I pay tribute to the hon. Member for Richmond Park (Sarah Olney) and the other colleagues who secured the debate. It is great to be having a debate about early years again; we are having a few of them these days. It never happened when I first became a Member of the House and has not for much of my 24 years here. It is really fantastic that such a relevant and important subject to so many of our constituents is now commonplace in the Chamber and that there is real, concerted action. We may disagree over the extent or detail of that, or the amount of money that is going into it, but I think we all agree about the direction and emphasis.
It is a great pleasure to follow the hon. Member for Newcastle upon Tyne North (Catherine McKinnell), and I agree with much of what she said. It is also a great pleasure—but a great challenge—to follow my right hon. Friend the Member for South Northamptonshire (Dame Andrea Leadsom), who is such a guru on this subject that anything the rest of us say subsequently will pale into relative irrelevance, but I will give it a bash anyway.
I want to recount an episode that happened when I was Children’s Minister 11 years ago. I used to spend a week of the summer recess going out on the frontline with some of the workforce, without any fuss and without any cameras, just to see what their job involved at first hand. I remember my first time: I spent a week in Stockport going out with social workers, knocking on doors, seeing cases at first hand, manning the overnight emergency helplines, sitting in on morning meetings and liaising with police and others. It was a fascinating experience, which I recommend to any other Member. I think it should be compulsory for all Ministers and their officials to spend time with the professionals over whose regulations that Department has responsibility. That is where we find out the most. I used to find out most of my information from sitting down with groups of children in care, as the Minister responsible for children in care; that is where we find out what is really going on.
A really good social worker took me to my first case, and I think that she deliberately chose the most challenging case in the most run-down, depressing part of the town. We went into a house that was a complete mess. There was a young mum with three young boys. There were no carpets on the floor. There was virtually no furniture, other than what had been dumped in the garden. There was no food in the house—the fridge was bare—other than what the kids literally were eating off the floor. There were bare mattresses for beds and piles of dirty clothing.
One of the kids had had a really dire toothache for some weeks, and the social worker had gone on at the mum about getting the child some treatment for it. On the day that we visited, the mum had had a toothache problem. On the previous day, she had gone down to the emergency dentist and had her tooth fixed, but she did not have the presence of mind to take her son who was suffering from toothache along with her.
What does someone do with a family like that? Plenty of professionals had been going in and out of that house to offer different bits of help, but that mum required some serious support. She had been abused as a child, as is so often the case. The father was not on the scene and she had been subject to domestic abuse, as is so often the case. We all know, extraordinarily, that about a third of domestic violence starts during pregnancy. So there she was, highly vulnerable and desperately in need of support, but her life was not improving and the life chances of her children were certainly not. So what does someone do?
Those children could have been taken into care. They probably would have been split up, going to different families across the area and perhaps beyond. The mum would have been completely distraught at that prospect. Inadequate though she was, for whatever reason, in the care that she provided, she absolutely doted on those kids and they doted on her, so what was the solution? That is the sort of judgment of Solomon that our social workers have to make day in, day out when dealing with those really complex, challenging cases.
That case, which I will remember for the rest of the time that I am involved in these areas, encapsulates all the challenges that we face in children’s social care and all the challenges relating to the whole issue of the best start in life and the project that the Government have undertaken, thanks to my right hon. Friend the Member for South Northamptonshire. That is why it is so important. One of the answers is to have a joined-up approach locally, with all the different professionals working together as a team to encapsulate mum and family. It is about having somebody who can literally take her by the arm and march her down to a children’s centre to get family support and advice or march her down to the dentist with little Johnny to make sure that he gets dental treatment—somebody to take control of people’s lives and get them on the straight and narrow until they can fend for themselves and their family again. We need local professionals working as one, with a lead person who has responsibility, who has all the joined-up knowledge about what needs to happen, and who has the force and confidence to make it happen.
We also need the Government to be joined up at the centre. I remember that when we were trying to get the early intervention grant sorted, we were getting the run- around from officials because the fund would affect various Departments. We were told, “Oh, we can book you an appointment with the Minister in that Department in a few weeks’ time, and then perhaps you can have another meeting with that Minister.” In the end, the only way my co-Minister Sarah Teather and I got the problem sorted was by ringing up all the Housing, Health, Home Office and other Ministers responsible. We all had pizza in the Adjournment, agreed what the strategy should be, went back to our Departments the following morning and told our civil servants, “This is what we want to happen.” All the civil servants said, “That’s not the way we do things here, Minister,” to which we all said, “Tough. Do it.”
The problem is that government does not work in a joined-up way, which is why the approach that my right hon. Friend the Member for South Northamptonshire has taken is really pioneering. I pay tribute to her for
the way she has brought things together, forcing Departments to sit down, work together and have a strategy that works as one. That is the only way we will sort the problem sustainably for the future, which is key to the whole approach.
The hon. Member for Richmond Park has set out the problems: the £8.1 billion that perinatal mental illness costs each year; the £15 billion that we spend each year in this country on child neglect, particularly in relation to younger children; the £6 billion that childhood obesity costs each year, which is likely to rise to £9 billion within the next few years. As well as the cost of domestic abuse and safeguarding, we are spending £20 billion to £30 billion-plus each year as the cost of getting it wrong for some of the most vulnerable children and their families. Spending a fraction of that on solutions to get it right will be absolutely transformational.
Let us look at some research from the Institute of Health Visiting. I will always speak up for health visitors; in my view, frankly, they are one of our emergency services. They have been diverted too often during the pandemic to other parts of the health service, and their absence has been greatly felt. There is a shortage of several thousand: the institute says that we need at least 3,000 additional health visitors over the next three years, and I completely agree. One of the great achievements of the Cameron Government was building up the health visitor workforce, which has since diminished, alas. A survey of health visitors shows that 81% have seen an increase in perinatal mental illness, 80% have seen an increase in domestic abuse, 80% have seen an increase in child behaviour problems, 72% have seen an increase in poverty affecting families and 71% have seen an increase in child safeguarding.
The hon. Member for Newcastle upon Tyne North is right, too. Research from Action for Children shows that
“only 57% of children from poorer backgrounds were ready for school at age five, compared to 74% of their better-off peers…82% of parents of 0-5s in England struggled, or were unable, to access vital non-childcare early years services…78% of parents who were unable to access a service were worried about potential impacts on themselves or their children. The most common concerns were children’s development, and parents’ own mental health and wellbeing.”
That is the cost of failure, and that is why it is so important to have a co-ordinated, joined-up approach. One statistic that has always stayed in my mind is that if a 15 or 16-year-old at school suffers from depression or some form of mental illness, there is a 99% likelihood that their mum suffered from some form of perinatal mental illness or depression—the link is that close. We should be spending so much more time and resources on looking at the pre-school period, particularly from conception to age two, because that is where it all goes pear-shaped. We see the consequences throughout childhood, and they so often carry on into adulthood and stay with the person for the rest of their life. So of course we should be doing more about this, and I am glad that at last the Government have recognised that that is where all the action—or a lot more of the action —needs to be focused.
On health visitors, I agree with the Local Government Association, which has said it is important for the Government to work
“on a children’s workforce strategy to support the development of a well-qualified, well-resourced workforce with the appropriate knowledge, skills and experience to work in a preventative way.
This needs to be an integrated strategy between local authorities, health, education and community and voluntary sector partners, which links effectively with established programmes, such as Supporting Families, Sure Start and Family Hubs and puts the child’s journey at the centre.”
That strategy, it adds, needs to be properly resourced. Well, we are having a lot of extra resource. We could all argue that it is not enough, and the more Opposition Members argue that it is not enough the more I will welcome that, because we could always do with more money; but I think this has been a good start.
Let us look briefly at some of the action areas. One of them is the provision of seamless support for families. As my right hon. Friend the Member for South Northamptonshire has said, we need to have a lead person who knows all the facts and history of the family involved, and who has the power to say, “This is what needs to happen for that family”, and make sure that it happens. Then there is the welcoming hub for families. I can answer the earlier question from the hon. Member for Newcastle upon Tyne North by saying that 75 family hubs have been identified, in about half the number of local authority areas. I hope very much that the other 75 will follow very quickly, so that there is at least one per authority.
Can we get away from the idea that these hubs are a challenge to, or in place of, children’s centres? They are building on the experience of children’s centres and are complementary to them, but they are not just about bricks and mortar; they are about services. I think that in the past we have been too hung up about the amount of bricks and mortar that we have rather than the quality of the services provided, whether as outreach or within children’s centres, and, most important, the outcomes that they are creating for the children for whom they exist and their families.
It is important to ensure that families have the right information at the time when they need it. When people are reluctant to cross the threshold of a children’s centre or a family hub, as my family in Stockport were, they need to have other ways of obtaining that information. It may be a night-time call line, or it may be online, on the internet. It may mean having another professional to call on, or even volunteers—even members of another family who are looking out for vulnerable families. What those people need is a trusted source of information that they can access, rely on and then act on to their benefit.
I think we have all learnt in the past that a top- down approach, with all the geeks in the civil service coming up with whizzy new schemes and trying to impose the same scheme in Newcastle as in a village in South Northamptonshire or a coastal town like Worthing, rarely works. We need national frameworks and national quality thresholds, and we need local design and local implementation. We need to hold people’s feet to the fire. Every local authority needs to come up with a best start in life plan. That local plan needs to meet the thresholds for children’s outcomes, and then the centre needs to ensure that authorities go ahead with those plans and achieve those outcomes. In that way we can have local ownership, local design and local flexibility that are in the best interests of children and their families.
I welcome the “best start in life” programme, and I congratulate all who have made it possible. This has been a huge joint effort. It has been a false economy not
to look at those initial few pre-school years, because that is when we can have the biggest impact on the nurturing value of parents and the attachment that is so essential between a parent or parents and their children, when a child’s brain is growing exponentially—and will be impacted on for the rest of his or her life. At last we have a programme that realises that. Let us ensure that we make it a success for our future generations.