I beg to move,
That this House
has considered the matter of giving every baby the best start in life.
I am grateful to the Backbench Business Committee for giving us time for the debate. Among all the turbulence created by the pandemic and the lockdown, I am pleased that we have the opportunity to debate at length the impact of those events on those who are likely to live with its after-effects the longest.
The building blocks for lifelong emotional and physical health are laid down in the period from conception to the age of two. Those first 1,001 days are a critical time for development, but they are also a time when babies are at their most vulnerable. Babies do not yet have the language skills to advocate for themselves, so carers and services must be equipped to do that on their behalf. During the first 1,001 days, babies are also uniquely susceptible to their environment. Chronic stress in early childhood, whether caused by maternal depression, poverty or ill health, has a negative impact on a baby’s development.
Early intervention and prevention to support the wellbeing of babies during this time is strongly linked to better outcomes in later life, including educational achievement, progress at work and mental health. Failing to invest in giving babies the best start in life delivers not only a human cost but an economic one. The total known cost of parental mental health problems per year’s births in the UK is estimated to stand at £8.1 billion.
I thank the hon. Lady for securing the debate on an issue that is close to my heart, having had a lockdown baby at the end of January—he is just over nine months now, and he is very happy and causing all sorts of chaos in my and his mother’s lives. The hon. Lady mentioned mental health, and my constituent Mark Williams has spent many years speaking publicly about the mental health issues he experienced after having his first child. It is extremely important that we wrap care around the mother and the baby after birth, but does the hon. Lady agree that we should also do more to allow fathers to get support with their mental health and to realise that becoming a father is a deeply profound thing and that there is nothing wrong with talking about our mental health as a father after having a child?
I congratulate the hon. Member on the birth of his baby, and I hope that all is progressing well. I am grateful to him for raising that point about fathers, and I will come to it later in my speech.
My interest in this topic arose from conversations I have had with constituents who gave birth during lockdown. They told me about the isolating experience of not being able to have their partners in the delivery room with them, not being able to share their new babies with the wider family and not being able to meet up with other new parents to support each other and share their experiences. Thinking back to my own experiences of early motherhood—12 years ago—I remember how much it meant to me to have all those people around me as I recovered from the birth and got used to my new life as a parent. My heart goes out to all those who struggled in isolation during those early months, and I am determined that young families should be prioritised for support as we emerge out of the other side of the pandemic.
The UK Government’s recent focus on investment in the first 1,001 days in their “Best Start for Life” vision and funding is very welcome and will undoubtedly make a significant difference to families. I pay tribute in particular to the efforts of Dame Andrea Leadsom, who has been unsparing in her work to bring the needs of our very youngest citizens to the forefront of public policy and funding.
One of the most important sources of support for new parents is a health visitor. Even for those who enjoyed the most robust mental health, having sudden responsibility for a tiny and vulnerable new baby who is entirely dependent on them is a source of great anxiety. Having a visit from a trained health care professional who can give them advice, answer their questions and, above all, reassure them is enormously helpful and can make all the difference to their early experience of parenthood.
Although the UK is no longer in lockdown, both access to services and working patterns have changed. Some support services, such as playgroups, have not survived, and some have closed altogether. Children’s centres have reopened, but numbers are limited and places need to be booked in advance, which may mean that the families with the least time on their hands will lose out. The co-ordinators and volunteers at Home-Start Richmond, Kingston & Hounslow have told me about the high levels of anxiety experienced by new mothers unable to access health visitor advice and reassurance. That is impacting new mothers’ confidence and their ability to meet their baby’s needs.
Health visitors are a skilled workforce of specialist public health nurses who have the expertise to provide holistic care to families. As the only professionals positioned to reach every young child before they start school, health visitors play a crucial role in child safety and early childhood development. They identify and manage developmental delay, as well as common and serious health problems. They also provide support around childhood immunisations and advice on infant feeding, safe sleeping and mental health, all of which relieves pressure on NHS emergency departments and specialist services.
However, there is currently no national plan to address falling health visiting workforce numbers. The Government's spending review stated that it
“maintains the Public Health Grant in real terms, enabling Local Authorities across the country to continue delivering frontline services like child health visits.”
In fact, the Government are maintaining the public health grant at a level that is too low for many local authorities to resource health visiting services that can deliver face-to-face visits and the support described in the healthy child programme and other national guidance.
Ahead of the spending review, 700 leading children’s sector organisations were united in their call for investment for 3,000 more health visitors over the next three years. However, I am concerned that £500 million over the next three years will not deliver the Government’s pledge to rebuild health visiting. It is of the most urgent importance that we restore face-to-face health visiting to every new mother as the most essential building block of support to families as they welcome their new babies.
The importance of early home visits by skilled healthcare professionals was highlighted to me by one constituent who wrote to me last summer. She said:
“My baby is now 6 months old and soon after birth he was diagnosed with SMA type 1. If you are not familiar with it, the full name is Spinal Muscular Atrophy and it’s a muscular wasting illness. There isn’t a cure for it and without treatments and proper care the life expectancy of a baby is less than 2 years. He is currently under treatment but, and here is the reason for this letter, every possible centre specialised in physiotherapy, hydrotherapy or other physical activities for disabled people is shut due to Covid-19.
My husband and I were the ones who had to notice something was not right with Peter because, due to Covid, no one came for home visits after birth to see the baby or me. I almost died in child birth and because we were left alone I had to endure 1 month bed ridden due to further complications, once again noticed by me. Only once I was able to walk again we saw something wasn’t right with the baby. If after 2 weeks the health visitor had been able to come home, my son would have started treatment sooner without losing the mobility of his legs.”
I want to talk a little more about the importance of diagnosing and treating perinatal mental health. Maternal suicide is the leading cause of direct deaths within a year of pregnancy. An estimated one in four women experience mental health problems in the first 1,001 days after pregnancy. While depression and anxiety are the most common perinatal mental health problems, other conditions include eating disorders, psychosis, bipolar disorder and schizophrenia. One in 10 fathers is also affected by perinatal mental health problems. Of the 241 families that Home-Start Richmond, Kingston & Hounslow supported during the most recent year, 66% were experiencing mental health difficulties, including post-natal depression, anxiety, depression and chronic mental health conditions.
I was privileged to be able to visit Springfield University Hospital in Tooting recently to meet the perinatal psychiatry team for the South West London and St George’s Mental Health NHS Trust. I was extremely pleased to hear about the work the trust is doing in successfully supporting new mothers who struggle with their mental health, and particularly that it was able to maintain its services during the lockdown and after. Akvinder Bola-Emerson, the clinical services lead for perinatal psychiatry, stressed in particular the need for peer support but also the importance of health visitors, whom she described as the “eyes and ears” of perinatal mental health services.
The visit highlighted for me that we also need better provision for new and expectant fathers. Currently only mothers can be formally diagnosed with a perinatal mental health problem. Springfield provides services for fathers, but it is currently able to identify mental health issues in fathers only when they accompany a mother who is attending the hospital for perinatal mental health issues.
I am extremely grateful to the hon. Lady for securing the debate, and she is making some very important points. Does she agree that one of the worst situations expectant parents can find themselves in is when there is a miscarriage and that parental leave for such parents would be a welcome reform?
I am grateful to the hon. Member for his intervention. He is absolutely right that there are a large number of events and incidents surrounding pregnancy and birth—as I know from my own experience—that can cause huge distress, and it is right that mothers and the people supporting them, and fathers as well, get the support they need, including statutory leave from employment for the time it takes to come to terms with the miscarriage. That is certainly something we should be looking at.
We know that impending fatherhood can be a cause of great anxiety for men, and more services need to be developed to support them. We also know that over a third of domestic violence starts or gets worse when a woman is pregnant. I would speculate that some of that is attributable to undiagnosed and untreated mental health conditions in expectant fathers, which underlines the need to do more to support them.
In addition to health visiting and perinatal psychiatry, support for children and their families throughout their early years is vital for enhancing children’s prospects at school and beyond. Evidence shows that effective integration of services in the earliest years can bring broad benefits. For example, Sure Start children’s centres are shown to decisively reduce hospitalisations during childhood. However, 1,300 children’s centres have closed since 2010, and recent research has shown that 82% of parents of young children have struggled to access early years services. I am pleased that the Government have now committed £80 million to introducing family hubs to 75 local authorities across England, and £50 million for parenting programmes. However, we need more information on what family hubs can provide, and I would particularly like to ensure that health visiting and mental health support are included.
The importance of the right support in the early years was brought home to me after a recent meeting with primary headteachers in my constituency. I heard about how difficult it is for nursery and reception-age children to settle into class and to get used to spending time with other children and not spending all day at home with their parents. For adults, lockdown has been 18 months of inconvenience, after which we expect to be able to pick up the threads of our former life. However, some young children who started nursery this term will have spent up to a third of their life in lockdown, and we cannot yet know what the long-term impact will be.
Is my hon. Friend alarmed, as I am, by the fact that domestic violence has increased during lockdown, which has particularly affected young or very young children? The Government need to look at the backlog of cases that have arisen through the lack of attention to domestic violence, or inability to look at it, during lockdown, as it did not really come to our attention.
My hon. Friend is absolutely right, and incidents of domestic violence during lockdown are a matter of grave concern. We know there is a clear link between domestic violence starting or worsening and a pregnancy in a family. That issue needs a huge amount of attention; more mental health support for both partners would help a great deal.
The lockdown will have increased disparities in educational outcomes between those from poorer backgrounds and their richer classmates, and I call on the Government to do more to provide catch-up funding to our schools, and allow them to spend it on a greater range of services. Local headteachers tell me that funding can be allocated only to academic tuition, and that they have identified many children, including the very youngest, who need mental and emotional support to help them in school.
I will conclude by saying thank you to everyone who has talked to me about their experiences in this area, but particularly our health visiting and perinatal mental health teams, who do so much good and valuable work for new families. I also acknowledge the huge contribution made by the voluntary sector in supporting new families, in particular the work of Home-Start, which provides an excellent network of support. It takes only a small amount of encouragement, a little word of advice or a sympathetic listening ear to give a new parent confidence, but it can make a world of difference to their children. A small investment in the beginning of life can reap huge rewards, not just for individual children and their families but for whole communities, and the right start can enhance not just individual educational achievement and wellbeing but reduce risky and antisocial behaviours. Few pounds could be better spent, or yield a more valuable return, than those invested in our youngest citizens.
It is a pleasure to follow Sarah Olney in this important debate, and I congratulate her and Catherine McKinnell as fellow co-sponsors and tireless fellow campaigners for giving every baby the best start in life.
Despite the rough and tumble of politics, there are times when colleagues from all parties in the House come together. Early years is one such cross-party issue. Over the past 11 years in Parliament, I have been proud to work with many colleagues on the early years. The hon. Members for Manchester Central (Lucy Powell) and for Washington and Sunderland West (Mrs Hodgson), my stalwart and long-standing hon. Friend Tim Loughton, and my hon. Friends the Members for Eddisbury (Edward Timpson) and for Winchester (Steve Brine) have all been amazing campaigners for the earliest years, as has Alison Thewliss. The former Member for Birkenhead, Lord Field, and the former Member for East Dunbartonshire, Jo Swinson, have been great allies, as have all those Members who supported the all-party group conception to age two: first 1,001 days, and Ministers on the inter-ministerial group on early years family support from 2018-19.
It is fantastic that since the 2019 general election, the early years agenda has received fresh support from new colleagues such as my hon. Friends the Members for Penistone and Stocksbridge (Miriam Cates), for Stroud (Siobhan Baillie), for Cities of London and Westminster (Nickie Aiken), for Truro and Falmouth (Cherilyn Mackrory), and for Ruislip, Northwood and Pinner (David Simmonds). I also pay tribute to the late Baroness Tessa Jowell. She and I worked together on the 1,001 critical days agenda, and she campaigned for it to be introduced as part of the sustainable development goals at the United Nations. I must also mention the superb work of the Royal Foundation and its Centre for Early Childhood. The commitment from Her Royal Highness the Duchess of Cambridge and her team has generated fresh attention for ensuring that every baby gets the best start in life.
This subject has been my personal passion for more than 20 years, from chairing the Oxford parent-infant project, to setting up the parent infant partnership UK, and the Northamptonshire parent infant partnership, establishing the 1,001 critical days manifesto and the all-party group conception to age two: first 1,001 days, and chairing the inter-ministerial group in the Government of my right hon. Friend Mrs May. July 2020 marked a huge opportunity when the Prime Minister commissioned the early years healthy development review and invited me to chair it. Since then, we have been able to build on years of cross-party support, and a wealth of knowledge and expertise from the early years sector, to create a new vision for the 1,001 critical days initiative that was launched in March this year. The review has put the baby’s needs at the centre of all our work. Through meetings with parents and carers, virtual visits to local areas, and detailed discussions with parliamentarians, practitioners, academics and charities, we heard about the experience of early years services and support, and about what is going well and where change is needed.
First and foremost, we learnt from every parent and carer of their strong desire to be the best parent they can be, but we also learnt that new prospective parents often struggle to find the support they need. We heard from many parents who had deep concerns about their own or their partner’s mental health, and struggled to get timely support. We heard from many mums who desperately wanted to breastfeed but gave up because the support was not there. Parents told us how frustrating it was to keep telling their story over and over again to different people. Their cry was, “Why don’t you people ever speak to each other?” Equally, we heard from professionals and volunteers who said it would have been so helpful for them if they had known before meeting a new parent or carer about previous trauma or health challenges.
We heard from many dads about how excluded they felt from what they saw as “mum-centric” services. Some felt that they should not ask for any support for themselves, while others just felt sidelined and, in some cases, traumatised by what their partner had gone through in childbirth. We heard from foster carers of babies how little information came their way when caring for a vulnerable baby. More specifically, in 40 cases of babies who went into foster care, only two arrived with their red book. Those carers had no formal information about that baby’s early traumas that had caused them to be taken away from their birth family.
We heard from same-sex couples about unhelpful assumptions by early years professionals about their relationship and parenting roles. We heard from black mums about how particular cultural and health issues can be overlooked by busy staff. We heard from single mums and single dads about how they can feel isolated, and sometimes stigmatised, at such a life-changing time. We heard from many parents with particular challenges, such as not speaking English well, concerns about possible disabilities, experiencing violence in their lives, or other significant challenges. We heard that support is inconsistent and sometimes hard to access.
It comes as no surprise that the covid pandemic has been an extraordinarily difficult time for new families who, through no fault of their own, have not been able to access services or support in the normal way. The “Babies in Lockdown” report from the Parent-Infant Foundation, Best Beginnings and Home-Start reveals that nearly seven in 10 parents felt that changes brought about by covid were affecting their unborn baby, their baby, or their young child, and that 35% of parents would like help with their concerns about their relationship with their baby. The report also found that nine out of 10 parents and carers experienced higher levels of anxiety during lockdown.
Despite the many stories of difficulties, we also heard fantastic examples of good support for families. Many health visitors went the extra mile to keep in contact with families who were struggling, and many families found it incredibly reassuring to be able to text or Zoom their health visitor at short notice. Parenting programmes have been a huge support to many families, and we virtually visited Camden’s Bump to Baby programme, where classes continued online throughout the pandemic, and have proved incredibly popular with new parents and carers who are also helped to make friendships outside the programme. Dads gave us positive feedback on services that gave them space to share their experiences, without worrying about whether they were taking the focus away from the other partner’s health and wellbeing.
In lockdown, we also heard about excellent online and virtual services, and how they came into their own. One such service, Parent Talk, provided by Action for Children, reported a 430% increase in the number of parents seeking advice online during the pandemic. The Baby Buddy app, produced by Best Beginnings, has seen a huge take-up of its digital and virtual advice for everything from breastfeeding to nappy changing, and from sleep management to mental health concerns. Many local authorities are now determined to improve their joined-up offer to new parents and carers, so I certainly feel that we are pushing against an open door.
Our report, “The Best Start for Life: A Vision for the 1,001 Critical Days”, was launched by the Prime Minister in March this year. It contains six action areas. The first is that every local area should publish its own joined-up set of start for life services so that every parent and carer knows where to go for help.
The second is a welcoming hub for every family, in the form of family hubs. Those will build on the excellent work done by the late Baroness Tessa Jowell and others on creating Sure Starts, but the benefit of family hubs is that they will be the place where every family goes for support and advice, including from midwives, health visitors, mental health support workers and breastfeeding advisers within their walls. Not only will those services be physically available but they will be virtually available through the family hub model.
The third action area is a digital version of the red book, which will provide parents and carers with a record of their baby’s earliest life, from lovely moments such as their first tooth and their first steps, all the way to records of immunisations and professional support interventions.
The fourth action area is about the workforce. We all know that health visitors provide critical support for new parents and carers, but we also know that their case load can be very heavy, and parents and carers have told us that they really want more continuity of care and more frequent contact in the earliest years. We are therefore working with health visitors and local areas to consider resourcing levels and training needs, and whether a mixed-skill workforce can provide that greater continuity of care.
The fifth action area is to continually improve the start for life offer. A key action will be to establish parent and carer panels in every local area to ensure that the voices of families are heard when services are designed and improved. We are looking at improving the collection of data, at the evaluation of different interventions and at the need for proportionate inspection of the start for life offer in each area. A final but critical action area is to ensure that there is sound leadership, both locally and nationally, to drive the ambition to give every baby the best start for life.
I want to say a huge thank you to the Under-Secretary of State for Health and Social Care, my hon. Friend Maggie Throup, and to all the review’s sponsoring Ministers, past and present, for their support for the review. I am sure that it was their commitment, combined with the support of the Prime Minister and the Chancellor, that ensured such a positive spending review settlement for the earliest years, with £82 million for family hubs, £50 million for parenting programmes, £10 million for the start for life offer, £50 million for breastfeeding support, £100 million for infant and perinatal mental health support, £10 million for new workforce pilots, and a £200 million uplift for the supporting families programme. I believe that £500 million is a transformational sum that will allow many more parents and carers access to the vital help they need to give their baby the best start for life.
Why does this matter so much to our society? Well, we know that it is in the period from conception to the age of two when the building blocks for physical and emotional health are laid down. Babies born into secure and supportive homes will usually go on to become happy children who do well at school and grow into adults who cope well with life’s ups and downs and are more likely to hold down a job, have better health outcomes and form healthy relationships themselves. On the other hand, we know that in families under pressure, particularly where there is partner conflict, substance misuse, poor mental health or deprivation, the consequences for a baby’s developing mind in that critical early period can be far-reaching and very harmful.
Prevention is not just kinder; it is also significantly cheaper than cure. For example, the NHS has estimated that for every one-year cohort of births in England, the long-term cost of lack of timely access to quality perinatal mental health care is £1.2 billion to the NHS and social services and more than £8 billion to society. That is for every year’s cohort. We also know that up to 30% of domestic violence begins during pregnancy, and that health issues such as tooth decay and childhood obesity cost hundreds of millions of pounds every year in health-related expenses. We believe that those things could be significantly reduced by better education and support for new families.
With these six action areas, I think we can transform our approach to early years support and services, improving the health outcomes and life chances of the youngest in our society. Just as we need to level up economic opportunity across the country, we must also focus on where it begins—that critical period of human life from conception to the age of two.
The right hon. Member is giving a very comprehensive speech. Does she also agree that the Government should look at the issue of shared parental leave? The stats seem to indicate that fewer than 4% of eligible fathers take up the Government’s current policy. The Government need to look at that, and the forthcoming employment Bill may be an opportunity to strengthen those provisions.
I completely agree with the hon. Gentleman that it would be fantastic for families and babies if more dads took up shared parental leave. Of course, as he will know, that has been legislated for. Unfortunately, as he points out, far too few fathers have taken it up to date. I certainly wish that more would have the confidence to do so.
I believe that all colleagues across the House would agree that the world in which we all want to live is one where every baby is nurtured to fulfil their potential, where good lifelong emotional wellbeing is the norm, where our society is productive and co-operative, and where every one of our citizens has the chance to be the very best that they can be.
I thank the Backbench Business Committee for granting time to debate this incredibly important subject. I also commend my colleagues, Sarah Olney and Dame Andrea Leadsom, for setting out so eloquently and passionately the case for focusing on this issue. I had hoped that, as co-sponsors of the debate and co-conspirators on this issue, we would not just repeat one another’s arguments, and I believe that, without co-ordinating in any way, we will not. We agree on the problem—we agree on the challenge and the importance of this issue—but today I want to focus on the enormous challenge presented by poverty in overcoming many of these issues.
We know from international evidence that so many important life outcomes, from health to wealth and wellbeing, have their origins in early childhood, but the reality is that not all childhoods are equal. If we truly want to give every child the best start in life, we must tackle poverty and economic disadvantage. There is substantial evidence demonstrating the damaging, stigmatising and often lifelong impact of experiencing poverty in childhood. It affects cognitive skills, social and emotional development, physical health, mental health, educational outcomes, employment prospects, the likelihood of being in poverty as an adult, and life expectancy.
Recent reports have highlighted starkly that the impact of poverty begins in very early childhood, or even pre-birth. For example, last month, MBRRACE-UK— Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK—reported that
“babies born to women living in the most deprived areas are twice as likely to be stillborn, and at a 73% excess risk of neonatal death compared to babies born to women living in the least deprived areas”.
Likewise, national child mortality database research published in May found a clear link between deprivation and child death. It concluded that around 700 fewer child deaths per year—a fifth of all child deaths—might be avoided if children living in the most deprived areas had the same mortality risk as those living in the least deprived. Poverty is literally killing children.
Is the hon. Member as concerned and shocked as I am about data showing that a mother from an ethnic minority background has a much higher likelihood of experiencing complications during pregnancy or birth that result in their baby being either stillborn or born with a disability? Does she agree that we need absolutely to focus on such discrimination and disadvantages?
Yes, I absolutely agree with the hon. Lady. As the Chair of the Petitions Committee, I can say we received petitions on that issue and debated it in Parliament. We have been given some assurances from the Government, but it is imperative that all of us in this House ensure an improvement in both the statistics and the reality for those who experience it.
It is well established in education research that on average the longer a child has been disadvantaged the worse their performance will be at school, particularly in key stage 4 assessments. Even where children from more deprived backgrounds do achieve the same results as their better-off peers, they are still likely to have lower lifetime earnings. How unbelievably disheartening is that?
Sadly, child poverty is getting worse. Government statistics on households below average income published this spring show just how many families were struggling before covid-19. In 2020, 200,000 more children were pushed into poverty compared to the previous year, using the measure of relative poverty after housing costs. That means 4.3 million children living in poverty: real children living in real hardship. I know the Government do not readily accept the concept of relative poverty, but Ministers should listen to the recommendation of the Work and Pensions Committee to end the sole focus on absolute poverty and look at broader measures. After all, if the Government are committed to levelling up, improving the position of a child in Newcastle relative to a child in Middlesex is surely more relevant to comparing a child in Newcastle today with a child in Newcastle 11 years ago.
Even if we use only the Government’s preferred absolute poverty measure, the proportion of children living in poverty rose by an average of four percentage points in every north-east local authority area between 2014-15 and 2019-20, while the number of children living in absolute poverty across the north-east rose by more than 21,000 during that period. The latter point is particularly concerning as absolute poverty is a measure that has always tended to naturally improve over time as living standards rise, but in the north-east it is going in the opposite direction. As troubling as the pre-pandemic figures are, none of that should come as a surprise given the direction of Government policy over the last 10 years. Indeed, the country went into the pandemic expecting to spend £36 billion less on social security because of Government welfare policy. That has to come from somewhere, and it is coming from the poorest pockets and the mouths of children.
Just as Government action can lead to increases in child poverty, it can bring them down too. We have seen it before, especially under the previous Labour Government. What we need is a cross-governmental strategy for tackling child poverty, something groups such as the North East Child Poverty Commission and the Child Poverty Action Group have consistently called for. It needs to go a lot further than anything we have heard from the Government to date. It should include a welfare system that prevents and reduces poverty, giving all families a dignified safety net when they are going through tough times. It should tackle unemployment and low-paid insecure work, the kind of work that means most children living in poverty are now in working families. We need concerted action to support families with the cost of major outgoings: energy, housing and childcare.
All those things were problems pre-pandemic and they still need to be addressed, but covid-19 and the lockdowns of the last year-and-a-half have brought additional challenges for parents and young children. For the past 18 months, the Petitions Committee, which I Chair, has investigated the pandemic’s impact on new parents and children, and expressed its deep concerns that it is being overlooked by the Government. Our first report in July 2020 highlighted the need for urgent catch-up investment to help new parents access support services disrupted by the pandemic, and to do more to ensure employers meet their health and safety duties towards pregnant women. Unfortunately, the Government rejected almost all our recommendations, saying that support was “sufficiently generous” for
“the vast majority of parents”.
That, however, did not match up with all the evidence we heard from new parents about their struggles. We heard that crucial support for children’s wellbeing and development was being missed, that there were concerns about employers not meeting their health and safety duties towards pregnant women, and about additional difficulties in accessing childcare. I fear that the Government know that the impacts of all of that are long term, and that by the time the impacts of their failure to invest will be seen, they may be well gone, or at least their failure forgotten.
This year the Committee decided to revisit those issues with a follow-up report, but unfortunately it is already clear that we are seeing the impact of the Government’s lack of action in this area, including: children coming into early years classes behind in their social development; increasing rates of poor mental health among new mothers; and childcare providers going out of business. The Committee found that new and expectant parents’ access to support has remained severely limited. Many have lost out entirely on the crucial window of support available in the early months of their child’s life, and issues around children’s development and parents’ mental health will have been missed. I have said repeatedly that there is a good reason why we wrap a blanket of support around new mums and their babies—and dads, too. It is needed at the time and the long-term impacts of not providing it are well known. Urgent investment is needed to provide catch-up mental health and health visiting support.
The Government have failed to deliver on stronger workplace discrimination protections for new and expectant mothers, and they have repeatedly promised to do that. That is especially concerning as the economic impact of the pandemic continues to be felt. I pressed the Prime Minister on that at the Liaison Committee, and I urge the Government to pass those protections into law as soon as possible. If mums are being discriminated against, it is bad for their children, too.
The pandemic has also exacerbated pre-existing problems in the early years sector. Government financial support has been welcome, but it has not prevented many early years providers seeing a significant impact on their finances, with low pay for staff, many of whom are mums too, and high costs for parents. The pandemic may well contribute to or even accelerate an ongoing erosion of provision. I therefore urge the Government to consider a review of early years funding to ensure it is affordable and meets the needs of new parents seeking to return to work. They could set out a clear vision for our children, our undervalued early years and childcare workforce, and ensure that no parent must choose between their child and their career.
Before I conclude, I want to ask the Minister some specific questions on the Government’s proposed family hubs. Given that there are 152 upper-tier councils in England and there will be 75 family hubs, it looks like just under half of local authorities will benefit from the programme. Have the Government already determined the criteria by which the funding will be allocated? We assume it will be based on some measure of deprivation, but will the Minister confirm that? May I urge the Government not to continue their approach of forcing overstretched local authorities to commit their scarce resources to making funding applications? We should not be pitting local authorities with high levels of deprivation and child poverty, such as those in the north-east, against each other to receive support. How does the Minister see family hubs working in large local authority areas, often with poor public transport links? For example, getting across Newcastle with young children to access services via public transport can be challenging, particularly for my constituents in the Outer West. Large rural areas like Durham and Northumberland face their own challenges. I hope when the Minster responds, she will confirm that services will be “within pram-pushing distance” of the families they are intended to help, as was the aim of the Sure Start programme.
In conclusion, the crushing pressure that poverty places on families and children is clear. It impacts our children’s lives directly when parents and carers do not have enough money to meet their children’s material, social and educational needs. It impacts on them indirectly by creating stress, insecurity and conflict at home.
These adverse childhood experiences inevitably influence children’s development and wellbeing, creating a vicious cycle. To escape that cycle, we need a coherent, cross-departmental anti-child poverty strategy, backed by proper investment. It is fair to say that we are pretty far from that at the moment when the Government often seem unsure about which Minister to send to respond to child poverty debates. Such pervasive child poverty is not inevitable. The last Labour Government reduced child poverty and the concerns about child welfare that it creates. We can do it again and truly give every child the best start in life. We just need the Government to care truly about achieving it.
I pay tribute to Sarah Olney and the other colleagues who secured the debate. It is great to be having a debate about early years again; we are having a few of them these days. It never happened when I first became a Member of the House and has not for much of my 24 years here. It is really fantastic that such a relevant and important subject to so many of our constituents is now commonplace in the Chamber and that there is real, concerted action. We may disagree over the extent or detail of that, or the amount of money that is going into it, but I think we all agree about the direction and emphasis.
It is a great pleasure to follow Catherine McKinnell, and I agree with much of what she said. It is also a great pleasure—but a great challenge—to follow my right hon. Friend Dame Andrea Leadsom, who is such a guru on this subject that anything the rest of us say subsequently will pale into relative irrelevance, but I will give it a bash anyway.
I want to recount an episode that happened when I was Children’s Minister 11 years ago. I used to spend a week of the summer recess going out on the frontline with some of the workforce, without any fuss and without any cameras, just to see what their job involved at first hand. I remember my first time: I spent a week in Stockport going out with social workers, knocking on doors, seeing cases at first hand, manning the overnight emergency helplines, sitting in on morning meetings and liaising with police and others. It was a fascinating experience, which I recommend to any other Member. I think it should be compulsory for all Ministers and their officials to spend time with the professionals over whose regulations that Department has responsibility. That is where we find out the most. I used to find out most of my information from sitting down with groups of children in care, as the Minister responsible for children in care; that is where we find out what is really going on.
A really good social worker took me to my first case, and I think that she deliberately chose the most challenging case in the most run-down, depressing part of the town. We went into a house that was a complete mess. There was a young mum with three young boys. There were no carpets on the floor. There was virtually no furniture, other than what had been dumped in the garden. There was no food in the house—the fridge was bare—other than what the kids literally were eating off the floor. There were bare mattresses for beds and piles of dirty clothing.
One of the kids had had a really dire toothache for some weeks, and the social worker had gone on at the mum about getting the child some treatment for it. On the day that we visited, the mum had had a toothache problem. On the previous day, she had gone down to the emergency dentist and had her tooth fixed, but she did not have the presence of mind to take her son who was suffering from toothache along with her.
What does someone do with a family like that? Plenty of professionals had been going in and out of that house to offer different bits of help, but that mum required some serious support. She had been abused as a child, as is so often the case. The father was not on the scene and she had been subject to domestic abuse, as is so often the case. We all know, extraordinarily, that about a third of domestic violence starts during pregnancy. So there she was, highly vulnerable and desperately in need of support, but her life was not improving and the life chances of her children were certainly not. So what does someone do?
Those children could have been taken into care. They probably would have been split up, going to different families across the area and perhaps beyond. The mum would have been completely distraught at that prospect. Inadequate though she was, for whatever reason, in the care that she provided, she absolutely doted on those kids and they doted on her, so what was the solution? That is the sort of judgment of Solomon that our social workers have to make day in, day out when dealing with those really complex, challenging cases.
That case, which I will remember for the rest of the time that I am involved in these areas, encapsulates all the challenges that we face in children’s social care and all the challenges relating to the whole issue of the best start in life and the project that the Government have undertaken, thanks to my right hon. Friend the Member for South Northamptonshire. That is why it is so important. One of the answers is to have a joined-up approach locally, with all the different professionals working together as a team to encapsulate mum and family. It is about having somebody who can literally take her by the arm and march her down to a children’s centre to get family support and advice or march her down to the dentist with little Johnny to make sure that he gets dental treatment—somebody to take control of people’s lives and get them on the straight and narrow until they can fend for themselves and their family again. We need local professionals working as one, with a lead person who has responsibility, who has all the joined-up knowledge about what needs to happen, and who has the force and confidence to make it happen.
We also need the Government to be joined up at the centre. I remember that when we were trying to get the early intervention grant sorted, we were getting the run- around from officials because the fund would affect various Departments. We were told, “Oh, we can book you an appointment with the Minister in that Department in a few weeks’ time, and then perhaps you can have another meeting with that Minister.” In the end, the only way my co-Minister Sarah Teather and I got the problem sorted was by ringing up all the Housing, Health, Home Office and other Ministers responsible. We all had pizza in the Adjournment, agreed what the strategy should be, went back to our Departments the following morning and told our civil servants, “This is what we want to happen.” All the civil servants said, “That’s not the way we do things here, Minister,” to which we all said, “Tough. Do it.”
The problem is that government does not work in a joined-up way, which is why the approach that my right hon. Friend the Member for South Northamptonshire has taken is really pioneering. I pay tribute to her for the way she has brought things together, forcing Departments to sit down, work together and have a strategy that works as one. That is the only way we will sort the problem sustainably for the future, which is key to the whole approach.
The hon. Member for Richmond Park has set out the problems: the £8.1 billion that perinatal mental illness costs each year; the £15 billion that we spend each year in this country on child neglect, particularly in relation to younger children; the £6 billion that childhood obesity costs each year, which is likely to rise to £9 billion within the next few years. As well as the cost of domestic abuse and safeguarding, we are spending £20 billion to £30 billion-plus each year as the cost of getting it wrong for some of the most vulnerable children and their families. Spending a fraction of that on solutions to get it right will be absolutely transformational.
Let us look at some research from the Institute of Health Visiting. I will always speak up for health visitors; in my view, frankly, they are one of our emergency services. They have been diverted too often during the pandemic to other parts of the health service, and their absence has been greatly felt. There is a shortage of several thousand: the institute says that we need at least 3,000 additional health visitors over the next three years, and I completely agree. One of the great achievements of the Cameron Government was building up the health visitor workforce, which has since diminished, alas. A survey of health visitors shows that 81% have seen an increase in perinatal mental illness, 80% have seen an increase in domestic abuse, 80% have seen an increase in child behaviour problems, 72% have seen an increase in poverty affecting families and 71% have seen an increase in child safeguarding.
The hon. Member for Newcastle upon Tyne North is right, too. Research from Action for Children shows that
“only 57% of children from poorer backgrounds were ready for school at age five, compared to 74% of their better-off peers…82% of parents of 0-5s in England struggled, or were unable, to access vital non-childcare early years services…78% of parents who were unable to access a service were worried about potential impacts on themselves or their children. The most common concerns were children’s development, and parents’ own mental health and wellbeing.”
That is the cost of failure, and that is why it is so important to have a co-ordinated, joined-up approach. One statistic that has always stayed in my mind is that if a 15 or 16-year-old at school suffers from depression or some form of mental illness, there is a 99% likelihood that their mum suffered from some form of perinatal mental illness or depression—the link is that close. We should be spending so much more time and resources on looking at the pre-school period, particularly from conception to age two, because that is where it all goes pear-shaped. We see the consequences throughout childhood, and they so often carry on into adulthood and stay with the person for the rest of their life. So of course we should be doing more about this, and I am glad that at last the Government have recognised that that is where all the action—or a lot more of the action —needs to be focused.
On health visitors, I agree with the Local Government Association, which has said it is important for the Government to work
“on a children’s workforce strategy to support the development of a well-qualified, well-resourced workforce with the appropriate knowledge, skills and experience to work in a preventative way. This needs to be an integrated strategy between local authorities, health, education and community and voluntary sector partners, which links effectively with established programmes, such as Supporting Families, Sure Start and Family Hubs and puts the child’s journey at the centre.”
That strategy, it adds, needs to be properly resourced. Well, we are having a lot of extra resource. We could all argue that it is not enough, and the more Opposition Members argue that it is not enough the more I will welcome that, because we could always do with more money; but I think this has been a good start.
Let us look briefly at some of the action areas. One of them is the provision of seamless support for families. As my right hon. Friend the Member for South Northamptonshire has said, we need to have a lead person who knows all the facts and history of the family involved, and who has the power to say, “This is what needs to happen for that family”, and make sure that it happens. Then there is the welcoming hub for families. I can answer the earlier question from the hon. Member for Newcastle upon Tyne North by saying that 75 family hubs have been identified, in about half the number of local authority areas. I hope very much that the other 75 will follow very quickly, so that there is at least one per authority.
Can we get away from the idea that these hubs are a challenge to, or in place of, children’s centres? They are building on the experience of children’s centres and are complementary to them, but they are not just about bricks and mortar; they are about services. I think that in the past we have been too hung up about the amount of bricks and mortar that we have rather than the quality of the services provided, whether as outreach or within children’s centres, and, most important, the outcomes that they are creating for the children for whom they exist and their families.
It is important to ensure that families have the right information at the time when they need it. When people are reluctant to cross the threshold of a children’s centre or a family hub, as my family in Stockport were, they need to have other ways of obtaining that information. It may be a night-time call line, or it may be online, on the internet. It may mean having another professional to call on, or even volunteers—even members of another family who are looking out for vulnerable families. What those people need is a trusted source of information that they can access, rely on and then act on to their benefit.
I think we have all learnt in the past that a top- down approach, with all the geeks in the civil service coming up with whizzy new schemes and trying to impose the same scheme in Newcastle as in a village in South Northamptonshire or a coastal town like Worthing, rarely works. We need national frameworks and national quality thresholds, and we need local design and local implementation. We need to hold people’s feet to the fire. Every local authority needs to come up with a best start in life plan. That local plan needs to meet the thresholds for children’s outcomes, and then the centre needs to ensure that authorities go ahead with those plans and achieve those outcomes. In that way we can have local ownership, local design and local flexibility that are in the best interests of children and their families.
I welcome the “best start in life” programme, and I congratulate all who have made it possible. This has been a huge joint effort. It has been a false economy not to look at those initial few pre-school years, because that is when we can have the biggest impact on the nurturing value of parents and the attachment that is so essential between a parent or parents and their children, when a child’s brain is growing exponentially—and will be impacted on for the rest of his or her life. At last we have a programme that realises that. Let us ensure that we make it a success for our future generations.
Before I call the next speaker, I must tell the House that we have another debate following this one in which 11 Members have put in to speak so far, so we must be conscious that there are slight time pressures.
I would like to start by thanking Sarah Olney, Dame Andrea Leadsom and my hon. Friend Catherine McKinnell for securing this debate at this incredibly important time. I also offer my thanks to the right hon. Member for South Northamptonshire for her tireless campaigning on this issue over many years, for her recent leadership of the early years review and for her success in securing funding for the sector in the recent Budget. All those are to be welcomed. It is not easy getting money out of a Chancellor, as we all know. She also knows my dismay at the short-sighted cuts that preceded this funding, making it all the more necessary. I know she agrees that we need to ensure that no Government cut valuable services such as Sure Start or family hubs ever again.
I stand here as a former shadow Minister for children and families, a role now most ably held by my hon. Friend Tulip Siddiq. It has been said that once anyone has been a children’s Minister, like Tim Loughton, or a shadow, they can never quite leave the issue alone. It is sort of like an “Order of the Babies” maybe, or a ministerial Hotel California.
Covid-19 has had a profound impact on all of us, but the effects of the lockdown restrictions and social distancing measures were keenly felt in the early years sector. I welcome the “Babies in Lockdown” survey report published today by the Parent-Infant Foundation, Home-Start UK and Best Beginnings. The pandemic is, sadly, far from over, and the report offers signs that the early years sector has developed a form of long covid, if you like. The survey found that nearly a third of mothers questioned reported that health visitor drop-in clinics that existed before the pandemic were no longer operating. I urge colleagues to read the report.
But let me take Members back to 1970, well before Zoom and Teams. Back then, fewer than a quarter of mothers worked; society expected a full-time mother. Without a central focus on the early years, and no talk of the 1,001 critical days or adverse childhood experiences, the education of very young children was neglected. Baroness Blackstone, writing in 1974, highlighted the fact that only 10% of three and four-year-olds attended state nursery schools or classes in 1971, with some areas receiving no service at all.
To combat the lack of state nursery education, the mothers did it themselves. Belle Tutaev set up a playgroup with her neighbour which eventually bloomed into the Pre-School Playgroups Association. This has since become the Early Years Alliance. But the state should have taken up this mantle, rather than the already burdened mothers. Not everyone was convinced of that principle, however. In 1980, George Young, then the Conservative Secretary of State for Social Services, said that he did not
“accept that it is the state’s job to provide day care to enable the parents of young children to go out to work”.
Listening to the debate today, 40 years on, we can see how far we have come from that thinking.
It was the last Labour Government who finally addressed this problem. I have spoken before, as others have today, about the late Tessa Jowell’s Sure Start programme being a beacon of early years policy. Sure Start brought children’s services together under one roof, uniting healthcare with wellbeing, education with childcare, babies with other babies, and parents with other parents. There were 3,620 Sure Start centres in 2010 under Labour. That has fallen, as we heard from the hon. Member for Richmond Park, by more than 1,300 in the past decade or more of Conservative Governments. Those that remain have been effectively hollowed out, offering only skeleton services with minimal opening hours. While the Government’s pledge to fund 75 more family hubs is obviously welcome, it does little to make up for that loss. I know the hon. Member for East Worthing and Shoreham said it is not all about the buildings but, when we have lost 1,300 and replaced them with 75, it is trying to get a quart into a pint pot, as they used to say.
It has been such a pleasure to work with the hon. Lady on this topic for so many years. I just want to put on the record that it is not 75 family hubs, but 75 upper-tier local authorities; it will be for them to decide, but it could be hundreds or thousands of family hubs. Catherine McKinnell drew the same conclusion, so I really want to set the record straight on that point, if the hon. Lady will forgive me.
I am very grateful to the right hon. Lady. That is an important clarification, and we must ensure it is out there that maybe it will not just be 75, but that they can make it many more. Let us hope it is 1,300; I am sure she will agree with that. That said, I warmly welcome what I think is the Government’s tacit admission that they got it wrong when they defunded the Sure Start programme, even though, as we all remember, on the eve of the 2010 election, David Cameron promised it would be safe in his hands.
However, we are where we are. Earlier this year, I also co-chaired a cross-party early years commission alongside Edward Timpson, who, as a former children’s Minister, is also a member of the “Order of the Babies” and a resident of the ministerial Hotel California. The commission heard from a wide range of stakeholders, including educators, academics and policy professionals. I will take the House through some of the recommendations in the comprehensive report.
First, there should be integration of health and education support for children, ensuring that every child receives the health visitor appointments they are entitled to and a new health visit when the child is 18 months old. Secondly, because too few families have access to essential services, a locally relevant and dedicated parent support service is needed in every community in every area. Thirdly, we should upskill early education practitioners by investing in continuing professional development, so that the workforce stay fit to face the challenges of the future. Those proposals could easily be made reality. I sincerely hope that, as part of the £500 million brought forward in the Budget, the Government will deliver all of what we seek in this debate.
As we take part in this debate, we are mindful that the babies and children themselves will not be listening. They will not be tweeting their agreement or penning letters to our offices. I will spare a moment to mention how, beyond their value on their own terms, reforms to the early years offer can be instrumental in improving the lives of those without children, via the economy.
The Early Intervention Foundation found that the cost of late intervention in 2016-17 was £17 billion, owing to the need for services to help with mental health issues, youth crime and exclusion, including a £5.3 billion spend on looked-after children. Early intervention can offset that cost. The Carolina Approach to Responsive Education programme provided intensive, high-quality childcare for ages 0 to 5 in the United States of America and delivered a 13% return on investment per child each year. It netted IQ gains, higher wages, increased likelihood of home ownership and higher scores on achievement tests.
For the family unit, the economic returns are clear too. As the hon. Member for Richmond Park said, parents in areas with Sure Start local programmes moved into paid work more quickly than those without, reducing the benefits bill to the taxpayer and increasing tax receipts for the Treasury. But that is not the full picture: the economic benefits are often only modelled on specific, targeted interventions, whereas the benefits of intervention fan out across a range of factors, such as reducing the later burden on the public purse— the whole point of early intervention—and greater participation in the economy over many years. As such, it is practically very difficult to model the effects of a web of measures applied at once. So just imagine the results we could achieve if those interventions were provided simultaneously, with wholesale improved outcomes delivered via intensive early years support. Britain’s early years offer has the potential to be much greater than the sum of its parts.
To conclude, I would like to look to the world we are creating as legislators in this place. As we speak, delegates from around the world are discussing the means of preserving the planet and protecting the environment in Glasgow at COP26. It is incredibly important that we limit climate change to an increase of 1.5°. Missing, I believe, is leadership for those who will grow up into these environments. The pursuit of climate justice is in no small part to ensure that our children and their children’s children do not face an uninhabitable, hostile world. As those at COP26 work for the future of the planet, let us, here and now, seize this golden opportunity to help those who will inherit it.
It is an honour to follow Mrs Hodgson and I thank Sarah Olney for securing this important debate. I pay tribute to my right hon. Friend Dame Andrea Leadsom, whose leadership on the issue and perseverance over many years has led to the incredible result of this investment in the first 1,001 days —in such a difficult economic time, it is a real achievement to secure that. It has been a privilege to be part of the early years healthy development review, with a number of others sitting in the House. It has been a great learning experience as a new MP but also a real honour to be part of that. This is an issue I am also very passionate about.
There is no more important period in anyone’s life than the first 1,001 days. As we have heard from many hon. Members, that is the time when the foundations are set for childhood and for the rest of life. Building blocks in terms of patterns of behaviour, how we communicate and our health are all connected and made during that time.
Lockdowns have been so, so damaging for the youngest in society, in all those areas we have heard about: lack of access to professional services, to community support and even to family support, which has really harmed the very youngest in our society. So the £500 million funding comes at a crucial time. I have to say it: it is time to build back better for babies. So there is no better investment for the Government to make than on the first 1,001 days. Babies who go through healthy development have a far greater chance of becoming healthy, happy, fulfilled adults who are going to contribute to the economy and, as the hon. Member for Washington and Sunderland West said, will be much less likely to be a burden on the taxpayer.
One great paradox of human society is that parenting is so important, but it cannot be left to the experts. About half of us were brought up by people who had never done it before. The truth is that having babies is really hard—I have had three and I should know. It is amazing to me that something so natural, desirable and fulfilling is also so incredibly challenging. It does not always start well. My first child was a full two weeks late and I just escaped induction. He came into the world following a 32-hour labour, so we started parenting after two full nights without any sleep—something I did not even manage to achieve as a student. I had never even held a newborn, let alone been responsible for its survival. When we add the challenges of breastfeeding, living on no sleep, trying to identify when nappies need changing, and eating with one hand when a meal consists of a dry piece of toast that you can put in and out of the toaster without even opening the fridge, it is really tough.
I vividly remember one day, when my newborn was crying and my husband was out. I desperately needed a shower, as we were going out. He would not stop crying. I still needed a shower. I put him in the car seat, strapped him in and stuck him on the floor of the bathroom. I got in the shower and started crying myself. That is just what it is like as a parent of a newborn—then throw in mastitis and the challenges of getting to the town hall to register the baby’s birth, before we get to weaning, potty training and more sleepless nights. What kept me going, and what kept us going, was family, friends and baby groups. Every day of the week, I found a different group to go to. I developed a routine that made sure that I saw adults every day of the week—other people who were going through the same experiences.
I was really fortunate to develop a strong group of friends who learned to be mums together. Because of that support, interaction and camaraderie, I can honestly say that it was a joy and a privilege to care for a baby and to see them learn and develop. Despite the sheer exhaustion, there is nothing more worth while.
My husband and I had all the support we could ask for—I had a full year of maternity leave and we had the financial security and the practical support to enjoy the first 1,001 days—but it was still really hard. My right hon. Friend the Chancellor, who we know is not short of a bob or two, remarked in a recent newspaper article that even they found it incredibly challenging. It is tough, whatever a person’s circumstances. I would like to say that I was a pro by the time the third child came around, but I am afraid the challenges were just threefold.
The truth is that we are not supposed to care for babies alone: it takes a village to raise a child. Every first-time parent might be a novice, but the truth is that millions of other people out there have done it before and can help. The sad fact is that so many parents do not have the support that I was so fortunate to have. If just one area of a person’s life is fragile—such as relationships, mental or physical health, geographical isolation or poverty, as Catherine McKinnell said—caring for a baby can go from challenging to impossible. For many, there is a cycle of generational abuse and neglect that it is almost impossible for them to break on their own.
As we heard from the hon. Member for Washington and Sunderland West, the world has changed. A couple of generations ago women did not work outside the home—they definitely worked inside the home—and there was a network of mums, grandmas and aunties on hand to help. Our social fabric was much richer. Nobody wants to return to the 1950s, and we have made incredible progress in so many areas—we must not deny that and must celebrate it—but we do need to intervene to rebirth the social and relational support that is so crucial in equipping families to thrive in the early years. That is why family hubs are so important and why I am so delighted that the Budget included £82 million to develop the network further throughout the country.
Family hubs should provide a one-stop-shop for parents, not only to make it easier for them to access professional support and advice from midwives, health visitors and other professionals but to integrate them with local community groups, build friendships and support networks and bring together the whole community to provide that “village” to help to raise the child, which every parent so desperately needs and to which so many parents do not have access, for all sorts of reasons. Family hubs can also be a place where intervention can happen early so that families with particular issues, whatever they may be, can be helped before the problem gets out of hand and leads to damaging consequences for both the baby and the parents.
How is a first-time parent supposed to know how to deal with colic, with their baby not putting on weight or with conflicts with a partner that are exacerbated by a lack of sleep? We do not know this stuff without asking other people. That is why family hubs should be available for everyone. Every parent needs support and a great way to provide it is through family hubs. I support the idea of allowing birth registrations at family hubs: if parents have to go there, under a statutory duty, they have then put their foot through the door, seen what is available, made that first contact and, hopefully, built some relationships with people in the community. That will make it that much easier to get support in future. A parent going to their local family hub should be as everyday an event as a person going to their GP surgery, with no stigma attached.
Of course, the start for life offer is all about babies, but if we want to use the language of the market, the parents and carers are the clients, so the whole offer is actually aimed at supporting and equipping parents and carers. I am delighted that we are recognising parenting as the most valuable contribution that anyone can make to society, so I am also pleased that £50 million for parenting skills is part of the offer.
On parenting, I wish to speak briefly about motherhood, which is not something we speak about much. It is brilliant that women are much more valued, in every sense, outside the home than we used to be—we are valued in the workplace and have full equality under the law, and those things should be celebrated—but I sometimes wonder whether we are too much valued through the lens of the traditional male role model, and the hugely important work that many women do in looking after children and building community through the home is massively undervalued, and sometimes looked down on and talked about in the language of oppression. I do not deny that that is the case for many women, but many women are fulfilled in that role and choose it in the early part—the first 1,001 days—of their child’s life. There are good biological reasons why women desire to do that, and I know that I certainly did.
Even the Department for Education’s own stats say that mothers of young children would prefer to work less, but we as a society have made it almost impossible for many women—parents, but often women—to choose to focus on their children in those early years. Our ever-increasing drive to get everyone into the workplace, the tax system and house prices make it impossible for the majority of families to survive on one income. They make it impossible for so many families to choose to take that crucial time out from work in the first two years of a child’s life. We also have a system that expects single mothers to be able to be the provider and the care giver, and that places so many in an impossible situation, which is difficult for them and difficult for the children.
I conclude by saying that children are not an economic inconvenience; they are our best hope for the future and deserving of every investment and support that we can give them. The start of life offer is a once-in-a-generation opportunity to refocus our priorities, to put babies at the centre of policy making, and to give every child the opportunity they need to grow and flourish.
It is a pleasure to follow Miriam Cates.
When I was first elected to this House nearly two years ago, I came here not just as a new Member of Parliament but as a first-time new mother. As the hon. Lady has already mentioned, it takes a village, and my village is the best. I had all the support in the world, from my husband, from my family, and from my mam especially, but I still found balancing motherhood and work incredibly difficult. In all honesty, I am still struggling to find the right balance.
How do we give every baby the best start in life? Quite simply, we ensure that our baby is born in Wales. In Wales, we have a real focus on childcare from our Labour Government. Everyone is offered 33 hours of childcare each week for children aged three to four with no terms, no condition. The Flying Start programme in particular does fantastic work supporting families with children under four who live in some of the most disadvantaged areas of Wales. I am also very lucky to have some fantastic local childcare providers in my constituency, including Little Inspirations, which has branches in Tonyrefail and Llantrisant.
Supporting families in looking after their children is an incredibly important part of giving every child the best start in life, and we must do more to support families at this difficult stage in their lives. For many people, myself included, bringing a baby home from hospital is not a straightforward process. I have spoken many times in this place about my own experiences when my son was being cared for on a neonatal unit, and I cannot resist once again taking this opportunity to urge the Government urgently to bring forward their promised legislation on paid neonatal leave for parents. On this occasion, I also want to draw attention to some research by the fantastic charity Bliss on the specific challenges that young parents—those under 25—face.
Bliss found that babies born to mothers aged under 20 are at an increased risk of premature birth and at a 75% increased risk of neonatal death compared with those born to mothers aged 30 to 34. Women living in the most deprived areas of the UK also have a significantly higher risk of stillbirth and neonatal death than more privileged women, as we have already heard today. In order to ensure that every baby has the best start in life, we must start here. Pre-natal and post-natal care are vital, and I would be grateful to the Minister if she could outline exactly what steps the Government are taking to address these inequalities.
We know that the first 1,001 days—from conception to a child’s second birthday—are vital. In many cases, these days are predictors for what level of education a baby will attain, what their health will be like, and even how long they will live. It should be of paramount importance to any Government to work to level this playing field. In this day and age, it simply should not be the case that where a person is born, and who they are born to is the most determining factor in their life.
This Tory Government talk a lot about levelling up, but when it comes right down to it, they fail to act on their promises. Just a few weeks ago, I and my colleagues on the Labour Benches lined up to urge the Government to rethink their decision to cut universal credit. We warned that nearly 300,000 children faced being plunged into poverty, and, once again, they failed to listen and failed to reverse the cut.
We have had a very high-profile U-turn from the Government in this past week, so how about we have another one this week? While I will not hold my breath for meaningful change, I will use the brief time that I have left to raise genuine concerns about the future of breastfeeding for mums up and down the country. I have spoken out many times about my passion for increased education, awareness and support for those who are breastfeeding in this place, and I pay tribute to the fantastic Breastfeeding Network, which gave a wealth of support to me personally when I was struggling, but, once again, I have to say that the Government have failed to protect those of us who are breastfeeding. I was frankly appalled that the campaign to make it illegal to photograph breastfeeding women without consent reached a halt in the other place last week when a Minister implied that banning photographs of this nature would potentially impact family pornography and require a complex change in the law. We should speak more and more about breast- feeding and the law surrounding the practice, especially in the context of giving babies the best start in life. I sincerely hope that the Minister and the Government are listening. Diolch.
All of us in this House who are parents or have young children among our family and friends will know that there is an abundance of advice available on the topic of today’s debate and many of us take that advice: we talk to our babies in the womb; we play games with them before they are born; we study baby-led weaning; and we invest in stain-proof covers that never seem to extend quite far enough. But wherever on the nurturing scale we sit as mums and dads, babies thrive when they are surrounded by adults taking an active interest.
The focus of my contribution is the babies and young children who need extra help to thrive—those whose interests are at the heart of the decision by the Government to invest in family hubs in the recent Budget, as championed by my right hon. Friend Dame Andrea Leadsom. As many Members have said, it is welcome that this agenda is taking a higher profile in the context of levelling up, because we all recognise the need to build on sound foundations.
Twenty years’ experience in children’s services has taught me a lot about the strengths and weaknesses of the child support system in our country. Like our NHS, we are very good at emergency services, and studies by academics at the University of Bristol and the University of Warwick show that the UK has a world-leading child protection system. But today’s debate goes beyond protection from harm, and into how we help children to thrive and flourish—something that is a matter not just of social responsibility but, as my right hon. Friend the Member for South Northamptonshire highlighted, of long-term economic benefit to our country.
Thriving children live lives that cost the taxpayer less and contribute more to everyone’s benefit. To that end, I am going to offer three points, which are focused on how we turn the widely-shared aspiration that we hear in the Chamber—I grew up in the village of Alex Davies-Jones and am glad to hear of the progress it is making—into a change that children and their families can see and feel in their lives.
First, we need to follow the flow of money. The funding for early years, which is a key statutory responsibility for all local authorities, remains mired in bureaucratic processes that are dominated by those whose focus, for good reasons, is elsewhere. Schools forums, which determine the distribution of the dedicated schools grant, in which much of this funding sits, are dominated by the interests of our secondary schools. A fragmented early years sector of small private, voluntary, charitable providers often struggles to be heard. There is a structure around the money that inhibits innovation and flexibility, and stands in the way of creating the joined-up local offer that my hon. Friend Tim Loughton highlighted. Although I can see that there is a perceived political benefit to lumping that early years funding in with schools, in reality the needs of the sectors are different.
I have listened carefully to what the hon. Gentleman says about ringfencing and I do not disagree, but that is why Sure Start funding was directed through local authorities and ringfenced at a local level for local authorities to draw up their local strategies. He talks about levelling up, but this process did not start in 2019. We have seen the devastation of Sure Start centres, certainly in County Durham, as a result of cuts to that funding by his Government—although I know that he perhaps was not in the House then.
It is good to hear the right hon. Member’s contribution. I was in a local authority throughout Sure Start’s implementation period, and although it was welcome to see a Government giving a high degree of priority to children in the earliest years of their lives, there were a number of failings with that programme. One was that the pace at which Government sought to deliver it—for understandable reasons, it was a political priority—meant that poor decisions were often made about the location of services and exactly what was delivered. At a time when many activities outside Sure Start were a high priority for local areas, Sure Start was generously funded to meet the Government’s aspiration while other activities, such as child protection, were starved of cash. Although all Governments want to deliver their priorities, we need to achieve a longer-term consensus about what is in the interests of children in the earliest years of their lives.
I call on Ministers to consider how we free the early years sector from the shackles imposed by the dedicated schools grant and bring it together with other local authority and NHS budgets, so that investment can be aligned with the needs of local families and built on the strengths of the early years sector. We must not forget that the sector is not just about nurseries; it provides an opportunity to join up with a range of local statutory and non-statutory services, which include health visiting, child minding, family hubs, child protection, public health, vaccination services, libraries, play and informal learning. When I was a new parent, the services provided by the libraries of the London borough of Hillingdon, including story time for young children, were an outstanding example of that early support. They were a chance to meet other parents whose children were at the same stage, to get informal advice and tips. That may sit outside what Government mandate, but it is exactly the sort of thing that parents of young children treasure.
Having touched on the funding challenge, we need to ensure that every area has the scope to develop a strategy for thriving that suits local circumstances. Many of our councils—the 152 top-tier authorities—are in partnership arrangements of one kind or another. Some are council to council, and others reflect outsourced services. That all reflects issues of local need and capacity. Along with the statutory lead member for children’s services and the director of children’s services, the health and wellbeing board has the most scope to join up the offer to get babies the best start in life. Those boards—statutory committees of the local authority—still struggle to assert their role, especially with the NHS, which in my experience is strategically disengaged, despite their role as key partners.
The rearguard action fought by the NHS against making public health a local and accountable service has also inhibited innovation and tied up resources in rolled-over NHS contracts rather than stimulating the reshaping of local services around children. I have seen some outstanding examples of such reshaping, however. I pay tribute to my constituent Dr Jide Menakaya, a leading paediatrician who has led work across the sector in his field of neonatal care in the London borough of Hillingdon to join up children’s services and Sure Start so mums and dads have a seamless experience. However, the system still tends to stand in the way of creativity rather than promoting it.
My suggestion to the Front-Bench team is that, in line with previous asks of our health and wellbeing boards—for example, to produce joint strategies on child mental health—we look at setting a clear expectation for them on a strategy for helping children to thrive in line with the first 1,001 days ambitions. Much of this already exists in different forms at a local level, but for a new parent or an expectant family, it can feel hard to access and fragmented, because it is driven by the disparate duties and funding regimes imposed by Government. In line with the local offer for children with special educational needs and disabilities, a strategic approach to the local offer for the earliest years will deliver greater value for money and, vitally, greater coherence for parents who access it.
The final area that I would like to put forward for consideration is accountability. Successive Governments have adjusted the regulatory environment for the early years, but broadly speaking the two priorities today are school readiness—seen in the regulation of settings such as child minding and nurseries—and the avoidance of harm to children, which is seen in the regulation of child protection and the NHS. We are in a context where resources are extremely stretched—not just money, but, as we have heard from a number of Members, the workforce too—which tends to drive a risk-averse approach in the early years, prioritising the absence of failure, rather than the promotion of innovation. We need to consider how we line up the accountability that we have all talked about with what we are seeking to achieve for our children. My suggestion to Ministers is that we need to look beyond the current inspection regimes and datasets used for performance management, many strengths though they have, and think about how we measure the things involved in a child thriving—the positive health and social outcomes that we want for babies in our country and how we incentivise the behaviour that will deliver them. Time is tight, so I will simply say that we have so many statutory duties in place that will help us deliver that, but so often the holders of those duties lack the autonomy needed to fulfil the aspirations we have. We need a permissive approach from Government.
In conclusion, we need to recognise that much of what we do is world class and of the highest quality, as many parents of young children, including me, can attest, but the regulatory regime still too often expects low standards. Rather than contributing to success, we have a complex funding system that stands in the way of local communities and their leaders delivering value for money and good outcomes for every child. We all want to give our babies the very best start in life. By enabling local leadership, setting high standards and setting people free to innovate, we give ourselves the best chance of levelling up life chances for all our children.
It has been a real pleasure to listen to all the different contributions made this afternoon. I congratulate my hon. Friend Sarah Olney and her co-sponsors on securing this debate. One of the observations I want to make is in reference to Miriam Cates, who asked why we cannot give women the choice. I absolutely agree. We all know that the most nurturing environment for young children is with their parents. The question then is why this country has one of the poorest maternity pay and leave settlements compared with any other country with a similar economy. We need to look at statutory maternity pay.
I completely agree with the hon. Lady. Maternity benefits are certainly something we should look at. As well as that, we have a taxation system that penalises families—to the tune of 20% or 30% for the poorest families—compared with the taxation systems of, say, France, Germany or America. One of the problems we have in this country is that we do not recognise the importance of those early years in terms of protecting families from those costs. That would have a far bigger impact on parents’ ability to choose in those early years.
I absolutely agree with the hon. Member. We are on the same page. We need to recognise the importance of parenting and the early years and help families of all incomes to make that happen, but the issue mostly strikes families of poorer backgrounds, where women are then being forced into work much earlier than they would like. The Government need to look urgently at that, as well as shared parental leave, which is actually a transfer of parental leave, rather than shared leave. We should look at how we can fix that system, too.
I will speak briefly as the chair of the all-party parliamentary group for the prevention of childhood trauma. Preventing adverse childhood experiences from occurring is vital, particularly in those first 1,001 days. Within the APPG, we are working to improve understanding of adverse childhood experiences or childhood trauma, how to heal them, and ultimately how to prevent them. It is about breaking that cycle of trauma, which can so often pass from a parent to their child.
Those who experience childhood trauma are two times more likely to develop depression and three times more likely to develop anxiety disorders. Adults who reported four or more adverse childhood experiences had a four to twelvefold increase in alcoholism, drug abuse and suicide attempts, compared with adults who experienced none of those. Recently, the APPG heard from Josh MacAlister, the chair of the independent review of children’s social care, which produced “The Case for Change”. He made the critical point that we have children in care who become parents, and they often pass their childhood trauma to that next generation of children unless it is treated and recognised. One of the most important things on which I campaign as a Member of Parliament is preventing childhood trauma, recognising trauma in those who experience it later in life and making all our services trauma-informed.
I pay tribute to the WAVE—Worldwide Alternatives to Violence—trust, which does excellent work alongside the APPG. Its 70/30 campaign needs no introduction because it has just reached 500 supporters in the House—an incredible milestone. The campaign aims to reduce child abuse, neglect and other adverse childhood experiences by at least 70% by 2030. Professor Sir Harry Burns, a former chief medical officer, said that
“reducing child maltreatment by 70%...is the minimum acceptable outcome in responding to this unacceptable—and profoundly costly—harm to our youngest children.”
We have all heard in various forms about how important it is to get to childhood trauma. The Government can do much to achieve that, but they must start by increasing early years funding, by appointing a senior Minister for families and the best start in life and by prioritising prevention in the early years.
Earlier this year, I tabled an early-day motion on giving every child the best start in life, which calls on the Government to adopt a comprehensive early years strategy to prevent harm to children before it happens. It has now been signed by 100 Members from across the House. I grateful to all of those who have put their name to it and hope that many more will join them.
I have just two questions for the Minister. Given the overwhelming support for the 70/30 campaign and my EDM, will she give her public support to the campaign today? Will she also commit to meeting the APPG so that we can discuss a way forward and end childhood trauma once and for all? Let us start now to ensure that every family has the full support needed to give their child the best start in life. That would be to all our benefit.
I commend the hon. Members for Richmond Park (Sarah Olney) and for Newcastle upon Tyne North (Catherine McKinnell) and, in particular, Dame Andrea Leadsom for sponsoring the debate. I know that the right hon. Lady has pursued this issue in the House for many years, and I am pleased to see the culmination of her championing of it in the funding that the Government have set aside. Congratulations and well done.
As the proud grandfather of five children—Katie-Leigh, Mia and Austin, and two so-called lockdown babies in one-year-old Max, and Freya, who is one-and-a-half—I believe that our babies and our young families have never needed more help and, like others, I have a fervent desire that we in this place get it right. We must consider the pandemic’s effect on lockdown babies who have never attended a mother-and-toddlers group, never learned to play and share with another child, and never sung a nursery song or a rhyme in a group. I believe that will have a huge impact that they will carry into their early years at school. Others have referred to that, and I want to refer to it as well.
I have spoken in this place about the pandemic’s academic effect on schoolchildren and its mental effect on children. It is right and proper that we also address its effect on babies. We can simply do better. The debate may be England-centric, but the problems faced in the UK mainland mirror those faced by parents and babies in Northern Ireland. I am hopeful that proper funding streams in the mainland will be replicated when the Assembly allocates the Northern Ireland funding received for the levelling-up agenda. It is important that we in Northern Ireland also receive that assistance through the levelling-up agenda.
Action for Children has stated that, in 2018-19, only 57% of children from poorer backgrounds were ready for school at age five compared with 74% of their better-off peers. Its “Closed Doors” report found that, between 2014-15 and 2017-18, the number of children using children’s centres decreased by about 18%. That is a worrying trend, as it is that the numbers fell fastest in the most deprived areas. Those statistics give us concerns and show us that the debate must focus most on the deprived areas where the problems are.
Action for Children’s most recent report found that 82% of parents of children in the nought to five age bracket struggled or were unable to access vital non-childcare and early years services. Some 78% of parents who were unable to access services were worried about potential impacts on themselves or their children. The most common concerns were about children’s development and parents’ own mental health and wellbeing. Other speakers have referred to that, and the fact that we are all saying the same thing based on our constituencies tells us that these issues are clear and real, so the work that Action for Children carries out is essential for giving babies the best start in life.
I am a great supporter, and always have been in all my years as an elected representative, of Home-Start in Northern Ireland. It knows that well trained volunteers complement the early years workforce, significantly contributing to the support that families receive and enabling them to access services when those are most needed. More than 1,500 families are being supported by 300 Home-Start volunteers in 16 communities in Northern Ireland. Newtonards, the main town in my constituency, has a Home-Start facility. During the dark days of the pandemic, more than 200 families were supported by the volunteers, and that was really significant and important work at a critical time. Although volunteers are helping out, funding is needed to enable their work to continue. Funds must be available to charities such as Home-Start to make a real and practical difference to the lives of the most vulnerable—our babies, who are what this debate is really all about.
Some 59% of respondents to a Home-Start inquiry admitted to feelings of loneliness and isolation, and 23% said they needed help with their mental health. After help, 94% said they were more able to cope, so it is clear that intervention can make a difference. The money that the Government have set aside for this strategy and these schemes over the next period can and will make a difference. The next debate is about a separate issue, but some of it will also refer to education and mental health issues.
It is my humble opinion that funding should be allocated to such streams, which allow trained and interested volunteers to go into homes and help with practical issues. Tim Loughton referred to going to a home where the deprivation and the problems were incredible and hard to take in, but these volunteers help households to find mechanisms to better cope with the pressures of young children. The UK mainland also uses the Home-Start charity, and I am sure the Minister will have cognisance of this great charity and the wonderful work it does.
Time is short, and I am very clear about what you said earlier, Madam Deputy Speaker, so I will come to the crux of my comments. Time has prevented me from talking in depth about the wonderful work carried out in churches. It is no secret, but I want to put it on the record, that what churches do at parent and toddler groups in community halls throughout the country is incredible. We all know those groups, and I have a large number in my constituency—indeed, I think that every church is actively helping parent and toddler groups.
One of my local churches, Newtonards Elim, had to go ahead and open its group again, and it has had massive numbers of parents and childminders simply desperate for company, desperate for their child to talk with others and to interact with them, and desperate for normality. However, if more churches and community facilities are to do these things, more expensive protocols need to be put in place. Perhaps a one-off grant would encourage more churches to take the same step, which can be somewhat daunting due to the way things are. We cannot neglect, we cannot forget and we cannot ignore what churches do and the commitment they give to our constituents.
In conclusion, I believe that we can now safely meet, and if we can, we must. The characters of our little ones are formed in this time, and people need people—children need children, and mums need mums. In this place we need to support, encourage and facilitate the essential component of early years development. Levelling up has promised it, but let us make sure that that levelling-up process reaches out to all parts of the United Kingdom of Great Britain and Northern Ireland. The levelling up starts here, today, through this debate.
I want to pick up where Jim Shannon left off and thank all the organisations in our constituencies that provide such vital support to families in their time of need. I have Home-Start in my constituency too, and it does a fantastic job. I also thank the Backbench Business Committee for giving us this debate, as well as all those who have contributed so valuably to it. I particularly thank Dame Andrea Leadsom for the work she has done on early years and the first 1,001 critical days. We see by its inclusion in the Budget that her work has been recognised by the Government. I would like that money to go further, as I am sure would many hon. Members, but it is certainly a good first step.
Some might consider it slightly odd that the Scottish National party Treasury spokesperson is winding-up this Backbench Business debate, but there is an economic imperative to the debate. The Women’s Budget Group estimates that 1.7 million women are prevented from taking on extra hours as a result of lack of childcare, which leads to a £28.2 billion loss in economic output. Those on the Treasury Bench should consider that when they think about childcare. It is not a burden in any way; it is an investment and should be considered as such. The Nordic countries have much better outcomes and more equal societies, and they invest much more in their early years.
Alex Davies-Jones said that Wales is the best place in the world to grow up. I dispute that—certainly Scotland is up there as well, and we are doing a great deal on that front. The Scottish Government baby box is emblematic of that investment. A box is given to every new family, regardless of their circumstances, and it provides them with all the essentials they need. The feedback on that is overwhelmingly good, and around 186,000 baby boxes will have been delivered to families by its fourth anniversary. All families will have benefited from that, with all babies entering the world with a degree of equality, even when other things are not equal, as we know.
I was glad—well, I suppose I was not glad—to hear Catherine McKinnell speaking about the impact of poverty on young people; I feel that not everybody has reflected on that crucial part of the debate. Significant inequality is growing in the UK. Such things do not happen by accident; they happen as a result of specific policies designed by the Government and inflicted on the people of these islands. Let us take, for example, the two-child limit for tax credit and the rape clause that is part of that. By
Hon. Members have referred to the £20 uplift in universal credit, which has been a lifeline for many families throughout the pandemic. By not keeping that uplift, and by reducing the taper on universal credit—something I welcome—the UK Government have divided households into the worthy and the unworthy. The taper rate affects those who are in work. I am glad for them and it is right, but the Government are only fixing the harm that their predecessors caused by adjusting the taper rate, and there is no help for those who are out of work, many of whom have caring responsibilities, illness or disability. There is nothing whatsoever for those on legacy benefits whose children also need that help. All of this is at a time when costs in shops are increasing and fuel prices skyrocketing. What impact will that have on children in those homes in the cold winter that is coming? What impact does the lack of fresh food and a warm home have on the lives of the babies we are talking about?
Sir Harry Burns, the former Chief Medical Officer for Scotland, has spoken poignantly about the lack of a sense of control, and the impact that that has on people’s lives. Tim Loughton talked about a household he visited, and many more households like that now exist after the past 10 years. Many families have a lack of control over their lives, because they do not have the financial resources to build a safe environment for them and their children. That lack of control, certainty, or of knowing what will happen when an unexpected bill or illness could bring everything down around your ears, is no way to give babies the best start in life, and neither is it to have families reliant on foodbanks and charities. That only adds to the trauma mentioned by the hon. Members for Bath (Wera Hobhouse), for Newcastle upon Tyne North, and for Strangford (Jim Shannon). These families are growing up in trauma because they do not know how to cope. They do not have enough money to make ends meet, and living in such circumstances day after day means trauma for those parents, and trauma for those children. The Government should recognise that when they talk about recognising trauma, and consider how they can lessen it.
I want to talk briefly about the impact on ethnic minority families. There is a significant cost to them that is not often recognised, and that is the cost of the immigration system. Many families that come to me are finding life more and more of a struggle because they have to pay for visas, which are extremely expensive and a huge family cost burden. I cannot imagine how those families in relatively low-paid work make ends meet. They often cannot get the family support that Miriam Cates so valued having around; they cannot get their mother-in-law, their mother or their sister over to give that support with their babies because they are not allowed visas. I have seen many families really upset by their inability to have a family member there at that most important time in life—and worse, I have seen families where there has been a baby loss and all that mum wanted was to have her mother there, but the Home Office said no. We need to recognise the wider implications of family support in all Departments.
I also want to talk about the impact of no recourse to public funds. There is a lack of data about how many constituents in Glasgow Central are affected by no recourse to public funds, but that immigration condition on benefits means that many families are not entitled to the same support as their neighbours, and they find it harder to make ends meet. I have had families come back for support for school uniforms and for presents for Christmas. They are working very hard, but not hard enough, because they cannot earn enough money. That will only get worse under the Nationality and Borders Bill.
I would be doing the all-party parliamentary group on infant feeding and inequalities a disservice if I did not talk about breastfeeding. Breastfeeding rates in Scotland are really improving, because we have a comprehensive plan to improve them. Almost two thirds of babies born in Scotland last year were breastfed for at least some time after their birth. More than half of babies were being breastfed at 10 to 14 days of age, which has increased from 44% in 2002-03. There are increases across the board. There has always been a marked gap in deprivation rates, with more deprived communities tending to breastfeed less. With the investment and comprehensive planning that the Scottish Government have put into breastfeeding support, that gap is beginning to narrow in Scotland, which is very positive.
I have two brief questions for the Minister on that. The “Becoming Breastfeeding Friendly” report was published in Scotland in 2019, but it has not yet been published in England. When is that going to happen, and when will the infant feeding survey be reinstated and published? We cannot track that data.
There is a great deal more that I would like to have said in this debate, but I urge the UK Government to look to Scotland and the comprehensive plans that are being put in place there, and to improve services for everybody who requires them.
I am grateful to Sarah Olney, Dame Andrea Leadsom and my hon. Friend Catherine McKinnell for securing this debate. The collective case that they made was weighty, and I think there was universal agreement; I certainly did not disagree with anything that was said.
I associate myself with the comments made by the hon. Member for Richmond Park about the importance and the centrality of good health visiting. She also made very interesting points about lockdown and covid that were shared by Jim Shannon and the right hon. Member for South Northamptonshire, whose statistic that seven in 10 parents feel that they have not had enough support was sobering. That shows the scale of the challenge that we have in building back.
Of course, the right hon. Member has also gifted us her rich report, which we are discussing, in many ways, today. I want to take this opportunity to reiterate in public what I have said to her in private about the Opposition’s support for her. She had real success at the Budget, which we were all heartened by. We know there is more to do, but she is clearly doing something right and, as I say, we will be with her along the way.
My hon. Friend the Member for Newcastle upon Tyne North made a stark and powerful speech about poverty. She could have changed Newcastle upon Tyne North to Nottingham North—my constituency—and the entire thing would have read across, but particularly the cruelty of pre-ordaining a child’s destiny at their birth.
The hon. Members for East Worthing and Shoreham (Tim Loughton) and for Ruislip, Northwood and Pinner (David Simmonds) talked about turning the strategy into a local plan and putting an emphasis on local authorities or health and wellbeing boards—in my case, I think integrated care systems is the model. I proposed that in a new clause that I tabled to the Health and Care Bill, which the Government were not minded to accept. I hope that we might be able to work together on that, and that we might get something in the Bill to that effect in its remaining stages. I think that would be a very good way to do that.
I pay special tribute to my hon. Friend Mrs Hodgson, my predecessor in this role, because so much of our policy is her policy and I have just been carrying on that work. The point she made about the environment was one I had not heard her make before. I am always fearful that children can sometimes grow up in hopeless environments and the future of the planet is one of the things that restricts hope. That is a very important point and we have a responsibility in this place to address it.
My hon. Friend Alex Davies-Jones made the point that, if in doubt, look at Wales. In many ways, that is very much the way to go.
Previously, and certainly for the last 10 years, the place to start when talking about early intervention and the best start in life was the breakthrough 2011 report on early intervention by my friend and constituency predecessor, Graham Allen. Happily, the right hon. Member for South Northamptonshire is providing him with some good competition with her report. As we have seen in the debate, that has established a cross-party consensus to make good on this. The report confirms and builds on what we know about how critical the first 1,001 days are.
In my maiden speech four-and-a-half years ago, I talked about similar themes for my community and how these challenges are cyclical, and said that the way to break those cycles is to intervene as early as possible. A healthy pregnancy is very important for mum, but also for the baby’s development. Beyond specific dangers such as smoking, alcohol or drugs, we know that stress can cause challenges for babies. That is an awful lot of pressure on mums, so health visitor support is really important, as the hon. Member for Richmond Park said. The next two years are crucial, too, in setting out how a child’s life is likely to go. Wera Hobhouse made important points about adverse childhood experiences, which we know have a lifelong impact. As I say, the case for change is well established, but we have to have concrete things to do and the report and the six action areas effectively laid out that route for us.
I want to briefly address Sure Start. We know that Sure Start prevented hospitalisations, impacted children all through their adolescence, improved mental health, helped particularly in the poorest communities and, of course, made major, long-lasting savings for the NHS. The tragedy is that any savings made by cutting those services will be hoovered up in costs to the NHS. It is dreadful public policy. I say that not to litigate the events of the last 10 years, but because at the moment councils are setting their budgets. Councils in cities such as mine will be making decisions that mean children’s centres will again be lost. So we have not adequately addressed this yet. It was not adequately addressed in the support for local authorities in the Budget. Family hubs are very welcome and I accept the point that they are not a like-for-like replacement, but my point is that we are weakening our approach in this area by filling the bath at the top and then draining it at the bottom. I think that is a big mistake.
I will make a final point on what I consider to be our greatest hurdle in this endeavour: the public finances and the Treasury. This is the sort of spending that we know—the hon. Member for Ruislip, Northwood and Pinner said this—benefits future generations. Politically, I think we can get our heads around that. The previous Labour Government showed that we can do that. The growing consensus is that we want to make long-term investments, even if we are not in this place seeing the benefits from them. However, I do not think we have quite got there yet with regard to the Treasury. Clearly, significant progress was made at the Budget—I want that to be recognised—but we need models that, for the Treasury’s purposes of balancing the budget and having good responsible public finances, also recognise that investing now can give returns in a decade. Even if we are not able to get the pound and penny of where that return will be, we know that it will happen. I do not think we are quite there yet and I would be very interested to hear the Minister’s thoughts on that.
The report by the right hon. Member for South Northamptonshire has set us a real road map. A political consensus is being established around it. However, we now need to know the long-term commitment. On the Labour Benches, we are committed in finance and in public policy terms to make the investments here. The Government showed at the Budget that they are starting to get to that place, but I hope to hear from the Minister that that is for the longer term and not just a one-Budget commitment. The prize is so great for our nation. As a result, our ambition must be great, too.
I thank Sarah Olney, my right hon. Friend Dame Andrea Leadsom and Catherine McKinnell for securing this important debate. I also thank all hon. Members for their important contributions; it has been a very worthwhile, informative and forward-looking debate.
Ensuring that every baby gets the best start in life is of central importance to the Government. The critical 1,001 days of a child’s life lay the building blocks for lifelong emotional and physical health. By investing in supporting the youngest members of our society and the families who care for them, the Government will deliver on their ambition of levelling up health outcomes across the country.
The health and wellbeing of parents and carers is important for the healthy development of their babies. Approximately one in five mums and one in 10 dads experience mental health problems during the 1,001 critical days of their baby’s life. Poor mental health can impact on their parents’ ability to bond with their baby and meet the baby’s emotional needs. Later development is heavily influenced by the loving attachment that babies have to their parents or carers, and there is a wealth of evidence that poor parental mental health can lead to worse outcomes for young children.
It is vital that parents and carers have access to the help and support that they need to give their baby the very best start in life. The Government’s vision is for every parent and carer to have access to high-quality universal services in their local areas. That is set out in, “The best start for life: a vision for the 1,001 critical days”, published by the Early Years Healthy Development Review in March. I thank my right hon. Friend the Member for South Northamptonshire for that inspirational work. Thanks to her dedication, the Government are delivering on six priority action areas that will realise that vision.
First, we will ensure that all parents and carers have access to clear information about the Start for Life offer and family services in their area that they can access virtually and physically. Secondly, we are championing family hubs and working with local authorities to make them a place where families can access universal Start for Life services.
Thirdly, we are designing digital, virtual and telephone services around the needs of families with babies, including digitising the red book. Fourthly, we are developing a modern, skilled workforce to meet the changing needs of families with babies. We are doing that by looking at new ways to support, train and retain the skilled professionals that we need.
Fifthly, we are working across the system to ensure that local services are high quality, considering how improved data can enhance the evaluation of outcomes and how inspection and feedback from parents and carers can drive excellence. Finally, we are working with local areas to encourage them to nominate a leader with responsibility for Start for Life services and ensuring that Start for Life is at the heart of policy making at a national level.
Alongside the Early Years Healthy Development Review, the Government are implementing a wide range of policies to improve child health. That includes the most ambitious child obesity plan in the world, the transformation of children’s mental health and maternity services and a world-leading immunisation programme.
Investing in the 1,001 critical days is the most important long-term investment that we can make. Failure to invest in that critical period comes at a great social and economic cost. Adverse experiences at the start of life are linked to negative outcomes later in life, as a number of hon. Members have mentioned. It is estimated that late intervention amounts to a cost of £17 billion a year in England and Wales. Investing in prevention and early intervention is a much better use of taxpayer money. That is why the Budget announced a £500 million investment package to transform support for babies and families.
The Government will invest more than £80 million in expanding the network of family hubs, improving access to a wide range of integrated support services for families with babies and children. A further £10 million will support local authorities to publish clear Start for Life offers, helping parents and carers to understand the services available to them locally, while £100 million will be invested in rolling out bespoke parent and infant mental health support, helping to nurture parent and infant relationships and improving access to support for new and expectant parents.
There will be £50 million available to local authorities to establish multi-component breastfeeding support services in line with local needs, ensuring that parents receive the help that they need where and when they need it. There will be £50 million to fund evidence-based parenting programmes, which will support parents and carers to have positive interactions with their children. Seventy-five upper-tier local authorities in England will benefit from this funding. The evidence and learning from this investment will help to improve services across England where they are most needed.
An additional £10 million will be available to trial and evaluate innovative workforce models in a small number of local authorities. This will enable local authorities to bring together and train staff under the clinical supervision of health visitors to provide babies and families with the high-quality, timely support that they need. It will also support future workforce reform.
I am short of time, so I will continue.
Some 300,000 of the most vulnerable families will be supported with an extra £200 million boost to the Government’s supporting families programme, which helps families through complex issues that could lead to family breakdown. In addition to the £500 million investment to transform support for families, the Government will provide more than £2 million per year to continue the holiday activities and food programme, providing healthy food and enriched activities for disadvantaged children in England and delivering our flexible childcare fund commitments.
Before I draw my remarks to a close, I would like to address some issues that have been raised this afternoon. The hon. Member for Richmond Park raised the issue of health visitors. As I have outlined, £10 million has been allocated to trial and evaluate new workforce models. The specific number of health visitors and case- loads is a locally determined decision based on local health needs, so the number and ratio of health visitors support staff will vary. She also raised perinatal mental health, which has been recognised in the spending review with £100 million allocated to rolling out bespoke parent-infant mental health support.
My right hon. Friend the Member for South Northamptonshire rightly stated that babies’ needs should always be at the heart of our work. She also highlighted some new ways of working that have developed as a result of the pandemic, from Camden’s Bump to Baby programme to Parent Talk, and the benefits that physical and virtual support can offer in reaching out to even more families.
My hon. Friend Miriam Cates said that we are building back better for babies. She was quite right. I welcome her support for family hubs and her recognition that they will provide support and services from conception to the age of 19 and to parents and carers.
The hon. Member for Newcastle upon Tyne North also asked about family hubs. In the Budget, as I said, the Government announced a further £82 million to create a network of family hubs. Each of the 75 selected local authorities will receive transformational funding to support the change process of moving to a family hub model.
My hon. Friend Tim Loughton brought a great deal of experience to the debate, as did Mrs Hodgson and my hon. Friend David Simmonds. Alex Davies-Jones raised the important issue of breastfeeding. I am delighted that the Chancellor has announced £50 million to establish multi-component breastfeeding support services in line with local needs.
I must finish; I am sorry.
In conclusion, we will continue to work across the whole Start for Life system to improve health and development outcomes for our youngest citizens. We must do everything in our power to support all families to give their baby the very best start in life.
It was great to hear from the Minister about how much has already been delivered and the spending that has been announced. I thank Catherine McKinnell for all her support in getting the debate together. She made some very interesting points about employment discrimination. I also want to pick up on what Mrs Hodgson said about the importance of climate change.
Miriam Cates made some very interesting comments about the economic impacts of motherhood. I was particularly struck by her comment that children are not an economic inconvenience; I agree 100%. I thank Tim Loughton for sharing his personal experience, which was really thought-provoking. I also thank my hon. Friend Wera Hobhouse for mentioning trauma and adverse childhood experiences.
All hon. Members have added a really interesting dimension to the debate. I thank them all.
Question put and agreed to.
That this House
has considered the matter of giving every baby the best start in life.