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My Lords, it is a great privilege to initiate this debate today on early years intervention. My interest in this subject comes from my experience as a paediatric speech and language therapist, then in parish ministry and now as a bishop committed to the flourishing and well-being of diverse individuals and communities. In light of that, I draw your Lordships’ attention to my entry in the register of interests.
The experiences we have as children, and in particular as young children, shape the rest of our lives. A child’s development score at just 22 months can serve as an accurate predictor of educational outcomes at 26 years. Adverse childhood experiences—ACEs—have significant public health and social consequences. Having had four such experiences is associated with poorer physical and mental health, drug and alcohol abuse and inter- personal and self-directed violence. There are stories up and down the country, including those I hear in prisons and women’s centres, about those who are now adults who were deprived of appropriate early years intervention, and about those who are turning their lives around for their children and their families as a result of receiving early intervention for their children and for themselves as parents.
My intention in tabling this debate today is to reflect on how government, both centrally and locally, can work with families and communities to support children’s well-being, particularly at the start of life—I deliberately use the word “with”. The Government have plenty of evidence that early interventions are not just good for children’s life chances, they are also sound financially. The old adage, “an ounce of prevention is worth a pound of cure”, rings true here. Despite this, the Children’s Society estimates that local authority spending on early intervention services for children and young people fell by 49% between 2010 and 2017.
Health visitors are a highly effective intervention and support for all babies and families across the social spectrum, yet their number is falling. Similarly, most areas in England have experienced a real-terms reduction in reported spending on speech and language therapy over the last three years, despite the fact that children with poor vocabulary skills at the age of five are three times as likely as their peers to have mental health problems in adulthood, and twice as likely to become unemployed.
For those in government concerned about money, it should be enough to point out that, when we provide early support and catch problems early, intervention is far less expensive. However, we have to be able to do this. The Government’s troubled families programme comes too late. The families it supports are already in trouble, not simply struggling or at risk.
Increases in government spending on children’s services have been largely a result of the increased number of looked-after children and the Government’s expansion of free childcare hours, while spending on children’s centres and provision for families has decreased, particularly in the most deprived parts of the country where they are most needed to address inequality. In the case of looked-after children, this is by far the most drastic and expensive intervention the Government can make in a child’s life. What assessment have the Government made of the causes of this rise?
On childcare, academic research shows that pre-schooling and paid childcare improve children’s outcomes only if they are of high quality. Where children are looked after by private providers, vital links with local authorities can be missed and staff may not have the specialist training required to spot early issues. Research done by the Institute for Fiscal Studies and the Joseph Rowntree Foundation suggests that the free entitlement for three and four year-olds does not effectively target the most needy and at risk. What assessment have the Government made of the quality of this provision and its effect on early years outcomes for children?
Child poverty has a strong link with child development. Children who have lived in persistent poverty during their first seven years of life have cognitive development scores on average 20% below those of children who have never experienced poverty. The Millennium Cohort Study shows that poor children are four times more likely than rich children to develop a mental health problem by the age of 11. Gaps in achievement open up early on, and by the time they start school the poorest children are already 11 months behind their more advantaged classmates. Overcrowded, poorly maintained housing can lead to children sleeping in living rooms or with parents, which has consequences for physical and mental health. Poverty puts families under pressure, and that stress can be a source of ill health and family breakdown, leading to expensive work by public authorities further down the line.
Simply expanding both entitlement to free childcare for disadvantaged two year-olds and the number of free hours that older children are entitled to is unlikely to counteract the effect of benefit changes and the two-child limit. To put it simply, incentivising single mothers to work is not a panacea for their child’s development. Can the Minister explain what analysis the Government have made of the impact of DWP changes on child poverty, particularly the two-child limit, and any impact assessment of the effect that this will have on children’s life chances and well-being?
We also know that worklessness is no longer the root of poverty. Seven in 10 children in poverty are now in a working family. Part of the problem is that families have to pay the entire cost of free childcare up front before they can claim back the 85% that the Government will cover. Many low-income families do not have the capital to pay this up-front cost or risk going into debt. Moreover, childcare support has been capped at £175 per week since April 2016, while childcare costs continue to rise. The deep irony of this situation is that most childcare workers are themselves women on low pay, and 44% of childcare workers claim state benefits or tax credits.
To paraphrase the Sutton Trust and the Marmot review published earlier this week, it is difficult to see how even well-designed policies to support parenting and ensure access to high-quality early education can have the optimal impact against a backdrop of a sharp increase in child poverty.
Furthermore, navigating the benefits in the childcare system is hugely complicated, especially as families begin to migrate on to universal credit. Anecdotally, we hear that this is something that churches and toddler groups help with around the country. Toddler groups —many provided by churches and other community-based groups—do a huge amount of early intervention and signposting work, informally across the country. It amounts to thousands of hours each year. Often, these are the only places in a community where children from different backgrounds mix and parents and care givers are provided with support. Yet toddler groups are almost invisible in impact studies and government reports. They are a tremendous asset to the country, provided by hard-working, committed volunteers. We want to encourage this sort of expression of civil society, but the Government must partner with the community to make sure that local services are joined up, holistic and sufficiently funded. This work cannot simply be outsourced to stretched volunteers.
While I welcome the Government’s commissioning of research on family hubs, surely the case for children’s centres is already well known. For each Government to have to learn the benefits of early intervention for themselves is frustrating and a poor use of resources. One of the most important parts of Sure Start was co-creation with the local community—a bottom-up approach that listened to the needs of service users. Will this happen with family hubs? What support will the Government provide for children and their families from all walks of life to ensure that parents who have concerns about their child’s welfare and development have somewhere to turn?
If I had longer, I would have liked to say something about families of children who have a disability. The long-term well-being of such children and families is about not only access to early diagnosis but appropriate early intervention. Early intervention by definition needs to be made early, and I hope that the Minister, in her reply, will explain how the Government are working across departments to improve early years policy, given that the interministerial group on the early years has been disbanded. Will the Government introduce a cross-departmental early years strategy as part of the plan to level up Britain, and ensure that every child can achieve their potential? What attention have the Government paid to the work of the Early Intervention Foundation and its analysis of what works as effective interventions? Will the Minister assure the House that local authorities have sufficient ring-fenced funding to deliver them?
There is an urgent need for join-up. At present, we do not have a single framework, even across health and education, to assess and support the development and well-being of every child. This is more than join-up across health and education—although that would be a good start. This is about every aspect of life if we are rightly to look at the whole child in the context of the family.
In this debate, we are not simply focusing on little people. We are talking about investment in the start of life, which affects the long-term well-being of individuals, families, households, communities, our country and beyond. There is a very strong case for improving early years interventions and having a clear and joined-up strategy for doing so. I look forward to hearing the contributions of other Members on this topic today.
I thank the right reverend Prelate the Bishop of Gloucester for securing this debate. It gives me a great opportunity to share with your Lordships the excellent work being undertaken in Wales on early years education and care. As a classroom teacher with more than 35 years’ experience in the secondary sector, I saw all too often that if only issues had been addressed earlier on in a child’s life, the problems that surrounded them in their teenage years could have been solved.
Last October, the Welsh Government launched a new approach; the reform of the provision is aimed at creating a single, child-centred approach to early childhood education and care. The early years are defined by the Welsh Government as the period of life from prebirth to the end of the foundation phase, or nought to seven years of age. These years are a crucial time for children. They grow rapidly, and both their physical and mental development are affected by the environment in which they find themselves.
The first three years of life are particularly important for healthy development, due to the fast rate of neurological growth that occurs during this period. There is an abundance of research showing that investing in the first years of a child’s life improves outcomes for them throughout the rest of their life. A mentally healthy child has a clear sense of identity and self-worth and the ability to recognise and manage emotions, to learn to play, enjoy friendships and relationships, and deal with difficulties. A wide range of interrelated factors play a role, such as individual, family, wider society and of course environmental issues.
Co-ordinated interagency action at national and local level is required to improve the health of children and young people and its determinants. It is hoped that this will reduce the attainment gap between children from disadvantaged backgrounds and their peers and will allow parents and children better access to education and childcare in ways that meet their differing needs and circumstances. The six outcomes the Welsh Government are looking at are that children: feel safe are cared for; feel supported and valued; are resilient and capable; are coping; are healthy while they learn and develop; and are not disadvantaged by poverty.
We know that adverse childhood experiences play an important role in lack of future development, and development is the start of a good life. We know that by the age of just three children from poorer backgrounds start to fall behind. This gap then widens as they start school, and the self-fulfilling prophecy of under- achievement and underattainment is set in motion, with a lifetime’s impact.
With this renewed approach, the Welsh Government are determined to redress the imbalance and close the gap. They want to ensure that every child has access to the same, high-quality support, and early childhood education and care are key to this. In Wales, we have managed, despite a decade of crushing austerity and lack of funding of public services, to extend excellent childcare provision across the early years. We have a long-established and well-regarded offer for three and four year-olds, with the delivery of the innovative foundation phase of education.
The foundation phase is the developmental statutory curriculum for three to seven year-olds in Wales, and it is based on the principle that early years education provision should offer a sound foundation for future learning through a developmentally appropriate curriculum. It brings more consistency and continuity to children’s education in this all-important period. It places great emphasis on children’s learning by participating in practical activities. Young children are given opportunities to gain first-hand experience through play and active involvement rather than by more formal education and completing exercises in books. It encourages children to be creative and imaginative and to have fun, and places the child at the centre of their learning. They are given more opportunities to explore the world around them and understand how things work by taking part in practical activities that are relevant to their developmental stage. They are challenged with open-ended questions and given opportunities to explore and share ideas for solving problems.
This latest approach will be built on those foundations, and at its core is the aim that all children will have a high-quality, stimulating learning and care experience in any education and care setting that they attend, whether in Welsh, English or bilingually. Putting child development at the heart of early childhood education will ensure that the principle of quality is clear to all who work with children and will underpin the provision in every setting in Wales.
Who is eligible? Working parents of three or four year- old children can claim 30 hours of free early education and childcare in Wales a week, for up to 48 weeks of the year. Local authorities will be a key player in this delivery, and there is investment in innovative solutions that will enable more parents and children to have better access. It is particularly important to ensure that children with additional learning needs or physical disabilities can access this provision without any inequalities.
It is an ambitious change and full implementation will take the next decade, but it will include a plan for developing a quality framework that enshrines the principles supporting it by setting out the quality required. This will be the guide for practitioners to use, for parents to understand and for inspectors to assess, thus linking those elements together.
I commend the Welsh system of early years education and care to the House and hope that Ministers in the UK Government will look carefully at what Wales is doing, learn from that embedded good practice and those future ambitions, and develop similar excellent systems of care for young children across England.
My Lords, I thank the right reverend Prelate the Bishop of Gloucester for securing this vital debate and refer to my interests in the register.
It is widely understood and acknowledged these days that what happens during pregnancy and in the early years shapes children’s physical health, language and communication, learning, emotional well-being and ability to form positive relationships. In short, the early years of a child’s life are pivotal to their ability to flourish throughout childhood and into adulthood.
Given the importance of early years, I am sure I am not alone in this Chamber in thinking that improving outcomes in the early years is just about the smartest investment we can make as a society. We still have much to do in ensuring that high-quality early years services are equally accessible to all families, wherever they live.
I make the case for improved childhood interventions on two grounds. First, intervention is crucial to a child’s long-term well-being, which should be a crucial objective of any Government; and, secondly, there is certainly room to improve a system that at the moment is either barely adequate or, in some places, does not even exist.
The evidence is instructive: 4 million children living in poverty; 50,000 children aged nought to five living in households with domestic violence, alcohol or drug dependency and severe mental ill-health; and an attainment gap between disadvantaged children and their better-off peers clearly evident at the age of five when they start school. There is also a wealth of evidence showing that failing children in the early years has devastating and long-lasting consequences. For example, we know that an estimated 220,000 children aged 10 to 15 are unhappy with their life. Children who live in families under financial strain are more likely to be unhappy and to experience symptoms of depression than their better-off peers. As we have already heard, there is a clearly established link between poverty and poor mental health, which manifests itself early on in a child’s life. Where we fail to act early, we fail to equip children with the necessary tools to improve their life chances and social mobility.
Before turning to some specific policy responses, I will say another word about poverty, because it is so important. Child poverty is acting as a key barrier to children’s educational achievement and good health. At just five years old, children from the poorest income groups are twice as likely to be obese as their better-off peers. This is just one example of how poverty can ruin childhoods and cause irreparable damage to society’s future health and productivity. Early years education, childcare health visitors and early help family support services, often provided by the voluntary sector, can boost outcomes for most disadvantaged children, but research shows that take-up among these groups is low. Simply put, those who need these services the most are often missing out. Many families are unaware that the services are available to them.
I very much share the view expressed by the right reverend Prelate the Bishop of Gloucester that one thing we currently lack is an overarching children’s strategy. Happily, this can easily be addressed. It is absolutely crucial to demonstrate joined-up working and leadership within central government to inspire local areas to see early intervention as a shared responsibility. Early intervention needs to be everyone’s business, and we must reflect the complex ways in which various components of children’s well-being interact.
The National Children’s Bureau—last year I stepped down as its president after a seven-year term—has called for a comprehensive cross-government children and young people’s strategy to establish a new vision for childhood and create a binding set of outcomes that all government departments are accountable for delivering. Many programmes to drive these improvements in early years either exist or we know about them, but to make the most of these interventions, we need the sustained, focused and committed efforts of all government departments to address poverty, integration of services, and funding.
Service integration is key. Children’s lives are heavily influenced by many aspects: their family, their neighbourhood, their nursery or school, their GP surgery and so on. These interactions impact on child outcomes in a complex way. Therefore, co-operation and integration between education, social care and health services, and between the voluntary and statutory sectors, is needed, not only to improve outcomes but to narrow inequalities. Of course, this needs to be done in full partnership with children and their families.
I will finish on the issue of funding, which is so important. The last decade has seen the capacity of early years services to work in a preventive way undermined by significant reductions in public spending, with local authority budgets particularly badly affected. We have already heard the statistics: since 2010, cash-strapped councils have had to reduce spending on early intervention by almost 50%. That is a very big figure. The LGA estimates that an investment of at least £3.1 billion per year by the middle of the decade is needed to prevent children’s services from collapsing. The Government have committed just £1 billion per year, to be split between adult and children’s services, so let us hope that there is better news in either the Budget or the spending review. It will be great if the Minister can give some reassurance on that point.
The Government also promised in their manifesto to develop a network of family hubs, but no further detail has been given. With proper funding, they could be a very welcome re-extension of early intervention services back into the communities. Can the Minister give an update on the Government’s plans for family hubs?
Finally, Storing Up Trouble, a report published by the All-Party Parliamentary Group on Children, of which I am co-chair, found that just a small proportion of local authority resources are being spent at the early, preventive end of the agenda. Virtually all of it at the moment has to go on crisis support. We have already heard today—and so powerfully—how it is crucial to intervene before families reach this crisis point. I am looking forward to the all-party group’s hearings and inquiries in May, which will take a strategic look at spending and identify the interventions on which the Government could best target its investment. I will be delighted if the Minister attends those inquiries and responds to the APPG’s recommendations.
My Lords, as the right reverend Prelate said, early intervention in education is essential to any child with special educational needs or any learning disability. Numerous studies in the past decade show that early intervention increases a child’s potential for greater all-round development, that a child learns as much in the first three years of its life as it will throughout its remaining years, and that if help is not given that vital period is irretrievably lost. These points were very well made by the noble Baroness, Lady Wilcox.
I am the father of a 27 year-old daughter with special needs. At the age of four she was diagnosed with severe autism and a learning disability, as well as dyspraxia. Through my personal experience I feel sufficiently qualified to know the enormous value of early intervention. Our daughter attended special-needs schools and left at 19 with several entry-level qualifications, able to read fluently and work a computer and mobile phone. This would not have been the case without the early intervention that she received.
Autism is a lifelong condition that affects more than one in 100 children and young people. Intervening early in these children’s lives to support their communication, learning and development increases the chances that they will make good progress with their education and ability to cope throughout their adult lives. Children may be able to access early intervention only if they have a diagnosis, but the length of time that many families wait for an autism diagnosis means that too few autistic children benefit from early intervention programmes. Research by the National Autistic Society found that children wait, on average, three and a half years from when their parents first seek help to when they receive a diagnosis of autism, despite NHS guidelines stating that children and adults who may be on the autism spectrum should be assessed within three months.
Diagnosis is vital. It enables a child on the autism spectrum to be better understood by their parents, teachers and others. It should also open access to crucial help and support. As soon as a diagnosis is made, intervention should be carried out with immediate effect. If children are not given the help that they are entitled to when they are young, they will grow into adults who require infinitely more expensive care throughout their lives and put enormous strain—emotional and financial—on their families.
An important initiative for young children on the autism spectrum is the EarlyBird programme, run by the National Autistic Society, a three-month programme of group training and individual home visits for families of preschool children. The aim is to help parents understand their children better; how to support them; how to get into their child’s world; how to find ways to develop their interaction and communication; and how to understand how the child behaves and reacts. Children on the autism spectrum do not experience the world in the way that we expect of most children in the early years stage of development and learning. Early intervention programmes can help these children learn and develop the skills they need, understand their environment and reduce their levels of stress and anxiety.
Early intervention is vital for these reasons, and should be available for everyone, regardless of their postcode or bank balance. There are over 1 million children in the United Kingdom with special educational needs. In the light of this, will the Government make a commitment to implement the guidelines on waiting times for diagnosis, so that no child must wait years for the help and support they need?
My Lords, for 35 years my colleagues and I have supported East End families and children and worked with them at the coalface. We have spent our lives operating within the machinery of the state and have witnessed countless promises made to these families and communities, many of which did not turn out quite as expected. It takes a family and a community to raise children well. If we want to be serious in this debate, given all the money that Governments spend on research that few people read, we might like to look back over the last 30 years and learn from the programmes that the state has run. In our experience, government is not a learning organisation. It has little memory, and this fact has unintended consequences for many of our most vulnerable families.
We had a rich ecology of childcare providers in our area 30 years ago, often with strong relationships with parents and families. Then Governments started disrupting this. They said that they would encourage children to enter school one or two years earlier, thus destroying the business model of many small nurseries and support networks. Then they set up Sure Start and children’s centres. The launch of these centres was at the Bromley by Bow Centre, which I founded. They were all our ideas. We were told that we were the model for what should happen nationally, and now, of course, we are saying that we cannot afford them. The Bromley by Bow Centre had its children’s centre contract cancelled at short notice. What is the net effect on childcare and support services over the last 30 years? How much money has been spent, to what overall effect? One experienced children’s officer in one London borough described to me recently the present overduplication in her borough, the outdated silo systems incapable of real integrated working and staff waiting out their pensions and poor leadership.
Our work—often despite government—is starting to go national and my colleagues and I are today working in challenging communities across this country. I was in Skelmersdale last Monday at one of our innovation platforms with the NHS civil servants who are writing the new Green Paper on prevention. Local people and I shared with the civil servants the long journey of state intervention in this town and the unintended consequences. I do not know Dominic Cummings—I have never met him—but if he is really interested in the dysfunctionality of so much of the machinery of government systems and their countless interventions, he would do well to spend some time in Skelmersdale. This community, like countless others, is littered with three-year government programmes that spent loads of money and came to little. Local families know this fact. The civil servants we met seemed more interested in policy than implementation—classic Oxbridge culture. It is the impact that counts.
As a Christian community in east London, we took these families seriously and created four nurseries—a network of integrated health centres—which now have 42,000 patients because we saw that the health services were not joined-up locally around them. We have set up 87 businesses with local people and countless programmes and projects. We began to understand the state only when we tried to bend it and make any of the machinery work for these families. You only really understand and learn by practical engagement, not through policies, research and the paraphernalia the Government seem to spend so much money on—most of it, in our experience, simply does not work. The Word becomes flesh in John’s Gospel, not policies, not research, not minutes—flesh. You learn by doing.
There is an awful truth: the poor will always be with you. I was listening to a woman on the radio in Rotherham recently, another town where my colleagues and I are working. Even after all the sex scandals there, the horrific effects of a PC religious culture and ideology in that Labour council and all the statements about lessons being learned, she said that nothing had fundamentally changed. In poor areas, the state struggles too—that is true. It will only ever be part of the solution. It is the traditional Catholic message; it is what the Pope would say. He, of course, has the long view.
When we began working with families and children, we decided not to follow the then trendy approach in the 1980s focused around equal opportunities and an advert in the Guardian when it came to employing a person to work with these families. We knew we would end up with a bright young graduate with all the right papers, who had done all the right courses but had never had a child. We chose Jackie, a brilliant East End mum who had had four children by the time she was 21. She was a brilliant mother and role model, and she did a great job. She eventually introduced us to a 35 year-old mother called Jean Vialles, a friend from school, who had two kids aged 16 and two, sleeping in the same bed. Jean was dying of cancer and the NHS was busy writing four reports about her, but no one was giving her a bath. Through Jackie, we discovered a Baby P scenario on our doorstep—the profound dysfunctionality of the state. Jackie forced us into a massive confrontation with the NHS and we have the scars to prove it. Out of it came the first working model of a fully integrated primary healthcare centre in the country. Nowadays we have 2,000 visitors a year coming to see what this all means in practice. It was all about focusing in a joined-up way on the complicated lives of local children and families and believing in them, and that they could achieve great things, as many of them have gone on to do—learning by doing.
It is easy to blame the state, but what about the behaviour and interventions of our own institutions? Let us start there. I am listening to too many bishops telling us that the solution is for the state to spend and do more, and all will be well. They are listening to too many academics who have never built anything. I worry about all this research our politicians are quoting, emanating from our universities. They all seem to be saying the same thing. I do not believe in these too tidy by half solutions. The clinical psychologist Dr Jordan Peterson, the Ezekiel of our day, is raising some rather awkward questions about the state, our universities and their Marxist/liberal consensus that is infecting a generation. He is worrying away about the simplistic ideological glasses through which so many academics, whose salaries rely on the next research document, view the world. Few of them will spend real time with these children and families. Go and look at the many millions of pounds being spent on the Born in Bradford study and ask yourself: where is the money going and how much of it will stick to these families and communities in Bradford? Will we be able to point to the name and address of one family in the city who will have benefited from all this research funding?
This is not about policy but about implementation. I encourage the Minister to come with me to Rotherham to have a look at what that means in practice. I have had the invite out for a while, but maybe after this debate we might have coffee.
My Lords, I thank the right reverend Prelate for arranging this debate, for her excellent introduction and for her reliance on expertise in her introduction. I hope to reflect that approach in my speech also.
For our debate on early intervention, the invaluable House of Lords Library briefing, which we always have for such debates, talks about early intervention specifically for children with atypical development, but I want to focus first on what is typical for children in the UK. A Children’s Society report from August 2019 showed that the level of happiness of our children is the lowest for a decade: a quarter of a million children said that they were unhappy with their lives; a third of 10 to 17 year-olds were fearful about the future; and one in eight children were unhappy at school. If we go back to 2016, a UNICEF study placed Britain 13th out of 16 countries for the happiness of our eight year-olds. We have a problem, widely acknowledged, with child poverty. There are 10 constituencies in the country where more than 50% of children—whole communities of children—are living in poverty. Overall, around the country, 4.6 million children are living in poverty.
If we look at where the support and the services for children—both those who need special interventions in children and in general—come from, local council funding has fallen by 17% on local services. That is nearly £300 per person in the past decade. Some 57% of the budget for services goes to social care, under huge pressure for the need for early interventions, among other causes. That has meant the loss of libraries, parks and other services, so I put it to your Lordships’ House that we have a real problem in our treatment of all children and this will increase the number of children who will have what will be seen, in historical terms, as atypical development and who will need intervention.
I turn briefly to some reflections on what that intervention should be like and how it should be funded. A report from the Sutton Trust recommended:
“The Government should move towards giving early years teachers qualified teacher status, with the increase in pay, conditions and status” to match. I think we can all agree that there can be no more important job than taking care of our youngest children, particularly helping those children who need extra support to reach standard landmarks. I will, very shortly, be joining the National Education Union outside, which is concerned about the funding for post-16 education. We have a problem of how we prioritise education right across the board in our country.
I move to another point brought forward by the Sutton Trust in its 2014 report Sound Foundations. It stressed the importance of prioritising quality of services, particularly for the under-threes. There are two things I want to pick out from that: one is the focus on play- based activities and routines and the other is the opportunity to move and be physically active. Last night, when I joined the National Trust downstairs to celebrate its to celebrate its to celebrate its 125th anniversary, it was focusing on the importance of access to nature for all of us, but if we think about children, particularly struggling children, that access to nature—the chance to play and run around—is absolutely crucial. All the expert evidence shows that, yet we know this is being denied to many of our children, particularly children who may need early intervention. I think of the recent exposure in London of the fact that children living in social housing that is divided between social housing and purchased housing were being excluded from playgrounds. That is the kind of behaviour that will create situations that need intervention.
The point I really wish to make to your Lordships’ House is that there will always be a need for acute interventions for some children whose development is not proceeding as it should, but we are now at risk of creating a situation where social and economic circumstances put more and more children in that situation. That will demand more and more resources for more and more stretched services. We risk entering a downward spiral. Many speeches have already focused on the detail of the services for early intervention, but we also need to look at issues of equality—not social mobility for the few, nor help just for those most acutely affected, but a decent life for all our children.
My Lords, I too thank the right reverend Prelate the Bishop of Gloucester for bringing this issue forward. For far too long, issues relating to families and their support have had a confusing history and some have been lost in time. One Government would organise the benefits system to penalise mothers who went to work, and the next would penalise those who stayed at home. Who suffers? It is of course children and families. Society would demonise mothers who chose to earn a living because they were not at home to control their children, but then penalise mothers—especially single mothers, and single fathers—who stayed at home but also claimed benefits.
The practical help needed came just over 20 years ago when the Government of the day—I am pleased that it was a Labour Government—introduced the idea of Sure Start. It really was a start. These centres were designed to boost the educational and life chances of socially and economically disadvantaged children. The first centres were set up in deprived areas, with baby-weighing clinics, childcare and play sessions alongside more general health needs, as well as parenting advice and employment coaching. Looking back, and judging by today’s standards, I think it was a progressive start.
In 2004, the programme was expanded, with the aim of delivering a childcare centre in every community. At its peak in 2009, Sure Start had more than 3,500 centres delivering major health benefits for youngsters in deprived areas. A report last year by the Institute for Fiscal Studies told of how Sure Start centres had reduced the number of people taken to hospital and delivered millions of pounds of NHS savings.
However, in 2010 the coalition came into office and introduced austerity cuts that reduced centre numbers by nearly 1,000 and their funding by some two-thirds. The numbers have reduced every year since. The biggest reductions have been in deprived authorities at a time when rising poverty has fuelled demand for parent and child support services, and when families and children need their support more than ever.
Millions of parents are now being punished and pushed out to work in order to feed, clothe and look after their children. A weapon is used in some instances; it is called universal credit. If your child is aged under three you will not have to find a job, but you will have to prepare for work, which means having regular meetings at the jobcentre and possibly doing some training. There is, presumably, a presumption that granny will look after the children. Those with children aged under 13 can limit their availability for work around their schooling and childcare, if they can find an employer prepared to accommodate that. If their child is aged over 13 the number of hours they are expected to work will vary, but they can be assured that their problems will be greater and more expensive.
Universal credit might pay up to 85% of childcare costs, but the maximum payment assumes a lower cost of childcare than you are likely to find. With payment in arrears, many applicants find themselves in a position where there is only one way out: to take out a loan. At different times we have all heard of latch-key children and criticisms of parents who are perceived not to control their children. Via universal credit, the Government positively encourage this. The threat is: work or else.
The Government continually argue that employment leaves the individual in a better place. No one disagrees with that, but everyone believes that it should not be solely at the expense of looking after children and families. Therefore, we on this side of the House believe that the Government and the media should not blame children and families. They are victims, not the cause. We believe that the regeneration of the principles that underpinned Sure Start would make a fundamental difference today.
Sure Start and children’s centres were closed; sports centres, playground and other outside playing areas are unkept; schools are deprived of resources and staff; children with special needs are deprived of services; libraries are closing. That is the United Kingdom shutting down, rather than looking up. It is therefore time to place responsibility where it belongs. It is time for the Government to take responsibility, in the context not just of work, but of work and the community. That is how we build a nation. If we were to judge building our nation by how we treat our children overall, we would be failing.
My Lords, I also thank the right reverend Prelate the Bishop of Gloucester for this important debate. However, it also saddens me that yet again we are talking about young lives. Over the past 12 years, for 10 of which I have been in your Lordships’ House, including just recently over the weekend, my girls and I have gone through turmoil and upset at the lack of confidence in government departments, policies and systems that we all genuinely and honestly believed would provide support when it was truly needed. Yet the system itself retraumatises and breaks you once again.
This debate shines a light on systems which for some are simply no longer available, or else the severity of the case does not match the threshold set by agencies. Adverse childhood experiences, or ACEs, are potentially traumatic events that occur in childhood from birth to 17. They include violence and abuse to a family member, committing or attempting to commit suicide, substance misuse, parental separation, chronic health problems and mental ill health, and, again, substance misuse in adulthood, all leading to a negative impact on education and job opportunities.
I do not stand on ceremony. I am not a policy person and I do not do scripts very well. But while I do not wish to undermine the role of my noble friend Lady Berridge, who I have great support for, the time has come to take all political parties out of this loop. This is about tiny, small children who are undernourished and undereducated and have such a dreadful start from birth onwards—be that substance misuse, domestic abuse, or simply that we now have a generation of young, vulnerable and mentally ill people having babies.
As a mother of three daughters, I am very proud of my working-class background. I do not say that to show that I have the profile of someone who understands what it is like; I say it because my working-class parents worked so very hard for my sister and me. They had a day job as well as a night job, always providing to make sure that we had a happier and healthier lifestyle, always saying education was very important but also providing a warm home and food to instil in my sister and me that you have to work hard in life to get what you want—and we also knew that we had the support of our parents.
Parenting is not the easiest of jobs. I am definitely not Mother Teresa and Gary was not the Pope and we were not a family who lived on a mountain like the Waltons. Parenting is very, very hard, whether you come from a good family or a bad family. There are worrying issues of health, as my parents had with me because, unbeknown to them, I was born with a hole in my lung. I had really bad health, and still do, so at times it shook them. Also, my parents did not have the best upbringing—they suffered hardship and parental separation—but they ensured that my sister and I had the best. So I am proud to stand here to say that I am stood here today because of them. They made me the person that I am and they made me understand that we should have morals and manners and we should respect one another. We will only get that if everybody who has spoken in this debate—hence my notes look like something out of the Beano, with blots everywhere—understands that it is not easy for the system if the system does not understand the hardship on the ground.
I have worked with many communities to find out what is going wrong in cycles. What I find further insulting is that we hear about young lives battling to survive daily struggles, as well as peer pressure which leads them into bad behaviour in our schools. Then that system moves them into pupil referral units, and in turn that system makes their vulnerabilities bait for those who feed them and give them love, only to turn that into the power to corrupt so they end up within our criminal justice system. And then we blame that system, but is that not putting the cart before the horse?
The real issues have been spoken about again and again in this Chamber, but now we are seeing young people become young parents, those children now scavenging in bins for food, washing uniforms at schools because they have no other uniform and no washing facilities at home, children not wanting school holidays because they are scared to be at home. We have children unable to speak who get frustrated because they cannot communicate, which then sadly manifests itself in mental health problems further down the line. That leads to behavioural and social problems and we no longer flicker so much as an eyelid when we read about this or watch it on TV. We label young people with exclusions and yet it is their very home environment that makes them behave in the way they do. So, unless we change, we are feeding that carousel even more.
I have had the pleasure of working with the Wise Owl Trust with children as young as three, talking to them about their character traits and emotions, having weekly missions with them where they have to use resilience. I love the resilience programme because it is a pipe where the rain goes down, which brings a nursery rhyme with a spider. If they cannot get the spider out, they have to carry on, because they get angry until that spider appears. That is an innocent childhood nursery rhyme. But I am fed up with seeing people pushing prams and their babies have got iPads—people who cannot take the time to have conversations with their children because the mother or the father is on their mobile phone. And, more importantly, I am sick and tired of sitting at tables, hearing about the lack of health visitors, of midwives, of GPs and of GP surgeries when we have families living in poverty, children being carers to mentally ill parents, going to school and to bed in the same clothes, and children in nappies at five because they know no other thing to do.
Surely it is a sad occasion when we stand here today. There is one thing that I know. The character build for respect is called resilience. It stands for “Resilience: I can do it”, Empathy: “I know how you feel”, Self-awareness: “I understand”, Positivity: “I believe in that”, Excellence: “I will do my best”, Communication: “I will share”, and, moreover, “I will work with others”. We have three-year-olds doing that, but we need to act soon before we have a generation who will not do that.
My Lords, I join other noble Lords in congratulating the right reverend Prelate on this timely debate, which has been particularly enhanced by her speech; she has very considerable and distinguished experience in this matter. Early intervention is not short of attention, and the excellent briefing from the Library highlights no fewer than 10 different sources and authorities on this vital subject. The absence of early intervention, which can go back to the womb, can affect the subsequent adult life of a child; this is absolutely irredeemable.
The case for early intervention is fortunate in having among its advocates a number of committed and articulate charities, of which the Early Intervention Foundation mentioned by the right reverend Prelate is a good example. The mission of this body is simply expressed. It identifies four causes requiring its services: home lives and family relationships, physical and mental health, cognitive development and educational attainment, and social and behavioural skills. There is nothing new here, but by working on these simple categories the EIF is more able to target the children most in need of its support.
Research by another fine charity, Home for Good, gives very bleak statistics, mentioned by the noble Baroness, Lady Tyler. Of 75,000 children in care in England, 10,000 are between the ages of one and four and a further 4,500 children are under the age of one, and 63% of those children will have experienced abuse or neglect. This charity places great emphasis on the alternatives for care through kinship, foster care and adoption. Its guiding principle is that every person needs a family for life. Those are just two outstanding charities among many.
There have been three relevant Select Committees in another place: on education, science and technology, and health and social care. The Science and Technology Committee acknowledged the marked differences in the need for early intervention in different parts of England and called for a national strategy. This has been rejected by the Government, who have argued that
“Local areas are best placed to understand the early needs of their local communities to commission early intervention services to meet those needs”.
However, the committee contended that the national strategy would not have to run contrary to this locally led approach. Instead, it
“could have raised the awareness and ambition among local authorities with regards to adversity-focused early intervention, provided guidance and described best practice”.
This sentiment was echoed by the Health and Social Care Committee and the Education Committee, the latter of which in February 2019 published the report Tackling Disadvantage in the Early Years. It concluded:
“There seems to be little strategic direction … on early years”.
I also draw noble Lords’ attention to a powerful cross-departmental committee organised by my right honourable friend Andrea Leadsom. It focused on ages one to two. It had a debate in the other place in July 2019, but a report has never been issued. Will the Minister say whether it is possible that the Government will release that report? The committee was, of course, disbanded.
All these reports add up and give the impression that the Government are missing the chance to give an effective national lead on this vital subject. I shall very much welcome the Minister’s assurance that the Government are looking again at their role in early years intervention. I am particularly pleased that in response to a Written Question by my honourable friend Steve Baker, on
There have been references from many quarters to the three years wasted by the Brexit debate, and I suggest that it meant that many domestic issues have not had the time and attention they deserve. The Conservative manifesto at the election stated:
“A strong society needs strong families.”
The Government now have a strong mandate, and I hope the Minister can assure your Lordships that they will be unstinting in their support for bodies such as the foundation to which I have just referred, Home for Good and others that share their admirable aims in giving effect to that manifesto pledge.
My Lords, every child has the right to a good life and, even more, every child has a right to a good quality of life. The right reverend Prelate the Bishop of Gloucester set the scene when she opened this debate in such a powerful and expressive way. We have a duty to ensure that children are given the best opportunities in life whatever their circumstances. For this reason, early years interventions are important. Those early experiences are crucial, as they set in motion a child’s life trajectory. The decisions made and the support received in the first few years of life will have lifelong implications.
As this debate has shown, early years interventions are a broad subject so I will focus specifically on the need for early diagnosis for children with learning disabilities and autism. There are around 700,000 people with autism in the United Kingdom, which is more than one in 100. If we include their families, we are talking about 2.8 million people who live every day with someone with autism. Children with autism can start exhibiting signs from as young as 18 months. Evidence shows that early diagnosis of special educational needs allows these children to make better progress, with minimised long-term impacts. For children with autism or learning disabilities, giving them much-needed skills early allows them to reach their full potential.
Non-diagnosis can result in difficult behaviour, social isolation and children not attaining their best achievement in school. When I visited a school in Wales last year I saw at first hand how, with the benefit of early diagnosis, the staff had helped a young boy with behavioural problems. When I was introduced to him, he said, “You know I have behavioural problems?” I said, “Yes.” He said, “My brother’s five. He’s got behavioural problems, but I’m helping my mother cope.” I said, “Well done.” He said, “You know I’m going to comprehensive school in September?” “Yes,” I said, “I’ve been told.” “I’ve decided on my career,” he said. “Well done,” I said, “What are you going to be?” “I’m going to be a High Court judge, and if you come up before me you’ll get a lenient sentence,” he said. That young lad’s quality of life had been helped so much by the early diagnosis and the understanding and support of the education system. An early diagnosis gives a child and their family understanding, the relief of knowing and the ability to get the help the child needs.
An important early intervention for children on the autism spectrum is the EarlyBird programme run by the National Autistic Society, of which I am a vice-president. The noble Lord, Lord Astor, spoke about the society and explained how it operates. However, children may be able to access early intervention only if they have a diagnosis. I endorse and support the noble Lord, Lord Astor, in pressing the Minister to commit to implementing the NHS guidelines on waiting times for diagnosis—a wait of no more than three months—so that no child has to wait years to access the help and support they need.
Investment in improved early intervention must be paired with an investment in support further down the line. Yet, from my experience of talking to people, diagnosis is sometimes a double-edged sword. Knowing that your child needs support and not being able to get it, or having to make a full-time job of fighting to get it, can in many ways be as damaging to quality of life as non-diagnosis. Reports from the Commons Science and Technology, Education and Health and Social Care Committees have all highlighted the lack of government strategic direction in early years policy and the need for a cross-governmental approach. The noble Viscount, Lord Bridgeman, spoke about this. The Government rejected those claims. Well, sadly, they would, wouldn’t they? Look at what has happened to Sure Start. My noble friend Lord Morris spoke powerfully about Sure Start. It was one of the best examples of early years intervention this country has known. It targeted parents and children under the age of four living in the most disadvantaged areas. Sure Start projects delivered a wide variety of services designed to support children’s learning skills, health and well-being, and social and emotional development—and where is it now? Since 2010 the Government have presided over the laying waste of this scheme, cutting funding by two-thirds and seeing more than 500 centres close.
In the meantime, the Government continue to put pressure and responsibility on to our underfunded local councils and schools. If a child with special educational needs is lucky enough to get across the hurdles of receiving a diagnosis and getting an education, health and care plan, we are asking our schools to stump up £6,000 per child in addition to the funding from the local authority. Given that local authority schools have an average funding deficit of £570,000 and that there will be a projected national high-needs spending deficit of between £1.2 billion and £1.6 billion by next year, this is surely untenable. Short-term cash injections of too little money will not suffice. Local authorities and schools in their current state cannot adequately support the most able of our children, let alone those in most need. We must ensure that the importance of early years intervention is not under- estimated. We must invest in early years interventions across the board. While good work is being done, more needs to be done so that no child goes unsupported and no family has to fight for the support their child desperately needs. This is Britain in the 21st century. We need to wake up to this.
My Lords, I am grateful to the right reverend Prelate the Bishop of Gloucester for securing this important debate. I congratulate her on the excellence of her speech.
Early years intervention for the most vulnerable children and families is a multifaceted topic that requires a collaborative approach. The evidence which suggests that the early years of a child’s life are pivotal to their ability to flourish throughout their childhood and into adulthood is compelling.
It is a grave misfortune that far too many children do not experience the care and security they need in their early years. The welfare of the most vulnerable citizens in our society is not a partisan issue so it is only right to pay tribute to the former Labour MPs, Graham Allen and Frank Field, for their extensive work in this area.
I broadly welcome Her Majesty’s Government’s decision to allocate an extra £165 million to the troubled families programme. Can my noble friend the Minister say how the Government will ensure that the money is used effectively?
Research suggests that children from unstable homes are 75% more likely to fail academically, 70% more likely to engage in drug abuse and 35% more likely to experience long-term unemployment and become reliant on state benefits. These children are also often dealt with in the juvenile criminal justice system.
I welcome the Government’s emphasis on how the merits of localism can bring about the change so desperately needed in our communities. Local authorities, agencies and community groups have the potential to play a vital role in ensuring that individuals and the most vulnerable members of society receive the support that they need.
A renewed focus on prevention is required to draw on the expertise and capacity from all areas of society for it to be sustainable. These groups have a role to play in offering practical and emotional support to children and families in need. Can the Minister inform your Lordships’ House of any steps HMG are taking to give local councils adequate support in tackling this important issue?
The delivery of early years intervention programmes will be most effective when operating with the long- term stability of the children in mind. In cases where children are unable to return to their birth parents, permanency will be sought elsewhere through adoption or foster care. In the context of early years intervention, adoption is particularly relevant as a high proportion of children placed for adoption are under the age of five. There are 75,000 children currently in England’s care system, of which 13% are between the ages of one and four, with a further 4,500 children not even one year old.
The charity Home for Good has been running a campaign called Change His Future, which raises awareness of the reality that black children wait significantly longer to be adopted compared to other children. This is largely due to a lack of adopters stepping forward from BAME communities and an overrepresentation of these children in the care system. As such, many of these children face long waits to find an adoptive home or never find one at all. Furthermore, there is a large shortage of foster carers from BAME communities in two-thirds of English councils.
We are all aware that committed family relationships have an unrivalled impact on children in their early lives. The current shortage of foster and adoptive families in this community must be addressed. Can the Minister inform your Lordships’ House of any steps Her Majesty’s Government are taking alongside local authorities to address these challenges?
Analysis by the Early Intervention Foundation suggests that £16.6 billion is spent on late interventions by the public sector each year in England and Wales. This figure does not take into account the ancillary costs to society. I wholeheartedly welcome the Government’s decision to commission the Early Intervention Foundation to investigate the family hub model and sustainable local practices. I very much look forward to learning the findings of the report later this year.
We all have a moral duty to support the most vulnerable children and families in our communities. Early intervention requires a collaborative approach built on trust and sustainability. I sincerely hope that we are closer to reaching a point where no child is left behind.
My Lords, I, too, thank the right reverend Prelate the Bishop of Gloucester for her splendid introduction to this debate. I did not disagree with a single thing she said. I also did not disagree with the points made by the noble Lord, Lord Mawson.
Prior to working in the trade union movement, I worked in community development and I agree that the involvement of local people, with their experience and knowledge, is hugely important in the proper delivery of services in local communities. However, these two matters are not mutually exclusive. Local people, no matter how well intentioned, experienced and knowledgeable, cannot deliver a service out of thin air. It needs financial support and clear policy guidelines and commitment from central government for those two interventions to work together.
Other noble Lords commented on the closure of Sure Start centres. I will repeat the point, despite it having been made several times already, because the more we say it, the more people out there may take notice. More than 500 Sure Start centres have closed since the coalition Government came in in 2010. The programme had been established by the Labour Government and was just finding its feet. Closing the centres was a completely ridiculous decision and a waste of both money and the experience and knowledge that were being built up. Some 66% of the finance for Sure Start has been taken away but the Government have the audacity to say that they support early years intervention.
I will give the House a small example I saw a couple of weeks ago that made me think that a local Sure Start centre would have been a really good thing. I got on the bus to start my journey to the House. A mother had a baby in a pram and a little boy, probably about three years old, sitting next to her. She was not one of those mothers who never says a word to her children—of which there are many—but she never said a single positive thing to that little boy. She told him to shut up. She told him to stop fidgeting. The final straw, in my opinion, that nearly made me leap up, was when she told him to stop laughing.
That poor little fellow was getting no encouragement, no language development and no assistance to know how to behave. I thought that a Sure Start centre would help that family. However, the Treasury in its wisdom has its books at the ready, adds up its figures and, like the computer, says no. The result is a family with no help, where the children will be incapable, as they grow up, of developing their full potential or being able to make a good contribution to the state. It is penny-wise and pound-foolish.
The second example that has been brought to my attention is the effect upon children of homelessness. Personally, I do not know anybody who has become homeless. I count myself as grateful for that because there are so many homeless people. Shelter tells us that, every eight minutes, a child in this country becomes homeless. We may as well be living in a third-world, undeveloped area when we think about those kinds of statistics. This particular family includes five children: an older teenager, an 11 year-old, a seven year-old and two year-old twins. The father lost his job, and the private landlord decided that he would not have a family on benefits living in his rented accommodation, so out they had to go.
They approached their local authority, Redbridge London Borough Council, and were rehoused in a room in a hotel miles from anywhere. There is no bus to go to the shops, so the mother and the twins are stuck in the one hotel room. The father takes the two other children to school on the school bus. The school bus turns up at 7 am. It takes the best part of two hours to get to the dropping-off point. Actually, he can take only one child to school, so, when I said he takes the two children, I made a mistake—I beg noble Lords’ pardon. He takes one child to school. By the time they get to the dropping-off point, there is insufficient time for him to take the two children to two different schools. The seven year-old was going to junior school; but the 11 year-old is now at senior school. It has been decided by the family that, as the 11 year-old is in more senior education, she is the one who has to be taken to school. So the seven year-old is now not at school.
Is that a good start in life? Any early years intervention that the seven year-old may have benefited from when she was smaller will soon be gone. The two year-old twins are getting no stimulation as they are stuck in the hotel room miles from anywhere. Do we think this policy is going to help the young people of this country? If austerity carries on for much longer, we may find what John Maynard Keynes always said: the more you have austerity, the poorer everybody gets and the more we go down and down. I beg this Government to reconsider their austerity programme. If we are to have young people able to grow up properly and contribute to our society and to this country, we have to invest in them. That means money.
My Lords, I congratulate the right reverend Prelate the Bishop of Gloucester on securing this important debate, and for her continued work to support children and families. I declare my interests as set out in the register, particularly as a board member of Ofsted.
If your Lordships will indulge me, I would like to start today by paying tribute to the many wonderful early years professionals who have supported my own family over the last decade. It would feel wrong not to do that. I have three young daughters, born in 2010, 2012 and 2015. Many times I have wished away a sleepless night or a toddler tantrum, yet now I find myself emotional about the fact that the “baby”, as we still call her, will start reception in September. We are coming to the end of our own early years.
Like millions of others up and down the country, my family is indebted to the people who helped us: the midwives, the health visitors, the nursery teams; they do not often become famous, but these are the people who save our sanity when we stumble blindly into the journey that is parenthood, and whose patience seems to know no ends when we ring up, once again, and ask, “Is this normal?” I thank each and every one of them. I have a simple ask of the Government—I am afraid that it is a wish list, but I do not do this often. I echo my noble friend Lady Newlove: train more of these people, pay them properly and use your platform to speak about their value to us all.
It strikes me that, when we talk about early years policy, we sometimes fall into the trap of thinking about the country’s youngest children as isolated individuals, weirdly forgetting altogether that they are completely dependent on their parents and, when their parents need help, on wider society. I do not mean this as a particular criticism of the Government. I am simply thinking of the number of times that I have heard funded nursery hours cited as the magical solution to every societal problem, as if two and three year-olds will get themselves up and dressed and trot along to nursery, leaving the rest of us to focus on economic productivity.
To be clear, I think funded nursery hours are a wonderful thing; my youngest daughter will be taking part in story time as we speak—at least, I hope she is. However, the debate around early years provision is sometimes soulless. We have spent endless hours in Westminster agonising over our national identity in the context of Brexit. I suggest that what we are talking about today is far more important, although there may be fewer of us. I venture to suggest that, if we invest as much time in thinking about how we bring up well-balanced young people, we may find the upcoming generations less likely to tangle themselves up in the way that we have all done over the last few years. We can but try.
This is why I want to talk again about family hubs— now a very welcome government manifesto commitment —as an integral part of the early years offer. Family hubs ensure that families with children from the early years right up to age 19—or up to 25 for special educational needs and disability—can access early help to overcome difficulties and build stronger relationships. Before I go on to say why I think they are the right approach, I want to say that I have listened very carefully to the all the contributions today. I accept some of the criticisms that have been levelled at the Government; I think that, on the whole, they have been made in a fair-minded way. I will talk about why I think this is the right approach, but it is in that context.
At the moment, even in areas with excellent services, they can often feel piecemeal to users. One consequence is that the transitions for young people are often difficult. Family hubs bring together both targeted and universal services. Placing universal services such as birth registration within a family hub means that they can provide the ideal place to identify more complex needs and refer people on to targeted provision. This is particularly important for perinatal mental health. With 20% of new and expectant mothers experiencing mental illness, hubs provide an opportunity for practitioners to identify early warning signs, especially where they include health visitors and antenatal and postnatal support. The integration of voluntary initiatives into hubs means that mothers have access to community and peer support that go beyond just statutory services.
Time is, as ever, tight, but we can point to some very good examples of hubs, from the Isle of Wight, to Leeds, to Wallsend in my own native north-east, where hubs can take an innovative and bespoke approach to early years based on a deep understanding of local need. I am urging the Government to support family hubs because I think that a birth-to-adulthood support service will establish deeper relationships and make transitions less risky.
I am very aware that children’s centres across the country have closed and that local authority budgets are tight. I want to be clear that there can be no dilution of early years support. This is about offering support in a holistic way, not striving for efficiencies for the sake of it. There is evidence, of course, that family hubs can report cost savings through the co-location and co-delivery of their services. I have no problem at all with making public money work harder and better; this is for local authorities to lead on. But I want to know that the investment is there in the first place, and I would be grateful to my noble friend the Minister for reassurance.
As we sit here this afternoon, parents up and down the country will be confiding in a health visitor, or perhaps awaiting the results of a speech and language assessment, worrying about the short and longer term. The early years are, for families, some of the most joyful but also the most anxious. Will the Minister please update the House on how the Government plan to implement their manifesto commitment to “champion family hubs”, and reassure the House that excellent early years provision will be at the heart of all that hubs do? When it comes to working with our youngest, there is a saying that another mother gave me one night as I was sitting by a hospital bed when my little one had bronchiolitis. She said, “The days and nights are long, but the years are short.” We have a short window of opportunity, and we cannot let our children down.
My Lords, I too congratulate the right reverend Prelate on securing this debate, which is timely given the other things going on.
All children learn and develop quicker in the early years than in the rest of their lives. By the time they are two, the brains of babies will have a different shape and size which reflect the nurture, care and stimulation or the neglect they have had. When you look at scans of two year-old babies’ brains, it is terrifying to see the difference between someone who has been severely neglected and someone who has had the sort of loving care and stimulation we all want for our own families. It is, therefore, in the interests of all of us to pay attention to the needs and opportunities of children in their very early years.
We need to look at this again. The nature of family and community life has changed drastically in my lifetime, and our services need to understand and reflect that. We hear stories this week of the rising costs of childcare. It is now a problem for most families. I have not come across a family with young children that is not talking about it. The noble Baroness, Lady Wyld, addressed this complexity and lack of coherence, but it is also very challenging, so we all have to look at this again, and do so seriously.
When I was appointed to the Cabinet Office—and this reflects my old age—in 2006, I was given the social exclusion brief. The Prime Minister charged me with looking at why the Government had not succeeded in really changing the life opportunities of the bottom 2% of our society. I will not talk about the rest but about that bottom 2%. We had set up and started the Social Exclusion Unit in 1997 and, 10 years later, were really frustrated that we had not shifted this bottom 2%. Anybody who had any engagement or work with the different benefit systems for single-parent families, people with disabilities and so on was able and encouraged to access other services, such as Sure Start, and received tax credits and the minimum wage. That sort of package made an incredible difference to their lives.
Sure Start was part of a package to improve opportunities across the board, but we also knew there had to be systems within it to recognise not only the best start for every child but those who were going to face particular challenges, so they could be picked up early with appropriate interventions and just to keep hold of them. My work was to ensure that the most disadvantaged had the most effective interventions and opportunities. Spotting or identifying these children and beginning the intervention cannot wait until school. People now talk about school readiness, because they know that, if we do not enable children to start school with a chance, we are making it clear that, for the rest of their lives, they will struggle to keep up.
I insisted that there was someone from the health service based in every Sure Start centre. It was normally a health visitor, because they have a statutory responsibility to visit every family in the early years. I would like to see more health visitors, but that is part of their role. I looked around the world at all the different interventions for disadvantaged families to find the most effective. Coming back to the speech from my noble friend Lady Wilcox, I discovered the Incredible Years in Wales. It was an international programme, devised in Canada, but taken up by an inspirational educational psychologist in Wales, who persuaded the Welsh Government to train every Sure Start in how to introduce the Incredible Years parenting package. It had fantastic outcomes.
I also learned from other evidence-based programmes and introduced 10 pilot programmes of the nurse-family partnership—we now call it the family nurse partnership. It is expensive, because it starts six months before birth and then works with the mother and newly born child until the child is two. The 20-year analysis that we looked at showed better outcomes than anything else in the world, in terms of the amount of money spent for the return, first by the time the child was seven and then when they were 15. All Governments say it is great to introduce programmes like that, but they are virtually disappearing in this country, because we are not paying for them. It goes back to that: if we make the right investment, at the right time, we will save a lot of money down the road. I do not care what the Government call any intervention but, for goodness sake, do not throw everything out because it was done by a different Government. Learn from what works and make sure kids get those opportunities.
My Lords, this is one of those debates in which there has been an incredible amount of agreement. There has been a slight tonal difference, but the agreement has been overwhelming. The right reverend Prelate—I thought of this, so I have to use it—is a prelate who displayed some punch today. She started the whole thing by saying that if you get the basis right, somebody’s life gets a little easier; it is easier for them to have a pleasant experience and for society to benefit. I am paraphrasing, but that is roughly what was said, and everybody has agreed.
The difference becomes clear when you look at what it means. It means start at the beginning: government has to work together. I do not know how many people have spent how many hours, in this Chamber, saying, “Get two departments of government to work together to a commonly agreed goal.” There are many ex-Ministers in this place who have battle scars and tears on their bodies from trying to drag another department to work with them. I have seen it happen. I have seen stress lines appear on a face almost in front of me. We have touched on housing, the DWP, education and health today, all of which have a key part to play here.
The briefing from the Library lists 12 different projects over two pages—and it said it was not in any way an exhaustive list. These are the structures and organisations involved in trying to support people. The number of problems here is mind-blowing, because of the number of things that do not work and create problems. A parent may not have the facility, financially, intellectually or educationally, to deliver this, usually because they did not get support themselves.
The right reverend Prelate the Bishop of Gloucester brought in language development. If a child cannot talk properly, there may be many reasons why—for instance, dyspraxia, mental development, language facilities or autism, down to simply not being talked to and stuck in front of a screen or being shouted at and told not to speak. If that is coming through and that person cannot talk, they are stuffed when it comes to dealing with the rest of society. If their capacity to communicate is fundamentally limited, what will they do? How are you to explain that you even have a problem if you cannot talk coherently? You might need help at school but be unable to talk or interact. This can be caused by a variety of things, and it is just one small example of how you cannot get by.
With regard to my own background—I remind the House of my interests, predominantly in special educational needs—dyslexia is not normally easily identified at an early age because it is not really ingrained in education. However, the principle is the same: if you get in early, you will get help. The noble Lords, Lord Astor and Lord Touhig, pointed out that autism is possibly the classic example of early recognition being needed to get the right help. In this area, too, you need to identify early, but if there are lots of people around who for other reasons are not communicating or developing normally, it gets much more difficult.
You have to start developing because if you have a hugely clouded field of vision, with the best will in the world, you cannot deliver the help you want to. How can you do this? What happens normally is that the parent comes in and supports the child, who gets the help. That process involves 12 different bodies, and people try to find their way through. If you have not come from that background yourself, how do you do it? My noble friend Lady Tyler put her finger right on this issue; indeed, I have not forgiven her for taking away the biggest point in my speech. The parents who come from that background are the best equipped to get the best out of the system. That has become accepted practice. We have a series of debates coming up next week that point that out.
How are the Government going to help people to identify the problems just for people with special educational needs? Let us take that group to get them out of the way; if they are dealt with then that clears the field for everyone else. We will do that only if we have very well-trained staff, access to them and support for them, but this is not an area awash with very well-paid jobs. There is SENCO support when you get in early, but do the staff know even when to call in the help? The answer is no, they do not have the training. These characteristics are found throughout the education system later on, but here I feel that they are even more difficult to identify.
You have to get the staff trained well enough to know when to call in help and say, “This is it”, particularly when you have parents who are not equipped to do the heavy lifting themselves. Those are the groups most difficult to reach. The question, “When are you going to come in and do this?” is very important. The rest of the organisations, such as those dealing with autism and dyspraxia, are run by parents who are taking on this job themselves. It is less likely to happen early on, but if it does it is better because you do not have the structure or the experience. Problems that manifest themselves at the beginning are less likely to be spotted. If you want to save yourself money later, start training staff properly. Of course, we know that that does not really work because no one looks beyond their own department and their own budget, so the Government have to co-ordinate. We have to make sure that these people are better trained and that the people who support them are numerous and well-trained enough to intervene. We should start to make a difference in that cohort.
The rest of this is a huge task that society may never get right but it can certainly improve on. Bad housing and bad accommodation, where people are not working together, will add to all these problems. We have to try to become a little clearer about where to apply leadership. I put my bid in there, but others will have other points to make.
The noble Lord, Lord Mawson, commented that we do not need another study or another survey. I quite appreciate what he feels because, many times in various fields that I have been involved in, I have heard people say, “Yes, they’re saying exactly what they said last time. They have said it slightly differently but it is essentially the same thing.” They still do not talk to someone else who may have carried out the same survey somewhere else. If you want to have a moratorium to ask, “What’s the best thing that we have discovered over the last five years?” you might save yourself some money and time and get yourself to a more coherent position.
Lastly, what is the Government’s position on centralising this issue? The briefing suggests that the local authority should do it, but there is no real doubt that local authorities are in no shape to do that. It does not really matter how we got there; it is where we are now. Are the Government going to co-ordinate this? How will they bring the departments together, even if in this field it is just health and education? What are we going to do and what is the timeframe? We have established very clearly that we need central direction and action. We have identified the problem; let us start identifying at least some solutions. Let us see if we can make some progress.
My Lords, I congratulate the right reverend Prelate the Bishop of Gloucester not just on securing this important debate but on the impressive and comprehensive manner in which she introduced it. I also noted the quite penetrating questions that she posed, not least about children and families hit hard by the cruelty often inherent in the introduction of universal credit, and about the Government’s determination to force mothers from disadvantaged backgrounds into work irrespective of the obvious effects, as other noble Lords have said, on their children’s early years development. I look forward to the Minister’s responses to those questions, among others. In passing, I welcome her to her expanded ministerial role in education.
The Early Intervention Foundation has shown that effective early intervention works to prevent problems occurring, or to respond immediately when they do before the problems get worse. It also helps to develop a set of personal strengths and skills that prepare a child for adult life. Every noble Lord has alluded to the fact that a child’s preschool years are critical to development, involving rapid growth unmatched by any other time in their lives. My noble friend Lady Armstrong spoke with great experience and highlighted the damage that can be done during that period.
Improving child development in the early years is vital in aiming to ensure that every child is school-ready, because only that will begin to reduce educational inequality. Despite successive Governments raising levels of development, according to research by the charity Action for Children, only 57% of children from poorer backgrounds are ready when they first arrive at school, compared with 74% of their better-off peers—a gap that the charity says has not reduced over the past year. Children from disadvantaged backgrounds spend significantly less time in preschool than those from affluent households. Timely and effective early years interventions have the potential to help reduce this difference. The Action for Children research also revealed that the availability of early years interventions, as well as the resources available to provide high-quality interventions, have reduced significantly over recent years.
My noble friends Lord Morris and Lord Touhig outlined the sad decline of Sure Start, which had some 3,600 children’s centres when Labour left office in 2010. My noble friend Lady Wilcox provided a Welsh perspective to the debate, and I know that the Flying Start programme there has brought similar success. I have to say that my noble friend Lord Touhig was actually too kind; there are now over 1,000 fewer designated Sure Start children’s centres, and it has been deeply depressing to see so much of this transformative programme allowed to wither on the vine under Tory Governments.
The family hubs that have been much mentioned today are supposed to replace those centres, but they do not. Many of them fail the Sure Start test of being within pram-pushing distance for parents, and as a result they are much less well used. I very much hope that the forthcoming report on hubs will address that issue.
If childcare and early years education policies are designed to enhance child development at the earliest opportunity, the underfunded 30 hours’ childcare offer is failing. The Minister may have seen an article in yesterday’s Times reporting that nursery fees have risen at twice the rate of inflation because the 30-hours policy does not meet the cost of delivering those hours, and the gap has driven up charges for the additional hours that working parents need. Fees across the UK now average more than £13,000 per child per year.
Last year an inquiry by the All-Party Parliamentary Group for Childcare and Early Education into the policy of 30 hours’ free childcare found that the average cost of delivering an hour of early education for three and four year-olds was £5.36. The Government’s funding rate is £4.46. That amounted to a £63 million shortfall and, unsurprisingly, has led to increase of almost two-thirds in the closure of providers, with those in the most disadvantaged areas, sadly, twice as likely to face closure as those in more affluent ones.
Last year, the Government announced what can only be called a miserly increase of 8p in the hourly rate for funded childcare, while it is estimated that the planned increase in the national living wage will add 51p an hour to the cost of provision. It is no wonder so many in the sector are in despair. I suspect the Minister will make much of the £66 million of funding allocated in last year’s spending review. But that does not even come close to the £300 million required to restore the cuts to early years provision and prevent providers having to close down, a fate awaiting many at maintained nurseries in August this year. They have the right to expect sustainable long-term funding to secure their future.
A research company contracted by the Early Years Alliance calculated that there is currently an overall annual funding shortfall of some £370 million for the various free entitlement offers, which represents a crisis by any standards. That plays into the landscape painted so ably by the noble Baroness, Lady Newlove.
Preschool provision, whether at maintained nurseries, PVIs or childminders, is extremely important for early years because of their low staff-to-children ratios. But there are not enough staff qualified to degree level; we believe each setting should have a graduate leader. Between 2007 and 2011, the graduate leader fund was successful in setting the early years sector on a path towards increasing staff qualification levels. That period saw ring-fenced funding lead to the number of staff holding a first degree or a foundation degree increase by 76%, while the number of those holding a higher degree increased by 13%. These are significant figures and were welcomed by the DfE. Indeed, the department commissioned an evaluation of the fund in 2011 which was largely positive, yet it was allowed to die. Given its proven ability to raise the level of support staff who are able to provide for children in their formative early years, it should now be resurrected. I would be interested to hear what the Minister has to say on this.
Currently in England’s care system, around 10,000 children are aged between one and four, with a further 4,500 under the age of one. Two-thirds of these children, many of whom are adopted, will have experienced abuse or neglect. Studies have demonstrated that experiencing trauma in the key developmental early years, including in the womb, can adversely affect childhood brain development, which has a lifelong impact. It is imperative that these children receive targeted, ongoing support in their early years. The noble Lord, Lord Sheikh, was right to identify the particular issues relating to fostering and adoption of BAME children.
One example of an existing intervention is the adoption support fund, which provides access to therapeutic support for adoptive and some special guardianship families across England. The need for that fund’s future to be guaranteed was a plea that I, together with other noble Lords, made in a debate in your Lordships’ House just two weeks ago. In what turned out to be his valedictory appearance, the Minister’s predecessor made it clear that he supported that aim. I hope that she will be able to repeat that today.
Equal focus should be given to the physical and psychological well-being of every preschool child and their family or carers. In its briefing to noble Lords, the British Psychological Society highlighted that 5.5% of preschool children have at least one mental disorder and that the preschool children of parents with poor mental health are three times more likely to have some kind of mental illness than children whose parents have good mental health. The noble Lord, Lord Astor, and my noble friend Lord Touhig spoke on this with regard to autism. The British Psychological Society wants the Government to develop a cross-departmental health and well-being strategy for under-fives. Central to that, it says, should be a cross-departmental, multi- agency approach—a plea made by several noble Lords today, including the right reverend Prelate and the noble Baroness, Lady Tyler.
The Royal College of Speech and Language Therapists also supplied an excellent briefing for the debate, pointing to the fact that around 50% of children from disadvantaged areas start school with delayed language and other identified communication needs, some of which they never fully recover from. The college also calls for the Government to have a national joined-up strategy: the need for one is a recurring theme in the various reports produced by Select Committees in another place in the past two years. They all reached that conclusion in order to counteract the fragmented and highly variable provision of early years intervention, and to meaningfully tackle childhood adversity. Yet each time in their response the Government rejected the proposal, citing their belief that local areas are best placed to understand the needs of local communities.
That might be plausible were all local authorities able to provide a common standard of provision, but that is certainly not the case. I suspect the real reason that the Government have set their face against a national strategy is because it would require national funding, which they are not prepared to countenance. Perhaps the Minister can explain why this Government believe they have a monopoly of wisdom on this subject, and know better than the professionals in the field as well as the considered views of parliamentarians, who have listened to evidence from a wide range of organisations before arriving at their recommendations.
Many noble Lords have spoken today about social mobility. Implicit in the notion of social mobility is that poverty and inequality are tolerable, provided some people can escape by climbing the social ladder. For Labour, the true measure of fairness is not social mobility but social justice. Social justice demands that we end poverty, reduce inequality and create a society in which the conditions for a fulfilling life are available to everyone. That should start from day one of a child’s life but that aspiration is some way removed from where we are today.
My Lords, I too congratulate the right reverend Prelate the Bishop of Gloucester on securing this debate and all noble Lords who have spoken on this important issue. I am grateful for this opportunity to set out the Government’s approach to improving early years interventions. I hope that the level of co-ordination, although not perfect, will assure the right reverend Prelate and other noble Lords that we are moving in the right direction.
The approach of the Government is based on a number of principles: that early, rather than late, intervention is the key, as noble Lords have outlined; that it is central government’s role to support, facilitate and work with local government and other partners to tackle the issues together; that our solutions should be focused on outcomes and underpinned by evidence; and that successful strategies should be identified and shared widely.
This is the first debate in my widened portfolio, and it is a serious and complex matter. It straddles a number of central government departments, including the Department for Education, obviously, the Department for Work and Pensions, the Department of Health and Social Care and the Ministry of Housing, Communities and Local Government. But a co-ordinated approach to tackling early intervention is what the Government aim to achieve. There are meetings between the Department for Education and the Department of Health and Social Care on the advisory programme board to ensure that there is co-ordination across government. The noble Baroness, Lady Wilcox, mentioned the Welsh example, which is open to the What Works institutions that the department has set up—so there is a spread internationally and from the devolved institutions.
The need for a national strategy has been clearly outlined to me by many noble Lords. That need is under review, but I will take back to the department the clear message that while co-ordination with local government is essential, noble Lords also believe that a national strategy is valuable in this area. With this co-ordination in mind, the Government have prioritised three areas: first, improving social mobility, supported in the early years by high-quality early education settings and learning in the home; secondly, protecting vulnerable children through effective children’s social care; and, thirdly, improving mental and physical health in pregnancy and childhood. This is underpinned by our work to empower local areas to improve multiagency working and build the evidence base—not necessarily the type of research that the noble Lord, Lord Mawson, would talk about—for what works.
Early educational entitlements are not a panacea, but there is extensive evidence to demonstrate that high-quality childcare supports children’s development and prepares younger children for school. This is why the Government have made sure that all three and four year-olds, and disadvantaged two year-olds, can now access at least 15 hours of free childcare each week. In 2020-21, this is at a cost of £3.6 billion.
As many noble Lords outlined, when children start their formal education, the reception year presents a window of opportunity to address the key development gaps between disadvantaged children and their peers, before they have a chance to widen. The noble Baroness, Lady Tyler, mentioned disadvantaged two year-olds. The take-up rose from 58% in 2015 to 68% in 2019, but there was a slight decrease last year, so the department is working with the Family and Childcare Trust and Coram to ensure that there is an upward trajectory in the take-up for those disadvantaged two year-olds.
The noble Baroness, Lady Armstrong, and the noble Lord, Lord Addington, focused on the early years foundation stage. Too many children leave the reception year with poor outcomes, and the current assessment system involves too much paperwork and reduces the time that reception teachers have to support children. The proposed reforms to the early years foundation stage profile will free up teachers to interact with and support children to ensure that they develop the rich vocabulary, skills and behaviours that they need to thrive in school and to access the education on offer to them. There is good news in relation to this assessment: in 2013, 51.7% of children achieved a good developmental score; by 2019, it was 71.8%. The assessment of language and development skills will also be introduced into the universal child assessment for all two year-olds. We have also set a 10-year ambition to halve the proportion of children who finish their reception year without the necessary language and literacy skills they need to thrive.
The home learning environment, as many noble Lords outlined, is also important. We are supporting parents to improve the quality and quantity of adult-child interactions—a point made by the noble Baroness, Lady Bennett. A three-year campaign called Hungry Little Minds has been launched by the department to encourage parents to chat, play and read with their children—the noble Baroness, Lady Prosser, talked about a very moving example she witnessed on public transport—so that they can help to set their children up for school and beyond. We are taking a society-wide approach to get that message out, with different organisations, including charities and businesses, playing their part. The campaign will build on the department’s work with the National Literacy Trust. An interesting example arising from that partnership has been the work of Penguin Random House with Arriva, the train company, to give away books at stations and to train staff to have the confidence to interact with young children on public transport. So we all have a responsibility when we interact with children to help improve their outcomes.
Looking beyond parents, charities and businesses, we are committed to supporting the workforce in this sector to gain the appropriate skills and knowledge—a point made by the right reverend Prelate and the noble Lord, Lord Addington. Alongside our training of 1,000 health visitors to identify and support children with speech, language and communication needs, we have invested £20 million to ensure that practitioners in disadvantaged areas have access to high-quality professional development. On the point raised by the noble Lord, Lord Watson, we are also supporting graduates into the sector through funding the Early Years Initial Teacher Training programme, including fees, bursaries and employer incentives.
In relation to the points made by the noble Baroness, Lady Wilcox, and the noble Lord, Lord Addington, early help of course plays an important role in promoting safe and stable families. It is about supporting and intervening with families at the right time and in the right way. Of course, that does not detract from the need for statutory guidance: Working Together to Safeguard Children is clear that local areas should have a comprehensive range of effective, evidence-based services in place to address assessed needs early. Although many noble Lords have made the point in relation to children’s centres, there is a statutory underpinning that local authorities still need to meet, when looking at services, to meet the needs of the most disadvantaged in their communities. We have also strengthened the duty placed on police, heath and local authorities to work collaboratively to safeguard and promote the welfare of children. Since September of last year, multiagency safeguarding partnerships have been in operation in England. We are implementing those reforms to try to see a further cultural shift in the way that police, health and local authorities work together in local areas to secure the outcomes for children.
I am grateful to my noble friend Lady Wyld for raising the issue of maternity and perinatal health. Since April 2019, new and expectant mothers have been able to access specialist perinatal mental health community services in every part of the country. Public Health England is currently undertaking a systematic review and refresh of the Healthy Child Programme in England to ensure that the future approach is both universal in reach and personalised in response to those families needing extra support. I am pleased to inform the right reverend Prelate that a revised health visitor and school nurse model is being looked at within that work. Also in relation to health, the noble Baroness, Lady Tyler, raised the issue of childhood obesity. The Government’s childhood obesity plan sets the ambition of halving obesity by 2030, and successful initiatives include breakfast clubs and doubling the PE and sport premium up to £35 million of expenditure.
As I have repeatedly outlined, local areas have a key role in commissioning and delivering effective early years interventions to meet the needs of children and families, and I have some examples of where we are supporting that. First, an additional £165 million has been announced for the troubled families programme, which many noble Lords mentioned, bringing the total expenditure to over £1 billion. Of the children on that programme, 34.2% are under two, showing that this is not always an intervention that is too late. This will ensure that more families get access to the programme’s support.
A key aspect of the programme is the key worker, who goes in and builds a trusted relationship with a family, with practical instructions and advice, but also helps that family access the specialist support on offer in their area. Many noble Lords referred to the fact that, often, the person needing the support is least able to be the advocate to go and get that support. That key worker reminds me of my noble friend Lady Wyld’s reference to the people who are around to help you in those years. As the noble Lord, Lord Mawson, said, it is the person who is on your side. I pay tribute to the local authorities—for schools, health provision and particularly those key workers—because this project has been and will continue to be evaluated.
When reading in preparation for today’s debate, there were moments that caused one to forget all the policy, the research and the words and to think about the lives that are being affected by this. The evaluation of this programme shows that, 19 to 24 months after starting to receive support, the proportion of children on the programme going into care—compared with a similar cohort—is reduced by a third. Those key workers, health professionals and local authorities have affected and changed the lives of hundreds, if not thousands, of children who, as we stand here today, are not in care and are still with their families. I thank them for all that work. Also, the proportion of adults on the programme going to prison has reduced by a quarter and juvenile convictions have reduced by 15%. So this is not an intervention that is always too late—and, of course, everybody would wish that we did not have to make any interventions with any families at all.
Secondly, my noble friend Lady Newlove spoke very movingly about the issues for families facing adversity. There is now the Reducing Parental Conflict programme, with £39 million of funding. I am pleased to say that 98% of first-tier local authorities have taken up work on this programme. We know that children who are exposed to parental conflict can suffer long-term harm, and intervening early to help parents reduce conflict obviously affects the outcomes for both children and parents. Through this programme, we are supporting local authorities and their partners to integrate support to reduce parental conflict into their local services for families. DWP is working with 30 local authorities across England to test eight face-to-face interventions aimed at reducing conflict. There is a theme here: it is the face-to-face, the key worker, the person who is there to intervene in situations.
Parental conflict is related to wider family risk factors including, for example, domestic abuse, poor mental health and substance misuse. The noble Baroness, Lady Tyler, referred to alcohol in this particular context. We are investing £6 million to improve the outcomes of children of alcohol-dependent parents who are also engaged in parental conflict. A key thing to say is that adult social services, which deal with the adult with the alcohol problem, work together with children’s social services to ensure that it is joined up.
The noble Lord, Lord Sheikh, asked specifically whether funding was going into local government. The early years local government programme has funding of £8.5 million and is focused on how local services work together across health, education and early help to improve the outcomes for five year-olds. As part of this work, multidisciplinary peer reviews are supporting councils to identify reforms to services, and our early outcomes fund has provided approximately £6.5 million of grants to local authority partnerships. Gloucestershire County Council, in particular, in partnership with Swindon, was successful in securing an early outcomes grant and is using the fund to develop and pilot an early language support pathway: I hope that the right reverend Prelate, with her professional background, will be very pleased to hear that that is happening in her location.
The local government programme also includes work by the Early Intervention Foundation to review effective models for provision. The foundation is reviewing what family hubs and children’s centres can offer. There are still more than 2,000 children’s centres and we do not want to throw out the baby with the bathwater. That evaluation will look at everything that works, and I assure noble Lords that it does not matter what badge is on it: we need to focus. The needs are so acute and these children need such help that it does not matter. What matters is what works: that is the threshold. The Government will continue to champion the role of family hubs because they are a slightly different model to children’s centres—to respond to the question from my noble friend Lady Wyld.
I assure my noble friend Lady Newlove that we are doing all we can for those children who live through adverse and traumatic experiences in childhood, such as abuse or neglect, or who have grown up in complex family circumstances. She has, in me, someone who did not relish school holidays and who is therefore going to take seriously these matters within the department. Such experiences can, and often do, have lasting consequences for children.
Many noble Lords raised the issue of mental health. New mental health support teams are going to be established in 25% of the country by 2023 and the Department for Education will be funding training for senior mental health leads in schools and colleges. The Government remain strongly committed to the What Works initiative. On the point made by the noble Lord, Lord Mawson, about research, I will be going back to the department to ask about the three foundations that the department funds: the Early Intervention Foundation, the Education Endowment Foundation and the Centre for Children’s Social Care—these are “what works”. I will take back his insightful experience in the use of research and the need to monitor how far What Works is spreading from one authority to another: who is using this information to improve and share what is going on.
A number of noble Lords raised the issue of special educational needs, in particular the diagnosis of autism. The NICE recommendation is that the length of time between referral and first appointment to start an assessment should be no longer than three months. Learning disability and autism is one of the priorities in the NHS long-term plan. Over the next three years, autism diagnosis will be included alongside work with children’s and young people’s mental health services to test and implement the most effective ways to reduce those waiting times. I was most moved by the contributions of my noble friend Lord Astor and the noble Lord, Lord Touhig, in this space, particularly regarding children with dyslexia. The Department for Education has contracted the Whole School SEND Consortium to deliver a two-year, £3.9 million programme to help embed SEND in school improvement. As I am sure the noble Lord, Lord Addington, is aware, from 2011 to 2018 the department funded the British Dyslexia Association and other organisations to provide resources to assist schools and local authorities in early identification of those needs.
On funding to tackle child poverty, there is to be a 4.4% real-terms increase in the local authority settlement. The specific issue was raised that local authorities have often prioritised spending on adult social care and other areas at the expense of children’s social care. The department is working with MHCLG to develop a robust and up-to-date fair funding distribution for children’s and young people’s services, which we are aiming to implement as part of a major funding reform package from 2020-21.
On child poverty, I have outlined that the 850,000 most disadvantaged two year-olds have been given free childcare places, and there is an additional 15 hours for lower income families in relation to the entitlement for three and four year-olds. There is also an early years pupil premium, which is just over £300 per pupil. It has been interesting to see how these issues all intersect and relate to that. I hope that the research into family hubs and children’s centres will enable us to look at how best we locate services and help the most disadvantaged children. The Government stand by our position that work is the most effective way to bring these children out of poverty, but of course we recognise that free childcare is needed for many parents to take advantage of that.
I apologise to noble Lords whose questions I have not answered, but I will conclude by responding to the two invitations I was kindly offered. The noble Baroness, Lady Tyler, invited me to the APPG. I think that may be for my honourable friend the Minister for Children and Families, but I will take the invitation back to the department. I apologise for my late response to the persistent invitations of the noble Lord, Lord Mawson, in relation to his wonderful work. I look forward to catching up with that and I hope that one of my first visits will be up to Rotherham. I thank noble Lords for their involvement in such an important debate.
I thank the Minister for her comprehensive response and all those who participated in this excellent debate. I do not have time to mention everyone, but I thank those who shared personal and professional experiences. I am sorry that the noble Lord, Lord Mawson, feels he has heard another bishop say, “It’s all down to the state”, particularly as that was not what I was saying. I am passionate about community engagement and how we enable that, not least through our churches, our faith groups and all sorts of charities and communities. In order to enable that, we need a comprehensive, joined-up early years strategy and I am glad that that point has been clearly heard. This is about how we are investing not simply in small children but in children who grow up to be adults: we are investing in families for long-term impact, and I agree with the noble Lord, Lord Mawson, that this is about the impact on our communities in the long term.