I am pleased to have secured this debate. I stress at the outset that the subject of extending Sure Start is firmly set within the early years framework and is in recognition of the Government's massive commitment to, funding of and progress on that sector.
I remind hon. Members that the key developments to date include the national child care strategy, which was launched in 1998 to ensure accessible, affordable and quality child care. There have been huge expansions in child care provision in the public, private and voluntary sectors. So far, 1.6 million children have benefited, and that figure is set to rise to 2 million by 2006. Neighbourhood nurseries are providing 50,000 new places, of which 45,000 have been given. Sure Start local programmes, of which there are 524, and mini-programmes have made an enormous contribution.
A network of children's centres is rolling out in disadvantaged areas and extending the Sure Start principle. It is providing good-quality child care, early education, family and health services, alongside training and employment advice. All those programmes are rightly located in the Sure Start unit. They do not constitute all the initiatives, but they are important measures to support families and to lift children out of poverty. No Government have done as much on that agenda.
In 1997, following the comprehensive spending review, a cross-cutting review was set up of services for young children. That was on the basis of concern that those services were not functioning adequately, that money was not effectively spent and that they were failing those in greatest need. The review's findings confirmed those concerns. Therefore, in 1998, the Chancellor of the Exchequer announced plans for Sure Start to bring together quality integrated services for under-threes through community-based local settings.
The rationale for the programme was the evidence base from the United States programmes, which were targeted at poorer children. For example, Early Head Start in the USA found that, for every $1 spent in early years intervention, $4 was saved in crime, social security and mental health costs. There were statistically significant positive impacts on learning, social emotional development and parenting outcomes. Similarly, an evaluation of the Perry pre-school study by High/Scope found that, when 27-year-olds went through the programme, there was a positive impact in terms of arrests, drug dealing, earnings, education performance and stable relationships. There were also enormous cost-benefits. The study described it as
"an extremely good economic investment, better than the stock market during the same period of time".
The National Evaluation of Sure Start was set up to examine its effectiveness and impact on children, families and communities. Its methodological report executive summary noted that the Sure Start model presumes that changes in existing services will lead to improved service delivery and, ultimately, to enhanced child, family and community functioning.
The programmes were to be targeted at the 20 per cent. poorest wards and were to be rolled out in six waves. Sure Start in Erewash is in the fifth wave. NESS agreed with that targeted decision because local programme areas experienced consistently worse deprivation across a number of indicators, including child and adult health, educational achievement, school behaviour, crime, unemployment and benefit dependency.
The common features for each programme are mandatory. It must provide outreach and home visiting, support for families and parents, good-quality play and learning, primary and community health care, support for children and parents to access services, and parental representation on local boards. To make progress, beyond those core elements there is a higher degree of flexibility. Innovation and local initiative are positively encouraged.
Four objectives to improve Sure Start service delivery were initially set, and a fifth has since been added. They are improving social and emotional development; improving health; improving learning; strengthening families and communities; and the availability of accessible, affordable and quality child care, which was added later. For each objective, public service agreements or targets are attached. Initial targets have been amended and further developed to include, for example, increasing the number of households with someone working, and improving children's language development.
Some initial targets and outcomes have been reported on. There has been success in reducing the number of children re-registered on the child protection register, which was an early target that no longer exists. The number of parents going back to work from households where no one was working has also gone up. Parents say that the information that is given is good, and nine out of 10 parents reported improvements in the quality of services. Sure Start was in contact with 90 per cent. of parents within two months of birth, and that target has been adjusted slightly to include contact prior to birth. The only target that is significantly failing is that for the reduction in pregnant mums' smoking.
Studies in the United States took a long time to produce a through-life evaluation, because benefits of these schemes are short, medium and long term. Nevertheless, there is encouraging progress. A 2002 report by NESS noted high parental involvement, voluntary organisations engaged in nearly all partnerships, a wide range of mechanisms to access services, good progress on partnership working, and an encouraging number of volunteers coming forward, with an average of 20 for each scheme. The flexibility given to local programmes has allowed them to be innovative and to respond to their communities. Many right hon. and hon. Members have heaped praise on their own local programmes, because they, like me, can see them working.
Erewash Sure Start has hit the ground running following best partnership multidisciplinary working with parents in key positions. There are many innovative programmes. For example, one notable achievement is the removal of all children in the scheme from the waiting list for a speech therapist—they now all have one. Volunteering is also excellent.
There are many other examples of success, which have been quoted before. In Corby, the number of children who have a special needs assessment before entering school has been cut by 10 per cent. In Leicester, children's referrals to emergency social services have been cut by 40 per cent. Leicester has also improved and expanded breast cancer counselling support by delivering it through a volunteering parent group, which has been trained. Interestingly, that peer approach is working much better than using professionals. In a London borough, children who were referred to the early years programme by social services are now performing as well at key stage 1 as children from far more advantageous homes.
Today's debate is about extending Sure Start, and the Children Bill is an exemplary way forward. It sets a sound statutory framework for partnership working; common objectives, a common assessment and an integrated inspection framework; rationalised budgets and simplified funding; greater freedoms and flexibilities for local circumstances; the commissioning of key services through a children's trust; the appointment of children's directors; and better information sharing and parental involvement. That is all to be welcomed. Local flexibility is at the heart of the Bill.
However, I want to see early intervention and co-located services in all areas, as Sure Start programmes have been a resounding success, meeting need while retaining individuality. I flag up my concerns about the tentative words in paragraph 3.10 of "Every child matters: the next steps". We want all local authorities and children's trusts to consider co-locating health, family and parenting support services for children and their families within good-quality early education and child care settings. That will provide easier access to a wide range of support for the whole family.
Ideally, I want that to be firmed up. Such an approach is a proven recipe for success, evidenced in the US schemes and the encouraging outcomes from our own local programmes and children's centres. Also, children's trusts are not statutory organisations, although they are expected to consider joint commissioning. On that point, appointments of children's directors are key to the success of early years arrangements. I seek reassurance that that process will be extremely rigorous. Will regional Sure Start managers, or local managers with excellent track records be involved in such appointments? Vitally, will parents and young people be involved?
My right hon. Friend the Minister recognises that the Children Bill is the first step in a long-term programme of change, with the last directors not in place until 2008. In the meantime, 46 per cent. of deprived children live outside the 20 per cent. most deprived wards. As Sure Start has proved its worth, I am impatient for further local progress. There is much best practice and good partnership working to build on.
My hon. Friend is referring to the extension of Sure Start, but she referred earlier to the success of Sure Start in her constituency in taking children off the waiting list for speech therapists. Unfortunately, that is not true in my constituency, and I know that there is a shortage of speech therapists around the country. The ability of a child to express themselves is one of the most important parts of their self-development. Does my hon. Friend hope that in conjunction with the expansion of Sure Start there will be an expansion of speech therapist provision?
I thank my hon. Friend for that intervention. I believe that there is not only an intention, but a programme to ensure that more speech therapists are trained. I was surprised that the scheme in my constituency managed to secure the professional work of a speech therapist, but apparently that was quite easy. However, I will wait for the Minister to confirm that speech therapy is a priority.
Camden is an example of a council that has forged ahead of the game. It has had an early years focus for many years. It has been so impressed with its five Sure Start schemes that it is rolling out the programme and will mainstream it—I think that it is the first council to do so.
The council has been wholly persuaded that early intervention, linking services and involving parents have the greatest impact on child development and poverty. A decision was taken that funding would be top-sliced without compromising passporting, and that it would be used to enhance existing local programmes through multi-agency parent support teams, drop-ins and community involvement in small areas. The council also funds extra family support and more subsidised nursery places being brought together in children's centres.
All local partnership boards were consulted and signed up to that way of working. Those extended areas will be coterminous with primary care trust localities, and smaller partnership boards will be set up for smaller areas. A Camden-wide Sure Start co-ordinating team already exists at the local education authority. It comprises a lead officer, a business manager, data and information officers and others, all supporting the project. The target date for roll-out is 2006.
Having five Sure Start schemes was an advantage for Camden, but commitment and creative thinking have allowed it to move forward. I know that the Government already support mainstreaming projects in some districts with a number of local programmes, but Camden did it first and there must be scope for others to follow sooner rather than later.
Other areas have far fewer programmes. My constituency has one, but it has developed skills to work across two areas—because it was part of a later wave, there was more flexibility. Some early strategic thinking by LEAs, PCTs and others, and additional seed-corn funding from those organisations could establish structures, including a central co-ordinating team. Identifying potential roll-out areas, encouraging key local people to learn through existing programmes and, where possible, implementing Sure Start principles and practice would be an excellent precursor to the Children Bill and children's trusts. It would begin to change the culture and practice at grass-roots level.
There is a wealth of capacity from volunteers, as I have already highlighted. In the words of Barnardo's,
"integrated pre-school settings, such as Sure Start, bring about the best outcomes for children".
What encouragement can be given to local authorities, primary care trusts, the voluntary sector and community groups to move further ahead? They know that new legislation is on the way, and moving towards a Sure Start approach can only be a good thing.
I warmly congratulate my hon. Friend Liz Blackman on securing this debate. I have had more representations in favour of additional funding for Sure Start from hon. Members across the political spectrum than anything else. It is a bit of an irony: everybody loves Sure Start, but not many hon. Members have chosen to come to have their say in this debate, which is a bit sad. Nevertheless, I am pleased that they like it and I would be delighted with any additional resources that we can secure to ensure the expansion of the programme.
I share my hon. Friend's commitment to the importance of investing in the early years. She comes to the issue having considered a lot of the powerful American research into investment in integrated services in the early years and into the impact that that can have on children's life chances. I come to the issue from that direction, but also from work that has been done in the UK by Feinstein, which shows how children from different socio-economic backgrounds start off very different competences at an early age. One can start measuring their cognitive skills at 20 months.
Children from lower socio-economic backgrounds can have high cognitive skills and those from high socio-economic backgrounds can have low cognitive skills at that age. What is depressing about the research is that, by the time one locks into school, class has overridden those early cognitive skills. The children with low cognitive skills in a higher socio-economic group outperform those with high cognitive skills from the low socio-economic group.
We should try to find ways in which children showing potential at an early age can realise it. That is at the heart of the Sure Start programme. If we really are committed to equalising outcomes on the basis of equality of opportunity, that has to be by investing in the early years. I came back from Sweden last week, and it is very telling that, after 30 years' investment, children there are offered far more equal opportunity. Far fewer children die from child abuse there, and I think that one of the reasons for that is the early investment in parenting support, family support and children's opportunities. That can help to deal with some of the tensions in family life that can lead to abuse, so other good results can come out of such early investment.
I looked with envy at the fact that in Sweden about 2.5 per cent. of gross domestic product is spent on early years services. Despite the very successful and massive expansion under the Labour Government, we still spend under 0.5 per cent. of GDP on early years services.
The early years are crucial. My hon. Friend mentioned Leicester and Corby as two examples. I opened a new children's centre in Hertfordshire this morning. It is a nursery school that has expanded into a children's centre and provides all the multi-agency services to children from the early years to age five. The headmistress finds that, as the children embark on their nursery education experience, those who have been able to take advantage of the early years services are even readier to do better than those who have not had that experience. Intervention from birth is very important.
My hon. Friend spoke about her experience of speech and language therapists and the benefit that she has experienced locally. My hon. Friend Chris Bryant asked whether we are expanding their use, and the answer is yes but it takes time. However, some interesting local experiments are taking place, involving the cascading of speech and language therapy knowledge and techniques to those who have not undertaken the full training programme but who can, in the nursery or pre-school setting, do sufficient work to help the development of children's language. That will allow para-professionals to work in early years settings and is one way of growing the competences more quickly than through the full training programme, which takes a long time to produce fully trained professionals, of whom we need more.
My hon. Friend the Member for Erewash mentioned our record to date, and it is worth reiterating that, before we came to office, there was hardly anything for children in their early years. There was no national child care strategy. We now have places for 1.2 million children, which did not exist before. There was no commitment to nursery education, but we now have a universal service throughout the country, so that all three and four-year-olds can have access to part-time nursery education for five days a week. We managed to deliver that six months before we said we would in our 1997 pledge.
There are more than 500 Sure Start programmes throughout the country, all of which are benefiting the children living in those areas. They are situated in the most deprived areas in the country, which is important in ensuring that those who can benefit most from early intervention have the opportunity to do so.
As my hon. Friend knows, we are trying to bring together the experience that we have gained with all the initiatives that we have tried during the past five years into the concept of children's centres. It is worth reiterating for the record what children's centres will deliver. They will provide good-quality early years education combined with full day-care provision for children of a minimum of 10 hours a day, five days a week for 48 weeks in the year. That provision will be substantially led by a teacher to ensure that we sustain and enhance quality.
The centres will provide an important outreach to parents. If I came back with only one plea from my visit this morning to Hatfield, it was that we should invest more in supporting parents in the difficult task of bringing up their children. The centres will provide a range of family support services, including child and family health services and antenatal and health visiting services. They will provide support to children and parents with special needs, and I know that my hon. Friend has a particular interest as chair of the all-party group on autism. The centres will provide strong links with Jobcentre Plus, local training providers and further and higher education institutions, so that they can support our welfare-to-work strategy, which aims to lift children out of poverty by providing job opportunities for their parents.
The model that we have developed for England is stronger than those that I have seen in some of the Scandinavian countries. Investment in those countries has been made over a longer time, but it has been on the welfare-to-work agenda, providing child care to enable parents to participate in the labour market. Our model is more child focused, takes a more holistic approach to the needs of the child and, over time, will prove more effective in turning around children's opportunities.
My hon. Friend made several points about the Children Bill and spoke about how, through it, we are embedding early intervention and working together across professional boundaries as key features of the delivery of services for children, not just in their early years but through all childhood and youth, from nought to 19. She asked me whether Sure Start managers will be involved in appointing children's directors, which is an important part of the proposal. I cannot promise that, because it is an issue for local authorities to determine, but the posts will be crucial because they will ensure proper accountability. They will embody the integration that we want in the front-line professional services that touch children's lives.
On whether children would be involved in the appointments, that, too, will be a matter for local authorities. It is part of our thinking to put children and young people at the heart of everything we do to configure and provide services. We want children to be involved in the appointment of a children's commissioner for England.
One of the big culture changes that makes co-location so important is that we want people who are not used to working together, whether they are from health, teaching or social care professions, to develop a mutual understanding of children's development. We want them to work across boundaries—even developing the same vocabulary would be a start. Co-location is one of the levers we can use to encourage that culture change. The others are leadership, training, the pooling of budgets and to set and to inspect targets for children's services in the locality.
My hon. Friend drew attention to what Camden is doing to bring the Sure Start programme into the mainstream and I entirely agree with what she said. One of my strong messages has always been that people do not have to wait for extra Government funding to change the way in which existing services for children are delivered in their locality.
Before the debate, I was engaged with officials in working out how to recognise and to brand the next group of children's centres. Although we will fund many of them, we hope to find mechanisms to brand others that do not get specific Government targeting, but which have all the features that I described, which we want in a children's centre. As my hon. Friend said, this is all about commitment and creative thinking. We want to spread knowledge and understanding of new ways of working, building services around the child and working together in multi-agency teams to improve outcomes for children. I am sure that, as we build and spread that knowledge, local authorities will respond by reconfiguring their services in a much shorter time than Government funding will enable us to do.
My hon. Friend asked what encouragement we could give and whether there would be some seed-corn funding for potential roll-out in the areas. I will consider that further. However, we have given money to some areas that are not in the most deprived wards in England, but where just a bit extra will enable them to develop a Sure Start children's centre. We are considering what further work we can do to encourage that development.
Much of the Children Bill is built on what we have learnt on what works for children through the Sure Start programme. We want to spread that learning throughout children's lives from nought to 19, not just in education and social care, but through children's trusts, extended schools, the development of children's directors and integrated local services, and by bringing into the community health services that work with children.
I am grateful to my hon. Friend for securing the debate. Although short, it has been fruitful and I look forward to further opportunities to discuss the issues to enable us to provide equality of opportunity, which is at the heart of what politics should be about.