The Minister of State, Department for Education (Sarah Teather)
I congratulate the hon. Member for South Northamptonshire (Andrea Leadsom) on giving an absolutely fascinating speech. I always respect what she says, and I am always grateful for her contributions on these issues. It is good to hear someone who has so much interest, expertise and passion speak on this subject. I share her passion for this subject, which is incredibly important.
Early intervention is a hugely important issue, and the term refers to many of the things that she described. However, I should say that I am the Minister with responsibility for early years, so I have a particular bias towards ensuring that early intervention really focuses on early years issues. The point about attachment is gathering pace in debate, as well as in the knowledge among professionals on the ground. The work that Oxpip has done, along with the hon. Lady’s work in continuously raising this issue, is important in ensuring that professionals understand the importance of attachment and that the Government consider it when we develop our early years policies.
I absolutely agree with the hon. Lady’s points about the importance of warm parenting and bonding. Those issues go to the heart of many of the things that we have been trying to do over the last 18 months. She will be aware that I and the Under-Secretary of State for Health, the hon. Member for Guildford (Anne Milton), who has responsibility for public health, jointly published a document in the summer called “Families in the Foundation Years”, which covers many of the things that she picked up. There is a lot more work to do in this area—some of it is just beginning—but some of the themes that the hon. Member for South Northamptonshire picked up are being addressed by what is very much work in progress, across both the Department for Education and the Department of Health. In a sense, the things that she has talked about go right to the heart of the intersection between those two Departments. Indeed, it was a toss-up as to whether it would be me or my colleague the Minister with responsibility for public health responding this evening. We both take such issues incredibly seriously, which is why we are collaborating on much of the work on the nought-to-five age group.
The hon. Member for South Northamptonshire outlined the impact that insecure attachment can have on neurodevelopment and, in particular, the ways in which it affects levels of cortisol and the long-lasting impact that this can have on brain development. That is worth emphasising. Not all the research is concrete enough for us to be able to tell in retrospect whether somebody’s difficulties are a result of attachment issues, but there is good evidence that stress in early years results in attachment issues later. It is not always possible to bring that back retrospectively, when somebody’s behaviour is difficult, but there is certainly good correlative evidence that the lack of a warm bond from the beginning can result in serious behavioural problems later.
The issues that the hon. Lady has raised go to the heart of a number of matters that are a priority for the Government in the areas of family policy, health policy and child development. We have many of the systems in place that will begin to pick up on those issues. This is about universal and targeted services. She made the powerful point that issues of attachment are no respecter of class or income, which is precisely why we need children’s centres that are universal, but that can focus on those who are in the most need. They must have a universal front door through which anyone can walk, and they must not stigmatise those people who walk in and ask for the services. They must then focus their resources on the most difficult and challenging problems, including those that the hon. Lady mentioned. That is exactly what we have been trying to achieve.
Regarding the statement that we published in the summer, a number of things will be key if we are going to get this right. First, it is about identifying need early and putting in place the support to help the families that need it. Frankly, the first problem that we need to get over is that of data sharing. As I have said, this problem goes to the heart of issues covered by the Department for Education and the Department of Health, and data sharing is one of the big nubs that the previous Government tried to get to grips with. My colleague the Under-Secretary of State for Health and I are determined to pick up on this issue, because until the information about which families are most in need can be passed between the different professionals, it will be difficult to put in place the help that we know is available.
Over the past six months, I have seen some really good examples of where the services are working really well, and it is worth taking a minute to talk about them. The most exciting of the examples was in Manchester. I visited the Clayton Sure Start children’s centre just after the riots to find out about the work that it had been doing in this area. As part of a drive to improve the integration of services with GPs in the area with the most deprived wards, the GPs themselves had arranged for junior doctors who were training to become GPs to spend time at children’s centres to see the services that were being delivered. Among the messages that they were trying to get across was that, when a woman presents with post-natal depression, it is not just the woman whom they need to treat. They need to look beyond the patient and to understand that a newborn child is also involved and that, unless they get the services right, there could be a risk of attachment disorder later. That is not to say that every woman who presents with post-natal depression will have a child who ends up with attachment disorder, but GPs need to be aware of these issues.
The hon. Lady made a point about training for professionals. Health visitors are trained to understand these things, as are early years workers, although I think that there is much that we can do to improve on that. I will come back to that in a moment. Many GPs have very little knowledge of child development and attachment issues. That was a really exciting project on social prescribing, and I will be fascinated to see the results. I hope that many other areas will follow Manchester’s example, and learn just what can be done.
Similarly, some really good work has been done in Hull, involving an agreement to share information between local health services and children’s centres. The project has been led by one inspirational woman who is absolutely determined to ensure that the information was shared. The result of the agreement was that health visitors and family outreach workers were not duplicating each other’s work. They were sharing information and getting to the families in need quickly. They were also able to put in place the kind of support that the children’s centres offer, to help parents to understand the need to speak to their children in a particular way, and to understand about the warm parenting styles and firm parenting styles that are important right from the beginning.
The hon. Lady will be aware that the Government have committed to significantly increasing the number of health visitors. We plan to increase the health visitor work force by 4,200 by 2015 to ensure that the healthy child programme is fully and consistently implemented. At the moment, because of the patchy availability of health visitors, not everyone gets the support that they need. Ensuring that that service is well linked to the work that we are doing with children’s centres is at the heart of what we are trying to do.
Similarly, the Government have doubled the amount of funding available for the family nurse partnership—a programme that works intensively with particularly vulnerable young mothers and young parents to make sure that they get support right from conception, as the hon. Lady said, so that we do not pick up problems several months down the line when some of the problems have already begun to cement. It is an important programme, which we know makes an enormous difference to families at what is often a particularly difficult time. The nurses are very experienced and receive additional training in motivational interviewing, neurological development, attachment, mental health and strength-based working in a therapeutic relationship. Those are important skills, which help to ensure that the nurses are able to support mothers at that time.
Andrea Leadsom
I agree that the family nurse partnership is excellent, but does the Minister agree with me that it is entirely possible to come up with other strategies that would be less expensive and less prescriptive, including different therapies that might be more appropriate for certain types of parents rather than a prescribed particular programme that costs the taxpayer a lot of money to implement?
Sarah Teather
As the hon. Lady says, the family nurse partnership is one of our more expensive programmes. It is focused on very young mothers, and the doubling of the programme has been aimed primarily at expanding the help available to young, mostly teenage mothers who we are know are vulnerable. That is not to say, however, that other forms of help cannot also be extremely effective. The hon. Lady speaks with great passion about the work of the charity with which she is involved. Children’s centres have other models for helping to support women, particularly in areas where data sharing is working well and someone might be brought into a children’s centre before they give birth. It does not necessarily mean that the support they get is through the FNP system. There may be other ways of supporting those women. It is important for children’s centres to build on the best evidence available, but they must also be left free to innovate and develop their own work—based on what is known works.
Let me provide an example—outreach work. We are trying to improve the quality of the work done on outreach and family support. At the moment, there is a great variety of types of work on outreach. We have been working with the National College for School Leadership to develop some leaders in this area so we can draw together the evidence of best practice and disseminate it to encourage all areas to adopt the elements that we know work. That is not to say that every programme has to be badged or that everybody has to call their family support worker—sometimes called something slightly different. We know that certain key components of this work make a difference, so the key components of best practice will make a difference to families in difficulty.
I have only a few minutes left, so I would like to pick up some other points raised in the debate. The hon. Member for South West Bedfordshire (Andrew Selous) raised a point about relationship support. I think that is critical for both the reasons the hon. Gentleman suggested, but also because when parents are in conflict, it is incredibly damaging for children as they grow up. That is the main reason why the Government are providing support for relationships—formal face-to-face relationship support, but we have also provided money for telephone counselling. This is an important feature of parenting programmes that work well. If we are to support parenting, we know that it is key to support the parents’ relationship and get them to talk to one another. They must have some support to ensure that the relationship is solid; parents should have the skills to negotiate with one another, not just with the child. Working with only one parent in such circumstances tends to be less effective. It may not have no good results, but the results will be much better if a component of relationship support is included.
Last September the Government announced a trial of a new offer of universal parenting support, which will take place in three areas for parents with a child under five. That was a response to evidence that parents’ relationships with their children was critical to the home learning environment—the hon. Member for South Northamptonshire mentioned children aged between nought and two, but in fact the relationship is critical throughout, and is one of the most important factors that determine how well a child does—but also a response to what parents tell us, which is that they want more support in this regard.
We will begin the trial, and we will see what happens. We will see whether parents take up the offer, whether it is popular, and whether it has an impact on parenting style. It is one of the things that we will need to evaluate at a later stage. We will want to know whether it deals with some of the points that have been raised this evening about harsh parenting styles that have an impact on children’s development and on discipline, but we also want to test the theory that if we provide this—