Giving Every Baby the Best Start in Life Debate

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Department: Department of Health and Social Care

Giving Every Baby the Best Start in Life

Wera Hobhouse Excerpts
Tuesday 9th November 2021

(2 months, 1 week ago)

Commons Chamber
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Sarah Olney Portrait Sarah Olney
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I am grateful to the hon. Member for his intervention. He is absolutely right that there are a large number of events and incidents surrounding pregnancy and birth—as I know from my own experience—that can cause huge distress, and it is right that mothers and the people supporting them, and fathers as well, get the support they need, including statutory leave from employment for the time it takes to come to terms with the miscarriage. That is certainly something we should be looking at.

We know that impending fatherhood can be a cause of great anxiety for men, and more services need to be developed to support them. We also know that over a third of domestic violence starts or gets worse when a woman is pregnant. I would speculate that some of that is attributable to undiagnosed and untreated mental health conditions in expectant fathers, which underlines the need to do more to support them.

In addition to health visiting and perinatal psychiatry, support for children and their families throughout their early years is vital for enhancing children’s prospects at school and beyond. Evidence shows that effective integration of services in the earliest years can bring broad benefits. For example, Sure Start children’s centres are shown to decisively reduce hospitalisations during childhood. However, 1,300 children’s centres have closed since 2010, and recent research has shown that 82% of parents of young children have struggled to access early years services. I am pleased that the Government have now committed £80 million to introducing family hubs to 75 local authorities across England, and £50 million for parenting programmes. However, we need more information on what family hubs can provide, and I would particularly like to ensure that health visiting and mental health support are included.

The importance of the right support in the early years was brought home to me after a recent meeting with primary headteachers in my constituency. I heard about how difficult it is for nursery and reception-age children to settle into class and to get used to spending time with other children and not spending all day at home with their parents. For adults, lockdown has been 18 months of inconvenience, after which we expect to be able to pick up the threads of our former life. However, some young children who started nursery this term will have spent up to a third of their life in lockdown, and we cannot yet know what the long-term impact will be.

Wera Hobhouse Portrait Wera Hobhouse (Bath) (LD)
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Is my hon. Friend alarmed, as I am, by the fact that domestic violence has increased during lockdown, which has particularly affected young or very young children? The Government need to look at the backlog of cases that have arisen through the lack of attention to domestic violence, or inability to look at it, during lockdown, as it did not really come to our attention.

Sarah Olney Portrait Sarah Olney
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My hon. Friend is absolutely right, and incidents of domestic violence during lockdown are a matter of grave concern. We know there is a clear link between domestic violence starting or worsening and a pregnancy in a family. That issue needs a huge amount of attention; more mental health support for both partners would help a great deal.

The lockdown will have increased disparities in educational outcomes between those from poorer backgrounds and their richer classmates, and I call on the Government to do more to provide catch-up funding to our schools, and allow them to spend it on a greater range of services. Local headteachers tell me that funding can be allocated only to academic tuition, and that they have identified many children, including the very youngest, who need mental and emotional support to help them in school.

I will conclude by saying thank you to everyone who has talked to me about their experiences in this area, but particularly our health visiting and perinatal mental health teams, who do so much good and valuable work for new families. I also acknowledge the huge contribution made by the voluntary sector in supporting new families, in particular the work of Home-Start, which provides an excellent network of support. It takes only a small amount of encouragement, a little word of advice or a sympathetic listening ear to give a new parent confidence, but it can make a world of difference to their children. A small investment in the beginning of life can reap huge rewards, not just for individual children and their families but for whole communities, and the right start can enhance not just individual educational achievement and wellbeing but reduce risky and antisocial behaviours. Few pounds could be better spent, or yield a more valuable return, than those invested in our youngest citizens.

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Catherine McKinnell Portrait Catherine McKinnell (Newcastle upon Tyne North) (Lab)
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I thank the Backbench Business Committee for granting time to debate this incredibly important subject. I also commend my colleagues, the hon. Member for Richmond Park (Sarah Olney) and the right hon. Member for South Northamptonshire (Dame Andrea Leadsom), for setting out so eloquently and passionately the case for focusing on this issue. I had hoped that, as co-sponsors of the debate and co-conspirators on this issue, we would not just repeat one another’s arguments, and I believe that, without co-ordinating in any way, we will not. We agree on the problem—we agree on the challenge and the importance of this issue—but today I want to focus on the enormous challenge presented by poverty in overcoming many of these issues.

We know from international evidence that so many important life outcomes, from health to wealth and wellbeing, have their origins in early childhood, but the reality is that not all childhoods are equal. If we truly want to give every child the best start in life, we must tackle poverty and economic disadvantage. There is substantial evidence demonstrating the damaging, stigmatising and often lifelong impact of experiencing poverty in childhood. It affects cognitive skills, social and emotional development, physical health, mental health, educational outcomes, employment prospects, the likelihood of being in poverty as an adult, and life expectancy.

Recent reports have highlighted starkly that the impact of poverty begins in very early childhood, or even pre-birth. For example, last month, MBRRACE-UK— Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK—reported that

“babies born to women living in the most deprived areas are twice as likely to be stillborn, and at a 73% excess risk of neonatal death compared to babies born to women living in the least deprived areas”.

Likewise, national child mortality database research published in May found a clear link between deprivation and child death. It concluded that around 700 fewer child deaths per year—a fifth of all child deaths—might be avoided if children living in the most deprived areas had the same mortality risk as those living in the least deprived. Poverty is literally killing children.

Wera Hobhouse Portrait Wera Hobhouse
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Is the hon. Member as concerned and shocked as I am about data showing that a mother from an ethnic minority background has a much higher likelihood of experiencing complications during pregnancy or birth that result in their baby being either stillborn or born with a disability? Does she agree that we need absolutely to focus on such discrimination and disadvantages?

Catherine McKinnell Portrait Catherine McKinnell
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Yes, I absolutely agree with the hon. Lady. As the Chair of the Petitions Committee, I can say we received petitions on that issue and debated it in Parliament. We have been given some assurances from the Government, but it is imperative that all of us in this House ensure an improvement in both the statistics and the reality for those who experience it.

It is well established in education research that on average the longer a child has been disadvantaged the worse their performance will be at school, particularly in key stage 4 assessments. Even where children from more deprived backgrounds do achieve the same results as their better-off peers, they are still likely to have lower lifetime earnings. How unbelievably disheartening is that?

Sadly, child poverty is getting worse. Government statistics on households below average income published this spring show just how many families were struggling before covid-19. In 2020, 200,000 more children were pushed into poverty compared to the previous year, using the measure of relative poverty after housing costs. That means 4.3 million children living in poverty: real children living in real hardship. I know the Government do not readily accept the concept of relative poverty, but Ministers should listen to the recommendation of the Work and Pensions Committee to end the sole focus on absolute poverty and look at broader measures. After all, if the Government are committed to levelling up, improving the position of a child in Newcastle relative to a child in Middlesex is surely more relevant to comparing a child in Newcastle today with a child in Newcastle 11 years ago.

Even if we use only the Government’s preferred absolute poverty measure, the proportion of children living in poverty rose by an average of four percentage points in every north-east local authority area between 2014-15 and 2019-20, while the number of children living in absolute poverty across the north-east rose by more than 21,000 during that period. The latter point is particularly concerning as absolute poverty is a measure that has always tended to naturally improve over time as living standards rise, but in the north-east it is going in the opposite direction. As troubling as the pre-pandemic figures are, none of that should come as a surprise given the direction of Government policy over the last 10 years. Indeed, the country went into the pandemic expecting to spend £36 billion less on social security because of Government welfare policy. That has to come from somewhere, and it is coming from the poorest pockets and the mouths of children.

Just as Government action can lead to increases in child poverty, it can bring them down too. We have seen it before, especially under the previous Labour Government. What we need is a cross-governmental strategy for tackling child poverty, something groups such as the North East Child Poverty Commission and the Child Poverty Action Group have consistently called for. It needs to go a lot further than anything we have heard from the Government to date. It should include a welfare system that prevents and reduces poverty, giving all families a dignified safety net when they are going through tough times. It should tackle unemployment and low-paid insecure work, the kind of work that means most children living in poverty are now in working families. We need concerted action to support families with the cost of major outgoings: energy, housing and childcare.

All those things were problems pre-pandemic and they still need to be addressed, but covid-19 and the lockdowns of the last year-and-a-half have brought additional challenges for parents and young children. For the past 18 months, the Petitions Committee, which I Chair, has investigated the pandemic’s impact on new parents and children, and expressed its deep concerns that it is being overlooked by the Government. Our first report in July 2020 highlighted the need for urgent catch-up investment to help new parents access support services disrupted by the pandemic, and to do more to ensure employers meet their health and safety duties towards pregnant women. Unfortunately, the Government rejected almost all our recommendations, saying that support was “sufficiently generous” for

“the vast majority of parents”.

That, however, did not match up with all the evidence we heard from new parents about their struggles. We heard that crucial support for children’s wellbeing and development was being missed, that there were concerns about employers not meeting their health and safety duties towards pregnant women, and about additional difficulties in accessing childcare. I fear that the Government know that the impacts of all of that are long term, and that by the time the impacts of their failure to invest will be seen, they may be well gone, or at least their failure forgotten.

This year the Committee decided to revisit those issues with a follow-up report, but unfortunately it is already clear that we are seeing the impact of the Government’s lack of action in this area, including: children coming into early years classes behind in their social development; increasing rates of poor mental health among new mothers; and childcare providers going out of business. The Committee found that new and expectant parents’ access to support has remained severely limited. Many have lost out entirely on the crucial window of support available in the early months of their child’s life, and issues around children’s development and parents’ mental health will have been missed. I have said repeatedly that there is a good reason why we wrap a blanket of support around new mums and their babies—and dads, too. It is needed at the time and the long-term impacts of not providing it are well known. Urgent investment is needed to provide catch-up mental health and health visiting support.

The Government have failed to deliver on stronger workplace discrimination protections for new and expectant mothers, and they have repeatedly promised to do that. That is especially concerning as the economic impact of the pandemic continues to be felt. I pressed the Prime Minister on that at the Liaison Committee, and I urge the Government to pass those protections into law as soon as possible. If mums are being discriminated against, it is bad for their children, too.

The pandemic has also exacerbated pre-existing problems in the early years sector. Government financial support has been welcome, but it has not prevented many early years providers seeing a significant impact on their finances, with low pay for staff, many of whom are mums too, and high costs for parents. The pandemic may well contribute to or even accelerate an ongoing erosion of provision. I therefore urge the Government to consider a review of early years funding to ensure it is affordable and meets the needs of new parents seeking to return to work. They could set out a clear vision for our children, our undervalued early years and childcare workforce, and ensure that no parent must choose between their child and their career.

Before I conclude, I want to ask the Minister some specific questions on the Government’s proposed family hubs. Given that there are 152 upper-tier councils in England and there will be 75 family hubs, it looks like just under half of local authorities will benefit from the programme. Have the Government already determined the criteria by which the funding will be allocated? We assume it will be based on some measure of deprivation, but will the Minister confirm that? May I urge the Government not to continue their approach of forcing overstretched local authorities to commit their scarce resources to making funding applications? We should not be pitting local authorities with high levels of deprivation and child poverty, such as those in the north-east, against each other to receive support. How does the Minister see family hubs working in large local authority areas, often with poor public transport links? For example, getting across Newcastle with young children to access services via public transport can be challenging, particularly for my constituents in the Outer West. Large rural areas like Durham and Northumberland face their own challenges. I hope when the Minster responds, she will confirm that services will be “within pram-pushing distance” of the families they are intended to help, as was the aim of the Sure Start programme.

In conclusion, the crushing pressure that poverty places on families and children is clear. It impacts our children’s lives directly when parents and carers do not have enough money to meet their children’s material, social and educational needs. It impacts on them indirectly by creating stress, insecurity and conflict at home.

These adverse childhood experiences inevitably influence children’s development and wellbeing, creating a vicious cycle. To escape that cycle, we need a coherent, cross-departmental anti-child poverty strategy, backed by proper investment. It is fair to say that we are pretty far from that at the moment when the Government often seem unsure about which Minister to send to respond to child poverty debates. Such pervasive child poverty is not inevitable. The last Labour Government reduced child poverty and the concerns about child welfare that it creates. We can do it again and truly give every child the best start in life. We just need the Government to care truly about achieving it.

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Wera Hobhouse Portrait Wera Hobhouse (Bath) (LD)
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It has been a real pleasure to listen to all the different contributions made this afternoon. I congratulate my hon. Friend the Member for Richmond Park (Sarah Olney) and her co-sponsors on securing this debate. One of the observations I want to make is in reference to the hon. Member for Penistone and Stocksbridge (Miriam Cates), who asked why we cannot give women the choice. I absolutely agree. We all know that the most nurturing environment for young children is with their parents. The question then is why this country has one of the poorest maternity pay and leave settlements compared with any other country with a similar economy. We need to look at statutory maternity pay.

Miriam Cates Portrait Miriam Cates
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I completely agree with the hon. Lady. Maternity benefits are certainly something we should look at. As well as that, we have a taxation system that penalises families—to the tune of 20% or 30% for the poorest families—compared with the taxation systems of, say, France, Germany or America. One of the problems we have in this country is that we do not recognise the importance of those early years in terms of protecting families from those costs. That would have a far bigger impact on parents’ ability to choose in those early years.

Wera Hobhouse Portrait Wera Hobhouse
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I absolutely agree with the hon. Member. We are on the same page. We need to recognise the importance of parenting and the early years and help families of all incomes to make that happen, but the issue mostly strikes families of poorer backgrounds, where women are then being forced into work much earlier than they would like. The Government need to look urgently at that, as well as shared parental leave, which is actually a transfer of parental leave, rather than shared leave. We should look at how we can fix that system, too.

I will speak briefly as the chair of the all-party parliamentary group for the prevention of childhood trauma. Preventing adverse childhood experiences from occurring is vital, particularly in those first 1,001 days. Within the APPG, we are working to improve understanding of adverse childhood experiences or childhood trauma, how to heal them, and ultimately how to prevent them. It is about breaking that cycle of trauma, which can so often pass from a parent to their child.

Those who experience childhood trauma are two times more likely to develop depression and three times more likely to develop anxiety disorders. Adults who reported four or more adverse childhood experiences had a four to twelvefold increase in alcoholism, drug abuse and suicide attempts, compared with adults who experienced none of those. Recently, the APPG heard from Josh MacAlister, the chair of the independent review of children’s social care, which produced “The Case for Change”. He made the critical point that we have children in care who become parents, and they often pass their childhood trauma to that next generation of children unless it is treated and recognised. One of the most important things on which I campaign as a Member of Parliament is preventing childhood trauma, recognising trauma in those who experience it later in life and making all our services trauma-informed.

I pay tribute to the WAVE—Worldwide Alternatives to Violence—trust, which does excellent work alongside the APPG. Its 70/30 campaign needs no introduction because it has just reached 500 supporters in the House—an incredible milestone. The campaign aims to reduce child abuse, neglect and other adverse childhood experiences by at least 70% by 2030. Professor Sir Harry Burns, a former chief medical officer, said that

“reducing child maltreatment by the minimum acceptable outcome in responding to this unacceptable—and profoundly costly—harm to our youngest children.”

We have all heard in various forms about how important it is to get to childhood trauma. The Government can do much to achieve that, but they must start by increasing early years funding, by appointing a senior Minister for families and the best start in life and by prioritising prevention in the early years.

Earlier this year, I tabled an early-day motion on giving every child the best start in life, which calls on the Government to adopt a comprehensive early years strategy to prevent harm to children before it happens. It has now been signed by 100 Members from across the House. I grateful to all of those who have put their name to it and hope that many more will join them.

I have just two questions for the Minister. Given the overwhelming support for the 70/30 campaign and my EDM, will she give her public support to the campaign today? Will she also commit to meeting the APPG so that we can discuss a way forward and end childhood trauma once and for all? Let us start now to ensure that every family has the full support needed to give their child the best start in life. That would be to all our benefit.