but she sparked a real interest in this area for me. This conversation happened many years before we were both in Parliament together, and it really marked out a very deep interest for me. I was able to follow that up as a shadow Minister—not particularly when I had a ministerial post, but when I was a shadow Minister—in the years before 2010.
My right hon. Friend is an expert in early years and attachment theory, and I do not want to add to what she and, indeed, the hon. Member for Manchester Central have said on a number of these issues. I want to go on to some other areas to expand the debate a bit more, but before I do so, let me say that it is absolutely fundamental that we get it right for every single baby in this country. The early intervention that my right hon. Friend and the hon. Lady have talked about in the debate is completely critical and vital.
As my right hon. Friend has said, having universal and targeted services is a critical part of this. While she was talking, I was reflecting on the service offered in my own constituency by Basingstoke breastfeeding counsellors. They are a mixture of paid-for counsellors and volunteers, but this is very much focused on volunteers who are there for mums to be able effectively and successfully to breastfeed in those early weeks and months. It is a service, frankly, that the NHS finds quite difficult to provide and that involves those expert counsellors. That is one way we can help to improve not only the health of our babies, but attachment from those very early weeks and months. That sort of support can be so important for babies and new mums in the early weeks—certainly, it was for me when I had my three children. Health visitor support makes a real difference in supporting mental health, breastfeeding and the health of the mother and baby.
I want to expand on the specific issues talked about today, because we need to get it right for families, too. To get it right for babies, we need secure and stable families and parents before babies are born, as well as afterwards. My right hon. Friend talked about the stress that can be put on mothers during pregnancy and how it can be transferred to the unborn child. That is one reason why I introduced a 10-minute rule Bill to try to change the law with regard to redundancy and pregnant women. More than 50,000 women a year in this country feel that they have no choice but to leave their jobs when they are pregnant. Those of us who have been pregnant, or have had partners who have been pregnant, can think of no time of our lives when we have less wanted to leave a job. At a time when financial stability is so important, one can only imagine the pressure individuals who have to give up their jobs are under.
In addition to specific expert support for parents around attachment, the Government need to reflect specifically on how we ensure pregnant women receive the support they need. In Germany, a law is in place that stops, except in extreme circumstances, any pregnant woman being made redundant. Not only does that help to alleviate some of the stress we have talked about, it enables that country to ensure that more women go back into employment after they have had children, and that helps to close the gender pay gap. I hope that the UK Government will continue to think about this issue, particularly at a time when we now have more women than men coming out of our best universities with science degrees. We need to find a way to ensure that those women can stay in the labour market and have a successful family life.
My right hon. Friend touched on the mental health of women after they have given birth. I commend the National Childbirth Trust’s campaign for a six-week maternal post-natal check. I think that happened in the past, but it seems to have dropped out of the most recent iteration of the GP contract back in 2005 or 2006. It would be a great way to ensure that, as well as protecting mums before they give birth, we have a mental health check after they give birth. If mum’s mental health is good, attachment can be strong.
The right hon. Lady is making a very powerful point about the perinatal mental health of women. NHS England and the British Medical Association are conducting a review of post-natal checks and the GP contract. Does she agree that now is the right time to include in the GP contract a mandatory check, as the NCT is asking for?
I have very strong sympathies with that. It should happen by rote for every woman, and I think that it happens haphazardly now. I can remember having that sort of conversation with my GP after the birth of my children, but it does not happen routinely. The NCT is right to pick this up. If we are to ensure that early years family support is as good as it can be, it needs to include a mental health check for mums. All of us know individuals who have gone through post-natal depression. For the health of the mother as well as the children, it is so important that it is identified early on and action is taken.
As well as protecting mothers who are pregnant or have new babies, and as well as making sure that they get the right support from their GPs on mental health, the Government also need to reflect on a couple of other areas to make sure that our children have the best early years support possible. We heard about one of these earlier from my hon. Friend Helen Whately, who talked about flexible working. The Government have already heard an expert dissertation from her, so I will not repeat what she said. In summary, however, the more that we can give flexibility to families, particularly when they have very small children, but not solely then—I speak as the mother of a teenager, as my youngest is now—so that they can balance work and family life, the better. This goes on for our children’s entire lives, even beyond them being children, so I hope that the Government are making sure that they take very seriously flexibility and flexible working as a default, which my hon. Friend spoke about in relation to her ten-minute rule Bill.
No Government have gone further than this one and the coalition Government in making flexible working something that we can all now request. We will take no lessons from anybody about any lack of understanding from Government Members on that, and I commend the Government for all the work that they have done, but we now need to look at going further to make sure that businesses take that flexibility for granted. The best businesses already do, of course, but we need more to do it routinely.
My final point is on shared parental leave. If we are to get it really right for our littlest people—the half a million babies that are born every single year—we need to get it right for both parents. At the moment, we do not get it right for dads at all. All the research coming out of countries such as Germany shows that if we have proper shared parental leave, fathers and children have much better relationships not just in the early years, but throughout their lives, including even if the adult relationship with the other parent breaks down. It is absolutely proven that a shared parental leave policy involving fathers far more in the lives of their children at an early age can lead to far better relations later in life as well. I urge my hon. Friend the Minister to consider very carefully the role of shared parental leave in future. My Committee—the Women and Equalities Committee—has done an excellent paper on it, which he can read at his leisure. It shows clearly that three months of “use it or lose it” leave for dads is one of the best ways that we can support family life and help to address the gender pay gap.
Those are just some other ideas, building on the debate secured by my right hon. Friend the Member for South Northamptonshire, on how we can make sure that every child in this country gets the best start in life and that every family can thrive.
I commend Andrea Leadsom for securing this important debate today, and I congratulate my hon. Friend Lucy Powell on her superb leadership of the all-party group on nursery schools, nursery and reception classes. I have been to several meetings. They happen to be held in room 14, and I am always amazed by how many people come from across the country to attend those all-important meetings to make the case for maintained nurseries, in particular.
I first came across the importance of this sector in education when I was a county councillor in Warwickshire. I realised the supreme importance of getting not only to these young people, but to young parents, who are perhaps inexperienced, first-time parents. I realised that there was such a need to help with those early weeks and months of a young child’s development and to assist young parents, who, as I said, may be a parent for the first time, to understand what has just hit them in their new lives. Having visited so many of the children’s centres, I was always struck by how important they were and what a fabulous environment they provided, which was not just safe, but very stimulating, and that was great for both infant and child. It helped them to develop their skills and provided the support for the parent, challenging what was normal and making the child think about those around them—perhaps something they did not have that home. It was a fabulous environment for them to prosper in.
It was a shame therefore to see the breaking up and closure of so many Sure Start centres and children’s centres. In Warwickshire, we have lost 25 of the 39 children’s centres we had seven years ago. That leaves our communities and society with the challenge of provision, particularly in highly deprived areas. In the time I have available, I want to focus on the work of maintained nurseries. My constituency is lucky to have some superb maintained nurseries, and I want to highlight in particular the ones in Warwick and Whitnash, both of which I have visited.
The vast majority of maintained nurseries are set up in the most deprived areas and are so important, but no matter how good they are, they are only as good as the people who run them and the funding they have to sustain themselves. That is the challenge. While many of us welcome the Government’s introduction of the free 30 hours’ provision for three and four-year-olds, it is having an impact on the viability of these nurseries and their ability to sustain themselves given the financial pressures. People working in maintained nurseries are on a real pay level of £3 or £4 an hour, which is way below the minimum wage and a long way short of a national minimum wage.
Maintained nurseries are important for stimulating and developing young infants in those early years—the 1,001 days we have been talking about. I join others in recognising the work of my constituency neighbour the Under-Secretary of State for Education, Nadhim Zahawi, and the additional funding he secured. I commend him for doing that and urge him to bring certainty to these nurseries, which are under huge pressure from the funding crisis they face.
Finally, I pass on my thanks to all those who work and volunteer in these nurseries and elsewhere in our provision of early years across Warwickshire but certainly in Warwick and Leamington. I cite in particular the example of Warwick Nursery School, which will be celebrating its 60th birthday tomorrow. I thank them all for their work.
It is a great privilege to follow Matt Western. I, too, worship at the altar of my right hon. Friend Andrea Leadsom. She is the great authority on this subject and I pay tribute to her. I also pay limited tribute to Lucy Powell, given I am no longer her favourite ex-Children’s Minister—but there we go. [Laughter.] You can go off people.
It is interesting that at the same time as we started this debate there was a debate in Westminster Hall on children’s mental health. In the many years I have been in this place, subjects such as children’s mental health rarely got on to the Order Paper. It is a sign of huge progress that it is now much more common for us to talk about them—and with a great deal of experience and consensus. It is long overdue. We are starting to appreciate the huge strategic importance of doing much more, much better, much earlier for our children. Some of us have been banging on about that for many years in this place, and it is great to see many other headbangers joining us. It is becoming almost common parlance.
I thank the hon. Gentleman. Does he agree that the whole body of knowledge about adverse childhood experiences should be shared even more widely in the House, because it makes so much sense when we are discussing, for instance, the Prison Service or the probation service? Every service should be informed about trauma. Once we understand adverse childhood experiences, it all seems to make sense.
I think that the hon. Lady is right. I shall come on to the way in which it is all joined up. “Adverse childhood experience” has become more common parlance now. Essentially, it goes back to attachment and all the stuff that Bowlby was talking about, often as a lone voice, many decades ago. However, it is true that we can now relate it to many of the challenges that we see as individual MPs and the Government see, in relation to antisocial behaviour, mental health conditions, and all the issues that have been referred to my right hon. Friend the Member for South Northamptonshire and others.
I am grateful to my friend, because he has given me an opportunity to do what I did not do earlier—which was hugely remiss of me, because it was in my notes—and express my huge respect for his leadership and all the work that he does on Sure Start, children’s services and education in the all-party parliamentary group for families in the early years. I thank him for that. He is, of course, absolutely one of my favourite Members on the opposite Benches, and he will long remain so, even if I am no longer one of his.
I am completely recharged and relieved by that. The hon. Lady is my absolute favourite Member of Parliament for Manchester Central, and many things besides. But this debate is getting far too consensual, so I shall return to the points that I was trying to make.
The phrase “1,000 days”—or, for those whose glass is half full, “1,001 days”—is almost becoming common parlance as well, and it needs to. It needs to be almost a brand. People need to understand that those 1,001-ish days of life from conception to the age of two are the period that will have the most impact on a child’s future life. If we do not invest in the right support then, the cost of picking up the pieces later will be so much greater, both financially and, as I think everyone here recognises, socially.
I should declare an interest, in that I chair PIP UK—the Parent Infant Partnership—which was set up by my right hon. Friend the Member for South Northamptonshire. I became chairman of the trustees, and am proud still to be so. Our most recent report is “Rare Jewels”. I pay tribute to Sally Hogg, who works for PIP and who did a great deal of research on the scarcity of parent and infant mental health specialist support. That was a false economy.
I shall now be slightly unconventional, and talk about the motion. The motion is about the inter-ministerial group, and I want to talk about some of the experiences of that group. As I found during my few years as a Minister, joined-up government is a complete myth. What the group almost uniquely did, because of the vim and force of my right hon. Friend the Member for South Northamptonshire, was bring together key Ministers from half a dozen key Departments to try to create joined-up solutions. A child’s mental health, and those early years affecting the child and his or her parents, are not just the preserve of the Department for Education and of children’s social care. They touch on the work of so many other Departments
I am glad that my right hon. Friend Mrs Miller is still here. She will remember that some years ago, when I was the Children’s Minister and Sarah Teather was also an Education Minister, we tried to put together the early intervention fund, which was largely intended to bring together different interests with a pooled budget so that we could work together on smarter solutions. However, that did not really fit the way in which the civil service worked.
We struggled for some months to pull together a plan that would involve various other Departments, and we were being frustrated at every turn; so we formed a pizza club, well before my right hon. Friend the Member for South Northamptonshire was on the scene. My then colleague Sarah Teather and I rang other colleagues—Housing Ministers, Health Ministers and others. I think that my right hon. Friend the Member for Basingstoke was then a Minister in the Department for Work and Pensions. We got together in “The Adjournment” restaurant, had a pizza, agreed what we wanted to do, and all went back to our Departments in the following days and told our civil servants what we wanted to do. The response was “Well, I’m sorry but that’s not the way we do things around here, Minister”, to which our response was “Tough, we’re now doing it.” That was the only way we could actually get through an important joined-up policy because the system just did not work. I do not think things have improved much at all.
Another innovation I set up then was the Youth Action Group. Again, there were problems and I tried to youth-proof all Government policy, which is something I still bang on about. There were many problems that transcended different Departments, and yet if there was a problem, it would go from one Department to another in a vicious triangle, as it were. So I got together six major charities led by The Prince’s Trust and Barnardo’s. I co-chaired it and, at one stage, I think we had nine Ministers from nine different Departments. Invariably most of those Ministers would turn up to those meetings and the children’s charities and youth charities would bring particular problems to us. One problem was about housing benefit for looked-after children who were care leavers, which was the responsibility of the Department for Education for care, the Department for Communities and Local Government—whatever it was called in those days—for housing and the Department for Work and Pensions for benefits. We got the three Ministers together with the three lead officials and said, “Here’s the problem; can you please take it away and solve it and come back with a solution that the children and youth workers can then take away?” Alas, that group no longer exists, but we need far more of that sort of rationale and mentality in Government. The inter-ministerial group showed how it could be done, and it is so important that the work continues. I hope that the recommendations that have been made are taken up and run with.
We need a Minister for early-years children and families at Cabinet level. It should not just be left to civil servants to people those committees when what we need is a co-ordinated ministerial response. This needs to be led by a high-profile Minister who has the clout, enthusiasm and drive to bring all the relevant Departments together and come up with a cross-departmental solution. I am afraid that we are still a long way from that in common practice, and that is partly what is wrong with Government and with our civil service. So that is my main plea.
On the investment equation, I am not going to repeat everything that has been said, but we know that healthy social and emotional development in the first 1,001 days means that individuals are more likely to have improved mental and physical health outcomes from cradle to grave and children will start school with the language, social and emotional skills they need to play and explore and learn. Children and young people will also be better able to understand and manage their emotions and behaviours, leading to less risky and antisocial behaviours and the costs that these bring to individuals and society, and they will have the skills they need to form trusting, healthy relationships—something we heard about in the Chamber earlier. If they had that, we would not have to spend such a lot of time teaching it to them at school because it would come naturally, and they would know what a proper quality, trusting relationship actually is. And if they know, they are much more likely to be able to hand it on and nurture their own children as they become parents in the future.
The cost of getting this wrong is huge. Some years ago—although it is still as true and important today—the Maternal Mental Health Alliance calculated the cost of getting perinatal mental health care wrong for the one in six women who will have some form of perinatal mental illness. The cost of that was £8.1 billion each and every year, and the cost of child neglect in this country is £15 billion each and every year; so £23.1 billion is the price of getting it wrong. A fraction of that spent on early intervention—well-targeted, well-timed, well-positioned by well-qualified and trained professionals—could save so much personal grief and so much financial and social grief later on.
It is not rocket science, as I constantly say; it is technically neuroscience, but it really is something we should have been doing so many years ago. The troubled families programme is the model here, and it is essential that the troubled families programme is not just retained, but expanded in the comprehensive spending review. I have always said that we need a pre-troubled families programme, because in the troubled families programme we are dealing with the symptoms of getting it wrong earlier. If we prevented those symptoms in the first place, working in those very early years, so that we have a well-balanced parent or parents with well-balanced children, they are more likely to arrive at school eager and able to learn and be contributing members of society. That is so vital. Some 28% of mothers with mental health problems report having difficulties bonding with their child. Research suggests that this initial dysfunction in the mother-baby relationship affects the child’s development by impairing the baby’s psychomotor and socio-emotional development.
Postnatal depression has also been linked with depression in fathers, and with higher rates of family breakdown. We forget the impact on fathers of not knowing how to deal with a mum—a partner—who all of a sudden has some form of postnatal mental illness. A lot of fathers are affected by this. I know that my hon. Friend Steve Double, who chairs the all-party parliamentary group on fatherhood, is going to talk about this. It is essential that we look at all parents, when both parents are on the scene, and give support to the family as a whole.
I well remember working with my hon. Friend and I remember his huge commitment in this area. If there are now more debates and discussions about child mental health, a lot of that is down to him. I should like to highlight a report that the Select Committee is doing on men’s mental health. Does he agree that the NHS needs to think long and hard about the way in which men can access mental health services? We are receiving evidence that the way in which these services are delivered is almost highly feminised, making it difficult for men to access them.
My right hon. Friend is absolutely right. There is still this myth that it is not manly to admit to having some form of mental illness. I hope that we are getting away from the stigma of that, but we still have far to go in encouraging people. Hon. Members in this place who have come forward with their own very painful experiences have done a huge service by providing role models, as have celebrities in sport and showbusiness, and by showing that there is nothing unmanly or abnormal about coming forward when they have an illness that happens to be a mental illness, just as they would come forward if they had a physical illness. Why should there be any difference? However, we need to make it easier for men to cross that threshold in the first place. We need to ensure that they can come and talk to somebody and get checked out.
I am not going to go into the whole children’s centre argument. That is an important issue but this is not just about the bricks and mortar. However, one of my criticisms is that those places need to be much more dad-friendly, and much more imaginatively used. I have opened many children’s centres in my time, and I have seen some great ones that have football clubs on Saturday afternoons when the children’s centre is too often closed because it is a nine-to-five, Monday to Friday institution. Dads bring their kids and they play football together, then they do computers and reading with their kids afterwards. That is great bonding and co-educational time as well. Again, this is not rocket science. We need to make those places more welcoming for dads, and we need to put them in places that young fathers inhabit.
The killer statistic that I always use is that if a 15 or 16-year-old child in school has some form of depression, there is a 99% likelihood that their mother suffered from some form of mental illness during pregnancy or soon afterwards. The correlation is that close, and if we do nothing to help the mother at that early stage, we will certainly see the consequences later on. It is great that the Prime Minister has flagged up mental illness, and it is great that so much more will be happening with additional funding—not enough, but there will be additional funding—for mental health services in schools, but we need to do all this before school as well so that kids are less susceptible to mental illness problems, given all the pressures that they will face as they go through their school years. We need a much more joined-up approach.
Research by the Children’s Commissioner shows that 8,300 babies under the age of one in England currently live in a household where domestic violence, alcohol or drug dependency and severe mental illness are all present. That is a very worrying amount. That is why the Domestic Abuse Bill, which was at last introduced today, is very important, but we need to look at the impact on children as well as the impact on parents, because that trauma will be long-lasting. We tend to look at the immediate victim of domestic violence without looking at the collateral damage that it also causes. My right hon. Friend the Member for South Northamptonshire mentioned the horrific statistic of something like one third of domestic violence starting during pregnancy.
I will come to a conclusion shortly, Mr Deputy Speaker, although you do not look too impatient, so I might go on a bit. To join up Departments, it is crucial to have key players who are wedded and committed to the issue and who want to work to achieve solutions. Domestic violence is dealt with in the Home Office. Child sexual exploitation is now dealt with in the Home Office. There is an impact on housing, which is dealt with in the Ministry of Housing, Communities and Local Government. There is an impact on justice as well. The consequences of social media—now dealt with by the Department for Digital, Culture, Media and Sport—have an impact on children’s mental health. I used to deal with most of those things in one Department when I was Children’s Minister, but they have now been dispersed across Government, and we have to bring them back together.
I will finish on the role of the Ministry of Housing, Communities and Local Government, and public health. Health visitors are a huge resource. One of the great achievements of the Cameron Government—I was part of the discussions in the shadow Health team when we came up with the idea—was the huge expansion of the health visitor programme. Based on the research we did in the Netherlands with the Kraamzorg programme, which showed the impact that health visitors can have at an early stage when they have good, strong engagement with new mums and dads, there was a commitment in the 2010 manifesto to increase the number of health visitors to a figure of, I think, some 4,200. By 2015, that figure had just about been achieved. Alas, since then, things have gone into reverse.
I pay tribute particularly to Dr Cheryll Adams CBE, head of the Institute of Health Visiting, who has had a major input into the work that my right hon. Friend the Member for South Northamptonshire has already mentioned and the all-party parliamentary group that I chair. As the IHV recently noted, England is now at risk of sleepwalking into the loss of the health visiting service as we know it, unless urgent action is taken to address the current threats it faces. There are ongoing cuts to the public health grant, a 26% reduction in NHS- employed health visitors since 2015 and an unwarranted variation in the quality of services commissioned for families based on where they live rather than the level of need. As the IHV says, investing in the earliest years saves money in the long run and ensures that every child is supported to achieve the best start in life, yet the cuts to services in England persist at a time when inequalities are widening and infant mortality is increasing.
Health visitors are the trusted face on the doorstep. Whereas social workers are often treated with scepticism and fear when they knock on the door, the health visitor is usually welcomed over the threshold, particularly by new parents. He or she is an early warning system of some deficiency in parenting, as well as for safeguarding. It is absolutely essential that we build those numbers back up before we lose too many more of those experienced health visitors, working out of children centres or wherever—hot desking even, with social workers, with the district nurses and other welfare officers—so that they can detect and signpost families to the relevant services. They really are absolutely invaluable. Since the switch in responsibility from the NHS to local authorities—this is no detriment to local government—there has been a lack of experience in how those sorts of services are run, and therefore the issue is not treated as a priority. It is a priority and we need to get back to that.
Finally, I reiterate the recommendations made in the “Building Great Britons” report that the all-party parliamentary group produced in 2015. It was about having a joined-up Government approach to the 1,001 days; about every local authority drawing up its local plan and working with all the local agencies on how to deliver that plan for the 1,001 days, within a five-year term at least; and about having a monitoring system, which I based on the adoption scorecards that we brought in back in 2012, so that there is no place to hide and everyone has to be transparent about how they are progressing towards producing those services, compared with other parts of the country.
The solutions were in that report. We all know what needs to be done. My right hon. Friend the Member for South Northamptonshire led the way in bringing together the relevant parties and Departments to show how it could be done. Now we need to do it.
I should start by apologising for not being here for the wind-ups, with the agreement of my right hon. Friend Andrea Leadsom and the Minister. Both are aware that we are suffering quite a challenging family situation at home—cortisol levels are quite high—so I will dash away immediately after I have spoken, although I could not miss the opportunity to speak this afternoon.
I remember a young woman from north Oxfordshire. She had two toddlers and was trying to do a part-time job, with a husband who was busy working away from home. She had suffered the death of a baby previously, so was relatively vulnerable in her state of early motherhood. I remember her standing outside a school gate near her home when a blonde woman bore down upon her.
Rather like my right hon. Friend Mrs Miller, my first experience of my right hon. Friend the Member for South Northamptonshire involved a long discussion about brain scans, Romanian orphans and how important brain development is in the first six to 18 years of life. Like my right hon. Friend the Member for Basingstoke, I found that the discussion took quite a long time, but at the end of it, I too was completely converted to the cause. I went on to become a founding trustee of NorPIP, the Northamptonshire Parent Infant Partnership.
Despite my extremely challenging family circumstances this afternoon, I have to speak in this debate. I pay enormous tribute, as everybody has, to my right hon. Friend the Member for South Northamptonshire. She has persuaded a generation of us from across the House that this issue really matters. Despite your enormous indulgence of her, Mr Deputy Speaker, she did not have time to tell you how fabulous the work of PIP UK is—OXPIP, the Oxford Parent Infant Project, and NorPIP were the pioneers in those days, along with a few other areas—or how its targeted work with vulnerable women who need careful, considered, medical, evidence-based treatment transforms the lives of their families, babies and the following generation’s babies, who will be brought up by those families, which is something that we perhaps have not said enough about. We need to look at this in the very broadest sense; this is about parenting.
I pay tribute to everybody who has spoken this afternoon. We have obviously all been got at in the same way by my right hon. Friend. We have read our briefs and have learned how critical the first 1,001 days are. We have learned to say things in words that have been carefully chosen: things about parenting, about brain development and—I am going to say it, because my right hon. Friend did not—about “two is too late”, an early slogan of PIP UK that is not comfortable to say or think. Of course, two is not always too late, but it is a blimmin’ sight easier to intervene before two. That should be the message that goes out loud and clear this afternoon.
Everybody else who has spoken is an expert in this field, so I will restrict myself to two constituency examples, as I want to add something in a small way to this debate. The first concerns a breakdown in parenting, which is something that one of my senior headteachers has been talking to me about for around 18 months. He has noticed that children arriving at the nursery in his school are not potty trained and have much lower levels of communication than in previous years, and he is really worried about that. He set up a fantastic organisation called Safeguarding Children in Banbury, which I am pleased to say the Minister came to visit not so long ago, with 19 other schools in my area. The organisation aims to help schools to deal with traumatised, not school-ready children.
I will not go into the examples that that headteacher has given me in any detail because it would probably be possible to identify the families, but it is fair to say that seven families cause him most of the concerns in his one school. Those seven families have 34 children, who have been or are currently in his care. These are complex cases that involve drug abuse, other forms of abuse and, it has to be said, neglect. He has asked me some profound questions, which he also shared with the Minister, about the role that we expect schools to play today.
Do we expect schools to educate our children as well as they possibly can through really good teaching, or do we also expect them to be a frontline safeguarding service that addresses concerns over which they have no control? Children arrive at school aged three or four, and we expect the schools to deal with earlier neglect and abuse. The headteacher whom I mentioned spends a lot of his time filling in education, health and care plans, which he does not feel is the best use of his time. He is concerned that we do not have the right balance or the right role for schools, which are on the frontline of this battle.
My second constituency example is of Adoption UK, which I am proud to say is based in my area. There is, of course, an enormous link between early-years support and successful adoption. My family have had successful adoptions over the years, but it is important to remember that, for my generation, the average age of adoption was three months. My cousin has recently adopted; the average age for a child being adopted now is three years. The first 1,001 days are critical, and we can all work out the importance of getting to these particularly vulnerable children at the earliest possible stage.
I said earlier that two is too late, and we know that two is the optimum age by which we have formed good attachments and the bonds we need to form good relationships in later life, but there is a plasticity in early adolescence, when it may be possible to help children who did not have the best start in life to recover as best they can.
I urge the Minister to do all he can to safeguard the adoption support fund, as it has been repeatedly shown that this brilliant innovation targets help at the families and children who need it, some 90% of whom say it has helped them a lot—children’s parlance—with their mental health issues. These are children who, by definition, have difficulties with attachment and who have suffered in the past. It is important that we do that as a minimum.
In the early adolescent years it is possible to help children who have had a bad start in life and, by default, we should help them by offering all the counselling and extra services they may need. It should almost be that an adopted child has to opt out if they do not need it. If it is possible to help with attachment during that early adolescent period, it is important that we do everything we can to do so.
We have had some brilliant solutions, not least from my hon. Friend Tim Loughton. I would also like to plug Home-Start UK, which has a great organisation in my constituency—I am sure other Members share my love for Home-Start. I learned in my early years at NorPIP that peer-reviewing and evidence is key to people taking this sector seriously, and I am interested in Cardiff University’s study, which shows high levels of improvement in the mental health of children who have been helped by Home-Start.
We have heard about the importance of universal services, not least from Lucy Powell. This is not all about deprivation, and other families do need to be picked up—my right hon. Friend the Member for Basingstoke suggested that six-week checks are critical—but targeted services are important, too. The families in Banbury identified by this headteacher are known to all sorts of services. We need to take a joined-up, targeted approach and get in there before the baby is born.
I very much hope that the IMG report and all its recommendations will be considered in enormous detail by the Minister—and by whoever takes over from him if he does move on. When I worked as a Parliamentary Private Secretary to my right hon. Friend the Member for South Northamptonshire, I was fortunate enough to sit in at some of the IMG’s meetings; I do not think I am breaking too many confidences by saying that after those meetings several—in fact more than several—of the Ministers present sidled up to me in the Lobby or in the Tea Room and said, “Golly, I didn’t know all that about early brain development. Do you think I got it right with my own children?”
I had that conversation again and again, and I sure my right hon. Friend has it daily with colleagues and everyone else she comes across. It is true that we can all be better parents, at all levels of parenting. Investing in early years really is spending to save.
It is a great pleasure to contribute to this important debate. I, too, want to pay tribute to my right hon. Friend Andrea Leadsom for her role in bringing this important issue and report before us.
I have the huge pleasure and joy of being the father of two boys. I feel somewhat old now, because the older one is due to be 29 shortly and my youngest one got married two weeks ago—it was a great day. So it was some time ago that I had that joy of being a new dad, but it is as a dad and as the co-chair of the all-party group on fatherhood that I want to talk a little about the role of fathers in this important matter.
I feel a little left out, because I did not meet my right hon. Friend until 2015, when I had been elected, and so did not have the benefit of her input on this matter before becoming an MP, but I know from my own experience of being a dad, and from various roles that I played before coming to this House, the importance of those early years, both before birth and immediately after. I know just how important that time is for getting that connection to the parents right.
The report is such a good thing—but if I were to have one concern, it would be that we could do more to recognise the importance of the role that dads play at this time in a child’s development. I encourage the Minister to consider and take note of the Centre for Social Justice report “Testing Times: Supporting fathers during the perinatal period and early parenthood”, which was written, in part, to support this review.
It is right we consider the role of fathers, who, according to the Office for National Statistics, are almost always present during this period; 95% of babies are born to couples, with 85% living under the same roof. Fathers are present, but despite that they often feel much overlooked at this important time in respect of their important role in supporting new families. Positive engagement and a strong emotional connection to a father has beneficial impacts—not just for the baby, but for the new mother, ranging from better physical and mental health outcomes to supporting emotional and cognitive development in young children.
It is a mistake to overlook the role of fathers, yet so often we do. In an analysis of inspection frameworks around maternity services, health visiting and children’s centres, we find that the word “father” is hardly ever used; the role of fathers is literally written out of expectations of our public services during this important period. Fathers are increasingly being written out of everyday language, being referred to through vague generic terms such as “birthing partner”. The intention of such phrasing might be to avoid causing offence, but it denies the reality of the pregnancy process and the early days of parenting that fathers are almost always around.
Health services will never have enough workers or resources to be the round-the-clock support network for new mums. When new mothers are asked about support, almost two thirds identify their partner as being their primary source—that is almost three times as much as the next option, which is their own mother. Only 5% say that healthcare professionals are the most valuable support. It is not surprising that fathers feel badly undervalued, with seven out of 10 new fathers saying that they are made to feel like a spare part during the pregnancy period.
The Centre for Social Justice and others have called for Ministers to introduce into inspection frameworks a “dad test”, which would mean writing into inspection frameworks for maternity services, health visiting and children’s centres a series of expectations around engaging fathers and helping them to help mother and child. There is so much more that we can do in this important policy area. Overlooking the role of fathers is misjudged. I hope that the Minister will look again at the report and ask what more can be done to ensure that new dads are given the support that they need, so that they can provide the help and support that the mother and child need at such a critical time.
It is a pleasure to speak in this debate in support of my right hon. Friend Andrea Leadsom, who has such passion for and knowledge about this issue. I too feel a bit left out, because I have never been accosted in that way. I am a little bit upset, but perhaps we can do that later. I echo what my Cornish colleague, my hon. Friend Steve Double, said about fathers. I will touch on it a little later, but I am one of those who felt left out throughout that process.
I am a huge advocate of cross-departmental working, if joined-up government is even possible. As with many issues, collaboration in early years work is incredibly important if we want to improve the effectiveness of services, both in Government and out there in service delivery at a local level. The working group chaired by the former Leader of the House, my right hon. Friend the Member for South Northamptonshire, was a positive step in bringing together all those Departments that need to be involved to find a rounded answer to the many complex issues relating to children’s services. I hope that that group drew some genuine conclusions that can be carried forward under a new Government, and it is positive to hear that my right hon. Friend expects that to be the case.
I wish to acknowledge the progress the Government have made on early years. My right hon. Friend Mrs Miller spoke about flexible working and shared leave. I am proud of the fact that more than 850,000 disadvantaged two-year-olds have benefited from free early education places since these were introduced. We spend £3.5 billion a year—that is more than ever—on early years entitlement, targeting those children who are less likely to access formal early education than their more affluent peers and helping to close the unfair gaps that exist from birth. As has been touched on, though, sometimes by the time those children reach two the challenges have already been set in place. It is then much more difficult to overcome them.
We need to do more to support children in disadvantaged areas, including Mansfield and Warsop in my constituency. On average, by the time a child from a disadvantaged background reaches the age of five, they are four months behind more affluent children in their overall development. The figures for children who start primary school in areas such as mine without the basic skills that they need are quite shocking. It simply is not good enough. The gap that exists at the age of five only widens and becomes more entrenched if it is not tackled early enough. We cannot wait until children get to school, when in many cases the damage is already done. My hon. Friend Tim Loughton chairs the all-party group on the first 1,001 days and rightly recognises that this time is vital in identifying the children who need support and who will likely always be disadvantaged if they do not get help early on.
I support the point made by my colleague on the Education Committee, Lucy Powell: we do not need more whizzy initiatives. In fact, the Select Committee has looked at lots of whizzy initiatives in recent weeks and I have been highly unimpressed by several of them. We need to spend that money on the high-quality delivery of the basic services that we know work out there in local settings.
I support Action for Children’s call for the Government to set a clear direction for children’s centres, to introduce an outcome framework to address the current funding challenges, and to use the next spending review to allocate additional funding to local authorities for children’s services. Children’s centres provide support to families so that they can overcome challenges and help to provide a safe environment for children, but without adequate funding for children’s services, children’s centres have struggled. So many local authorities are in deficit in respect of children’s services that it can be a huge challenge to look at moving to a more preventive, proactive approach, when they cannot fund the crisis services they are being asked to put in place.
We often argue in this place about Sure Start versus family hubs and other models. I advocate bringing some of those services into a primary school setting, because primary schools are trusted institutions that people might be happier to visit and to access. One way or another, a joined-up approach to proactive service delivery, accessible to those who need it, is necessary.
In those early weeks and months, we need to support the health visitors in their role of helping parents, babies and families across the country. I am happy to see that the Government will implement continuity of carers, which means that mothers will receive care from the same midwife throughout pregnancy, birth and into the post-natal period to better guard perinatal mental health. More support for young mothers and families can only be a good thing. I have mentioned my own experience as a new father, watching my wife cry as she fed our newborn baby, feeling very left out and totally helpless in that situation. Obviously, our family was a huge support, but so too were the health visitors. The advice that they gave us at that time was vital.
There are opportunities to access funding through other Departments. Obviously, the Ministry of Housing, Communities and Local Government has some funding challenges. Health visitors used to come under the Department of Health. Their role is still very clearly a health matter, and there is perhaps more money in that Department than there is in other places. That is an example of where cross-departmental working might be able to help deliver these services on the ground in a more effective way.
I am also pleased that the Home Secretary has recognised that the Government need to tackle the adverse childhood experiences that my right hon. Friend the Member for South Northamptonshire mentioned in her speech. The experience of drug abuse or domestic violence poses huge challenges throughout the lives of young people. Steps have been taken towards better cross-departmental working on this issue, identifying people who are at risk, but there is so much more to be done. When we compare people with four or more adverse childhood experiences with those who have none, we see that they are more likely to go to prison, more likely to develop heart disease, type 2 diabetes, or mental illness, more likely to commit crime and more likely to undertake other health-harming behaviours such as drinking, smoking and drug use. Many of those issues are far too prevalent in my constituency. If we look at the statistics, we see that places such as Mansfield often feature at the top of the wrong kind of tables, which puts children at particular risk. These adults often go on to have children of their own who experience the same issues in their childhood, creating a downward spiral that crosses many generations. If we do not intervene early, it will affect many families and individuals and create challenges for schools and adult services across the board. It is a prime example of how investing in early intervention services saves not only lives but money further down the line.
What is clear even from this short speech in this debate today is that the issues cross countless Departments, many different Ministers in Westminster, and a variety of local service providers from local government to health, education, police and many more. After decades of erecting barriers between these services, each with its own pot of funding and its own agenda, we now must find a way of bringing those barriers down and building on the evidence of successful schemes that require genuine collaboration—working and funding things together. We need to do that locally and nationally, which is why my right hon. Friend’s working group is still so important. It is why the troubled families programme is an example to follow. It is why we should be seeking out, rewarding and sharing best practice in this area.
Last week, I met the bigger charities in this sector, including Action for Children, Barnardo’s, and the Children’s Society. We discussed the collaborative approach that needs to be taken by those kinds of third sector organisations to make a convincing case to the Government and to the Treasury for proactive and preventive children’s services. A financial case for shifting that investment upstream also needs to be made, making it obvious that value for money as well as the social value of that kind of support are key aspects as well.
Ultimately, it is only cross-departmental working and properly funding early intervention services that will break the cycle and improve the lives of children in areas such as Mansfield. It too often seems to be children who fall through the cracks between Departments —whether it is children’s services across the Ministry of Housing, Communities and Local Government, the Department for Education, the Department for Work and Pensions and all the other services that come into that, all the way through the age range to youth provision, which has similar challenges across different Departments. We have to bring that back together. I certainly support the idea of Cabinet-level responsibility for these things all together.
I urge the new Government to commit to additional funding for children’s services and to properly prioritise early intervention in the first 1,001 days, building on the work that has been done by my right hon. Friend and others. I am encouraged to hear that the IMG’s work continues and will be taken forward under that new Government, as there is an awful lot to do in this area if we are to make sure that our children have the very best start in life. We need to deal with all those issues in the first two years, when it is vital that we find and support those young people.
It will not surprise those who know my background as a former school teacher that I want to focus a little bit on education and the literacy programme that I mentioned when I intervened on my right hon. Friend. I started teaching secondary school in Hull, sadly more years ago now than I would care to remember. When I went into that job I thought to myself, “Actually, I can really change lives in this role.” To some extent, that is true. But teaching 11 to 16-year-olds, I very quickly learned that so much of how my pupils’ lives were going to work out had already been set for them, mostly by the age of 11 and certainly by the age of 16.
When I left secondary school teaching, I became a primary school teacher and I went to teach year 1. Going from teaching 11 to 16-year-olds to teaching five-year-olds was probably the biggest shock of my life. I thought that that age would be the point at which a teacher really has a huge, life-changing impact on children; and, of course, they absolutely do. But I very quickly realised again that, by five years old, the life chances of so many of the children I was teaching had already been set for them because of their pre-school experiences, family situations, social deprivation and all the rest of it. It was incredibly sad. There were instances when a new child would be starting at the school and we would already have had pupils from that family through the school already. Sadly, we would already know the challenges we were going to face with that new child, whose name we only knew from the register, because of the situations that had already been determined for them even before they started school.
As a primary school teacher, it became clear to me that literacy was absolutely fundamental to how well a child would perform throughout their school career. Where they started in school at four or five years old very much determined where they would end up with their GCSE results at the age of 16. Those children who had a history and heritage of sitting at home and reading with their parents, carers and grandparents came to school with much better literacy rates. Their speech was also better, and they were so much further ahead than other children in their ability to communicate and interact with adults and children. For very many of them, that start set how they would perform not just in the first few years at school, but throughout their entire school career.
Not long after I was elected, I got in touch with Dolly Parton’s Imagination Library. As Sarah Champion will know very well, Dolly Parton set the library up because of her own childhood experiences with illiteracy. We met representatives of the Imagination Library and both my local councils—North Lincolnshire Council and the East Riding of Yorkshire Council—and we tried to set up a local scheme to support some of the poorest children into membership. It is a very cheap scheme, costing about £28 or £30 per child per year. For those who do not know about the Imagination Library, it sends children an age-appropriate book in the post every single month from birth through to five years old. This provides a really special time for families and it is a real event when the book arrives.
The Imagination Library had a transformative effect on children in Rotherham, not least because they felt so special receiving their books. Each book became something that was treasured, brought out and shown to other children. The scheme empowered a whole community, so I fully support the hon. Gentleman in trying to bring it to his constituency.
I thank the hon. Lady for her support. It might sound funny, but it is a real event when the book arrives in the post every month. The expectation of is a thing in itself. Then there is the process of the child opening the book, talking about it with their parent, carer or whomsoever, and spending time sitting down and bonding, which, as we know from the speech of my right hon. Friend the Member for South Northamptonshire, is so important in those early years. This has such a transformative effect.
I am very proud to say that there are two schemes running in my area. I run a very small scheme in Goole—the Goole and Snaith Imagination Library—which I provide all the funding for myself. I am always asking anybody local who could help to sponsor more children to cough up some dosh and put it in the pot. It is a very small scheme. Unfortunately, I could not get the local authority to pay for it, but there are 110 children in Goole on that self-funded scheme, which I run through my office and fund myself and through other donations.
In North Lincolnshire, however—this is not a political point, because my party runs both councils—in 2013 we secured funding to roll out the scheme to every single child in the area, thanks to the leadership of Councillor Rob Waltham, who is now the council leader but who previously held the portfolio for young people. Since 2013 we have delivered through the letter boxes of North Lincolnshire almost 500,000 books to local children.
The take-up rate in my constituency is about 95%, and across the whole of the borough it is about 90%. At present, 8,100 children from birth to five in North Lincolnshire are signed up to the scheme. The buy-in has been incredible. As I mentioned in an intervention, when someone has a child at the local NHS maternity unit at Scunthorpe General Hospital, the first thing that happens is they are signed up and given a basket that includes information about the Imagination Library. When the birth is registered, they are checked again to see whether they have registered for the Imagination Library. Children’s centres, health visitors and every local public service are signed up to the Imagination Library.
The council has done that without any additional funding from anywhere, in very difficult times. I am very proud of what we have done in North Lincolnshire to ensure that this is universal. Some people said at the start, “Some parents can afford this and should perhaps pay for it themselves,” but, to be frank, we took a political decision and said, “No, it doesn’t matter. Every child should be signed up, regardless of whether or not they can pay, because the benefit is beyond doubt.”
The results are reflected in our primary school figures. For example, in 2018 we were the most improved authority in the country for literacy and writing, and I think our phonics screening results were the seventh best in the country—they were certainly well above average. We have the data and it is manifesting itself in improved standards at primary school. Regardless of whether their parents can afford to buy a book every month, every child in North Lincolnshire gets a book through the post every month for five years, throughout reception and before they start school.
It is sad that the scheme drops off and ends at the age of five. A number of people write to me saying, “This is a brilliant scheme, but it’s such a shame that it stops at five.” As I have said, we have all the data and statistics showing the impact that the scheme has had. The most important data for me, however, is the testimony of local parents. When we set up the scheme, we focused it on the most challenged part of Goole, and a mother in Goole wrote to me saying, “I just want you to know that this scheme has been incredible for me and my child. I was not a confident reader, but sitting there every month with my child has improved my own literacy.”
When I was a schoolteacher, the reason that some parents did not spend time reading and writing with their children and teaching them the ABCs and 123s was not always neglectful behaviour; it was often because they lacked confidence in their own literacy or numeracy abilities. That then manifested itself in what might have appeared to be neglectful behaviour, but they were actually embarrassed that they did not have the confidence to pass those skills on to their children. I found that sad. A lot of work has been done across our local authority to address that. It was not always a matter of neglect.
I do not want to say anything further, other than that I hope the Minister will look at the example of the North Lincolnshire Imagination Library. As I have said, almost 500,000 books have been delivered to local children through their letter boxes, and that is having a very clear impact on primary school results. It is not necessarily cheap, but we have decided locally that it is a worthwhile intervention because we will turn out children and young people at 16 and 18 who will perform better than they otherwise would have done. They will have confidence in literacy that they may not otherwise have had, and that will benefit the community when they get jobs in the area, including exciting jobs at the new Siemens rail factory, which will require those skills. Whether they are small schemes, of which a number are running across the country, or big schemes, these programmes can really make a difference to children’s lives, including the 110 children in Goole who are benefiting and the 8,000-plus who are benefiting across North Lincolnshire.
It is a pleasure to respond to the debate on behalf of my party. I would like to thank the Backbench Business Committee and its Chair, my hon. Friend the Member for Gateshead (Ian Mearns), for making time for this important debate, as well as Andrea Leadsom and my hon. Friend Lucy Powell for their work. This is a serious and important debate. Now more than ever, we see that for some children, childhood hurts, with 2.3 million growing up with vulnerable backgrounds, including in families with the toxic trio of ACEs— domestic violence, addiction and mental health issues.
It has been a brilliant debate, with some fantastic contributions that were genuinely from the heart. My hon. Friend Matt Western talked about maintained nurseries. My good friend the Member for Manchester Central has shown great support and commitment to early years and always comes up with fantastic solutions to problems. Her Manchester example is exemplary. I thank her for her work on maintained nurseries—she has put fantastic pressure on the Minister—and the early years workforce academy.
Mrs Miller focused on health visitors. She does brilliant work with the Women and Equalities Committee on shared parental leave, pregnancy discrimination and maternity discrimination. I will take this opportunity to make a plug for my “selfie leave” ten-minute rule Bill for the self-employed. Tim Loughton has years of experience, and I was humbled by his contribution. He focused on adverse childhood experiences and called for joined-up solutions, which is exactly what we want. The scheme described by Andrew Percy was extraordinary, and I will definitely take it back to Batley and Spen. The numbers speak for themselves.
Victoria Prentis talked about local examples and adoption support. As we heard from Steve Double, fathers are often missed out. I am doing work on trying to get men into early years settings, so that fathers feel more comfortable taking their children into those settings and discussing parenting and so on. I apologise if I have missed any Member out.
We have had a fantastic debate. The contribution from the right hon. Member for South Northamptonshire was exceptional. Her personal experience was very moving. I am sure that lots of people outside this building will find the fact that post-natal depression can happen to anyone very relevant, and I hope that it will encourage them to seek support. Today’s speeches show the determination and imagination that exists in this House to get the first 1,001 days of a baby’s life right, and we have heard about the extraordinary speed at which babies’ brains develop.
I would like to speak to the two Select Committee reports cited in the motion and then move on to explore some of the options available to us. The first is the report of the Science and Technology Committee called “Evidence-based early years intervention”. I was very interested in the report at the time of its release, and it was a privilege and pleasure to enjoy a thorough debate on the report in Westminster Hall in March. Norman Lamb spoke with a great deal of wisdom in that debate. He had hoped to speak today, and his contribution is missed.
It is clear that there is cross-party consensus on the need for a data and outcomes-driven national strategy for early intervention. No matter how good the work that has been done by local authorities, that best practice should be spread across our country, and with technology, that should be easier than ever before. I share the disappointment that this key recommendation has not been accepted by the Government.
From reading the report, it is clear to me how important it is to share information. The fact that there has never been a tragedy in early life because too much information was shared speaks for itself. Unfortunately, we have seen how dangerous not sharing information can be. Much of this is because different agencies use different computer systems and different data handlers. We need a far better understanding of the principle of the Caldicott rules, sharing information when it is in someone’s best interests.
I now turn to the Health and Social Care Committee report on the “First 1000 days of life”, which is truly a fantastic report. It comes at a pivotal time for children, when, according to Action for Children and YouGov, two thirds of parents and grandparents believe, for the first time ever, that their children and grandchildren will have a worse life than they have had. There are children—so many—who are just not getting the best start in life. At the age of two, there is a six-month developmental gap between higher and lower-income families, with one in 18 two to four-year-olds experiencing mental health issues. When I read this report, not only did I think some of the recommendations were absolutely excellent, but it highlighted for me how many gaps there are in what we currently provide.
First and foremost, I pay tribute to the recommendations in the report, including that the Government should consider the needs of vulnerable families in all policies. This is an absolutely brilliant step forward if we can make that work. It is important for children and health, and it will also send a strong message about social mobility and social justice. I was really encouraged to see the work of the Better Start projects. I have been lucky enough to get to know the work of Better Start in Bradford and the way it works across the local area, with a focus on health and education, which is really encouraging. In fact, I was really lucky to join it for Baby Week last November. That weeklong celebration of babies was informative and enjoyable; I got to squeeze lots of babies, which is always a good bit of my job. I would like to applaud the National Lottery Community Fund for its vision in creating this programme.
As a last point on this report, I want to touch on health visits. The report recommends five mandated visits and an additional visit when the child is aged between three and three and a half. Visits are so important for the health of a child, but they also help professionals understand the home environment of the child so that they can identify children at risk and respond to their complex needs.
If we discuss the first 1,001 days of a child’s life, we must discuss Sure Starts and children’s centres. A number of interventions have pointed to the loss of Sure Starts and how they made a difference. We know these centres can be transformative—a place for help and advice when parents need them—but, more than that, they support parents in building a loving and nurturing environment for their children, as well as in building attachment and an opportunity for the caring and safe home that is so integral to much of what we are speaking about today.
Let me say, very briefly, that I was lucky to visit Sheringham Nursery School and Children’s Centre in Newham, where the focus is very much on the attachment theory. It has one worker who stays with a child, goes to their home and supports them throughout their experience in the nursery. I was told, statistically, about the children who will not settle. At the end of the first term, 1% of children leave maintained nurseries. However, there is not the focus on attachment in private nurseries, and often 12% of children leave those settings after the end of the first term because they have not settled. Attachment works, and we certainly see good practice in maintained nurseries.
Centres help with supporting children to become school-ready—whether through direct learning in the centre, or via the centre supporting parents to read to and to teach their children. This work is needed now more than ever, as just 57% of children from poorer backgrounds are school-ready by the age of five, by comparison to 74% of their wealthier peers. This just does not feel good enough, especially when we consider the frightening rate at which Sure Starts and children’s centres have disappeared from our communities.
As we have spoken about data, it is important to say that although the Government’s own figures show that hundreds of Sure Starts have gone, analysis I would call precise puts at roughly 1,200 the number of them closed since 2010, and certainly services have been hollowed out in the Sure Starts that are still standing.
Putting the number of centres aside for the time being, analysis provided by Action for Children shows a worrying trend in the usage of children’s centres. It says that local authority spending fell by £327 million between 2014-15 and 2017-18, which coincides with a decrease in the number of children using the centres. That figure fell by 400,000, or about 18%. There has been no reduction in demand for support or in the need for support, so there is clearly a gap between the centres and the ability of families to access them. If anything, the rise in the number of children growing up in poverty can only impact on the pressure on those services. I am sure that concerns us all across the House. If we discuss an inter-ministerial working group or seek consensus on the early years of life, we must accept the reality of the situation for children’s centres. It is often grave because of a lack of funding, and we must try to work towards a national strategy that ends the postcode lottery of provision.
One policy I want to talk about is the 15 hours of free childcare available to disadvantaged two-year-olds. The policy is there to help those children with their development and support them on their education path. We must applaud the direction of this policy, but I must ask the Minister—perhaps he will have an opportunity to answer when summing up—why it is that three in 10 of these children are still not accessing the care they are entitled to. Is he assured that the Department is using everything in its toolbox to make sure that eligible children are identified and that their parents made aware of the entitlement and encouraged to take up the place? We know the difference it makes. We have heard about that from Members across the House today.
It is worth noting that the Social Mobility Commission recommends extending the offer of 30 hours of free childcare to cover households where one parent is working eight hours a week, rather than the current system where they must work for at least 16 hours a week. In the interests of social justice, I would prefer for the policy to be universally available, but I hope that the Government look closely at that recommendation. Social mobility has remained “virtually stagnant” since 2014 and inequality exists “from birth to work”. Those are not my words, but the words of the Social Mobility Commission. I know we can do more to reach out to vulnerable children and their families.
In conclusion, of course we all want every single baby to have the best start in life and we accept that the challenges are great, but there is good work and innovation happening across our country. We have heard about it from many Members across the House. With initiatives such as Sure Start and children’s centres, the advanced knowledge we have about health outcomes and the support of Parliament, we should be able to strive for the very best. It will require determination and significant resource, but if the next Prime Minster wants to build a legacy, I hope that he pays attention to today’s debate and puts the first 1,001 days of a baby’s life at the heart of his agenda from day one in office. As we have discussed in many previous debates, if billions can be given to businesses and wealthy individuals then I know that every single Member who has spoken in this debate will want assurances that money will be set aside to rebuild services for our most vulnerable children.
I congratulate my right hon. Friend Andrea Leadsom on securing this important debate on a Tuesday—pretty remarkable. I guess it is a question of knowing which levers to pull to make sure these things happen. I thank her for her tireless commitment to this very important area. I also thank her for all she did to drive forward the work of the inter-ministerial group on early years family support in her role as chair. Madam Deputy Speaker, I think you would agree with me when I say that we have had a debate that epitomises all the great things about our Parliament. It has been deep and well informed. Lucy Powell, who co-sponsored the debate, made an excellent speech. I have been up to see the school readiness work that she is doing with Andy Burnham and I pay tribute to his work, passion and commitment not only to this issue, but to looked-after children. He is a champion of those children who, through no fault of their own, we have had to take away from their biological parents.
The hon. Member for Manchester Central spoke about funding, and she knows that I am putting my best foot forward and preparing for the spending review as well as I can. Her compliments mean that my head will not get through the double doors behind you, Madam Deputy Speaker. She is right to highlight the extraordinary work of maintained nursery schools and their passion, commitment and the additional hard yards, as she put it, that they go to. In many ways, they will be the trailblazers in Manchester for the joined-up, place-based, integrated early-years delivery model. She also talked about workforce development, which I will return to later.
My right hon. Friend Mrs Miller made the point incredibly well about flexibility in working, which I hope a future Government looks at very closely. He also talked about shared parental leave. Matt Western again referred to maintained nurseries, and his two maintained nurseries in Warwick and Whitnash, and I thank him for that.
It is almost impossible to compliment my hon. Friend Tim Loughton on this—he has heard me say before that he is a fountain of knowledge on this area. He reminded the House that the strategic importance of children’s mental health has come to the forefront in this place. He is right to highlight the number of debates and the number of colleagues who are now engaged in this agenda. I hope that he will continue his passionate backing for the troubled families programme and all the other issues that he rightly reminded us need support in a future Administration.
With my hon. Friend Victoria Prentis, I visited Safeguarding Children in Banbury, which is for children who have been traumatised, and the work there is remarkable. She also mentioned the adoption support fund. Rachael Maskell is not in her place today, but we had a fantastic gathering yesterday for the report on the adoption support fund, which my hon. Friend cited. Ninety per cent. of children said that this helped them a lot in terms of the additional support that they needed.
My hon. Friend Steve Double, who co-chairs the all-party group on fatherhood, rightly reminded us of the key role that fathers play and the fact that they are role models. I think of the work that I have seen, and we want to develop further the focus on not just mothers, but fathers. As a Manchester United supporter, it pains me a bit to say that Manchester City is doing remarkable work in early-years outreach—[Interruption.] The hon. Member for Manchester Central says “Four clubs” and she is quite right—I know. We will move on swiftly to my hon. Friend Ben Bradley, who rightly reminded the House that children’s services are challenged, and we need to look at that very closely when it comes to the spending review.
My hon. Friend Andrew Percy talked about the Imagination Library, and I will certainly take a look at that. It is extraordinary, and it is testament to his incredible entrepreneurial—I think that word has been used a lot over the last few weeks—abilities to be able to identify it and bring it to Brigg and Goole and North Lincolnshire Council. It is remarkable that 95% of children are now signed up.
I am grateful for this opportunity to set out the Government’s approach to the first 1,001 days. The evidence is clear that the first 1,001 days of a baby’s life can have an impact on their social, economic and physical outcomes in later life. We all know this is a period of significant physical change for the mother and baby and a critical period of development, cognitively and emotionally, for babies.
The early years family support ministerial group has considered carefully how the Government can improve the co-ordination and cost-effectiveness of family support for children under the age of two and identify the gaps in available provision. It has now made its recommendations to the Secretaries of State, and they are considering them. It is important that the next Government continue that work and, as my right hon. Friend the Member for South Northamptonshire pointed out, report to the House in due course.
From the point of conception, we have the opportunity to ensure that all children get the best start in life. We start building our health asset as a baby in the womb. The transition to parenthood is a key opportunity to provide good information and support to adults on the importance of the child’s first months and early years. There are clear benefits from early investment and support through pregnancy and the early years, and supporting early intervention means starting with good pre-conception care. The Government are committed to improving maternity services for vulnerable groups, and an enhanced and targeted continuity of care model will be implemented to help improve outcomes for the most vulnerable mothers and babies.
Positive adult-child relationships are key protective factors against adversity and trauma. The Government are committed to improving perinatal mental health services. The NHS long-term plan will increase access to evidence-based care for women with moderate to severe perinatal mental health difficulties and I hope benefit an additional 24,000 women per year by 2023-24. This is in addition to the extra 30,000 women getting specialist help by next year and the year after. We will be making care provided by specialist perinatal mental health services available from pre-conception to 24 months after birth, in line with the cross-Government ambition for women and children, focusing on the critical first 1,001 days of a child’s life.
We are also expanding access to evidence-based psychological therapies within specialist perinatal mental health services so that they also include parent-infant, couple, co-parenting and family interventions. As part of that, we will be offering fathers and partners of women accessing specialist perinatal mental health services and maternity outreach clinics evidence-based assessments of their mental health and signposting to support as required. This will contribute to helping to care for the 5% to 10% of fathers who experience mental health difficulties during the perinatal period.
We are increasing access to evidence-based psychological support and therapy, including digital options, in a maternity setting. Maternity outreach clinics will integrate maternity, reproductive health and psychological therapy for women experiencing mental health difficulties directly arising from, or related to, the maternity experience. In addition, over the current spending review period, we are giving local authorities more than £16 billion for public health for all of the health functions they commission, including health visitors. The Prime Minister announced our commitment to modernise the healthy child programme to reflect the latest evidence on the importance of the first 1,001 days, including how health visitors and other professionals can support perinatal mental health.
Beyond the perinatal period, the first few years of a child’s life are fundamentally important in achieving long-lasting outcomes. I am grateful to the shadow Minister for mentioning the 15 hours of free childcare for disadvantaged two-year-olds. It has reached 800,000 two-year-olds since its launch in 2013. I will certainly look at her points about targeting and take-up. We are spending £3.5 billion on our early education entitlements this year alone, which is more than any previous Government have spent. We are also supporting parents to improve the quality and quantity of adult-child interactions to support early language development in the home.
Following our successful home learning environment summit in November, we have continued to work with businesses and other partners. We have just launched the Hungry Little Minds campaign, a three-year campaign to encourage parents to engage in activities that support their children’s early learning and help to set them up for school and beyond.
Looking beyond parents, we know that a skilled early years workforce is also key. That was one of the three points made by the hon. Member for Manchester Central. Children and families come into contact with a great many professionals in the early years. This is a huge opportunity, but it is not easy to get it right, particularly for the families who are the hardest to reach. We want to engage everyone, from frontline professionals to local system leaders, in our efforts to improve early language and literacy outcomes. 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 to improve, in particular, early language, literacy and numeracy outcomes.
Local areas have a key role to play in commissioning and delivering effective early-intervention services to meet complex and specific needs, and the Government are supporting them in that task. The Department’s early years local government programme, in which we have invested £8.5 million, focuses on improving the way in which local services work together across health, education and early years to improve the outcomes of children aged five. As part of that work, multidisciplinary peer reviews will help councils to identify necessary reforms, and our early outcomes fund will provide an additional £6.5 million of grants for local authority partnerships to improve the delivery of services. I have commissioned the Early Intervention Foundation—this is an issue that has arisen repeatedly during the debate—to look into how children’s centres and other delivery models can help to improve outcomes for the most disadvantaged children and spread good practice across the sector. When we have the data, we shall be able to focus on where we should spread that good practice. We also remain strongly committed to the What Works initiative, embodied in our three What Works centres.
Part of the Government’s funding for the Early Intervention Foundation is being used to establish an early years transformation academy. The academy will provide a framework for the sharing of learning, including events and online material for leaders, commissioners and other stakeholders. The start of more intensive academy work began in June, and will provide further opportunities to pool learning.
Let me again thank my right hon. Friend the Member for South Northamptonshire for securing the debate. We know that getting it right in the early years is key to ensuring that all children have the best start in life. That is reflected in the excellent work that is already being undertaken across England at local and national levels, but we can certainly do much more. My right hon. Friend’s legacy should be the IMG’s continued delivery of what we agreed should be delivered.
It is fantastic to see you in your place for the final bit of the debate, Mr Speaker. I can paraphrase what it has been about as “all you need is love”, and I know that you would subscribe to that yourself. It has been an incredibly positive and optimistic debate.
Lucy Powell, my hon. Friend Tim Loughtonl and I have worked on this for years. Members throughout the House are determined to see every baby get the best possible start in life, and ultimately that is all about love. It is about attachment, about good early-years services, and about the Government working in a joined-up way. My hon. Friend the Minister has made huge strides in showing his personal commitment to progress in that regard, but I urge him, and the Government, to demonstrate that final commitment to getting the excellent work done by the inter-ministerial group over the line, so that we really do give every baby the best possible start in life.
Question put and agreed to.
That this House
believes there is now overwhelming evidence of the importance of the first 1001 critical days of a new baby’s life in determining his or her lifelong physical and emotional wellbeing;
notes the work of the Inter-Ministerial Group led by the Rt. hon. Member for South Northamptonshire, the Thirteenth Report of the Health and Social Care Select Committee, HC 1496, on First 1000 days of life and the Eleventh Report of the Science and Technology Committee, HC 506 on Evidence-based early years intervention;
and calls on the Government to take strong and decisive action immediately to ensure that every baby gets the best start in life.