Guest post from MP Andrea Leadsom: Share your views about early years services

[NicolaDMumsnet]

Andrea was appointed as the Government’s Early Years Health Adviser in 2020 and led a review into improving health outcomes for babies and young children. Following publication and subsequent adoption as Government policy of the report in March 2021, The best start for life: a vision for the 1,001 critical days, Andrea now chairs the Start for Life Unit, a team of civil servants tasked with implementing the various policies from the review.

Starting a family is wonderful and also overwhelming in so many ways!

Becoming a parent can be so challenging for everyone and all too often it is hard to find the support you need when you need it. The vision for the best Start for Life is all about making help easily available and in a joined up way for every family in the period from conception to the age of two - the 1001 critical days.

We all need help at some point, whether it’s with advice on crying, sleeping, weaning, or support with mental health issues, or with getting into a good breastfeeding routine. And many would welcome parenting support, including more information about how our babies develop and how as parents we can give them the best start in life.

For more than 25 years, my passion has been to make sure that every family and baby can get the best support. It is in the period from conception to age two that the building blocks for lifelong emotional and physical health are laid down, and if we get it right, we can improve the life and health chances of every baby.

I’ve spoken to lots of parents about their experiences - and what comes across loud and clear is that families need early years services - from midwifery to health visiting, from mental health to infant feeding support, and from parenting classes to debt advice services, to be joined up for them and easily accessible in a welcoming place that doesn’t make them feel any stigma.

It is that vision which lies behind the Family Hubs and Start for Life programme that is now being rolled out across England.

And we are also beginning the rollout of a digital version of the Red Book, so in future new parents will be able to access digital information about their baby, seek advice from early years staff as well as online help and guidance when you need it, any time of the day or night.

I would love to hear your views on early years support and services in your area - please do comment on this post below. Please also ask any questions you may have about the Family Hubs and Start for Life programme.

Andrea will return to this post next week to answer your questions.

Twitter: @andrealeadsom
Website: https://www.andrealeadsom.com/

[Purp1eRain]

Compared to support for families with teens provision for early years is already far better. We are in the midst of a mental health crisis, CAMHs is on its knees and pretty much not fit for purpose. There is a cliff edge in the 18-25 year group across all services, pressures on schools,teens and their parents are bigger than they ever have been before….Families need support and advice but still there is nothing out there and nothing from your party. So my question is why are you jumping on this bandwagon when families with teens who have no support at all are being ignored yet again. And before we hear the familiar”get the early years right and there will be no teenage struggles” mantra, access to Surestart type centres and health visitors( which we all had previously under Labour governments )do not help, support or eradicate need for families with teenage children. There is little point focusing on the early years if those children and their needs are then ignored and massively underfunded once they hit teenage years.

[JenniferBarkley]

Why has your government done nothing to improve access to childcare, and only made things more difficult. The cost of childcare is unachievable for many families on normal incomes, providers are struggling to stay afloat due to the abysmal funding from the 30 hours scheme, and the childcare workers (overwhelmingly women) are paid nowhere near what they are worth.

All of this keeps women out of the workforce, with all of the negative consequences that follow.

What are you actually doing to fix this?

[DaphneduM]

Why are you re-inventing the wheel? Surestart Centres were a fantastic, supportive resource which of course were all shut by the Conservatives. There are very few baby and toddler groups around where we live - and it's a deprived area (the Forest of Dean).

Private childcare is extortionate where it's available. Our grandson is in nursery part of the week and my husband and I as grandparents look after him for the rest. Otherwise it would be completely unaffordable to our daughter and son-in-law, who are actually both professionals in well paid jobs.

What is your strategy re early years? How will you obviate the negative effects of those Covid years of unnecessary isolation for babies and toddlers?

[GreatContinental]

Start for Life, Family Hubs
mmmm
Sound very like sure start children centres, a policy abandoned by your government despite evidence showing the benefit of early intervention.

It has been you passion for 25 years- how did you try and prevent the closure of sure start centres?

How will the new hubs be funded? Will you be re-opening the abandoned sure start centres in the most deprived communities? How will you get NHS buy in, they struggled to engage with children centres?, what will be different this time?

[Bunnycat101]

Unfortunately the health visiting service was decimated between the births of my two children due to funding cuts. The difference was quite stark and the health visitor actually apologised and said the service would be rubbish compared to what I’d had with my first. At that time my local sure start centre was also closed which was an informal route for many local mums to access support. With my second child, I saw a health visitor once or twice at 2 weeks and 6 weeks and then never again. There were no face to face development assessments, no workshops, no easy access to weighing, no local key person,
no home visits. All things that were available with my first child. I genuinely worry that vulnerable children born in my daughter’s year will have just been missed as the service was so depleted.

So my question is, what will you do to reverse the cuts to local authority funded services and ensure the public health grant is funded adequately.

Regarding childcare, it is an absolute lie that parents have universal access
to free hours. It is in practice a subsidy for many settings and the communication of ‘free’ hides the extent of the problem. My bill for this month for my 3 year old will be £1200 for 4 days a week for 40 hours of nursey. We are a high earning household so can manage but childcare costs are becoming untenable for many working parents especially key workers and will be forcing people to drop hours/leave the workplace. At the same time providers seem to be shutting because of rising costs and waiting lists are very long (my daughter’s setting is full for another 18 months).

[FlyingFlamingo]

I’m in Wales where health visiting/Flying Start has had huge investment (continuing and expanding on SureStart which I believe has all but disappeared in England since your government came to power) and the difference is stark. Families here get a minimum of 5 home visits before 4, and this rises to 10 in Flying Start areas, where they also get free, high quality childcare from age 2. There are several children’s centres near me offering free groups including baby massage, cooking groups, playgroups, and mental health support groups. There is so much research to support these interventions so why has it taken until now for your government to basically reinvent what already existed until you broke it? In contrast a relative of mine saw a health visitor when her nearly 2 year old was born and he hasn’t even been weighed since then. Luckily he is fine but so much could have been missed in that time!

[FlyingFlamingo]

Sorry, it should say ‘my relative in England’

[FlyingFlamingo]

@NicolaDMumsnet is Andrea ever coming to answer the questions?

[AndreaMP]

@Purp1eRain

Compared to support for families with teens provision for early years is already far better. We are in the midst of a mental health crisis, CAMHs is on its knees and pretty much not fit for purpose. There is a cliff edge in the 18-25 year group across all services, pressures on schools,teens and their parents are bigger than they ever have been before….Families need support and advice but still there is nothing out there and nothing from your party. So my question is why are you jumping on this bandwagon when families with teens who have no support at all are being ignored yet again. And before we hear the familiar”get the early years right and there will be no teenage struggles” mantra, access to Surestart type centres and health visitors( which we all had previously under Labour governments )do not help, support or eradicate need for families with teenage children. There is little point focusing on the early years if those children and their needs are then ignored and massively underfunded once they hit teenage years.

Hello @Purp1eRain and thank you for your question. I agree with you that support for teens is also vital. The Family Hubs introduction right across England will provide support from pregnancy to age 19 (25 where there are disabilities/special needs). My personal focus is on the period from pregnancy to age two (the Best Start for Life programme) because it is in this period that the building blocks for lifelong emotional and physical health are laid down. The experiences of a baby, both in the womb and in the earliest years, are critical to building a secure foundation. It is true that a baby who is securely attached to the primary caregiver will be better able to cope with life's ups and downs, and may also have better physical health than a baby that has not experienced loving attentive care. So investing in the 1001 critical days makes good sense, but you are right that children and young people of all ages need better support. Family Hubs will deliver that.

[AndreaMP]

@JenniferBarkley

Why has your government done nothing to improve access to childcare, and only made things more difficult. The cost of childcare is unachievable for many families on normal incomes, providers are struggling to stay afloat due to the abysmal funding from the 30 hours scheme, and the childcare workers (overwhelmingly women) are paid nowhere near what they are worth.

All of this keeps women out of the workforce, with all of the negative consequences that follow.

What are you actually doing to fix this?

hello @JenniferBarkley. The government introduced the current childcare support (free hours plus tax free childcare), but has recognised this is not nearly enough. Hence the announcement at Budget of free childcare for all working families with babies from 9 months old, and also wrap around childcare for primary school age. The disappointment for many is that this will take time, as the nursery and childminder sectors will need to expand to meet the demand. I'm working with some other MP colleagues to put forward ideas to treasury to speed things up, and improve on flexibility. If you have thoughts, it would be good to hear them.

[StraightOuttaContext]

Why have you let things come to 《 gestures broadly》this?

[AndreaMP]

@DaphneduM

Why are you re-inventing the wheel? Surestart Centres were a fantastic, supportive resource which of course were all shut by the Conservatives. There are very few baby and toddler groups around where we live - and it's a deprived area (the Forest of Dean).

Private childcare is extortionate where it's available. Our grandson is in nursery part of the week and my husband and I as grandparents look after him for the rest. Otherwise it would be completely unaffordable to our daughter and son-in-law, who are actually both professionals in well paid jobs.

What is your strategy re early years? How will you obviate the negative effects of those Covid years of unnecessary isolation for babies and toddlers?

Dear @DaphneduM. I agree with you that Sure Starts really helped many families and I am a big fan. In fact, there are 3,500 of them in England that are in operation today - it's not true that they were all shut down. My concern about them is that they were more about buildings rather than the services within them, and many are not providing universal support. I was chairing a parent infant mental health charity 25 years ago when the first Sure Starts opened, and was very sad that the huge Sure Start my charity wanted to work in would not allow us in unless we paid rent, which we could not afford.

The difference with Family Hubs (many of which will take over Sure Start buildings) is that each one will offer the six universal services of Midwifery, Health Visiting, Infant Feeding support, parent infant relationship/parenting support, Safeguarding and Special Needs support. And not only will this offer be available in the Hubs themselves, but it will also be available through outreach into communities (and of course - as now - in people's homes), and also via virtual links.

Covid feedback from many new families was clear that face to face is vital, but busy parents also hugely value the opportunity to join a class or an appointment online. Particularly a number of Dads told us that a Teams session on mental health/being a Dad would be more welcome than face to face. The point is that the services and support should be available in a joined up way (ie a one stop shop) but also flexibly, so that one day you can visit the Hub, and the next day join a virtual parenting class/ante natal discussion.

On childcare, please take a look at my reply to the previous questioner. I do think more should be done to recognise the role of grandparents and other carers in providing childcare support. This is part of the discussion I am having with Treasury.

[Mazza7412]

We had all of this with Children’s Centres, unfortunately you closed most of them! I’ve worked in Early Years for 13 years now and the lack of support from LA now is appalling both for new parents and the industry in general.
All very well supplying assisted funded hours - which you call free, but there not!
So much money being wasted over the last 10-15 years having Children Centres built, finished, staffed and then closed. You wonder why so many children are slipping the net! Families and children need support from pregnancy through to 18
it simply isn’t enough sticking a plaster on a gapping Early Years hole!

[Mazza7412]

@GreatContinental

Start for Life, Family Hubs
mmmm
Sound very like sure start children centres, a policy abandoned by your government despite evidence showing the benefit of early intervention.

It has been you passion for 25 years- how did you try and prevent the closure of sure start centres?

How will the new hubs be funded? Will you be re-opening the abandoned sure start centres in the most deprived communities? How will you get NHS buy in, they struggled to engage with children centres?, what will be different this time?

Totally this!

[JenniferBarkley]

@StraightOuttaContext

Why have you let things come to 《 gestures broadly》this?

Succinctly and accurately put.

[AndreaMP]

@GreatContinental

Start for Life, Family Hubs
mmmm
Sound very like sure start children centres, a policy abandoned by your government despite evidence showing the benefit of early intervention.

It has been you passion for 25 years- how did you try and prevent the closure of sure start centres?

How will the new hubs be funded? Will you be re-opening the abandoned sure start centres in the most deprived communities? How will you get NHS buy in, they struggled to engage with children centres?, what will be different this time?

@GreatContinental thanks for your question. I think I've answered some of it in the reply above, but I do understand your concern about making sure we build on Sure Starts rather than abandon them. As I previously said, many Family Hubs will be located in previous Sure Starts, as well as other re-purposed buildings. It won't be a case of starting again with new buildings.

The Family Hub and Start for Life Programme has been funded with £300M over three years, and that money will go towards 75 of the 152 local authorities in England (so roughly 50% of them) for this funding round. However, all local authorities in England (it's a devolved policy) will be helped to roll out the same programme under their existing funding, and many are already doing so. The funding is for 1. creating the FHs 2. publicising the local start for life offer 3. parenting programmes 4. infant feeding support. 5. parent infant relationship/mental health support 6. Establishing parent/carer panels to provide ongoing feedback/co design of services.

In addition, we are establishing a digital version of the Red Book that will transform the way in which families can access help and advice, as well as record their babies' health, development and immunisation records.

As the government's Early Years advisor I am focused on supporting the implementation phase that began last year and is now ramping up across England. We have a number of data points we will be assessing (for example birth weight, parental confidence, breast feeding initiation, parent infant relationship, just to name a few). With this data, I believe we will demonstrate once and for all the huge improvement in outcomes that is possible if we deliver joined up support that is non-stigmatising for every family. Then at the next spending review (due in May 2025) I plan to seek funding for the whole of England on an ongoing basis, much as we have school funding now.

[carriedout]

For more than 25 years, my passion has been to make sure that every family and baby can get the best support. Why did the Tories shut Surestart? Why have the Tories consistently underfunded the NHS, local councils and nurseries? Why have the Tories cut benefits paid to families? What have the Tories increased the tax burden on families? Why have the Tories increased pressure on parents whilst being happy to watch our wages drop in real terms?

Too little too late.

[AndreaMP]

@Bunnycat101

Unfortunately the health visiting service was decimated between the births of my two children due to funding cuts. The difference was quite stark and the health visitor actually apologised and said the service would be rubbish compared to what I’d had with my first. At that time my local sure start centre was also closed which was an informal route for many local mums to access support. With my second child, I saw a health visitor once or twice at 2 weeks and 6 weeks and then never again. There were no face to face development assessments, no workshops, no easy access to weighing, no local key person,
no home visits. All things that were available with my first child. I genuinely worry that vulnerable children born in my daughter’s year will have just been missed as the service was so depleted.

So my question is, what will you do to reverse the cuts to local authority funded services and ensure the public health grant is funded adequately.

Regarding childcare, it is an absolute lie that parents have universal access
to free hours. It is in practice a subsidy for many settings and the communication of ‘free’ hides the extent of the problem. My bill for this month for my 3 year old will be £1200 for 4 days a week for 40 hours of nursey. We are a high earning household so can manage but childcare costs are becoming untenable for many working parents especially key workers and will be forcing people to drop hours/leave the workplace. At the same time providers seem to be shutting because of rising costs and waiting lists are very long (my daughter’s setting is full for another 18 months).

@Bunnycat101 thanks for your question. I've answered some of the points but haven't talked about Health Visitors. First, they do an amazing job, and second, I agree the service is very stretched - I'm told recruitment and retention are both huge issues. In fact, the position for HVs is really variable across the country. In some places, the 5 recommended health visits take place for every baby, in others, there are even more visits for some. But overall, many local authorities are not able to provide even one visit for the supposedly 'less needy' families. This is obviously an unacceptable situation.

The Start for Life Unit in the Health Dept (that I chair) is working on some pilots of 'multi disciplinary work forces' in the early years. This is in response to the desire of parents to have a named 'key contact' to whom they can go when they have questions or need signposting to some specific help. Parents want consistency of care, and there was criticism of how hard it is to navigate the early years systems, and to get referrals.

The pilots recognise that HVs currently have a very broad range of tasks for which they are responsible, and that having a team involved together with a key contact for every family could enable them to focus on their essential role of the health and wellbeing of baby and family. In some local authorities, this team approach is already working very effectively and is hugely appreciated by families. The Unit is considering all the roles in the early years workforce, including that of HV apprenticeships and nursing apprenticeships, as well as those of family practitioners, community connectors and others.

[AndreaMP]

Thanks so much everyone for your questions! I have to go, but I'm really grateful for further feedback, particularly if you have good ideas!

[NicolaDMumsnet]

Thank you everyone for all the great questions. Andrea will be back on Thursday to answer some more.

[AndreaLeadsomMP]

@Mazza7412

We had all of this with Children’s Centres, unfortunately you closed most of them! I’ve worked in Early Years for 13 years now and the lack of support from LA now is appalling both for new parents and the industry in general.
All very well supplying assisted funded hours - which you call free, but there not!
So much money being wasted over the last 10-15 years having Children Centres built, finished, staffed and then closed. You wonder why so many children are slipping the net! Families and children need support from pregnancy through to 18
it simply isn’t enough sticking a plaster on a gapping Early Years hole!

@Mazza7412 thanks for your question. There are about 3,500 Sure Starts operating today in England, many of them doing great work. I worked with a Sure Start 25 years ago when they were first introduced, chairing a parent infant mental health charity that took referrals from the Sure Start.

The Family Hubs and Start for Life programme is, in my view, an up to date approach to supporting families - what is different is that all the key services for families (midwifery, HV, mental health support, parenting support, SEND support) will be provided in a 'one stop shop' family hub. This will be not just a physical place, but also services will be available virtually to meet the needs of parents/carers, and also in the community and via mobile family hubs. The hubs will offer universal provision and will be open for long hours and some will also be used out of hours by charities to provide community provision. The other big difference is that the hubs will offer support from pregnancy to age 19 (and to 25 where there are special needs).

This is a really ambitious programme, and I'm determined to see it embedded in provision for families in the same way as is universal education!

[AndreaLeadsomMP]

I'm grateful for all the questions, and I look forward to the day when we can all agree that every baby and their family are getting the best support in the 1001 critical days. In my view it is the best way to build a healthier and happier society.

[Bennyy]

You said "And we are also beginning the rollout of a digital version of the Red Book, so in future new parents will be able to access digital information about their baby, seek advice from early years staff as well as online help and guidance when you need it, any time of the day or night."

Why it is being delayed? What is happening? There are options if you really want to make it happen. Why the delay?