Parents and Carers of Infants: Support

While I understand that guidance on Start for Life offers already exists, I know there will be a huge amount of learning from the Government’s family hubs and Start for Life programme that could be considered and taken on board as part of new statutory guidance. A duty to consult on the statutory guidance will ensure that local authorities and bodies the Secretary of State consults will have the chance to have their say on what will most help them to fulfil that duty and support families locally.

Finally, the Bill requires the Government to publish an annual report that sets out information about support that is being provided in England for infants, their parents and carers, and prospective parents and carers. The report will also include information that the Secretary of State considers appropriate to include, such as information about the impact of support on outcomes. That is very important as it will create further transparency for prospective parents, and for parents and carers of infants, so that they can understand the support available as they navigate the joys and the challenges of raising a new baby.

I will say a few words on the family hubs and Start for Life programme. Family hubs offer early support to families and young children to help them overcome difficulties and build strong relationships. East Sussex County Council was one of the trailblazers benefiting from the £300 million investment up to 2025. It is leading the way and supporting other local authorities to improve services that are offered to families so that they can be rolled out more widely across the country.

We have three family hubs in Hastings, offering support including maternity and health-visiting services, breast and infant feeding, parenting programmes, budgeting, employability and many other things. I pay tribute to East Sussex County Council’s director of children’s services, Alison Jeffrey, who is soon to retire, for all her dedication, determination and service to all families across East Sussex—especially to ensure that children’s life circumstances are not life sentences.

The cost of not getting it right is considerable. Some years ago, when the Maternal Mental Health Alliance issued its flagship report, it costed maternal perinatal mental health problems at some £8.1 billion. That is what it is costing for not giving mums and dads the best support to ensure that they can bond with their children. One in six new mothers will suffer some form of perinatal mental illness, and covid certainly worsened that situation, with all the pressures on first-time parents in particular of babies born during covid, as they did not have access to some of the support networks that we took for granted until then. In addition, child neglect has been costed at something like £15 billion each year, so we are spending £23 billion-plus on the consequences of not getting it right by intervening at a stage when it could have the maximum impact for the parent and, mostly importantly, the developing and growing child.

Healthy social and emotional development in the first 1,001 days means that individuals are more likely to have improved mental and physical health outcomes from cradle to grave. It means that children can start school with the language, social and emotional skills they need to play, explore and learn, and that children and young people are better able to understand and manage their emotions and behaviours, leading to less risky and antisocial behaviour later on. It also means that children can have the skills they need to form trusting, healthy relationships.

It has been calculated that some 28% of mothers with mental health problems report having difficulties bonding with their children. Research suggests that the initial dysfunctioning of mother-baby relationships affects children’s development by impairing their psychomotor and socio-emotional development. As well as the direct impact on the child, it can have longer-term adverse effects on the parents and wider family. The onset of a maternal mental health condition can precipitate relapse or recurrence of previous mental illness. It has the potential to herald the onset of long-term mental health problems and is associated with an increased risk of maternal suicide, and we know how alarming the figures are for women who commit suicide soon after giving birth. It is important to say that this is not limited to mothers; there is also an impact on fathers. Post-natal depression has been linked with depression in fathers and high rates of family breakdown, so this is all about families and the children. That is why it is important not only that we have a range of services available in a joined-up way, but that those parents know how to access those services and whom to speak to.

I will give an example from all those many centuries ago when I was the Children’s Minister. One of the first things I did in the first summer recess was to spend a week being a social worker in Stockport. I went out with real-life social workers, without cameras, just doing their daily job. One of the first places I was taken to, with a really impressive social worker—I think they chose one of the most challenging cases they could—was a house in one of the most deprived parts of Stockport, where a young mum with three young boys from three different fathers, none of whom was on the scene, were living in absolute squalor. There were no carpets on the floor, and they were literally eating off the floor. There was nothing in the fridge, some furniture dumped at the bottom of the garden and dirty mattresses that the kids were sleeping on.

One of the children had a bad toothache—I remember it distinctly as if it were yesterday—so the social worker said to the mother, “Why haven’t you taken the child to the dentist?” because it had been going on for some time. The mother herself had had a tooth problem the day before. She had gone to the emergency dentist and had it sorted out, but she had not had the presence of mind to take the son with her. Before long, if things went on like that, those children would have ended up in care. The mother would have been absolutely beside herself—she doted on and relied on those children greatly, and the kids relied on her. For all her problems and challenges in being a decent mother, that was all she knew; she had had poor parenting herself.

What struck me was that a number of professionals had been going in and out of that house over a period of time, and virtually every time they went, she had to start her whole story again about the various problems. There was no real joined-up action where that mum and her kids were almost literally taken by the scruff of the neck to children’s support services at the local children centre, taken to the dentist, or given information and classes on nutrition and feeding and things like that. What was needed was somebody to take control of that family’s life, get them back on the straight and narrow, and join up all the services and all that information, and that just was not happening. A lot of money, time and resources were being spent on that family, and things were not getting any better. That is why the Start for Life programme, and the Bill that my hon. Friend the Member for Hastings and Rye is putting together, are all about making sure that somebody takes control of the information around a family’s requirements and needs, points them in the right direction, and takes them physically to where they need to go if necessary, so that it does not constantly start again every time the family comes into contact with yet another agency or professional service. That is why the work on the red book—digitising it, for example—is important to make sure that information is readily available to everyone having contact with families that need that sort of help.

None of this is rocket science or, frankly, new; we have been talking about it for many years. Earlier, I dug out one of the reports from the conception to age two: first 1001 days all-party parliamentary group. “Building Great Britons”, which we produced back in 2015, is now almost 10 years old. I reread the foreword, which I wrote, and we made some recommendations. I will go through those quickly to see how many have become reality and how many can still become reality with the assistance of my hon. Friend’s Bill. We also came up with two conclusions. The first was:

“We want to create children who at the end of their first 1001 days have the social and emotional resources that form a strong foundation for good citizenship.”

Tick—that is absolutely still our goal. The second conclusion was:

“Without intervention, there will be in the future, as in the past, high intergenerational transmission of disadvantage, inequality, dysfunction and child maltreatment. These self-perpetuating cycles create untold and recurring costs for society. The economic value of breaking these cycles will be enormous.”

Tick—that absolutely applies today, as it did then. A case in point is the one I cited in Stockport, which is a textbook example of how failing to intervene properly is costing an awful lot of money.

The first recommendation was:

“Achieving the very best experience for children in their first 1001 days should be a mainstream undertaking by all political parties and a key priority for NHS England.”

I hope that the Start for Life programme, which the Minister proposed, was done with the sign-up of all the other main political parties. That is really important, because it is a long-term scheme. When there are changes of Government, it is important that one does not change everything for the sake of changing it—I was going to say, “Throw the baby out with the bathwater.” One might want a bit of rebranding or tweaking here and there, but this needs at least a decade to really take effect. I hope that the good work the Minister has done will carry over if there is a change of personnel and Government in the future.

The second recommendation was:

“Require local authorities, CCGs and Health & Wellbeing Boards to prioritise all factors leading to the development of socially and emotionally capable children at age 2, by: adopting …a ‘1001-days’ strategy”.

That is part of what the Bill proposed by my hon. Friend the Member for Hastings and Rye will impress on local authorities. Much of this is delivered through local authorities and local health professionals. It is all very well for the Government to say, “This is what needs to happen,” but it does not happen unless there is the buy-in, the infrastructure and the commitment to deliver it at the sharp end at local level.

The third recommendation was:

“National government should establish a ‘1001-days’ strategy fund to support local authorities and CCGs to make a decisive switch over the next 5 years, to a primary preventive approach”.

I think we are only part of the way on that one. The Minister may want to pick that up and explain how we can achieve that.

The fourth recommendation was:

“Hold Health & Wellbeing Boards responsible for ensuring that local authorities and CCGs demonstrate delivery of a sound primary prevention approach”,

as outlined in part 2 of our report. Again, that is what my hon. Friend’s Bill is trying to get at. We need to see commitment at a local level for local people to judge. They can do it in different ways. What might apply well in my constituency might not apply so well in my hon. Friend’s constituency, in large northern metropolitan boroughs, or in rural constituencies. It is up to local interpretation how it is best delivered, with a framework set out nationally, but with local authorities and local agencies having to describe and set out how they are going to achieve the goals and aims.

The fifth recommendation was:

“Build on the ‘Early Help’ recommendations of the Munro Review”,

which I commissioned in 2010,

“by requiring and supporting all relevant agencies in prevention to work together to prevent child maltreatment and promote secure attachment.”

As I found in office, joined-up government is an illusion. I hope that the appointment of my right hon. Friend the Minister, with a remit in several different Departments as well as Best Start for Life, achieves more of a joined-up approach in that regard.

The sixth recommendation was:

“Appoint a Minister for families and Best Start in Life with cross-departmental responsibility”,

which I hope the Minister is achieving. I hope it will survive and continue under whoever fills her shoes at some hopefully distant stage in the future.

The seventh recommendation was:

“Make joint inter-agency training on the importance of the early years for social and emotional development, for all professionals working with children and families in the early years, a priority in the ‘1001-days’ strategy.”

That is important, as I found in safeguarding. We need professionals from different bodies singing from the same song sheet. The most effective way to do that is with joint inter-agency training so that they learn about the requirements of the job sitting next to the police officer, the health visitor, the teacher, the GP, or whichever professional is involved. We do not do inter-agency joint training nearly effectively enough.

Communication, information and all the things that my hon. Friend the Member for Hastings and Rye is endeavouring to achieve with her Bill—I wish her well with that on Friday—are all about continuing the jigsaw of the Best Start for Life, which my right hon. Friend the Minister started and which I hope will come to full fruition, because we desperately need it for so many of our children, families and babies in this country.

Sarah very excitedly introduced me to her best friend Ameena, who lived in Ashton. Those two would never have met but for that Sure Start provision. She said to me, “Mr Gwynne, let me introduce you to my best friend Ameena. Her daughter plays with my daughter. They’re best friends, and I go to her house. Mr Gwynne, before I came here I couldn’t boil a pan of water. She’s now teaching me to cook curry.” I just thought: Wow! Not only is it a safe space for different communities to come together by accessing support through mainstream statutory services, but they are informally helping one another. I thought that was great. If we could bottle that and spread it out, that is what we should be doing.

That is why I will always argue passionately that Sure Start was working and why I am pleased that the Minister has brought in family hubs. Although they are not yet on the scale of Sure Start, from small acorns grow great oaks. I believe that, whoever is in government, supporting the family and nurturing them in those first 1,001 days really matters. In terms of the Bill from the hon. Member for Hastings and Rye, some really simple changes can make a big difference. She mentions that for many it is not easy to access information for support and that local authorities should publish the Start for Life offer on its website.

I know we are not supposed to use props, but I draw Members’ attention to the website of Grow in Tameside, which has a page for key Tameside contacts for early years support and information. It is all there on the website, in part because early years has been a passion of Tameside Metropolitan Borough Council for a long time. In the 1980s, before it was fashionable, they had child and family centres in Tameside. Those centres were used as the evidence base for Sure Start when the Labour Government came in in 1997. The Minister made sure that Tameside was one of the pilots for the family hubs, so we have family hubs operating already in Tameside and doing great stuff. They could do more, but it is great what they do.

This is not just about statutory services but about the wider support network, whether that includes religious organisations, community organisations, the voluntary sector or others. There are lots of things going on. I am a very proud patron of Home-Start in Oldham, Stockport and Tameside. Sarah and the team there do great work. The Dad Matters team under Kieran does great work engaging with dads. They have a breastfeeding service, and they have Cascade, where people can donate toys and clothes to families who need them. That work is being done, but we need to turbocharge it. That is why Labour will always support any measure that means the best start in life for children and families.

There are many different measures to create the one-stop shop for parents, in a way that did not exist with Sure Start. Crucially, we want to make sure that those services are completely universal. What every parent and carer has said is, “No.1: tell me where I can get services and what they might consist of. No. 2: don’t stigmatise me. Don’t make me feel that if I go to this place, you might start proceedings against me and my children.”

The programme is designed to improve on, build on and grow that crucial support for the early years, and I am delighted to hear that it has the support of the hon. Member for Denton and Reddish.

As well as the support from Dame Tessa Jowell, Lord Field, Lord Blunkett, Lord Cameron, my right hon. Friend the Member for Maidenhead (Mrs May), Boris Johnson and our present Prime Minister, who all support this crucial early days agenda, I pay particular tribute to the support from my hon. Friend the Member for East Worthing and Shoreham (Tim Loughton), who has worked with me for so many years. We met when I was 18 and he was 19 at university. Before we were in Parliament together, we had this same interest in early years. As a former Children’s Minister, he has done so much to promote this agenda. I have mostly enjoyed working with him; sometimes I wish he would pipe down, but it is really excellent that he carries on banging the drum for early years. We have worked on it for so long together; he feels like an old pair of boots. Is that parliamentary language, Mr Henderson? I am sure it is.

As my hon. Friend the Member for East Worthing and Shoreham discussed, there is strong evidence that the 1,001 days from conception to the age of two set the foundations for our cognitive, emotional and physical development. Nurtured babies will go on to develop strong relationships and, as they grow up, will be better equipped to tackle the challenges that life throws at them. Investing in that critical period represents a real opportunity to improve outcomes and tackle health disparities by ensuring that millions of babies and their families have access to a one-stop shop style of family hub where all support services can be found in one welcoming universal hub.

Shockingly, up to 40% of babies are not securely attached by the time they reach the age of five to a loving adult carer. Worse still, around 10% have disorganised attachment, which is closely linked with the worst outcomes in our society.

I was delighted, back in July 2020, when the then Prime Minister asked me to chair the early years healthy development review. The goal was to create a vision for brilliance during the 1,001 critical days from conception to a child’s second birthday.

During that review, I met with families, academics, frontline professionals, charities and volunteers to understand what was going well and where change was needed. I saw excellent examples of people helping families when they needed it most, but I also heard how hard it can be for parents and carers to find timely support. I heard about the many services available to families, which are delivered by a workforce of highly skilled professionals, as well as many dedicated volunteers, but I also heard that information on those services is often patchy and difficult to find, with parents finding it almost impossible to navigate the system and understand what support is available to them.

In March 2021, the Government published “The best start for life: a vision for the 1001 critical days”. The vision set out six action areas for improving support for families during those critical days to ensure that every baby in England is given the best possible start in life, regardless of their background. It is the first action area in that vision that describes how every local authority in England, working with the NHS and other partners, will be encouraged to provide a clear and joined-up Start for Life offer to every new family.

Each local authority’s Start for Life offer would describe the essential support that every new family might need, as well as providing information on the additional support that some families require. A clear and accessible Start for Life offer will help to signpost families to the support and services available where they live, and those Start for Life offers should explain clearly to parents and carers what exactly is available and where to find it. The recommendations included in the vision are relevant to every local authority in England.

In my role as the Under-Secretary of State for Public Health, Start for Life and Primary Care, I now have the ongoing pleasure of visiting local authorities up and down the country, and I see directly some great work happening to give every baby the best start in life. Just last week I visited Uxbridge family hub, where I saw some fantastic work by Hillingdon Council and its partners to provide vital services to families with babies. That included providing a welcoming space for parents and carers to make new friends, and offering many different specialist support services, including antenatal, midwifery and health visiting, as well as infant-feeding and parent-infant-relationship support.

To support the implementation of the Best Start for Life vision, the Government are investing around £300 million to improve support for families through the family hubs and Start for Life programme. The programme is implementing many elements of the vision and is delivering a step change in outcomes for babies, children, parents and carers in 75 upper-tier local authorities in England, including most of those with high levels of deprivation.

The programme provides funding for local authorities to publish Start for Life offers and to establish parent and carer panels so that they can receive direct feedback from those using the services. There are many examples of good progress in publishing and publicising Start for Life offers right across the country. For example, Northumberland County Council has equipped every health visitor, midwife and family-hub practitioner with a QR-code keyring that, when scanned, takes users to a bespoke website setting out the local Start for Life offer. That ensures that parents and carers can be encouraged to access the offer at every opportunity.

Many local authorities that have not yet received additional funding through the family hub and Start for Life offer have also chosen to publish their Start for Life offers anyway, and to implement other elements of the vision, because they can see the huge benefits to future outcomes for families and their children. Early prevention is not just kinder but much cheaper than later interventions.

In the Government, and across parties, we all remain committed to ensuring that every baby gets the best start in life. Central to that is ensuring that parents are able to easily find the support that they need, when they need it most. The Support for Infants and Parents etc (Information) Bill, introduced by my hon. Friend the Member for Hastings and Rye, has the potential to help ensure that that is the case, so I want to conclude by reiterating my thanks to my hon. Friend for her introduction of that private Member’s Bill, and for securing today’s debate on such an important issue.

The debate has highlighted just how important the 1,001 critical days are, as well as the huge opportunity that the Bill provides to ensure that families have access to vital information about the support available to them at such a critical stage in both their lives and the life of their baby. I look forward to the Bill’s Second Reading on Friday.

5.20 pm