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Lord Kingsland: My Lords, I am most grateful to the Minister for giving way. I was not in any way criticising the introduction of the undertaking. I think that is a good thing. But at the moment, in a full trial, the loser pays all. It is my view that a number of directors accept a Carecraft solution, or will accept an undertaking, even though they are innocent, because they fear that at the end of the day they may be disqualified and have to pay very large sums in costs. They are simply not prepared to take the risk.
I do not suggest that the noble Lord should remove the undertaking from the legislation. I suggest that he should go further and consider renewing costs awards in the disqualification proceedings themselves.
I shall deal quickly with the question of insolvent estates of deceased persons. I understand the need to be satisfied that there is no retrospective aspect involved. I can write to the noble Lord to reassure him in that respect or we can debate the matter in Committee. However, generally speaking, I believe that noble Lords have welcomed this part of the Bill. Indeed, I am grateful for that welcome. In the case of UNCITRAL, I certainly agree that we should be pressing for adoption by other countries. This is our contribution to it: we could not have pressed for adoption unless we provided for it, as we have in this Bill.
The noble Baroness said: My Lords, I wish to thank my noble friend the Minister for her time in this debate, as well as noble Lords from all sides of the House who will be participating in our debate this evening on Sure Start. I wish to see this debate placed in the context of the Government's determination to eradicate child poverty in a generation and to halve it within the next 10 years.
The Government's own report published last year, Opportunity For All, along with the Rowntree Report and the latest report from the Institute of Policy Studies, which is based on 1997 figures, all paint a grim picture of child poverty in Britain that is truly shameful to own. The IPS study concludes that Britain, in terms of child poverty, is the worst place in Europe to grow up. It suffers from the worst child poverty rates; it has the highest number of households where no parent works and where 2 million, and more, children live; and has substantially more teenage pregnancies than any other European Union country. The study found that nearly one-third of children live in poor households in Britain, compared with only 13 per cent in Germany, 12 per cent in France and 24 per cent in Italy--figures that must be particularly hard for those noble Lords to swallow who spend so much time in this very Chamber decrying the economic and social efforts of our European partners.
The IPS study also tells us that in the 1980s and 1990s the number of children living in poverty increased by an extraordinary 40 per cent. Along with the rise in that time of worklessness and single-parent families, the previous government failed to do anything properly to address the problem of child poverty that has led to the current situation.
There is no doubt that lifting children out of poverty and powerlessness has to be this Government's greatest challenge. The study from the Centre for Analysis of Social Exclusion, published two weeks ago, underlines this huge challenge when it acknowledges that, although existing government policies to tackle poverty through tax benefits and work incentives would reduce the number of children living in poor families by 1 million, we would still be left with a further 2 million to be dealt with.
We all know that poverty has many faces--the face of poor housing, poor education, poor employment prospects and poor health. As every doctor knows, poverty is a major determinant of health. That is why Sure Start is designed to deliver help to those children who need extra help from birth to formal education.
With the first of the Sure Start programmes having been rolled out around the country in the past 15 months, there will, of course, quite rightly be questions as to the geographic criteria used; the most effective use of measures of deprivation and the ways in which outcomes will be judged and monitored; and how those outcomes are interwoven with other government policies, such as maternity and parental leave. But suffice it to say--in the words of my right honourable friend the Secretary of State for Education, Mr David Blunkett:
We have come a long way in the past 100 years in our present belief that the poor will not always be with us: from the fulminations of people like Herbert Spencer who, in 1884, and in an attempt to prevent their maiming or death, cited the Chimney-Sweepers Act (which prescribed the size of chimneys up which sweeps could send young children), as being against the liberty of contract and the system of laissez-faire, to the formal abolition of the Poor Laws in 1948, with its distinction between the deserving and the undeserving poor, and then to our own times. We must now commit ourselves to abolishing child poverty as a leftover of the 20th century. I look forward to hearing my noble friend's reply this evening on the current development of Sure Start.
Baroness Blood: My Lords, I thank my noble friend Lady Crawley for initiating this debate on the Sure Start programme which has as its aim improving children's health, social development and the ability to learn.
Sure Start is about a long-term investment in the future of our children. In the summer of 1998 the Government announced the national programme. The programme was made flexible to reflect the differing needs of each region within the United Kingdom. This was a tremendous idea as what could prove to be successful in one area might not prove to be so successful in another, as each area has its own set of priorities.
It was an innovative way of thinking on the part of the Government and indeed novel in some ways as it reflected the fact that during the consultation period the Government had listened to what local people involved in early years provision had told them and had responded. Thus, while holding to the overall aim of the programme, best practice and value for money could be used as each region decided. This appeared to be well received by both the Government and local groups. The Government also deserve praise for supporting the implementation of the programme through an investment of £540 million over a period of three years.
The ethos of the programme is to co-ordinate, streamline and add value to existing services for young families in local communities. That fits in well with the overall aim of the Health and Personal Social Services for Children and Families--Regional Strategy for Healthy Well Being into the Next Millennium 1996. We shall hear tonight how the programme is working in the different regions. We in Northern Ireland are delighted to hear of this progress. During the consultation period some of those involved in projects in the United Kingdom visited Northern Ireland to see and learn of the work that groups were attempting to carry out. I should be pleased to hear positive feedback about the programme and to hear that it is moving forward. However, I am sorry to say that that is not the case in Northern Ireland. As I speak, no progress has been made; in fact, the programme has not even started. As a result, Northern Ireland is almost two years behind the rest of the United Kingdom.
When Northern Ireland is mentioned, noble Lords within the House and indeed those within the communities and regions of the United Kingdom could be forgiven for thinking that the only problem faced in Northern Ireland is that of the peace process. I agree that that is the most significant problem faced by the Province and as such we have many people working towards a resolution right across the community. However, that problem cannot be viewed in isolation.
We have many other major problems within our region. Like many of our mainland neighbours we have areas of extreme poverty, high levels of unemployment, poor health and low educational attainment, to name but a few. In many respects we are no different from any inner city area within mainland UK. However, unlike the rest of the United Kingdom, our problems are compounded by the effects of the Troubles. But, again, many people are working hard to address those problems.
The need for Sure Start in Northern Ireland is indisputable. One in three children live in poverty; 30 per cent of our children receive free school meals; 21 per cent of household income in Northern Ireland is benefit-based, compared with 13 per cent in the UK. The area within Belfast where I live and work has the highest percentage of teenage pregnancies in western Europe. It also has a high rate of suicide, particularly among young men. However, as I said, many people are working hard to find solutions to these local problems.
I wish to give some examples of the work that is carried out and to indicate how it could fit naturally into the Sure Start programme. Within the Greater Shankill area of Belfast the need for local people to form partnerships with education authorities, health trusts and government departments is evident, as all these sectors have a part to play in the regeneration of the area. Research was carried out to assist with the work and a number of initiatives emerged from the research which would allow the community to work in partnership to help solve its own problems. The Greater Shankill Partnership was formed to co-ordinate a number of projects which would eventually lead to the regeneration of the area.
The partnership approach worked well. But it was soon realised that to effect real change a major investment had to be made in the young people within the area. There was need to concentrate on work with young parents and children, preferably from birth, or, ideally, before the baby was born. The partnership applied to, and received, major funding from Europe to set up an early years project. The project focused on employing parents and training them to go into homes in the area to befriend other parents, to provide support and guidance on parenting and to raise the awareness of early years education through quality play, interaction and learning. Through this support network, it was hoped that parents would be encouraged back into community life and back into education and training. Not only were the parents gaining new skills but these were filtered down to their children and, in turn, helped to raise the confidence of
In Coleraine, in the north-west of the Province, an area renowned for its outstanding beauty and a natural resource for tourism, the same needs and disadvantage can be found on the housing estates. A dedicated group of people have developed a similar programme to the example I have just given. Indeed, the excellent work of groups in Harpers Hill has been widely acknowledged in the good practice guide.
However, both those programmes are in real danger of closing down. Both depended on continuing support from the Northern Ireland Sure Start programme. I could give many more examples of cases where good practice is being carried out by a host of projects and organisations: the Northern Ireland Pre-Play School Association, Barnardo's, Save the Children, NSPCC, and so on. Again, the Sure Start programme has so far failed these groups. Can noble Lords imagine the disappointment felt by these groups when they learn that the Sure Start programme has not even begun in our region some two years after its implementation in mainland UK?
In early 1999 almost £16 million was set aside by the Government to implement the Sure Start programme in Northern Ireland. Groups were informed a few months later that as there had been no demand for Sure Start in the Province the money would be used for another purpose. There was no consultation and no explanation. This unexplained statement caused outrage among groups involved in early years provision. Representation was made to the Minister to re-think this strange decision. After several weeks of consultation the Minister announced in September 1999 that £9.8 million would be available from April 2000, £4 million in the year 2000-2001 and £5.8 million in the year 2001-2002.
While there was certain dismay at the loss of almost £6 million and a year of the programme, at least groups could now rely on Sure Start money to sustain their projects. However, this confidence was again shattered when the projects were informed that the £4 million promised was to be reduced to £2 million and that it would not be available until September 2000 and for six months only. The department dealing with the Sure Start programme in Northern Ireland told us that it would seek to ensure that the £5.8 million that was promised would be in place for 2001-2002. However, there is no guarantee as regards the sum of £5.8 million. The problem seems to be that there is a lack of ring-fencing to allow money to be protected within block grant allocation for a particular purpose. Many doubt that the £5.8 million in total will ever be made available.
The kind of work and the problems that we are discussing today cannot be solved on a short-term basis. Sustained funding and support are required if real changes are to be achieved in our children's lives and futures. Northern Ireland's youngest children
Finally, the Chancellor of the Exchequer, Gordon Brown, announced in his Budget the creation of a children's fund to fund work by community and voluntary organisations with children living in poverty. It forms a central plank of the Government's anti-poverty programme, a point referred to by the noble Baroness, Lady Crawley. There is concern among organisations in Northern Ireland that the money coming in for this scheme will also be part of a block grant and that once again the losers will be the children of Northern Ireland.
Baroness Thornton: My Lords, I thank my noble friend Lady Crawley for initiating the debate and for raising an issue which is of fundamental importance to the future and well-being of the most vulnerable children in our society.
Why is it that in one of the richest and best educated countries in the world there are children who do not have enough to eat? Why are there children who are never cuddled, children to whom no one ever reads, children who do not know how to play, when everyone knows that these kinds of stimulation help them grow into whole and happy people? We all know that there are babies who do not know how to laugh and smile because no one has ever laughed and smiled at them; we know there are thousands of children who know cold and damp, and violence and uncertainty in their lives. We know that, thankfully, such children are in a minority; we know that the vast majority of parents--even those on the lowest incomes and in the poorest circumstances--try to do their best for their children.
They may not always succeed in providing everything that they want for their children. There may be many reasons for parents finding it difficult to give their children the life they know they deserve. It may be because they do not know how; because they are themselves the inheritors of ignorance and poverty; or because they find life too difficult to cope with because they have too much debt, no work, few life chances, too little help and too many problems. We all bear a responsibility for such children and for what happens to them.
I feel fortunate to be associated with a charity which has fully embraced its responsibility for these children, a charity that has worked to improve life for the most vulnerable children in this country since 1869: I am talking about the NCH Action for Children. I am
It is important to mention NCH Action for Children in this debate because it is an organisation which is working with the most vulnerable children in our communities, some 70,000 a year, in its 400 local projects. I am pleased to report that it is a partner in running one of the Government's Sure Start projects. Some of what I intend to say tonight is based on its experience in that project. I should like to thank the head of the project for sparing the time to discuss her important work with me in preparation for the debate in your Lordships' House.
Two things distinguish Sure Start as an innovative idea. The first is its recognition that the early years are incredibly important in determining the life chances of a young person. How a baby thrives even before its birth can influence how as a small child it learns and grows. That, in turn, can make an enormous difference to how an older child achieves in school. Sure Start is a recognition that resources invested early reap huge benefits later in life. Secondly, the Government have recognised that to make real and meaningful changes they have to deliver support and services from the bottom up.
Sure Start projects are based on consumers' needs and specifically not on the delivery of services which professional people think might be good for them. I was very impressed with the process involved in the NCH Action for Children Sure Start project. NCH began by finding out what support the parents felt they needed--for example, what kind of help people such as health visitors could offer, and when they needed to be offered that help. The job of a Sure Start project is to streamline and add value to existing services, and health visitors are very important in the whole process.
The Sure Start project works alongside health visitors and offers consistent top-up work to their important advice and support to a parent. The key word is "consistent". Consistency is important, for obvious reasons--but how often, for perfectly understandable reasons, do statutory agencies sometimes fail to provide that consistency and, because they are stretched, fail to meet the needs of the most needy? Sure Start helps to ensure that that consistency is present at an early and crucial time.
The lack of take-up of support is often because parents are ignorant of what is available and of their rights to support. Often the starting point of working with parents and families is the provision of information.
So parents are getting the input and support that they feel they need, when they need it. That support is offered over a long term--five years--and it is of a high quality. I should emphasise the high quality of Sure Start projects. I am informed that many parents have been motivated by the principles of partnership and quality that lie at the heart of Sure Start; by the idea that they are working in partnership with the project to enhance the life chances of their babies, their children and themselves.
Many of the things provided by Sure Start seem simple and basic. They concern issues such as flexible childcare; the availability of rooms in which to socialise and to offer mutual support; and the provision of information and friendship. It is certainly the case that many parents feel that they are valued because the facilities and services of Sure Start are of a high quality and because they have a say in how these are accessed. This in itself creates self-worth and self-confidence. A parent with a feeling of self-worth and with self-confidence will be a better parent. We are attempting to create a virtuous circle, one which will create better parents who, in turn, will bring up better children.
All of the Sure Start projects and the other programmes which are being rolled out are not "quick fix" solutions. They seek to deal with what have seemed to be intractable problems, and so a long-term commitment is required. I should like an assurance from the Government that they recognise that they have embarked on a scheme which is unlikely to deliver in three years. I plead with them that their spending priorities should reflect the long-term nature of these projects.
One of the issues which arises out of the NCH projects with which I am familiar, and out of other projects, is that of mothers, babies and childcare. This is linked to the Government's commitment to childcare, to maternity leave and to pay. It would be an obvious piece of joined-up government to make it a priority that a mother can spend with her baby the first year of its life, and that high quality, flexible childcare is available when she returns to work. Better mothers are more likely to produce happy and fulfilled children.
The Government are to be congratulated on their commitment to delivering for women on the issue of most concern to them--that is, the balance between home and work. They are to be congratulated on the progress that has been made to eliminate child poverty. They are also to be congratulated on the Sure Start projects which address the issue of the importance of the early years of a child's life.
It does not take a genius to put these things together and to come to the conclusion that we need to look now at the possibilities of extending maternity leave so that mothers can spend more time at home. They do not want to give up jobs and should not have to; nor do they want to spend the crucial first year living in poverty because they have chosen to stay at home. We have already established the crucial importance of the first year. Poverty in the first 12 months of a baby's life make it more likely to suffer from long-term health problems. I urge the Government to carry out a review of this issue as part of the coherent drive to improve the life chances of the very young.
I shall not describe the Sure Start programme in detail. That has been ably done and those noble Lords here today will he familiar with its broad aims of promoting the physical, intellectual and emotional development of young children, particularly those who are disadvantaged. What I would like to do today is refer to some of the concerns of Growing up in Britain and link these to the aims of the Sure Start programme, and in particular to the importance of parenting.
I became interested in the under-fives when I had three children under five and helped to organise a pre-school playgroup. I realised then that I was dealing with a special species. We know, as parents and educators, that all children need security, love, attention to health needs and intellectual stimulation if they are to function well, as my noble friend Lady Thornton well described. The British Medical Association report to which I referred concluded that focusing on the early years of life would be of most benefit as that would influence childhood and adolescence. The Black report on inequalities in health insisted that a holistic approach was needed to overcome health problems--that is to say, that increases in well-being rather than a reduction in disease was crucial and that social and emotional health were as important as physical health.
Another report, The State They're In, from the Trust for the Study of Adolescence--I declare an interest as a trustee--the Prince's Trust, and the National Youth Agency also makes interesting reading as it is concerned with adolescents growing up in Britain today. It looks at issues facing young people with regard to education, employment, health, identity and behaviour, all of which need to be given attention early in life if young people are to be enabled to overcome disadvantage, such as that described so graphically by the noble Baroness, Lady Blood. The report emphasises,
Child health has undergone changes during the last century with respect to the fall in deaths and morbidity from infections such as TB, measles and whooping cough. This is due to improved hygiene, living conditions, antibiotics and immunisation programmes. However, there are new problems, with increased prevalence of mental and emotional difficulties, asthma and obesity. A number of children, particularly, but not exclusively, those from disadvantaged backgrounds, are not succeeding at school. We have not yet broken what Sir Keith Joseph called many years ago the "cycle of deprivation".
Of course, material wealth does not guarantee the well-being of a child. If a child is unwanted, neglected or subject to physical or emotional abuse, then the child will almost inevitably be scarred. If parents are poor, unemployed, isolated or homeless, they may well be rendered less capable of providing the attention their children need. It is therefore parental needs and the improvement of the quality of childcare which need to be addressed in any intervention aiming to enhance children's well-being. The BMA report defines good childcare as,
Let me now look at what seems to work in relation to reducing inequalities in health and education. Lessons from the Sure Start programme will be invaluable in adding to this body of knowledge. Studies suggest that interventions can have an impact on both the cognitive/intellectual and emotional well-being of children and that interventions designed to have an impact on one particular aspect of a child's life, such as health, are also likely to have an impact on other aspects, such as educational achievement.
Some of your Lordships may be familiar with the book Emotional Intelligence by Daniel Goldman. The author argues that emotional intelligence is as important, if not more so, than IQ. Emotional intelligence includes self-awareness and esteem, social skills and motivation. School success,
Another intervention in the US has been followed up until the child participants were 29 years of age. It was shown that those who benefited from the pre-school programme were more likely to finish high
Another programme in the US was targeted at low income, unmarried or teenage mothers. Nurse visiting was carried out to 400 women from pregnancy until the child was two years old. The mothers were supported and encouraged to parent in a positive way. They were also offered healthcare facilities and screening. A number of positive effects were found, including lower rates of child abuse and neglect, fewer accident and emergency visits and home environments where the children were given greater intellectual stimulation and emotional support than in the control group.
In the UK, the child development programme, offering monthly support visits to new parents before birth and for the first year of life, proved successful in raising the standards of parenting. Other support programmes in the UK have been shown to improve uptake and continuation of breastfeeding and immunisation, better nutrition and better interactions between parent and child. The noble Baroness, Lady Blood, described other good practice.
Much constructive work has been done focusing on the under-fives both in the UK and abroad. Sure Start pulls together a number of positive initiatives. Evaluations in the United States have concentrated not only on improvements in quality of life as a result of intervention programmes but on cost implications. It was estimated by one programme that savings added up to three times the amount spent on intervention as a result of reducing the need for foster care or institutional care alone. The American Committee on Economic Development has stated:
I conclude by stating my belief that attention to the well-being and development of the under-fives should be a priority for any government, for they are the foundation for the future well-being and development of society. I look forward to the Minister's response.
Earl Russell: My Lords, I, too, should like to thank the noble Baroness, Lady Crawley, for introducing the Question. Before getting down to business, perhaps I may begin with a story about Herbert Spencer which may offer the noble Baroness some consolation. Herbert Spencer was playing billiards with an undergraduate, and was absolutely thrashed. He turned to the undergraduate and said, "Sir, to play billiards as badly as you do argues a mis-spent youth". The undergraduate raised an eyebrow and replied, "Sir, to play billiards as badly as you do argues a mis-spent old age".
That brings us to a subject of some magnitude. I remember the Head Start figures offered by the noble Baroness, Lady Massey of Darwen. They are indeed startling. If any benefit of that kind is remotely in prospect, such programmes need to be taken very seriously. What I have not heard, and the Minister probably knows, is how the Head Start figures were calculated, and in what ways the programme that we are discussing either resembles or differs from Head Start.
I warmly welcome the concern about many questions--about poverty, and about the status of women with families and work that has led to this programme. However, I have a certain number of misgivings which I shall try to put in balance.
First, the scheme is still at the early pilot stage. I should have thought that the only possible answer as yet to the question, "Is the Minister satisfied?", is the answer given by Mao Tse Tung when asked what were the effects of the French Revolution: "It is too early to say".
The programme is also being applied selectively. In a recent Written Answer to Frank Field, Yvette Cooper said that by 2002 it was expected to affect 18 per cent of children under four. It is in effect being applied in particular deprived pockets. We know about those pockets; we discussed them on 16th February, and I am sure that we shall return to them. I understand the case for that approach. But of course the programme is a complement, not an alternative, to raising the overall levels of provision. People suffering deprivation do not all come from deprived areas. However, the Treasury being what it is, it is often a great deal easier to get money out of it for very small projects than it is for raising the overall level of provision.
I remember a remark by a newspaper correspondent who was following President Clinton around during the last presidential election. He said that the President continually offered very vague statements of general aspiration, followed by a number of very small
An aspect of the programme that struck me as particularly good is its application to all local families in the selected locality, so there is no possibility of any stigma attaching to those who are included in it. A great deal of the programme appears to be an extension in effect of what is presently done on a more selective scale by health visitors. That may do much good. I was particularly struck by the objective of early detection in cases of post-natal depression. When one can do that, it may save an immense amount of suffering and an immense amount of public money. If one can do both of those things at once, one really has hit the jackpot.
On the other hand, there are anxieties. I can well remember my first day as a new parent, having just brought the baby back from hospital. We do not sufficiently allow for just how nervous new parents usually are. If they are surrounded by young people just out of college with a thorough training who think they know all about how to do it, it can have the effect of undermining confidence rather than creating it. If history proves anything, it proves that the upbringing of a child can be done with success in a vast variety of cultures and a vast variety of different fashions, and according to a vast number of different theories of childcare. One method will not necessarily suit all parents. So the method that the young professional coming in to the house has read about and thinks everyone ought to be using may not always be right for that parent with that child. Indeed, if one has brought up more than one child, one cannot always say that exactly the same methods are appropriate to all of one's own children. I hope that that point will be borne in mind.
There is an immense problem with targets. The Minister knows that I have a problem with targets anyway. A great deal of what is most important is not quantifiable, and the search for the quantifier often results in a loss of the important things that are unquantifiable. I have noted some of the targets that are proposed. I can see the point of them, but they may be measuring outside matters, not internal ones. The target for reducing cases of gastro-enteritis may be one such example. Gastro-enteritis may be a crude measure of poverty and disadvantage. However, I remember that when my elder son went down with the illness, it was not the result of poverty or deprivation; it was the result of a French holiday. Such cases may significantly distort statistics. As to the target for the numbers involved in breast-feeding, I can see that there may be something in that as a broad brush indicator. But it may measure maternal health influenced by matters quite different from any social circumstance or even anything to do with the birth of the child.
Beyond that, I found a certain lack of specifics in regard to what will be done in Sure Start programmes. I should be glad if the Minister would fill us in. As to the outcomes, it may still be too early to say. I understand from watching last Friday's "Newsnight" that there is also a good deal of debate going on in academic circles about how far early learning, as distinct from early play and early encouragement, is necessarily to the advantage of children. It was alleged on "Newsnight" that the Government are not quite up to date with the latest research. That is a reproach that I would never make against the Minister herself, but it should be borne in mind. All latest research is necessarily to some extent the slave of fashion. It is not usually until 10 years later that one knows which research was the slave of a momentary fashion and which was not--and sometimes a good deal longer.
There is also a risk of failing to identify some disadvantaged children. During the "Newsnight" programme, Mrs Hodge expressed herself strongly and clearly in regard to the importance of toys as part of a child's learning process. I agree entirely with what she said. But I wish the Minister would ask Mrs Hodge to communicate her views on the matter to her right honourable friend Mr Straw, who does not seem to have heard the point. Toys are among the items that children of asylum seekers are not allowed since the Home Secretary appears to have decided that they are not necessary. The Minister can check that in Statutory Instrument No. 704/2000--we shall discuss it in a little while--which states in Regulation 9(3) that,
Lord Higgins: My Lords, it has been a complaint from this side of the House against the Government that the Treasury is consistently taking over the Department of Social Security. Today we seem to be in a somewhat different situation. The Department of Social Security seems to be taking over the Department for Education. None the less I am sure that we could have no better or more expert Minister to reply than the noble Baroness, Lady Hollis.
The Sure Start programme originated as a consequence of the comprehensive spending review, and in particular a review of services for children aged up to seven. It struck me as a superb innovation. I have always been in favour of Treasury Ministers advocating people's spending on certain projects. But one of the bad aspects of our system is that Treasury Ministers can only say "no" and never "yes". The
I welcome this debate. It is perhaps a little unfortunate that in initiating it the noble Baroness, Lady Crawley, stated in throw-away lines that the previous government denied that anyone was in poverty. I do not think such statements greatly improve the level of debate. In contrast, the noble Baroness, Lady Blood, made a moving speech in relation to Northern Ireland. I must have led a somewhat sheltered life in the south of England. However, when I began my national service I was sent within a week or two on escort duty to Northern Ireland to bring back a deserter who had had family problems. I was struck not only by the problems he faced but also by the level of poverty in Belfast at that time. No doubt there are still pockets of very considerable deprivation. I had never previously seen children without shoes. It brought forcibly home to me the differences which exist between the regions and which are exemplified in the approach the Government now take to this issue.
However, there are some problems. The size of the area is relevant. I noted today a distinction made between the levels of deprivation in Spitalfields and the City of London. It is difficult to define the size of the area on which one should concentrate when engaging upon an exercise such as Sure Start. As the noble Baroness, Lady Crawley, said, the Prime Minister stated that it is the intention to halve the level of child poverty in 10 years and to eliminate it in a generation.
That brings us to the important question of the definition of poverty. In debates on social security Bills last year, one distinguished between the poverty that exists, for example, in sub-Saharan Africa and poverty in this country. In a sense, poverty is relative. Can the Minister tell us what definition of poverty is being used as regards the Prime Minister's declaration? On some definitions it will not be true, as the noble Baroness said in opening the debate, that the poor will no longer always be with us. The level of poverty can be defined in such a way that it rises with the general standard of living. It would be helpful if the Minister could clarify that point.
The noble Earl, Lord Russell, was against quantification. I tend to quantify. We are told that £542 million will be spent on the projects between 1999 and 2002 of which £452 million is to be concentrated on 250 projects. I understand that the projects cover only about 5 per cent of the children in the country. How wide is it proposed to extend the figure? The noble Baroness says that these are not large amounts compared with some other government expenditures. But if the figure is to be 20 times that £452 million, it
I turn to monitoring, targets and local milestones. I refer to two targets. The first target relates to "improving social and emotional development". That is difficult to ascertain. The noble Earl, Lord Russell, referred to post-natal depression. But some targets are quantified--for example, the 10 per cent reduction in children re-registered on a child protection register. It will be interesting to see to what extent one can quantify such a target with any degree of accuracy.
However, what is more worrying about the figures for the 15 Sure Start programmes which have been approved so far is, on the one hand, the wide variation between regions--this really makes the Government's point; there are big variations in birth weights--and, on the other hand, the inadequacy of the figures. In some places, the figures are expressed in percentage terms; for example, in Birmingham 11 per cent of babies are said to be under 2,500 grammes. In other places, they are expressed by the number of babies.
There is no point in producing in an Answer to a parliamentary Question tables which compare percentages in one place with the number of babies in the other. We have no idea how many babies are covered in the Birmingham figure or what percentage of the total are the 62 babies in Derby. That is the point which I believe should be made this evening. Although in general this programme is considered to be admirable, it is important that we monitor it on a proper basis. For reasons which are totally obscure, in Leicester a baby is underweight at 1,500 grammes, whereas everywhere else a baby is underweight at 2,500 grammes. I do not understand why that should be so. Therefore, it is important that we sort out the matter.
Similarly, referring to a point made by the noble Earl and others, at present we do not have figures relating to emergency admissions to hospital of babies with gastro-enteritis in their first year of life. I gather that those figures are being collected this month. However, again, it is very difficult to draw any conclusions from the figures which have been provided to Mr Field. Therefore, I believe that it is important that we have real yardsticks which enable us to tell whether or not the programme is effective.
Generally speaking, the Government are spending substantial sums of money. However worthwhile that may be, there is no point if it is not effective. I believe that we on this side of the House wish to see the programme carried out in an efficient way. That will satisfy not only the Treasury but, it is hoped, the Department of Social Security, the Department for Education and Employment and the other departments which, rightly, are involved in this matter. Having said that, I believe that this has been a helpful debate, and I look forward to the Minister's reply.
The Parliamentary Under-Secretary of State, Department of Social Security (Baroness Hollis of Heigham): My Lords, I thank my noble friend Lady Crawley for giving us the opportunity to discuss this important initiative. It is fundamental to our efforts to eradicate child poverty and the consequences of child poverty for children, their families and society. I thank my noble friend for offering us and introducing for us such a thoughtful debate.
The poor in this country are children. One-third of all children are poor. As several of my noble friends said, the Prime Minister has made it his mission to eradicate child poverty in 20 years because it is, indeed, a stain on our society.
There is a clear moral drive and a moral case behind the Government's determination to end child poverty. However, as the noble Lord, Lord Higgins, suspected, there is also an economic and social one. He asked what our definition of poverty is. The Government's own report, Opportunity for All, makes clear that poverty is multi-faceted, not only in terms of deprivation of housing, health and educational opportunity, but also in terms of income. Obviously, he is right to make the distinction between absolute and relative income. The European definition is 60 per cent of median income, which equates approximately to 50 per cent of mean income. As noble Lords know, the difference between the two is that mean income is rather more sensitive to the distortions of the few very high earners at the top end; median is perhaps the more accurate reflection of where people stand.
There is evidence from the US High Scope programme for black children that integrating family support and early education can make a big difference to the outcomes for children later on. High Scope children did better at school, avoided early pregnancy, stayed out of trouble with the law, drew less social
Sure Start is one part of the Government's investment in young children. As my noble friend Lady Crawley described, that waterfront approach of the Government has been to include the New Deal for Lone Parents, the working families' tax credit and the National Childcare Strategy. Those are all efforts to help the child's parents back into work.
However, we also recognised that people in disadvantaged areas face still more acute problems. Services are often poor, transport links are bad, the baby clinic and the play group may be out of reach and the community may have lost confidence in society and in themselves. Through programmes such as the New Deal for Communities we hope that we are building the capacity of those communities to start to tackle those problems for themselves.
That is where Sure Start comes in. We want to improve significantly the outcomes for poor children and break the cycle of deprivation which is transmitted across the generations, as described so eloquently by my noble friend Lady Massey. Tackling such deep-seated problems requires a concerted approach, both at local level and in national policy-making. Therefore, for example, while I speak on Sure Start in the Lords as a Social Security Minister, the lead Minister is Yvette Cooper in the Department of Health, and David Blunkett at the Department for Education and Employment is the Cabinet Minister responsible for the programme.
How did Sure Start begin? When we came into power in 1997, we found that child poverty in the UK had been increasing rapidly since 1979 and, with it, alarming disparities between the life chances of children living in poverty and those living in more affluent circumstances. Those differences could be observed in children as young as 22 months. The differences widened and did not narrow as children grew older.
The need was clear. Therefore, we looked at how existing services were meeting that need. We found that services were patchy, uncoordinated and of mixed quality, especially for very young children in disadvantaged areas. There were no incentives for one government department to spend money that would save another department more money later on. That is the classic problem of government departments and chimneys!
All the evidence suggested that services needed to offer comprehensive, early and sustained support for children and families. We found that successful programmes share key features, all of which we have tried to build into Sure Start: they work with parents as well as with children; they offer support at an early stage before difficulties build up and become too much for the family to deal with; and, as far as possible, the focus is on prevention rather than cure.
They also offer sustained help and support over many years. They look at the whole child, working on health, learning and social development in an integrated way. They are firmly rooted in local communities and encourage local people to share in their design and delivery. They are non-stigmatising. Therefore, people are not put off using them by the thought that they will be branded as "bad parents". Finally, and importantly, they offer culturally appropriate services to all local families. Those are all considerations that were described by my noble friend Lady Thornton.
Sure Start takes that evidence and seeks to put it to work. Yes, it is aimed at families in poverty, but targeted by area rather than by individual families to avoid stigma. It requires agencies to work together, and local partnerships must involve local parents in designing and running services.
Therefore, what are we seeking to achieve? Sure Start aims to improve the health and well-being of families and children--if one likes, to address the outcomes of poverty in the same way as social security departments seek to address the basic issue of income poverty. It starts before birth and works with children and their parents up to the child's fourth birthday. We have invested £452 million over three years to set up local Sure Start programmes in 250 disadvantaged areas throughout England.
The selection of areas is based on local poverty indicators. There is no bidding process and no competition. Therefore, scarce community resources are not tied up in drawing up bids that never receive the go-ahead. In that way, our resources are targeted on areas of need and not on areas which make the best writers of bids.
The programmes are based in disadvantaged areas throughout the country: from Dover to Durham, from Penzance to Preston. I was reassured when I saw yesterday's study in the press of the 20 most disadvantaged areas in England. All are either in the first wave or invited to join the second wave of Sure Start trailblazer programmes. Over the 250 programmes, we expect to reach 8 per cent of children aged under four at any one time and 20 per cent of the age group of those living in poverty. Most, but not all, of the current programmes are based in the cities and larger towns where we find the biggest concentrations of deprivation. The noble Earl, Lord Russell, is right in saying that half of all poor children do not live in poor areas. The problems of outreach work for those who live in rural areas and the like is extremely difficult to make cost-effective without stigmatising by so overtargeting that the parents recoil.
The noble Baroness, Lady Blood, raised the problems of Northern Ireland and its failure to be included in the programme. I was grateful that she was able to give me notice of her concerns so that I could follow them up. I regret the delays in getting Sure Start up and running in Northern Ireland. We look forward to seeing Sure Start under way throughout the UK, but so far it has been an England-based programme.
Officials from the Sure Start unit in England have been to Northern Ireland to advise their counterparts on planning guidance and funding mechanisms because they have ring-fenced funding for those purposes. There remain some issues which need careful thinking through. Sure Start as constituted in England would not necessarily work in Northern Ireland. The local programmes in England are concentrated mainly in larger cities. The catchment area is typically 500 to 1,000 children under four. In Northern Ireland, the programme will need to take account of the rural character of poverty, with smaller pockets of deprivation.
In a devolved system of government, responsibilities for decisions in Northern Ireland remain with people in institutions based in the Province, including at present my ministerial colleague in the Northern Ireland Office. They must make decisions on priorities based on local needs and circumstances which I should not like to second guess and it would be inappropriate for me to do so. Certainly, I shall ensure that my colleagues in Northern Ireland receive a copy of the noble Baroness's speech and seek to reassure her that her concerns are being addressed there. She was right to raise them for us tonight.
The Sure Start programme will, we hope, also have a wider demonstration effect that reaches more children over time. Our aim is to find out what works and how, and then to make sure that we spread good practice to everyone involved in delivering services for children and families.
By influencing and improving mainstream services, we will obtain best value out of the substantial resources, which could be as much as £11.5 billion every year, that already goes into services for children and families; ranging from health to social services and the like.
Sure Start will provide high quality experiences for young children with first-rate services, well-trained staff and premises that are attractive and welcoming. The aim is better outcomes for disadvantaged young children, improved social and emotional development, better health and a stronger capacity for learning. Central to that is childcare. I am happy to reassure my noble friend Lady Thornton that more than 7,000 new places are within the 60 trailblazer programmes, which will be a useful and significant addition to our childcare provision in England.
Each local Sure Start programme works to nationally set objectives and 12 challenging targets to be met over three years, remarked upon by the noble Earl, Lord Russell. How those targets are achieved is up to local people to decide, drawing on the evidence of what works. This supports local enthusiasm and ownership. It allows a variety of approaches to be tested, based on local circumstances. It will be different in different areas and many of the benefits will not be apparent for several years.
However, one of the reasons for targeting under-weight babies is that they have less well-developed muscles in their mouths affecting their ability to suckle and take in food. They need to feed more often, which affects their sleeping patterns. We know that low birth weight is also associated with health problems in later life, such as coronary heart disease, diabetes and hypertension.
We also have a target to try to identify and care for mothers with post-natal depression. That is one of the best predictors of whether mothers and children bond with each other. We also know that the effects of a failure to bond can be long lasting. Researchers have found a correlation between mothers' post-natal depression and low IQ scores among boys at the age of 11. We hope to be able to work in that area.
We are also aiming for a 10 per cent reduction in the number of children admitted to hospital in the first year of life with gastro-enteritis. We shall exclude all those babies taken to France during the course of parental holidays who suffer infection or severe injury! We know--and this is the serious point that the noble Lord will respect--that poor children are five times more likely to suffer accidental, as opposed to non-accidental, serious injury or to die as a result of accidents than children in socio-economic classes 1 and 2. That measurement is a powerful proxy for the health and well-being of very young children.
Some things will be common to all programmes. For example, all families will receive a visit within two months of a new birth to introduce them to what is available locally. Outreach and home visiting are a core part of the Sure Start approach so that we engage with all parents including those who might not otherwise come forward.
The first trailblazer programmes are under way in 60 areas--57 have now been approved--and a second wave of 69 areas are building partnerships. We already believe that that is making a difference. We are seeing new partnerships between agencies which rarely worked together in the past. We are seeing public sector services and professionals working much more closely and with much greater respect for parents and responding to their needs.
We are beginning to see services developing in new ways. Health visitors and midwives, for example, have been enlarging what they are able to do. Parents are being offered more ante-natal advice and more work in depression is being undertaken. Help is being provided with baby sleep clinics and there are sessions for parents on dealing with the behavioural problems of their children.
In conclusion, Sure Start is an investment in faith and hope for children living in poverty. Some of the outcomes we are seeking to achieve will not be measurable until 15 to 20 years' time. However, we will be starting careful evaluation from this summer onwards. There will be some technical problems with evaluation, given the overlapping effects of other agencies, the health action zones, education action zones and the like. However, a large-scale, long-term national evaluation of Sure Start will begin in summer 2000.
As well as looking at short- and medium-term results, it will also include a major longitudinal study of outcomes using a significant sample of Sure Start children. It will also look at more qualitative assessments of small group work. We shall be looking at whether children have achieved their potential at school; whether they have a job; whether they have avoided becoming pregnant as teenagers; and whether they have steered clear of entanglement with the law.
Sure Start is a cornerstone of our drive to end child poverty and to tackle social exclusion by seeking to overcome the disadvantages that flow from child poverty. It is early days, but it is working and it is popular. We are releasing the powers of energy and innovation in deprived neighbourhoods across the country. It is ambitious, but our children are entitled to nothing less. I hope that as a result we will all work together in meeting those objectives and addressing the problems for our deprived children.
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