Public Health Model to Reduce Youth Violence Debate

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Department: Home Office

Public Health Model to Reduce Youth Violence
Sir Edward Davey Excerpts
Thursday 13th December 2018

(1 year, 2 months ago)

Commons Chamber
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Home Office
Victoria Atkins Portrait Victoria Atkins - Hansard
13 Dec 2018, 2:18 p.m.

The taskforce has met five times—it meets pretty much every month, although there may have been a period of five weeks between one or two meetings. There was a meeting only last week that I was unfortunately unable to attend because I was required for a debate in the House, but the next meeting is on 9 January. We do not publish the minutes of the meeting because we want people to be able to exchange full and frank views. I am grateful to hon. Members throughout the House who take part in the taskforce, which has pushed on a programme of work across Government, including on exclusions and social media activity. I plan to move on to that later in my speech.

Sir Edward Davey Portrait Sir Edward Davey (Kingston and Surbiton) (LD) - Parliament Live - Hansard

The Minister acknowledges that this is a huge problem and that the murder rate is at its highest since 2008, with the 130th homicide of the year in London happening earlier this week. Will she therefore explain why we are taking so long to get on to the public health model? It was deployed in Glasgow in 2005 and efforts and initiatives by groups such as Redthread have been going since 2005, so why is it taking so long to get this model going?

Victoria Atkins Portrait Victoria Atkins - Hansard
13 Dec 2018, 2:19 p.m.

The right hon. Gentleman will know that the serious violence strategy, which I am about to come on to, sets out the cross-governmental, multi-agency approach to the public health model. He mentions Redthread, so I hope he knows that the Home Office has been funding charities such as Redthread, St Giles Trust and other important and valuable contributors from the charitable sphere for some time now, because we recognise that law enforcement and policing is not the only answer. Of course it is important, but we want to get to the early causes of crime to prevent young people in particular from being dragged into criminality and snared by gangs, particularly in the case of county lines.

Break in Debate

Colleen Fletcher Portrait Colleen Fletcher (Coventry North East) (Lab) - Parliament Live - Hansard
13 Dec 2018, 3:37 p.m.

It is a pleasure to follow the hon. Member for Bexhill and Battle (Huw Merriman). It is always interesting to hear about Members’ former lives, and about what drove them to come to this place.

Sadly, youth violence, and knife crime in particular, has affected almost every community in the country in recent years, and it is a problem that has reached epidemic levels. Just last month in Coventry, a 16-year-old boy was tragically stabbed to death in the Wood End area of my constituency. That senseless act cost an innocent young man his life, ruined the lives of his family and friends, and left an entire city in a state of shock. It was yet another tragic example of how knife crime destroys lives and devastates communities.

That shocking event is just the latest in a rising toll of knife crime in the city. Over the last five years the number of knife crime incidents has almost doubled, from 164 in 2012-13 to 307 in 2017-18. There were more than 162 knife crimes in the first six months of 2018-19, with three fatalities in this year alone. The levels of knife crime in my area, and in other areas across the country, are rising, at a time when police budgets have been cut to the bone and the number of frontline police officers has fallen to the lowest level in 30 years. The West Midlands police force alone has lost more than 2,000 officers in the last eight years, and £175 million from its budget over the same period. There can be little doubt about the correlation between falling police numbers and rising crime levels. It is time that the Government finally acknowledged this link and acted to increase the number of officers on our streets to help protect our communities.

All forces need additional officers, and the West Midlands is no different; our PCC has asked the Government for an extra £42.2 million to cover inflation and the funding for 500 additional officers to help tackle violent crime more proactively. It is shameful that the Government failed to meet that request in full.

However, I accept that this problem has not been created by cuts to police budgets alone, nor is it a problem that can be resolved by simply putting extra officers on the streets. If we really want to address this problem permanently, we need to understand the social conditions that lie at the root of youth violence and recognise the underlying causes that have fuelled the recent surge in knife crime. In doing so it is impossible to ignore the cumulative impact of eight years of savage Government cuts to local services, which have exacerbated poverty and inequality, hampered our ability to tackle youth violence at source and pushed communities to a tipping point.

It is certainly no coincidence that areas of high deprivation have similarly high rates of knife crime. In Coventry we have seen cuts to education provision, children and youth services, Sure Start, the police and mental health facilities, all of which have had a direct impact on the most vulnerable in society. Cuts to such vital services not only make it difficult to identify young people who are most at risk of early offending due to their environments, but make it more difficult to address those environments through early intervention. That is why we need a long-term, properly funded, integrated public health approach to youth violence, an approach that focuses on the drivers of youth violence rather than the aftermath and that prioritises the safeguarding and protection of vulnerable young people over criminalisation.

We must ensure that carrying knives never becomes normal behaviour and seek to change the culture among many young people. To do this, we need to place a greater emphasis on community policing that builds trust, education programmes that equip young people to be resilient, and early intervention that targets those most at risk of becoming involved in violence, as well as targeting significant resources on prevention activities on a multi-agency basis. As a result, youth violence would no longer simply be within the purview of the criminal justice system; instead, this would involve the police, schools, parents, health professionals, youth workers and council services working alongside community groups, young people, faith groups and the voluntary sector.

There are already practical examples of this holistic approach taking place in Coventry with the roll-out of youth workers in our local A&E department. Those youth workers intervene at “teachable moments” and speak with young people who attend hospital with a knife wound, as victims often become perpetrators of violent crime—although I think we can all agree that it would be preferable to prevent the violent incident in the first place, rather than act in the aftermath.

There is also investment in mentoring projects and youth work, including through the Positive Youth Foundation in Coventry, to divert young people away from violence. Similarly, there is investment in education programmes that warn young people of the dangers of carrying a knife. We have also seen the introduction of violence prevention mentors—young people who mentor other young people in their schools away from violence.

Such local initiatives really do make a difference to both individuals and communities touched by violence, but they do not in any way negate the need for the Government to adopt a public health approach on a national scale. We need the Government to implement and properly fund a national programme, with measurable outcomes, that targets resources at communities to tackle the problem of youth violence at source while protecting future generations from it. I hope this is something the Government will look at very seriously.

Sir Edward Davey Portrait Sir Edward Davey (Kingston and Surbiton) (LD) - Parliament Live - Hansard
13 Dec 2018, 3:45 p.m.

I want briefly to talk about the consensus that I hear in the debate, as well as about some of the areas in which there is a divergence of views. I also want to make one or two constructive remarks. Everyone agrees that this is a serious and pressing issue. We cannot just look at the figures, although they are pretty appalling, with homicides and knife deaths at levels not seen for more than a decade. The right hon. Member for Hackney North and Stoke Newington (Ms Abbott) talked about how meeting the mothers involved really brings it home to you. I have had two fatal stabbings in my constituency in the past two years, and meeting the mothers of the two young men involved was most distressing. I could not leave those meetings without committing myself to take action, and I am sure that everyone in the House has had a similar experience.

There is consensus on the urgency involved, and there is consensus that the old approach of arresting everyone and putting them in prison is not going to work. We have to have a holistic public health approach, and I think that everyone has signed up to that. I refer people to the work of the World Health Organisation on the need for violence prevention and the need to treat this upsurge in violent crime as an epidemic linked to aspects of disease. A public health approach is absolutely right. I also think we can agree on the good work that is being done in communities.

Lyn Brown - Hansard
13 Dec 2018, 3:46 p.m.

I absolutely admire the work that has been done in Glasgow, but this is not the only cause of crime in London. If we continue to focus only on the public health approach, we are likely to miss the way in which children are being groomed by gang members and organised criminals and placed in harm’s way by being used as mules and dealers. We need to understand that, in London, the problem is massive.

Sir Edward Davey Portrait Sir Edward Davey - Hansard
13 Dec 2018, 3:46 p.m.

I agree with the hon. Lady, who has taken a great leadership role in this debate. However, the title of the debate is “Public health model to reduce youth violence”, which is why I am focusing on that.

A great deal of cross-party work has been done on this, including the work of the Youth Violence Commission, which the hon. Member for Lewisham, Deptford (Vicky Foxcroft) chairs. Her ears must be ringing in this debate. Colleagues from all parties are involved in the commission, including the hon. Members for Glasgow South West (Chris Stephens) and for Braintree (James Cleverly) and my right hon. Friend the Member for North Norfolk (Norman Lamb). My constituent and friend, Siobhan Benita, a former senior civil servant, has also been contributing her skills and knowledge to this cross-party work. There is consensus that this is the way forward.

So where is the disagreement? First, there is disagreement on the speed of the response. I just do not think that we are doing this quickly enough. This is a crisis. Yes, we know that some of the responses involving the public health model are going to be long-term approaches, but there are short-term measures that could happen sooner. Why are we not doing those things ever more quickly? There is a failure to see this crisis for what it is, and to understand how it is experienced by the families in our constituencies.

The other disagreement involves resources. We can always go on about resources and how well they are used—the hon. Member for Bexhill and Battle (Huw Merriman) made that point—but let us remember the cost of these appalling tragedies. It is estimated that every homicide costs more than £1 million for the investigation, the autopsy, the coroner’s court and so on. That is before we even talk about how much it costs to lock up the perpetrator, if he or she is caught, and before we have calculated the lost economic opportunity—never mind the emotional value to the family. We are talking about a huge waste of money and resources, as well as about the tragedy and the tears. When we look at resources, let us do our sums right. Let us recognise how much money we are wasting by not tackling this properly. I know that this is a debate that the Treasury sometimes has difficulty in hearing, but we have to get it to do its sums properly. It looks at this problem in too narrow a way, and for that reason we are getting the wrong solution. We are not making this the priority that it must be.

This has been a constructive debate, and I want to turn to some of the solutions. I am going to make one or two slightly weird suggestions, but people will see their relevance. Some solutions must be targeted and must focus on the individuals and communities at greatest risk, which can be a sensible approach for getting early responses. However, we should also consider the prevention side of things and deal with the long-term causes, as other hon. Members have said.

One such long-term problem is bereavement, which relates to the adverse childhood experiences issues to which other Members have referred. It will of course be only one of the issues, but we do not properly treat traumatised bereaved children at all in this country. I am not necessarily talking about children who may be traumatised because one of their loved-ones has been murdered; I am talking about children whose parent may have died naturally. We are hopeless as a society at dealing with that. I have been working with the “Life Matters” taskforce, which is not considering the issue from the angle that we are looking at it today, but I want to bring it in because it offers an example of how rubbish we have been at dealing with some of the adverse childhood experience issues.

We do not measure the number of children who have lost their mother or father, because we do not record that information. I have met the Office for National Statistics to talk about that, and the reason is that when a death is registered it is recorded if there is a partner, but not if there are any surviving children. There is no requirement in law, but this is a Home Office responsibility, so I will write to the Minister about that and I am having a second meeting with the ONS. If we measure something, surprisingly enough the officials say, “Oh. That’s a problem.” We can then share the problem out and say, “We’re not giving enough help in schools. We’re not giving enough counselling.” The system can suddenly kick into gear, but it does not do that at the moment because we do not realise that there is this massive problem. Let us start thinking at that level about how we can get attention on to such issues.

Another example—perhaps not so weird and wacky—is the local initiatives that are set up when someone loses a dear one. We have seen lots of charitable initiatives to tackle knife crime. We all know about Redthread, but a Christian youth charity in my constituency called Oxygen has set up an amazing programme—before the Minister reminds me, the Home Office helped to fund it—called “What’s the Point?” whereby the group goes into schools, bringing along people whose loved ones have been the victim of knife murders. There is also a new initiative in my constituency called “Drop a Knife, Save a Life” that was set up by an amazing woman called Sophie Kafeero, whose son, Derick Mulondo was murdered in my constituency 18 months ago. Sophie came to this country from Uganda about three decades ago, and she was a leading community activist on HIV/AIDS in the African population. She is an amazing lady, but she lost her only child in the later years of her life. She is full of grief when you talk to her, but she tells her story and goes into schools to talk to young people.

Interestingly, Sophie has noted in her work in the community that it is the really simple stuff that matters—just like the hon. Member for Bexhill and Battle was talking about when describing his time as a youth worker all those years ago—such as organising some football. Sophie tells a story about how a young boy knocked on her door after her son Derick had died and said, “Who’s going to help us play football now?” Derick had arranged football games among the young people in the local community, but he was killed with a knife. If we can find those sorts of initiatives, we can get on top of this problem, but we have to give it the seriousness that it deserves. Such solutions are not rocket science, but they are vital.

I hope that the Minister will not take my final point as me bringing in a little controversy, but police resources are vital, and we are particularly missing the police community support officers. When we had a sergeant, two PCs and three PCSOs in every ward in my constituency, the police knew what they were doing. We had days when wards had no crime reported at all, which has hardly happened since. People felt more confident and safer, and the community felt happier. Trying to measure that may be difficult, but that sort of thing is what I would call a public health model. This is about taking things in a different way and getting to the root of the problem. This is about giving our young people the support and the role models that they need.

Vicky Foxcroft Portrait Vicky Foxcroft (Lewisham, Deptford) (Lab) - Parliament Live - Hansard
13 Dec 2018, 1:50 p.m.

I will start with what motivated me to speak in this debate. I was first elected in 2015, and in September of that year I had to deal with losing two young men in my constituency. I saw the impact it had on the whole community. Since then we have lost 10 young people in Lewisham, Deptford. With 130 lost in London and 263 lost across the country this year alone, this clearly is not something we can simply tackle in Lewisham, Deptford alone.

If that many people had died in a football stadium, a music arena or a workplace, we would be having a national inquiry. From my conversations with experts and young people, I quickly realised that anything we do needs to be cross-party—we cannot play politics with young people’s lives—and evidence-led. That is why we established the cross-party commission on the root causes of youth violence. Warwick University joined as our academic partner, and academics from elsewhere, including the Open University, have supported our work. A public health approach was the key recommendation of our interim report.

In talking about a public health approach, people far too often, and particularly politicians and commentators, say the words but do not understand what they mean or where they come from. In 1996, at its 49th annual conference, the World Health Organisation declared violence

“a major and growing public health concern around the world”

and in 2002 it advocated tackling violence as a public health problem. The World Health Organisation identified that violence acts and spreads like a disease.

The focus is on dealing with violence just like any other disease. The World Health Organisation’s evidence shows that violence spreads like a disease and, as such, we need to treat the disease and prevent it from spreading. Across the world, from Chicago to Scotland, there are numerous examples of successful public health programmes aimed at tackling violence. I could name loads of them, but I have had to cut down my speech dramatically to stay within the time limit.

Cure Violence, founded in Chicago in 2000 under the name CeaseFire, runs projects all over the world, including in England at Cookham Wood young offender institution. The project at Cookham Wood resulted in a 50% reduction in violent incidents, a 95% reduction in group attacks and a 96% reduction in youths involved in group violence.

Cure Violence maintains that violence is a learned behaviour that can be prevented using disease control methods. The Cure Violence model has five required components, three core components and two implementing components. Put briefly, the model involves, first, detecting potentially violent events and interrupting them to prevent violence through trained, credible messengers; secondly, providing ongoing behaviour change and support to the highest-risk individuals through trained, credible messengers; thirdly, changing community norms that allow, encourage and exacerbate violence in chronically violent neighbourhoods to healthy norms that reject the use of violence; fourthly, continually analysing data to ensure proper implementation and to identify changes in violence patterns and levels; and fifthly, providing training and technical assistance to workers, programme members and implementing agencies.

In Scotland, the violence reduction unit established in 2005 has reduced the number of homicides by 39% and the number of violent crimes by 69%, which is huge. I could talk for hours about the unit’s work, but I will not. I will simply say that I have nothing other than total respect for the unit’s work and for the magnificent people I have met.

Karyn McCluskey and John Carnochan, who set up the unit, are two of the finest, most dedicated people I have ever met. It has never been just a job to them. They drafted the violence reduction unit’s first plan and they would say that they had lots of dedicated people who worked with them, and I know that to be true. What would be the main things they would say to me if they were here? They would say, “It is about relationships.” I interpret that to mean breaking down barriers, pulling people together on a common aim and enthusing people to do something that is going to work. It is also about the importance of individual relationships. They would also say, “Follow the evidence. Don’t do things that don’t work. Do things that work.” That might sometimes mean trying something, realising it is not working and binning it, and then trying something else that will work. They would also say, “ Listen. Listen to what you’re being told and what the evidence shows you. Listen to our young people and recognise they are so, so often so very vulnerable, even if they put a super-hard act on.” One of the most important things they would say is that our approach must be long term. They had a 10-year strategy, but when we speak to them, they say it could and probably should have been 15 or 20 years long.

I am glad to see that Sadiq Khan, the Mayor of London, has announced the establishment of a violence reduction unit in London, which will establish a public health approach to reducing violence, learning the lessons from Scotland, but appreciating we may need some different approaches in London. Local authorities need to have the legal duty—this is not just about having a consultation on a legal duty—to underpin a public health approach in tackling violent crime. I hope the Home Office can update us on that soon.

Turning back to what the Government can do, we need to learn lessons from what works. We need to be brave and follow the evidence, which can be difficult when the Government do not store data on crucial sources of information. Can the Minister tell me why the Government do not centrally hold data on the time of knife attacks, especially as recent research has shown that young people are especially vulnerable between 4 pm and 6 pm on school days? Data on the number of knife aggravated murders in each city or local authority is also not held centrally, which makes it far harder to compare the efficacy of different local authority approaches over time. The number of prisoners that were excluded at school is also not regularly recorded. Many victims of knife crime do not report their injuries to the police, so should we not be looking for this information in other areas, such as the NHS? The Government do not cross-reference ambulance service dispatch data for knife injuries and police records for knife attacks. Many people believe there is a link between deprivation and levels of violence, so why do the Government not hold this information? Finally, but extremely importantly, why do we not record the number of young people who applied but failed to meet the threshold for child and adolescent mental health services treatment?

Those are all extremely important areas—and I am sure there are many more—where we should hold data, as a minimum to ensure that the Government can successfully deliver on their public health approach. I have asked numerous questions of the Government and others in order to try to find this information, but, sadly, I know the Government do not hold this data. Why is that? Will the Government commit today to seeking to hold this data?

Why do we invest in programmes that we know do not work? For example, there is no evidence to suggest that programmes in schools that say, “Do not use drugs” or, “Do not carry a knife” have any impact. We should analyse the efficacy of these programmes and if they do not work, we must stop them. We know that programmes investing in social development, home visitation, training in parenting, mentoring programmes and family therapy work. We also know that the earlier the intervention, the more effective it is.

I will skip through what I have on adverse childhood experiences, because I know that other Members have gone through it, but ACEs is an extremely important area of work and we need to do a lot more on it. I encourage all Members of Parliament to do the survey on ACEs and get their scores, as I intend to do in the future. I understand that the Government are due to publish a report on ACEs; when will it be published?

I will skip through my comments on schools, but in previous speeches on education I have said a lot about what happens in schools. It is really important that we look into whether school finishing times are right and whether we should stagger them. Should we think about closing down all pupil referral units? Should we look into expulsion? We could absolutely invest that money in our children’s lives far earlier.

Let me conclude my remarks with an important quote from a Member of the Youth Parliament, Ciya Vyas, who spoke about the importance of tackling knife crime in the recent UK Youth Parliament debate on the subject. She said:

“More young people voted for this issue than any other…If there is a will for change on this issue among young people, there is a political will for change here at Westminster. Whether we see the need for a violence reduction unit and a public health approach, as pioneered so successfully in Scotland and endorsed here by London’s Mayor, or the Home Secretary’s recent proposals to increase levels of stop-and-search, this debate is happening now, and we cannot neglect our duty to bring young people’s voices into it.”

After that debate, and following a ballot of more than 1 million young people throughout the nation, the Youth Parliament and the British Youth Council chose knife crime as the subject of their national campaign. Let us make sure that as politicians we do not let them down.