Oral Answers to Questions

Andrea Leadsom Excerpts

Tuesday 5th December 2023 Commons Chamber

[Helen Hayes (Dulwich and West Norwood) (Lab)]

5. What steps she is taking to help reduce vaping by young people.

[The Parliamentary Under-Secretary of State for Health and Social Care (Dame Andrea Leadsom)]

The hon. Lady raises such an important question on a subject that is dear to both our hearts. We all know it is an offence to sell vapes to children under 18, yet one in five children tried a vape in 2023 alone and the number trying vapes has tripled in the last three years. We know the industry is targeting children, quite cynically. That is unacceptable. Our tobacco and vapes Bill will restrict the appeal and availability of vapes to children, and we are consulting on that right now.

[Helen Hayes]

As the Minister rightly said, under-age vaping has increased by 50% in just the past three years. Ministers had the chance to stop this trend two years ago, during the passage of the Health and Care Act 2022, when Labour tabled an amendment to prohibit branding that appeals to children, but Ministers would not support it and Conservative Members voted it down. Does the Minister regret the fact that the Government did not act sooner? When will the planned new legislation be brought to the House? The consultation is welcome, but there is consensus on the issue and action is urgently needed.

[Dame Andrea Leadsom]

The hon. Lady knows full well that making decisions that change legislation requires consultation. That is both the convention and the requirement. The Government have brought forward the consultation as soon as possible. It will close tomorrow and we will introduce legislation as soon as possible in the new year. I think the hon. Lady will find that that legislation really will tackle the problem of the cynical targeting of children.

[Mohammad Yasin (Bedford) (Lab)]

6. What steps she is taking to improve patient access to primary care.

[The Parliamentary Under-Secretary of State for Health and Social Care (Dame Andrea Leadsom)]

The hon. Gentleman will be pleased to know that, with huge thanks to all the superb GPs and health teams, our manifesto commitment for 50 million more general practice appointments a year compared with 2019 has now been delivered. Our primary care recovery plan is addressing access challenges by tackling the 8 am rush for appointments, cutting bureaucracy for GPs and, of course, expanding community pharmacy services.

[Mohammad Yasin]

I thank the Minister for her answer, but let me correct her. Since 2014, the number of GP practices in Bedford and Kempston has decreased from 18 to 11; there are fewer doctors, while the patient list has increased; and the number of patients per qualified GP now stands at 2,812, which is a rise of 60%. Will the Minister apologise to GPs and to my constituents, who face a daily struggle to access a GP because her Government have decimated NHS primary care services?

[Dame Andrea Leadsom]

The hon. Gentleman will appreciate that 50 million more appointments between 2019 and now is a fantastic increase. There are just under 4,000 new GPs since 2019, and the hon. Gentleman will appreciate that through the post-covid recovery plan to improve access we have said to GP practices that they should provide urgent appointments on the same day and for every patient within two weeks. That has significantly improved access for patients, and GP appointments are now being hugely supported by access to community first, our flagship programme to improve healthcare throughout the country.

[Kelly Tolhurst (Rochester and Strood) (Con)]

I am incredibly grateful for the significant increase in the number of GP appointments offered to residents in my constituency. However, last week Aspire announced that it wishes to close the Lower Stoke surgery on the Hoo peninsula, where the council proposes to build thousands of homes. Will my right hon. Friend meet me to discuss how I can work further with the integrated care board? I have been trying over a number of years now to work with the ICB so that it can come up with a plan for how it will deliver much-needed services, so I would be very grateful for the Minister’s help.

[Dame Andrea Leadsom]

I am of course always delighted to meet my hon. Friend to talk about issues in her constituency. I reiterate that 50 million more GP appointments is brilliant news. Our flagship Pharmacy First programme will mean that more low-level infections and problems—such as sinusitis, oral contraception, impetigo and various other conditions—can be treated by community pharmacists at great convenience to patients, and it will expand GPs’ ability to deal with more complex problems. All these things are alleviating the pressures on primary care and are very good news right across the country.

[Mrs Paulette Hamilton (Birmingham, Erdington) (Lab)]

A primary care walk-in facility at Warren Farm in my constituency faces closure due to the presence of reinforced autoclaved aerated concrete. The proposal to close the service will mean that services are relocated away from residents who need them. What is the Minister doing to fund the investigation and removal of RAAC in health facilities while making sure that communities can still access the healthcare that they so desperately need?

[Dame Andrea Leadsom]

I am incredibly sympathetic to the hon. Lady’s constituents. The issue of RAAC is one that the Government are determined to resolve. There has been a £698 million programme of new funding to eradicate RAAC from the healthcare system, and that work is under way. She will appreciate that it is for integrated care boards to ensure that the provision is there for all patients but, if she should need help with contacting or negotiating with her ICB, I will be delighted to help her.

[Steve Double (St Austell and Newquay) (Con)]

A recent report highlighted the fact that in September there were 15,000 missed GP appointments in Cornwall. That is 15,000 appointments that could have gone to people desperately waiting to see their GP. It is happening month after month. Does the Minister agree that that is completely unacceptable, and can she highlight what steps the Government will take to address the issue?

[Dame Andrea Leadsom]

My hon. Friend is right; it is appalling that people book an appointment and then do not show up. In many GP surgeries now they post the numbers of patients who do not turn up for their appointments and urge people to make the effort to cancel. As part of our access to primary care, we are creating digital tools so that GP surgeries can notify patients that they have an upcoming appointment and say, “If you don’t need it, press here and it will cancel the appointment.” Measures such as that make it easier for people to cancel, but he is quite right that it is incumbent on us all, if we book that appointment, to turn up for it.

[Priti Patel (Witham) (Con)]

7. What funding her Department is providing to help tackle health inequalities in Essex.

--- Later in debate ---

[Peter Gibson (Darlington) (Con)]

T6. Some six months ago, the dentist based at Firthmoor community centre, serving 8,000 of my constituents, handed back its contract to the integrated care board. I was shocked last week to learn that the ICB has still not commenced the tender process to replace that provision. What advice can the Minister give me to ensure that our ICB is doing what it needs to do?

[The Parliamentary Under-Secretary of State for Health and Social Care (Dame Andrea Leadsom)]

My hon. Friend has already raised this issue with me several times in the almost two weeks I have been in this post, so he is doing a great job, and he is right to raise it. Tendering exercises for NHS dentistry are bound by current procurement law, but I am happy to meet him to discuss how much faster we can go to get this sorted out.

[Amy Callaghan (East Dunbartonshire) (SNP)]

Brexit broke Britain and it is continuing to wreak havoc on supply chains. The shortage of ADHD medication is now set to drag on into next spring. The shortage has seen 70% of patients forced to ration their supply of ADHD drugs, with 62% reporting an increase in suicidal thoughts. What steps is the Minister taking to ensure that supplies of these vital medications are reaching pharmacies across the UK?

--- Later in debate ---

[Selaine Saxby (North Devon) (Con)]

While I recognise that money does not grow on trees, neither do teeth. Can my right hon. Friend advise me of how quickly my North Devon constituents will be able to see the NHS dentists they so desperately need?

[Dame Andrea Leadsom]

My hon. Friend is absolutely right: there is a lot more that we can do. We are working at pace to see what announcements we can make on the dental recovery plan as soon as possible. In the meantime, she will be aware that, in the south-west, NHS England has commissioned additional urgent dental care appointments that people can access via NHS 111.

[Patricia Gibson (North Ayrshire and Arran) (SNP)]

T7. Last week, the former Health Secretary admitted at the covid inquiry that sick pay across the UK is “far too low”. It is far lower than the European average and encourages people to go to work when they should be getting better. Does the Secretary of State agree with her predecessor? What discussions will she have with her Cabinet colleagues to improve the inadequate sick pay system?

--- Later in debate ---

[Richard Fuller (North East Bedfordshire) (Con)]

Will the primary care Minister join me in congratulating the Conservative Mayor of Bedford borough for proposing council money to invest in primary care facilities in Great Barford, Wootton, Wixams and Kempston? Will she condemn Labour and Liberal Democrat councils for voting it down?

[Dame Andrea Leadsom]

I am glad that my hon. Friend has raised this issue. He is absolutely right; in local authorities we need mayors and integrated care boards supporting primary care and not listening to the Opposition, who talk it down the whole time. The 50 million more GP appointments is something to celebrate.

[Mr Ben Bradshaw (Exeter) (Lab)]

Given that obesity now costs the NHS and our economy much more than smoking, why does the Secretary of State support a total ban on smoking but think that measures to tackle obesity are nannyish?

[Dame Andrea Leadsom]

The right hon. Gentleman raises a completely artificial barrier. Smoking is totally preventable; it is the cause of one in four cancers and 75,000 deaths. It is unbelievably appalling. Obesity is a complex area and one that the Government are focused on. We need to tackle it, but it is entirely different.

[James Sunderland (Bracknell) (Con)]

Would the Health Secretary please agree to meet me to discuss improved access to GPs and dentists in Bracknell Forest and Wokingham boroughs?

World Menopause Day

Andrea Leadsom Excerpts

Thursday 27th October 2022 Westminster Hall

[Dame Andrea Leadsom (South Northamptonshire) (Con)]

It is a pleasure to serve under your chairmanship today, Mr Hollobone.

I pay particular tribute to the hon. Member for Swansea East (Carolyn Harris). Not only did she share some purple hair dye with my daughter, who at the time was 17, but she persuaded my daughter, who is now 18, to ask me about the menopause, so in my household anyway, the hon. Member is quite a famous person.

I also pay tribute to my right hon. Friend the Member for Romsey and Southampton North (Caroline Nokes). I always get confused by that constituency name, because I represent South Northamptonshire, so it is somehow a real tongue-twister; I am sure she understands.

I also pay tribute to everyone here today who is now openly talking about the menopause. For me, all the way through until I started menopause—quite late, as it happened—I did not know the foggiest thing about it, literally. What is it? Nobody ever talked about the menopause, and that is extraordinary. We all chat about Viagra, and that serves a very different purpose; but the menopause, which affects 100% of women at some point in their lives, is somehow a taboo subject, particularly the consequences for women—feeling terrible, not being able to sleep and all the things that hon. Members have been talked about today.

Yet 41% of medical schools do not teach menopause as a mandatory subject. How utterly bizarre is that? It is completely strange. A study by Newson Health highlighted that 79% of women surveyed had visited their GP regarding clearly menopausal symptoms, yet only 37% were given hormone replacement therapy, and 23% were given antidepressants. In addition, women often face a wait of more than a year to get help. It is utterly ridiculous.

As Liz Earle, who is famous for her face products but is a real campaigner for helping women through the menopause, has said:

“It’s all about how to have a better second half of life, and I do believe the second half can be even better than the first.”

Hear, hear to that. Actually, in the second half of life, once the kids have grown up and you have got your life back and you are now an MP and want to get on, you actually want your hormone replacement therapy to be available on tap—don’t you, Mr Hollobone? “Yes”, I hear you say—shout, even.

I know that the Minister of State will be very sympathetic, because he really is a good listener, and while the menopause may not be his normal dinner-time conversation either, he will appreciate how important it is to all women of a certain age.

I will finish with the words of a lovely constituent who came to see me at my surgery:

“My GP encouraged me not to give up and 6 months later, after taking HRT, I’m now a new woman.”

So let us hear it for new women.

Contact in Care Settings

Andrea Leadsom Excerpts

Thursday 27th October 2022 Commons Chamber

[Helen Whately (Faversham and Mid Kent) (Con)]

I would say that it is a rare Minister who welcomes a debate on day one following their appointment, but truly I do welcome this particular debate because it is so important. Visiting in care settings is something I have spoken to many people about, and I had hoped that by now it would no longer be a problem now we have put lockdowns behind us, but it is still a problem.

I thank and commend the hon. Members for Liverpool, Walton (Dan Carden) and for St Albans (Daisy Cooper) and my hon. Friend the Member for Chatham and Aylesford (Tracey Crouch) for leading this debate and for their powerful speeches, and I thank all the other Members who also contributed very powerfully. I would also like to thank those who have been campaigning so hard for visiting rights, such as the Rights for Residents campaign, John’s Campaign and the Relatives & Residents Association. I know that some of them are here with us in Parliament today, and I am sure that many others are watching from home.

I do recognise the efforts that so many care homes have made to get back to normal, or as close to normal as they can, on visiting after the enormous challenges of the pandemic, because visiting matters. Visiting matters for the resident in a care home—we must never forget that it is indeed their home—and for family and friends who want to spend time with their loved ones. It can be the moment a resident looks forward to all week, a time that keeps their connection to life beyond the doors of a care home and—not to be underestimated—the chance to hold the hand of or have a hug with someone who loves them. I say this knowing that, sadly, many residents in care homes are living with dementia and may be confused or unable to remember things for long. Visits matter for them and their families, not least because dementia can progress so cruelly, as was mentioned in particular by the hon. Member for St Albans.

[Dame Andrea Leadsom (South Northamptonshire) (Con)]

My hon. Friend is absolutely right to talk about the impact of dementia in particular. During lockdown, a large number of people wrote to me, including a close family member of mine, whose dementia significantly worsened because they were not able to see family members just to keep those memories going. It was absolutely terrible, and I think we should do everything we can to make sure that cannot happen ever again.

[Helen Whately]

I thank my right hon. Friend for making that point, which we have heard from others in the Chamber.

Visiting is not just a “nice to have”, as we have just heard—all the stories we have heard today can leave us in no doubt about that. The hon. Member for Liverpool, Walton spoke very movingly about the experiences of others, but also about his own personal experience with his father, which he very courageously shared with us. The right hon. Member for Dwyfor Meirionnydd (Liz Saville Roberts)—I cannot pronounce her constituency, but Hansard will resolve it—also spoke very powerfully about her mother. I say to both of them that I am sorry for their loss.

Very importantly, my hon. Friend the Member for Chatham and Aylesford reminded us that this is not just about older people. Visiting, both into a residential setting and out of it, is also so important for younger people—for instance, those with learning disabilities. However, I am short of time, so I will press on.

On top of the stories, there are the facts. We know there is a body of evidence that supports the argument that not having visitors can be detrimental to the health of people living in residential care, as my right hon. Friend the Member for Tatton (Esther McVey) mentioned. For instance, there is a connection between social isolation, loneliness and mental health. In fact, back in October 2020, when I was previously the Care Minister, I commissioned research on the benefits of visiting as well as an assessment of the risks at the time and the options for opening up visiting.

I can also say that I do know personally what it feels like not to be allowed to visit a relative. In the summer, my mother was admitted unexpectedly to hospital and I was not allowed to visit her, even though I did not know whether I would ever see her alive again. The same was the case for my father, her husband for 50 years, who was also barred from entry to her ward, and that was even though we were clearly not in the heart of the pandemic by any stretch of the imagination.

I will look at this issue in three parts, at pace: what has happened to get us to this situation; what is really going on; and what can be done.

Sadly, during the pandemic we saw how hugely vulnerable to covid people who lived in care homes were, and the Government priority was to keep people safe, which meant doing everything possible to prevent covid from getting into care homes. It meant reducing the number of people going in and out who might take in covid. It meant requiring the use of personal protective equipment. It meant regular testing for care home residents and staff, and when we got the covid vaccine it meant prioritising vaccinations for care home residents and staff.

However, even back in 2020 we knew that residents in care homes and their families were suffering from the visiting restrictions, although I should mention that not all residents and their families had the same views. While some wanted more visiting, others did not because they were more worried about the risks. Balancing those two things, the Government sought to enable visiting in ways that would be safe, and we also made it clear that end-of-life visiting should always be possible.

In March 2021 we introduced the concept of the essential care visitor who would be able to visit a resident who needed personal care in any circumstances, including during an outbreak, following the same covid testing regime as staff. In June 2021 we expanded that to apply to all residents. At all times we worked with social care providers—with care homes—because they were the ones that had to put the guidance into practice; they were the ones at the frontline, balancing the prevention of covid with the practicalities of supporting visiting. I do not underestimate the demands that put on care homes, which were also carrying out testing, providing PPE and everything else.

Moving on to the situation today, since April 2022 the Government guidance has been that there should not be any restrictions on visiting in residential settings unless there is a covid outbreak, and even if there is an outbreak every resident should be able to have a visitor. Local public health teams may advise other restrictions on visiting if there is a particular local risk, but that should be proportionate and should stop visiting only in extreme circumstances.

Some Members have said today that the guidance is not clear, while others have said that it is not being followed; it has also been said that the problem is that it is guidance. On the content of the guidance, we have heard from many accounts that it is not being followed, and I will do further work on that.

Knowing the concerns during the height of the pandemic about visiting, the Department of Health and Social Care started tracking visiting restrictions; indeed, I started that as Care Minister, to try to get data about what was going on, because one of the challenges is knowing what is going on at the frontline, as the social care system is so diverse and fragmented. Our data told us in September that 98.4% of care homes were allowing visiting, but I recognise that that data is not the whole answer.

The CQC has been referred to in the debate. I spoke with Kate Terroni, chief inspector of adult social care at the CQC, many times during the pandemic about visiting and she, too, saw the importance of it. The CQC looks at visiting when inspecting care homes, and a lack of visiting or access is a red flag for it. Families should be reporting visiting concerns to the CQC, which then investigates them. I heard, however, the points made by the hon. Member for St Albans about some families feeling they got a mixed response or who were fearful of reporting to the CQC because of the possible consequences. Again, I will take that away from today’s debate.

Under the existing regulations, the CQC can take action if it believes that safe and proportionate visiting is not being facilitated, but I also took note of the point made by the hon. Member for Liverpool, Walton about the CQC powers to get live data being limited and its not having powers to require care homes to report changes to visiting restrictions. I will look into that, too.

Although we have the guidance and the CQC is able to take action on care homes, there is clearly still a problem. I have also seen the data from the Rights For Residents survey showing that 45% of responses said that restrictions on visiting had still been in place since April, and in 11% of outbreaks no visitors were allowed at all. Again, I am concerned to see that.

Infant Mental Health Awareness Week

Andrea Leadsom Excerpts

Thursday 16th June 2022 Westminster Hall

[Dame Andrea Leadsom (South Northamptonshire) (Con)]

I beg to move,

That this House has considered Infant Mental Health Week 2022.

It is a great pleasure to serve under your chairmanship, Mrs Murray—I think for the first time. I am delighted to have secured this debate.

Infant Mental Health Week is an annual opportunity to highlight that human beings are the most underdeveloped creatures on earth at birth. Our brains, and therefore our responses, our reactions and our knowledge, are completely undeveloped. In fact, many people would say that we are born about two years premature. What other animal cannot do anything for itself until it is at least a year old? That is the plight of human beings.

Infant mental health is therefore, without any shadow of a doubt, more important than mental health throughout the rest of a person’s life. It is in that critical period when a person is so small and does not know what’s what or where’s where that their ability to have secure lifelong mental health is laid down.

From conception to the age of two, a secure and loving relationship between a baby and his or her carer literally shapes the way the baby’s brain develops. That is when the building blocks for lifelong physical and emotional health are laid down. Like a sponge, the baby’s developing brain will soak up the atmosphere around them and the environment that he or she is born into. In the womb, a baby whose mum is terrified of childbirth or is being treated with violence by her partner, or who is misusing alcohol or drugs, will be profoundly physically and mentally impacted by that experience.

Infant mental health, or, more specifically, early intervention in the first 1,001 critical days of life, from conception to the age of two, has been a passion of mine for more than 25 years. I chaired the Oxford Parent-Infant Project in 1999 and set up NorPIP, the Northamptonshire Parent Infant Partnership, providing parent-infant psychotherapy to families who are struggling to form a secure bond with their babies. I established national charity PIPUK—the Parent Infant Partnership—which went on to establish and support a number of other parent-infant teams right around the country. I also wrote the 1,001 critical days manifesto, which went on to become the First 1001 Days Movement. Infant mental health is a subject incredibly dear to my heart.

Science tells us that a secure and loving relationship with the key carer will shape the way in which the baby’s brain develops, with long-term and positive consequences for that baby’s mental health. Fundamentally, it is about self-regulation. A baby who is secure in his or her earliest relationships will later on be able to experience anger, fear, jealousy and disappointment, and will be able to regulate their own responses appropriately. It is the earliest relationship between parents and their babies that constructs that ability to self-regulate and hence delivers that pathway to good lifelong mental health.

Research released today by the Royal Foundation shows that 91% of parents and carers agree that early years are important in shaping an adult’s life, but only 17% recognise how uniquely important the period from birth to five is. As the Duchess of Cambridge has said,

“Our experiences in early childhood fundamentally impact our whole life and set the foundation for how we go on to thrive as individuals, with one another, as a community and as a society.”

In 2015, the National Childbirth Trust found that one in three first-time dads were worried about their mental health following their baby’s birth, and according to the Maternal Mental Health Alliance, up to one in five mums, sadly, suffer due to the lack of focus on support for mental health in the perinatal period. Unfortunately, we do not really have the granular information on perinatal depression among parents and carers that we would need to properly impact-assess the mental health effect on babies, but the mental health of the parent clearly impacts on their baby’s development. A good example is that a pregnant mum who, for whatever reason, suffers from stress will produce more cortisol—the stress hormone—in her bloodstream, which will pass through the placenta into the unborn child. The more stressed the mother, the more frequently the foetus is exposed to higher levels of cortisol, and we know that exposure to high levels of cortisol in the womb can lead to modifications in gene expressions before the baby is even born, so even in the womb, the potential for lifelong emotional and physical health is already being determined.

Once out of the womb, being left to cry unattended for continuous, lengthy periods of time, or being terrified by witnessing violence and anger within the family or loud and aggressive behaviour in their environment, will have the same impact on the baby: raising their levels of cortisol. Over lengthy periods, there is evidence that this damages the baby’s immune system and will give him or her a lifelong predisposition towards higher risk-taking behaviour. When a baby is born, they have no cognition at all: they can only cry, sleep or look around. They do not know if they are cold, hungry, bored or in pain. They only know that something is wrong, so a baby cries to attract the attention of a loving adult carer. When that carer turns up and takes the time to soothe, change, feed or sing to the baby, the impact of that tender and loving response brings the baby back to a state of calm and reduces their level of stress. This continues until the baby is old enough to understand how to regulate his or her own feelings.

Even more important is the fact that at birth, a baby’s brain is only partially formed. It is understood that a baby’s brain puts on up to a billion neural connections every minute during the first year of life. Those neural connections are stimulated by the quality of attention of the principal loving carer and the baby’s experiences of the world around them, which is why parental attunement and loving attention are fundamental for the healthy brain development of a baby. Simply put, what we do with a baby from conception until the age of two is about building the human and emotional capacity of that infant; what we do after the age of two is almost all about trying to reverse damage that is already done. A wealth of evidence demonstrates that poor mental health, substance dependency and domestic abuse among parents lead to significantly poorer outcomes for babies and young children. Research from the Maternal Mental Health Alliance highlights that the locations with some of the greatest levels of socioeconomic deprivation are also those where poor maternal mental health is at its highest. When they start school, children from such disadvantaged backgrounds are on average four months behind their peers, and it gets worse from there.

The quality of attachment that a baby has to their principal adult caregiver therefore has a profound impact on their lifelong mental health, and our society’s ambition should be for every baby to achieve a secure attachment to that caregiver, be it mum, dad, kinship carer or adoptive parent. Secure attachment is the foundation for good lifelong mental health, its possible effects having an impact on parenting from one generation to the next: if a person was well parented, there is a high likelihood that they will become a good enough parent, and their baby will form a secure attachment to them. Examples of insecure attachment are therefore found where care giving is inconsistent.

Babies who suffer from insecure attachment are not given the consistent, loving care that they need in order to feel that the world is a good place and that people are generally kind. Neglect of a baby has a very damaging impact. The baby with insecure attachment will of course have other chances in life; we never write anyone off. Babies who are insecurely attached in the very early stages will have lots of other opportunities to make good friends and to have other key adults in their lives who might help to turn things around and help them build their own emotional capability, but there is no doubt that insecurely attached infants will always struggle a bit more in later life to deal with life’s ups and downs. It will be those babies who might struggle to keep friends and relationships and also to cope without help with parenting when their time comes. This is sometimes known as the cycle of deprivation, where a general lack of good mental health is passed down from one generation to the next.

The most challenging early mental health impact is reserved for babies who develop a disorganised attachment with their principal caregiver. That is where the person they rely on to look after them, soothe them and keep them alive is also the most dangerous person in their life. The person they turn to for comfort might one moment hurt them and the next moment hug them. Such babies often find that making sense of the world becomes very difficult, and many of the most damaging outcomes in society—criminality, suicide, self-harm, sociopathic behaviour—are enacted by those who suffer disorganised attachment as a baby. It should be blindingly obvious to all that whatever we do to invest in giving every baby the best start in life will pay us back a million times over—a billion times over—in terms of general wellbeing, healthy communities and a stronger society.

We had a long way to go before the covid lockdown, but there is no doubt that Infant Mental Health Awareness Week is vital because it shines a spotlight on the huge damage done by two years of pandemic lockdowns: dads and co-partners not permitted to be with mum and the new baby; face-to-face health visits and other support such as family hubs moving to virtual only; wider family and friends unable to meet the new arrival and provide support; babies not able to meet other babies; and an exacerbation of existing problems such as addiction, domestic violence and poor mental health.

Above all else, there was the devastating isolation at a time when we all know that new parents are desperate to get out of the house to go and chat to another parent about the sleep that they did not get last night, what size nappies the baby should have, what they are doing about weaning, and whether the baby has had its first tooth yet. All the chats, empathy and consolation that new parents give each other were missing during the covid lockdown. A report carried out by the Parent-Infant Foundation, Best Beginnings and Home Start, titled “Babies in lockdown”, revealed that six in 10 parents were concerned about parental mental health in lockdown, and two thirds said that covid had affected their ability to cope with caring for their baby.

We know that health visitors provide a vital support service to families who are struggling. Every family in England should be offered five mandated reviews from a health visitor between pregnancy and age two and a half as a minimum. Local authorities, many of which are still using phone and virtual appointments to count as reviews, have reported in their latest quarterly data, from May, that 18.6% of babies missed out on their nine to 12-month review and more than a quarter of toddlers missed out on their two to two-and-a-half-year review. That includes all those who got the telephone-only service. There were still many who did not get anything at all.

Data, again published in May, shows that only 85% of children in England were at or above their expected level in communication skills, compared with 89% before the pandemic, and 79% were at or above the expected level in five key development assessments at the review stage, compared with 83% pre pandemic.

A report by Ofsted in April 2022 found:

“The pandemic has continued to affect young children’s communication and language development, with many providers noticing delays in speech and language…The negative impact on children’s personal, social and emotional development has also continued, with many lacking confidence in group activities”

and

“social and friendship-building skills have been affected.”

There continues to be an impact on children’s physical development, including delays in babies learning to crawl and to walk. Lockdown has caused many challenges and exacerbated many existing ones.

The early years healthy development review, which I chair, could not have come at a more important time. Since the summer of 2020, the review has focused on ensuring that every baby gets the best start in life. Its vision sets out six key action areas, which were made Government policy in March 2021. The action areas will deliver, first, a joined-up set of Start for Life services for every family in England; secondly, the roll-out of family hubs as a welcoming place, providing physical, virtual and outreach services for every family in England; thirdly, trusted digital, virtual and telephone support designed to meet the needs of the baby and their carers, as well as the development of the digital red book, which will allow much greater continuity of care for every baby; and fourthly, a modern, mixed-skills workforce that will provide much greater continuity of care and that works, with the baby at the centre of everything we do, to deliver wraparound, empathetic support.

Fifthly, we need much more understanding of the impact and potential of early intervention, so we will improve data collection and evaluation, and outcomes for the mental health and wellbeing of babies and their families, and we will develop proportionate inspection of services. Sixthly, these action areas will require real leadership locally and nationally. Fundamentally, we need to ensure that the Treasury will continue to fund the “Best Start for Life” vision in the long run.

I am delighted that the vision is shared cross-party, and I have no doubt that the spokespeople here today on both sides of the Chamber will want to support giving every baby the best start for life. It is a fantastically cross-party issue, and I pay tribute to the many colleagues here today, as well as to those who could not be here, who have lent their support to this agenda over so many years.

The views and lived experiences of babies and their carers have been at the heart of the early years review. From Blackpool to Stoke-on-Trent, from Worthing to Bexleyheath, from Camden to Cornwall, parents have shared with us the good and the bad. My “1,001 Critical Days” podcast has highlighted the mental health journeys of parents and their babies, and an LBC phone-in made clear the challenges faced by so many dads and co-parents, and the particular support they need, which is currently lacking, in their amazing journey to parenting.

Time and again we have heard that every parent wants to know how to be a good a parent, where they can access early years support, what is on offer for them and why they might need that support. They want companionship and not to be isolated, and they want to be able to share their stories with parents in a similar situation.

We heard from parents of babies with disabilities that they do not want to be left out, stigmatised and treated as different. We heard from many parents from different ethnic backgrounds, as well as LGBT parents, single parents and foster parents, that they do not want to be treated any differently from other parents either. All parents, of every type, asked for a seamless, joined-up approach to accessing the support they need. Face-to-face support is a priority, but in this 21st century, parents and carers also want access to services virtually when things are urgent, they are pressed for time or they just have a quick question.

Parents also want to avoid telling their story over and over again to different early years professionals, and there is huge support for a digital version of the red book, where parents can keep a permanent record of their baby’s birth experience, first tooth and first photo with Granny, along with all the other lovely records that parents want to have, as well as communicate with the professionals who are supporting them.

The positive to take away from today’s debate is that if we provide support and reach out to make sure that every family knows where to go to get help, and we educate families as to what good looks like, we can transform our society for the better. To end, in this platinum jubilee year, I would like to use the words of the Queen, who said:

“in the birth of a child, there is a new dawn with endless potential”.

[Mrs Sheryll Murray (in the Chair)]

I intend to call the Front-Bench spokespeople at a few minutes before 4 pm. I hope Members will bear that in mind. I call Munira Wilson.

--- Later in debate ---

[Dame Andrea Leadsom]

What a fantastic debate. We need to keep doing this—it is wonderful. Every time we get together, we have the most positive and constructive discussion about what is, in my view, the most significant contribution we can make to building a happier, healthier and more successful society.

I pay tribute to the hon. Member for Richmond Park (Sarah Olney), who recently held a Home-Start celebration. I remind her that one of the people there trying to get money from all of us told a wonderful story about how, sadly, he had lost his mum when he was quite young. His mum was on her death bed, and he was thanking her for being such a wonderful mother, and she said to him, “I’m not a wonderful mother; I was just well parented and I passed it on.” I thought that summed it up. That is what we need to do—we need to make sure that every family gets well parented so that they can parent well.

As a postscript, I will admit to something weird. I chair the review, so all the stuff that the Minister is talking about is well known to me. However, it is so lovely to hear her saying it. It feels like it is actually happening—it is not just a figment of my imagination. I thank colleagues for a wonderful debate.

Question put and agreed to.

Resolved,

That this House has considered Infant Mental Health Week 2022.

Midwives in the NHS

Andrea Leadsom Excerpts

Monday 17th January 2022 Commons Chamber

[Siobhan Baillie]

I think what we will hear from the Government is that there is a plan for recruitment, but we need more details. The Royal College of Midwives is certainly asking questions. My right hon. Friend the Member for South West Surrey (Jeremy Hunt) knows from the work of the Health and Social Care Committee that when the current Culture Secretary was maternity services Minister last year, she was incredibly passionate about this issue. She accepted that the NHS was short of the equivalent of 1,932 full-time midwives—but since then, sadly, the number has fallen by a further 222, leaving the shortage at over 2,000. Since records began in 2009, the number of NHS midwives has fallen in England year on year. We are in a really difficult situation at the moment.

To put this into perspective, there were more than 613,000 births in England and Wales in 2020. At the last count of midwives in 2021, there were 26,901 in England, but that drops to 22,301 if we look at part-time figures. By looking at the birth rate and the number of midwives, we can see just how stretched midwives are.

The Association for Improvements in Maternity Services says that

“urgent action is certainly needed to shore up what seems to be a maternity service that is losing staff at a catastrophic rate.”

Over half of midwives surveyed by the Royal College of Midwives say they are considering leaving their job. I know personally a wonderful midwife, Stevie, who has chosen to retire this year, and I wonder how many midwives are making the same choice. My mother, who is a nurse, not a midwife, is choosing to retire as well. They have had a pretty tough two years in the NHS, as we know, but the most worrying feature of the RCM survey, which the hon. Member for Strangford (Jim Shannon) mentioned, is that the highest levels of dissatisfaction are among newer midwives—those who have spent five years or less working in the NHS. So we have a pipeline problem, a new intake problem and a problem with retention of experienced staff.

[Dame Andrea Leadsom (South Northamptonshire) (Con)]

I congratulate my hon. Friend on getting this important debate, and on the part she has played in looking at the best start in life for every baby, which we worked on together over many months. Does she agree that the problems not only for midwives but for the whole early years workforce have been exacerbated by the covid lockdown, with far too many families unable to see their health workers face to face and partners often excluded from important events such as scans and the birth itself?

[Siobhan Baillie]

I could not agree more, and I thank my right hon. Friend for everything she has done for early years provision. When we think about the early years and the importance of giving children the best start in life, we remember that midwives have children in their hands at year zero; it could not be any earlier than that. I will give more details of the reality of the pandemic world and what midwives and NHS staff have faced, but the effect on the beginning of the relationships and the fear when you do not have your partner with you in the ward has been absolutely awful. I appeal to all Ministers to think extremely carefully about further covid restrictions, if they ever again become necessary.

We know that the staffing shortage does not affect only midwives and hospital staff, but it has a real impact on families trying to bring new life into the world. As the hon. Member for Strangford alluded to, 87% of RCM members say that they delay using the toilet due to lack of time, more than 75% skip meals, and over half say they feel dehydrated most or all of the time at work—no doubt telling women to hydrate while unable to do so themselves. These professionals have the lives of our most precious loved ones in their hands. I ask the House: are those really the conditions we want them to be experiencing?

I have had messages from midwives all over the country. Last year, I received a letter from a former midwife saying that she was

“extremely concerned about the deepening crisis within maternity care.”

She handed in her notice. That is a loss of more than 10 years’ experience in clinical midwifery—experience that we cannot magic up overnight to replace her. She felt that she could not always provide the good, kind midwifery care that she was trained to give. She cited increasing paperwork, long hours and the inability to work hours that fitted around her family as key concerns.  She had begun dreading each shift. Being required to work faster and do more than was humanly possible meant fearing making a mistake that could lead to a tragic outcome.

Another midwife wrote a blog entitled, “How do we keep going when there is nothing left to give?” in which she talks about midwifery being a celebration of new life and how midwives get to share the joy of families starting out, but also how they are struggling in a system that does not allow them to do what they dreamed of, trained for and worked so hard for. With no staff available or even in the pipeline, the midwife describes having to close facilities, reduce antenatal education, and minimise post-natal visits. Another midwife talks about trusts having to introduce incentive payments, selling back annual leave and employing agency staff, but even then staff are declining the extra work because they are so cream-crackered and feel constantly stressed that the money just does not get them over the line.

Maternity staff are all incredibly caring human beings and they want to do a good job. They tell me they can recover from the physical strain of their job each day, but the mental anguish is weighing heavier and heavier. That mental strain is very real, as problems and errors in maternity services can have devastating consequences.

Although outcomes for mothers and babies have improved in so many areas in the last 10 years, any loss is too great. Understandably, the families affected cannot rest until they have knowledge of what happened and believe that it will not happen again. My heart breaks for them and, if I am honest, I will struggle to tell their stories without crying.

Birthrights is a UK charity that provides advice and information on legal rights, and trains doctors and midwives. The Ockenden review, which looked at maternity services, took serious evidence following the devastating loss at the Shrewsbury and Telford Hospital, and I know that the Health and Social Care Committee has also investigated maternity. Approximately 59%—about £4.2 billion—of the value of new clinical negligence claims is attributable to poor maternity care. In 2021, maternal mortality rates were found to be more than four times higher for black women, two times higher for mixed-ethnicity women and almost twice as high for Asian women. There is clearly so much more that we need to learn and change.

I know that this is issue is close to the hearts of many across this House. Between them, the Prime Minister and the Leader of the House boast a lot of experience of births, and the Minister is an excellent person to be responding given her own professional experience. The Government have made two important commitments: the first is to train 3,650 student midwives over four years, starting in 2019-20, and the second is to employ an additional 1,200 midwives. Obviously, that is hugely welcome, but given the seriousness of the situation and the fact that midwives are taking to the streets, I ask the Minister to update us on any progress and explain the recent decline in the number of midwives.

Public Health

Andrea Leadsom Excerpts

Tuesday 14th December 2021 Commons Chamber

[Dame Andrea Leadsom (South Northamptonshire) (Con)]

Our covid measures have, and continue to, hurt our citizens—from a man with late-stage dementia who is terrified of face masks to an 80-year-old constituent who got stuck in South Africa, not because of omicron, but because flights were suspended; and now, the news that non-urgent primary care will be diverted once again, with the huge risk of harm to babies and young children if face-to-face support is unavailable for long periods of time once again. And the creeping regulation is so hard to keep up with, resulting in teachers cancelling school plays, businesses stopping events and families staying away from happy occasions for fear of breaking a rule they did not know about. Surely the campaign against covid should now focus on two key fronts—more boosters and more education.

The action by Government on boosters is fantastic, but instead of criminalising people, why do we not start a hard-hitting public health campaign—“If you’re going out this Christmas, don’t forget to take a test” or, “If you’re seeing your granny, make sure you get a jab”? Let us persuade people, rather than criminalise them. And let us go much further to reassure those who have a fear of vaccines, whether because of a needle phobia, because of cultural sensitivities, or just because of fake news.

My specific concern about testing requirements for big events is the sheer challenge of enforceability in a commercial setting. It would be far better, in my view, to use the approach of a daily test or a vaccine exemption for NHS staff and carers instead. That would be a practical and fair solution for both carers and the cared-for, and it would be enforceable. It would also avoid the risk of losing NHS and care workers who were unwilling to accept compulsory vaccinations.

I have supported the Government throughout the pandemic when I could see the present danger that we faced, but this time around the measures proposed are precautionary—just in case—and I cannot see where this will end. Covid will be with us for many years to come and it is unthinkable that, every autumn from now on, we will be limiting the quality of life for all citizens, just to be on the safe side; and justifying our new illiberal rules on the basis that “They are less authoritarian than those of other countries” is truly appalling. That is not our culture; that is not our history.

This is a slippery slope, down which I do not want to slip, so I am afraid I will not be supporting these measures.

Covid-19 Update

Andrea Leadsom Excerpts

Monday 13th December 2021 Commons Chamber

[Sajid Javid]

The hon. Gentleman is right to point to the lag between the point of infection and hospitalisation. That emphasises the need to act early and strongly. That is why the booster programme and that response is so important in Scotland, in England and throughout the UK, and it is good that all four nations are working closely together on it.

On lateral flow tests as an alternative to self-isolation, I think they are the right approach. They can be taken daily, so the individual is tested each day for seven days, whereas a PCR would be a single test at a single moment. This is much more flexible and it is based on advice Ministers have received. On the hon. Gentleman’s questions on economic support, that is something we keep under review.

[Dame Andrea Leadsom (South Northamptonshire) (Con)]

I congratulate the Government on the roll-out of the vaccination programme—it is impressive—but what does my right hon. Friend say to my constituent who says she is now less afraid of covid than she is of intrusive and incoherent Government regulations?

[Sajid Javid]

I would say to my right hon. Friend that I hope her constituent would appreciate that the Government have to act on the information they see before them on the rate of spread of this new variant and what we now know about its degree of vaccine escape—not just to protect my right hon. Friend’s constituent, but to protect that constituent’s loved ones and her community.

Covid-19 Update

Andrea Leadsom Excerpts

Monday 29th November 2021 Commons Chamber

[Sajid Javid]

Surely the hon. Gentleman is not suggesting that if we had had different rules on masks over the summer, this variant would not have emerged.

[Dame Andrea Leadsom (South Northamptonshire) (Con)]

I am sure that my right hon. Friend will want to pay tribute to the South African Government for raising the existence of the omicron variant, which resulted in their having a travel ban imposed. I have constituents—and, in fact, a family member—stuck in South Africa. For how long does he expect cancellations and suspensions of flights to occur? It is a worrying time for anyone stuck overseas.

[Sajid Javid]

First, I join my right hon. Friend in again expressing thanks to the South African Government for how they have handled this difficult situation. I understand her point about her constituents. Many of us will have constituents in a similar position. It is hard to say when direct flights might start. We have started our hotel booking programme, which is one part of trying to get our citizens back, but we will do everything we can to support them in that way.

Health and Care Bill

Andrea Leadsom Excerpts

Report stage
Monday 22nd November 2021 Commons Chamber

[Dame Andrea Leadsom (South Northamptonshire) (Con)]

This Bill can really help support giving every baby the best start for life.

First, new clause 55, in the name of my hon. Friend the Member for Ruislip, Northwood and Pinner (David Simmonds), would require the Secretary of State to publish guidance on how integrated care systems should meet the needs specifically of babies. “The Best Start for Life” report, published in March, calls for every local area to publish a seamless start for life offer for every new family. That must include midwifery, health visiting, mental health support and targeted services such as couple counselling, debt advice and smoking cessation. Each of these services is currently provided from silos within the public, private and civic sectors, so properly integrating them is no small task. I urge my hon. Friend the Minister to ensure there is very clear guidance to every local area on how it should co-ordinate its support for babies.

I also want to support amendments 91 and 92, in the name of my hon. Friend the Member for Broxbourne (Sir Charles Walker), which call for parity of esteem between mental and physical health. Mental health support for families who are struggling in that critical early period is vital. The London School of Economics has assessed that perinatal depression, anxiety and psychosis carry a total long-term cost to society of about £8.1 billion for each one-year cohort of births in the UK. Prevention is not only kinder but so much cheaper than cure.

Finally, I would like to support amendment 102, from my right hon. Friend the Member for Basingstoke (Mrs Miller), which calls for integrated care boards to provide clarity about their plans to tackle domestic violence. I am delighted that the Minister has already agreed to accept it. Analysis by the WAVE Trust indicates that up to 30% of domestic violence begins during pregnancy. The WAVE Trust highlights the crucial nature of experiences in the period of conception to the age of three in the formation of seriously violent personalities, largely because of the sensitive nature of the infant brain in those formative years. Domestic violence within a family is incredibly damaging to the emotional development of a baby, and I encourage my hon. Friend the Minister to ensure that plans for tackling domestic violence cover not just relations between partners, but reducing the impact on babies.

Madam Deputy Speaker, you may have heard me speak in this place before about giving every baby the best start for life, and I keep doing so because I am convinced that, if we invest in the 1,001 critical days, we really will transform our society for the better. It is in the period from conception to the age of two that the building blocks for lifelong physical and emotional health are laid down.

[Jess Phillips (Birmingham, Yardley) (Lab)]

I was not expecting to be called, Madam Deputy Speaker, but here we are. I want to tell a little story about my dad. My dad often rings me and tells me the things I should say in Parliament—I am not entirely sure any of you are quite ready for it, but I want to tell a story about my dad. He was born in the war, and they were given a council house by the Attlee Government—my dad could lecture us on it for weeks! He was given a council house, which his very Conservative parents bought in the 1980s. My granny, unbelievably—a lovely, generous woman—was a massive Thatcherite. She bought her council house in the 1980s, and that council house stands in my constituency. It is worth around £120,000.

My dad went on to get an education—a free education—and he moved into an area of Birmingham that was not very trendy at the time. He stayed there, I was born there, and my brothers lived there. All through our lives we watched that area get a little bit trendier, and the price of my dad’s house, which he bought for £30,000, went up and up and up. He didn’t particularly do much work—he likes to woodwork in his garage, but he has not done much. His house is probably worth around £700,000 now, and it was £30,000 when he bought it.

If my dad were here today, what he would say to hon. Members, and what he will almost certainly say to me, because he watches it all, lurking on Twitter, is that he does not deserve to keep his wealth for his children at any greater rate than the people who live in the council house that his parents bought on Frodesley Road in Sheldon. Yet today, the people who live in my constituency and the council house that my granny bought, to try to get a better life, will subsidise the care of my father, who has a £700,000 house that I do not need to inherit. I’m all right. I’ve got quite a good job. It is totally unacceptable that that is the situation we are putting almost all my constituents in, compared with constituents in Chipping Norton, for example, or the constituents of other hon. Members who have stood up and spoken. My constituents will largely be left with nothing. They will not be grateful.

Giving Every Baby the Best Start in Life

Andrea Leadsom Excerpts

Tuesday 9th November 2021 Commons Chamber

[Dame Andrea Leadsom (South Northamptonshire) (Con)]

It is a pleasure to follow the hon. Member for Richmond Park (Sarah Olney) in this important debate, and I congratulate her and the hon. Member for Newcastle upon Tyne North (Catherine McKinnell) as fellow co-sponsors and tireless fellow campaigners for giving every baby the best start in life.

Despite the rough and tumble of politics, there are times when colleagues from all parties in the House come together. Early years is one such cross-party issue. Over the past 11 years in Parliament, I have been proud to work with many colleagues on the early years. The hon. Members for Manchester Central (Lucy Powell) and for Washington and Sunderland West (Mrs Hodgson), my stalwart and long-standing hon. Friend the Member for East Worthing and Shoreham (Tim Loughton), and my hon. Friends the Members for Eddisbury (Edward Timpson) and for Winchester (Steve Brine) have all been amazing campaigners for the earliest years, as has the hon. Member for Glasgow Central (Alison Thewliss). The former Member for Birkenhead, Lord Field, and the former Member for East Dunbartonshire, Jo Swinson, have been great allies, as have all those Members who supported the all-party group conception to age two: first 1,001 days, and Ministers on the inter-ministerial group on early years family support from 2018-19.

It is fantastic that since the 2019 general election, the early years agenda has received fresh support from new colleagues such as my hon. Friends the Members for Penistone and Stocksbridge (Miriam Cates), for Stroud (Siobhan Baillie), for Cities of London and Westminster (Nickie Aiken), for Truro and Falmouth (Cherilyn Mackrory), and for Ruislip, Northwood and Pinner (David Simmonds). I also pay tribute to the late Baroness Tessa Jowell. She and I worked together on the 1,001 critical days agenda, and she campaigned for it to be introduced as part of the sustainable development goals at the United Nations. I must also mention the superb work of the Royal Foundation and its Centre for Early Childhood. The commitment from Her Royal Highness the Duchess of Cambridge and her team has generated fresh attention for ensuring that every baby gets the best start in life.

This subject has been my personal passion for more than 20 years, from chairing the Oxford parent-infant project, to setting up the parent infant partnership UK, and the Northamptonshire parent infant partnership, establishing the 1,001 critical days manifesto and the all-party group conception to age two: first 1,001 days, and chairing the inter-ministerial group in the Government of my right hon. Friend the Member for Maidenhead (Mrs May). July 2020 marked a huge opportunity when the Prime Minister commissioned the early years healthy development review and invited me to chair it. Since then, we have been able to build on years of cross-party support, and a wealth of knowledge and expertise from the early years sector, to create a new vision for the 1,001 critical days initiative that was launched in March this year. The review has put the baby’s needs at the centre of all our work. Through meetings with parents and carers, virtual visits to local areas, and detailed discussions with parliamentarians, practitioners, academics and charities, we heard about the experience of early years services and support, and about what is going well and where change is needed.

First and foremost, we learnt from every parent and carer of their strong desire to be the best parent they can be, but we also learnt that new prospective parents often struggle to find the support they need. We heard from many parents who had deep concerns about their own or their partner’s mental health, and struggled to get timely support. We heard from many mums who desperately wanted to breastfeed but gave up because the support was not there. Parents told us how frustrating it was to keep telling their story over and over again to different people. Their cry was, “Why don’t you people ever speak to each other?” Equally, we heard from professionals and volunteers who said it would have been so helpful for them if they had known before meeting a new parent or carer about previous trauma or health challenges.

We heard from many dads about how excluded they felt from what they saw as “mum-centric” services. Some felt that they should not ask for any support for themselves, while others just felt sidelined and, in some cases, traumatised by what their partner had gone through in childbirth. We heard from foster carers of babies how little information came their way when caring for a vulnerable baby. More specifically, in 40 cases of babies who went into foster care, only two arrived with their red book. Those carers had no formal information about that baby’s early traumas that had caused them to be taken away from their birth family.

We heard from same-sex couples about unhelpful assumptions by early years professionals about their relationship and parenting roles. We heard from black mums about how particular cultural and health issues can be overlooked by busy staff. We heard from single mums and single dads about how they can feel isolated, and sometimes stigmatised, at such a life-changing time. We heard from many parents with particular challenges, such as not speaking English well, concerns about possible disabilities, experiencing violence in their lives, or other significant challenges. We heard that support is inconsistent and sometimes hard to access.

It comes as no surprise that the covid pandemic has been an extraordinarily difficult time for new families who, through no fault of their own, have not been able to access services or support in the normal way. The “Babies in Lockdown” report from the Parent-Infant Foundation, Best Beginnings and Home-Start reveals that nearly seven in 10 parents felt that changes brought about by covid were affecting their unborn baby, their baby, or their young child, and that 35% of parents would like help with their concerns about their relationship with their baby. The report also found that nine out of 10 parents and carers experienced higher levels of anxiety during lockdown.

Despite the many stories of difficulties, we also heard fantastic examples of good support for families. Many health visitors went the extra mile to keep in contact with families who were struggling, and many families found it incredibly reassuring to be able to text or Zoom their health visitor at short notice. Parenting programmes have been a huge support to many families, and we virtually visited Camden’s Bump to Baby programme, where classes continued online throughout the pandemic, and have proved incredibly popular with new parents and carers who are also helped to make friendships outside the programme. Dads gave us positive feedback on services that gave them space to share their experiences, without worrying about whether they were taking the focus away from the other partner’s health and wellbeing.

In lockdown, we also heard about excellent online and virtual services, and how they came into their own. One such service, Parent Talk, provided by Action for Children, reported a 430% increase in the number of parents seeking advice online during the pandemic. The Baby Buddy app, produced by Best Beginnings, has seen a huge take-up of its digital and virtual advice for everything from breastfeeding to nappy changing, and from sleep management to mental health concerns. Many local authorities are now determined to improve their joined-up offer to new parents and carers, so I certainly feel that we are pushing against an open door.

Our report, “The Best Start for Life: A Vision for the 1,001 Critical Days”, was launched by the Prime Minister in March this year. It contains six action areas. The first is that every local area should publish its own joined-up set of start for life services so that every parent and carer knows where to go for help.

The second is a welcoming hub for every family, in the form of family hubs. Those will build on the excellent work done by the late Baroness Tessa Jowell and others on creating Sure Starts, but the benefit of family hubs is that they will be the place where every family goes for support and advice, including from midwives, health visitors, mental health support workers and breastfeeding advisers within their walls. Not only will those services be physically available but they will be virtually available through the family hub model.

The third action area is a digital version of the red book, which will provide parents and carers with a record of their baby’s earliest life, from lovely moments such as their first tooth and their first steps, all the way to records of immunisations and professional support interventions.

The fourth action area is about the workforce. We all know that health visitors provide critical support for new parents and carers, but we also know that their case load can be very heavy, and parents and carers have told us that they really want more continuity of care and more frequent contact in the earliest years. We are therefore working with health visitors and local areas to consider resourcing levels and training needs, and whether a mixed-skill workforce can provide that greater continuity of care.

The fifth action area is to continually improve the start for life offer. A key action will be to establish parent and carer panels in every local area to ensure that the voices of families are heard when services are designed and improved. We are looking at improving the collection of data, at the evaluation of different interventions and at the need for proportionate inspection of the start for life offer in each area. A final but critical action area is to ensure that there is sound leadership, both locally and nationally, to drive the ambition to give every baby the best start for life.

I want to say a huge thank you to the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Erewash (Maggie Throup), and to all the review’s sponsoring Ministers, past and present, for their support for the review. I am sure that it was their commitment, combined with the support of the Prime Minister and the Chancellor, that ensured such a positive spending review settlement for the earliest years, with £82 million for family hubs, £50 million for parenting programmes, £10 million for the start for life offer, £50 million for breastfeeding support, £100 million for infant and perinatal mental health support, £10 million for new workforce pilots, and a £200 million uplift for the supporting families programme. I believe that £500 million is a transformational sum that will allow many more parents and carers access to the vital help they need to give their baby the best start for life.

Why does this matter so much to our society? Well, we know that it is in the period from conception to the age of two when the building blocks for physical and emotional health are laid down. Babies born into secure and supportive homes will usually go on to become happy children who do well at school and grow into adults who cope well with life’s ups and downs and are more likely to hold down a job, have better health outcomes and form healthy relationships themselves. On the other hand, we know that in families under pressure, particularly where there is partner conflict, substance misuse, poor mental health or deprivation, the consequences for a baby’s developing mind in that critical early period can be far-reaching and very harmful.

Prevention is not just kinder; it is also significantly cheaper than cure. For example, the NHS has estimated that for every one-year cohort of births in England, the long-term cost of lack of timely access to quality perinatal mental health care is £1.2 billion to the NHS and social services and more than £8 billion to society. That is for every year’s cohort. We also know that up to 30% of domestic violence begins during pregnancy, and that health issues such as tooth decay and childhood obesity cost hundreds of millions of pounds every year in health-related expenses. We believe that those things could be significantly reduced by better education and support for new families.

With these six action areas, I think we can transform our approach to early years support and services, improving the health outcomes and life chances of the youngest in our society. Just as we need to level up economic opportunity across the country, we must also focus on where it begins—that critical period of human life from conception to the age of two.

[Jonathan Edwards]

The right hon. Member is giving a very comprehensive speech. Does she also agree that the Government should look at the issue of shared parental leave? The stats seem to indicate that fewer than 4% of eligible fathers take up the Government’s current policy. The Government need to look at that, and the forthcoming employment Bill may be an opportunity to strengthen those provisions.

[Dame Andrea Leadsom]

I completely agree with the hon. Gentleman that it would be fantastic for families and babies if more dads took up shared parental leave. Of course, as he will know, that has been legislated for. Unfortunately, as he points out, far too few fathers have taken it up to date. I certainly wish that more would have the confidence to do so.

I believe that all colleagues across the House would agree that the world in which we all want to live is one where every baby is nurtured to fulfil their potential, where good lifelong emotional wellbeing is the norm, where our society is productive and co-operative, and where every one of our citizens has the chance to be the very best that they can be.

--- Later in debate ---

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

I would like to start by thanking the hon. Member for Richmond Park (Sarah Olney), the right hon. Member for South Northamptonshire (Dame Andrea Leadsom) and my hon. Friend the Member for Newcastle upon Tyne North (Catherine McKinnell) for securing this debate at this incredibly important time. I also offer my thanks to the right hon. Member for South Northamptonshire for her tireless campaigning on this issue over many years, for her recent leadership of the early years review and for her success in securing funding for the sector in the recent Budget. All those are to be welcomed. It is not easy getting money out of a Chancellor, as we all know. She also knows my dismay at the short-sighted cuts that preceded this funding, making it all the more necessary. I know she agrees that we need to ensure that no Government cut valuable services such as Sure Start or family hubs ever again.

I stand here as a former shadow Minister for children and families, a role now most ably held by my hon. Friend the Member for Hampstead and Kilburn (Tulip Siddiq). It has been said that once anyone has been a children’s Minister, like the hon. Member for East Worthing and Shoreham (Tim Loughton), or a shadow, they can never quite leave the issue alone. It is sort of like an “Order of the Babies” maybe, or a ministerial Hotel California.

Covid-19 has had a profound impact on all of us, but the effects of the lockdown restrictions and social distancing measures were keenly felt in the early years sector. I welcome the “Babies in Lockdown” survey report published today by the Parent-Infant Foundation, Home-Start UK and Best Beginnings. The pandemic is, sadly, far from over, and the report offers signs that the early years sector has developed a form of long covid, if you like. The survey found that nearly a third of mothers questioned reported that health visitor drop-in clinics that existed before the pandemic were no longer operating. I urge colleagues to read the report.

But let me take Members back to 1970, well before Zoom and Teams. Back then, fewer than a quarter of mothers worked; society expected a full-time mother. Without a central focus on the early years, and no talk of the 1,001 critical days or adverse childhood experiences, the education of very young children was neglected. Baroness Blackstone, writing in 1974, highlighted the fact that only 10% of three and four-year-olds attended state nursery schools or classes in 1971, with some areas receiving no service at all.

To combat the lack of state nursery education, the mothers did it themselves. Belle Tutaev set up a playgroup with her neighbour which eventually bloomed into the Pre-School Playgroups Association. This has since become the Early Years Alliance. But the state should have taken up this mantle, rather than the already burdened mothers. Not everyone was convinced of that principle, however. In 1980, George Young, then the Conservative Secretary of State for Social Services, said that he did not

“accept that it is the state’s job to provide day care to enable the parents of young children to go out to work”.

Listening to the debate today, 40 years on, we can see how far we have come from that thinking.

It was the last Labour Government who finally addressed this problem. I have spoken before, as others have today, about the late Tessa Jowell’s Sure Start programme being a beacon of early years policy. Sure Start brought children’s services together under one roof, uniting healthcare with wellbeing, education with childcare, babies with other babies, and parents with other parents. There were 3,620 Sure Start centres in 2010 under Labour. That has fallen, as we heard from the hon. Member for Richmond Park, by more than 1,300 in the past decade or more of Conservative Governments. Those that remain have been effectively hollowed out, offering only skeleton services with minimal opening hours. While the Government’s pledge to fund 75 more family hubs is obviously welcome, it does little to make up for that loss. I know the hon. Member for East Worthing and Shoreham said it is not all about the buildings but, when we have lost 1,300 and replaced them with 75, it is trying to get a quart into a pint pot, as they used to say.

[Dame Andrea Leadsom]

It has been such a pleasure to work with the hon. Lady on this topic for so many years. I just want to put on the record that it is not 75 family hubs, but 75 upper-tier local authorities; it will be for them to decide, but it could be hundreds or thousands of family hubs. The hon. Member for Newcastle upon Tyne North (Catherine McKinnell) drew the same conclusion, so I really want to set the record straight on that point, if the hon. Lady will forgive me.

[Mrs Hodgson]

I am very grateful to the right hon. Lady. That is an important clarification, and we must ensure it is out there that maybe it will not just be 75, but that they can make it many more. Let us hope it is 1,300; I am sure she will agree with that. That said, I warmly welcome what I think is the Government’s tacit admission that they got it wrong when they defunded the Sure Start programme, even though, as we all remember, on the eve of the 2010 election, David Cameron promised it would be safe in his hands.

However, we are where we are. Earlier this year, I also co-chaired a cross-party early years commission alongside the hon. Member for Eddisbury (Edward Timpson), who, as a former children’s Minister, is also a member of the “Order of the Babies” and a resident of the ministerial Hotel California. The commission heard from a wide range of stakeholders, including educators, academics and policy professionals. I will take the House through some of the recommendations in the comprehensive report.

First, there should be integration of health and education support for children, ensuring that every child receives the health visitor appointments they are entitled to and a new health visit when the child is 18 months old. Secondly, because too few families have access to essential services, a locally relevant and dedicated parent support service is needed in every community in every area. Thirdly, we should upskill early education practitioners by investing in continuing professional development, so that the workforce stay fit to face the challenges of the future. Those proposals could easily be made reality. I sincerely hope that, as part of the £500 million brought forward in the Budget, the Government will deliver all of what we seek in this debate.

As we take part in this debate, we are mindful that the babies and children themselves will not be listening. They will not be tweeting their agreement or penning letters to our offices. I will spare a moment to mention how, beyond their value on their own terms, reforms to the early years offer can be instrumental in improving the lives of those without children, via the economy.

The Early Intervention Foundation found that the cost of late intervention in 2016-17 was £17 billion, owing to the need for services to help with mental health issues, youth crime and exclusion, including a £5.3 billion spend on looked-after children. Early intervention can offset that cost. The Carolina Approach to Responsive Education programme provided intensive, high-quality childcare for ages 0 to 5 in the United States of America and delivered a 13% return on investment per child each year. It netted IQ gains, higher wages, increased likelihood of home ownership and higher scores on achievement tests.

For the family unit, the economic returns are clear too. As the hon. Member for Richmond Park said, parents in areas with Sure Start local programmes moved into paid work more quickly than those without, reducing the benefits bill to the taxpayer and increasing tax receipts for the Treasury. But that is not the full picture: the economic benefits are often only modelled on specific, targeted interventions, whereas the benefits of intervention fan out across a range of factors, such as reducing the later burden on the public purse— the whole point of early intervention—and greater participation in the economy over many years. As such, it is practically very difficult to model the effects of a web of measures applied at once. So just imagine the results we could achieve if those interventions were provided simultaneously, with wholesale improved outcomes delivered via intensive early years support. Britain’s early years offer has the potential to be much greater than the sum of its parts.

To conclude, I would like to look to the world we are creating as legislators in this place. As we speak, delegates from around the world are discussing the means of preserving the planet and protecting the environment in Glasgow at COP26. It is incredibly important that we limit climate change to an increase of 1.5°. Missing, I believe, is leadership for those who will grow up into these environments. The pursuit of climate justice is in no small part to ensure that our children and their children’s children do not face an uninhabitable, hostile world. As those at COP26 work for the future of the planet, let us, here and now, seize this golden opportunity to help those who will inherit it.