Support for Infants and Parents etc (Information) Bill [HL]

Second Reading

10:08:00

Moved by

That the Bill be now read a second time.

My Lords, a vast amount of evidence unambiguously points to how critical the first 1,001 days of life, from conception to age two, are to the health, well-being and opportunities of children throughout their lives. Those days are also incredibly stressful for the vast majority of parents. Is the baby feeding properly? Is she putting on enough weight or too much weight? Why will she not stop crying? Is she sleeping too much? What am I doing wrong? What should I be doing? What information can I rely on? Why are we arguing so much? These questions are typical during those early days after a baby is born. This is therefore a vital stage of family life to support. I know that one of this Government’s key missions is to turbo-boost opportunities for babies, children and young people. Parents are a key means of achieving gains in this area. Being child focused requires being parent and family focused, as I am sure they are aware. Finnish research shows that the bond a parent has with their child is the most potent and all-consuming form of love. Using MRI scans, researchers could see how feelings of parental love provoked the strongest level of brain activity and fired up the largest number of regions within the brain, sparking areas untouched by other forms of love. Support to harness, encourage and strengthen that parental love, also known as kin altruism, complements the clinical support that everyone needs when a baby is born and is the heart of the intent of this Bill. In outlining the Bill, I declare my interest as a guarantor of FHN Holding, the not-for-profit owner of the Family Hubs Network Ltd. Vital though they are, GPs and health services cannot do it all. NICE reports that in the first year after birth, around 15% to 20% of women and possibly one in 10 men experience depression and anxiety. This is frequently missed or undertreated in general practice. The risk is greater if new parents are isolated, or relationships are not good between parents. Many break down in these early days. These non-medical issues have massive knock-on effects on mental and physical health, requiring a holistic and whole-family approach. My interest in the Bill stems from an awareness that many fathers are treated as incidental in the antenatal and postnatal periods, yet they are often the mainstay of support to the new mother and will, of course, be of considerable importance to the growing child. A new joined-up and continually improving Start for Life offer was the focus and first action of Dame Andrea Leadsom’s early years healthy development review. This reported in March 2021 and named a welcoming family hub as the place where families could access those Start for Life services. Although much support and many services were available to new parents, her review established how hard it is for families to access information about what is available so that they can draw on it when they need it most. Moreover, access to help is often inconsistent across the country. For example, great ambitions over several decades to increase breastfeeding will be constantly thwarted if parents do not get the support and information needed to keep breastfeeding beyond the earliest days, when extreme tiredness, pain and mastitis often set in. Baby tongue-tie is another issue, but many must go private to resolve it or for accessible advice. Many go online for help, without knowing how reliable that will be. But now, thanks to the family hubs and Start for Life programme, mothers in Derby, for instance, have support from breastfeeding experts and from each other in their local family hub. Peer support can be decisive for women to keep breastfeeding. This is one of the five named services that the early years healthy development review said should be universally available to support parents and carers and to ensure babies’ sound cognitive, emotional and physical development from pregnancy to age two. But, as the 2023 progress report from this review points out, just providing better services does not go far enough: all families need to know what support is available to them and be able to access it easily. Funding was provided to ensure that expectant parents in the 75 eligible local authority areas receive a physical copy of their local Start for Life offer and can find it online. However, without the Bill, which simply and modestly requires all local authorities to publicise their Start for Life offer to all new parents, future funding is not guaranteed. The Start for Life offer is information on services that a local authority is aware are available in its area for infants, parents or carers of infants, and prospective parents or carers, provided by or on behalf of public authorities. The named services in the Bill are maternity; health visiting; services promoting positive relationships between infants and their parents or carers; mental health; and breastfeeding and other infant-feeding services. Local authorities should also provide additional information on other services as appropriate. The Bill includes a regulation-making power so that the Secretary of State can include information on other specific services in the future. This future-proofs the Bill by ensuring that services that become indispensable are also systematically included. The transformation fund for 75 local authorities, mentioned earlier, is allowing much innovation and good practice to emerge. This could eventually become universal. For example, family hubs in Bishop Auckland in County Durham have begun to offer birth registration to make this process easier for new parents, starting with just one day a month—but this could grow with demand. There have been many calls over the years to make this standard across the country. The Bill introduces a further duty on the Secretary of State to publish guidance to local authorities relating to those duties. Current guidance is non-statutory and does not include the learning from the Government’s family hubs and Start for Life programme, because evaluations from these have not yet been completed. Finally, the Bill requires the Government to publish an annual report that sets out information about support being provided in England for infants, their parents and carers—and prospective parents and carers—as well as outcomes. Certainty about what can reasonably be expected and where it can be accessed makes a great difference during a phase of life when very little is certain and everything is being experienced for the first time. Everyone wants to enjoy this period when a new baby comes, but not knowing where to find help if things go wrong puts a major dampener on that. Information is vital, which is why we need family hubs right across the country so that parents can access that joined-up early support to help them overcome difficulties and build strong relationships. Family hubs do not replace children’s centres. Many local authorities still run these nought-to-five facilities and integrate their work into the family hub network of buildings and services across an area. Family hubs do not deliver everything but are the access and connection points for families of children aged nought to 19, and up to 25 where there are special educational needs. They draw together all the family support available, which combats fragmentation of help and costly duplication. Many family hubs in Essex provide paediatric healthcare that would otherwise be delivered in hospitals far from the community, as well as inoculations and oral health drop-ins for children aged nought to 19. Westminster includes GP clinics in family hubs so that families have access to a wide range of other support. GPs report how working in this way facilitates early intervention, holistic practice and a better grip on the myriad determinants of health. Family hubs also draw in support provided by faith and other community organisations, in which parents place a high level of trust. Relationships are key to how they function. Family hubs in North Tyneside and Camden, among many others, adopt a “barefoot professional” model, which recruits local people from communities of greatest need and who have experienced poverty or family difficulties. Through peer-to-peer learning and appropriate supervision and support from the family hub, their ability to overcome adversity becomes a transferable skill set. For family hubs to be sustainable, they need to draw in and on the local community and build prosocial peer support networks. Research has shown that these are invaluable to health visitors and other professionals, and certainly do not replace them—but they can never on their own address the problems of isolation I mentioned at the beginning. University College London research proves that well-functioning relationships are themselves health assets, and the relationships that parents have with their children can be most powerfully so. I reiterate that information about where help is available supports these from the earliest point before birth and afterwards, giving all children the best start for life. I beg to move.

10:19:00

My Lords, it is a pleasure to follow the noble Lord, Lord Farmer, and I congratulate him on bringing this Bill forward. Its antecedents were in the previous Parliament, in the House of Commons. I commend the speech that he has just delivered; I did not disagree with a single word of it. I start by paying tribute to Dame Andrea Leadsom, who is viewing our debate this morning from, I think, the Throne steps. I was not sure whether I should call it the Throne or not—but she was certainly the queen of the review and the Start for Life initiative. I played my part in discussions with Dame Andrea, and I see the initiative as a valuable starting point for rebuilding the Sure Start initiative, for which I was partly responsible. I see the Start for Life initiative, and all the elements spelled out by the noble Lord, Lord Farmer, as the granddaughter of Sure Start—and, as with all granddaughters, we want it to grow into adult life and be able to provide the range of services and comprehensive approach which the noble Lord, Lord Farmer, spelled out. Information and guidance are a no-brainer; it is obvious that people need that from the time when they become pregnant all the way through those early two years that are so important, as we acknowledge. This is acknowledged and supported by parties of all persuasions. I noticed that the new Liberal Democrat MP for Torbay put a Question down very quickly on this issue. I also noticed that his dog got a lot more publicity than mine, for which my dog is deeply resentful. The Bill takes a step forward, because it requires co-ordination and mapping of what is available at local level, and it requires thinking about how you reach people, particularly those hard to reach, in that early period. When Tessa Jowell and I, among others, were responsible for developing Sure Start, we discovered that the crucial element, which the noble Lord, Lord Farmer, mentioned at the end of his speech, was the outreach to community and the strength of community. I happen still to be a communitarian and I believe that it is not just about the professional delivery of services, critical as that is—the noble Lord, Lord Farmer, spelled out a whole range of professional services that should be involved—but actually should be seen as growing the strength and social capital of the community to surround and support families of whatever persuasion and size. It seems to me also that, in providing that information, we highlight the inadequacies of what is already available. My right honourable friend the Secretary of State for Education and her Ministers are deeply committed to developing and building on Start for Life in terms of getting the resources over the years ahead to be able to provide comprehensive support, childcare and nursery education. There is a commitment from the new Government to developing that with primary schools so that continuity and support are available, seeing this on a timeline and a continuum, rather than as a one-off. If we can get the information, guidance and important support immediately available, it will help families to flourish and overcome the gross inequality that we see in this country and elsewhere, in terms of that start for babies. The problem is, of course, that even with the resource for the limited number of hubs we are covering only part of England. It will be critical that we extend this right across the country and that, in mapping the available resources, public, private and voluntary, in an area, we can highlight what the need is and resource it in due course, despite the miserabilist picture at the moment. I should not say things like that, should I? I want to put it on record that getting information, advice and support to the most vulnerable and more widely is not easy. Most parents do not access local authority websites; they do not even know about them. From the moment when a mother touches services when she discovers that she is pregnant, and the support services click in, that information and advice should be readily available—and, with consent, overcome data protection problems. Furthermore, we need to use new ways of reaching people as we have not done in the past. I am working with the University of Sheffield on this; it has an action research project using smartphones to reach families—because even the poorest families these days tend to have a smartphone—to provide direct advice by text and WhatsApp to those families, for them to be able to reach advice and support very quickly at the time they need it. The noble Lord, Lord Farmer, was right to spell out the real challenges and pressures that exist on a new family and the dangers of underestimating the mental health problems. By such immediate access to advice, we can add to the multiplicity of commitments that would be available at local level if we managed to develop the services that this Bill would allow the local authority to highlight. We have a long way to go and we know that there is a massive shortage of provision and that the workforce challenges are equally enormous in terms of childcare and nursery education provision, but we need to put them all together. If we do that, and the information is readily at hand, it will be possible to intervene and offer that help at the time when it is needed most. We all know how to develop a child long after we have failed to do it really well—I speak as a father, and it was very important that the issue of fathers was mentioned. It is partly about overcoming child poverty, by the way. People in the debate about child poverty seem to forget that there should be a father as well as a mother available, and it is their duty and responsibility to contribute to the well-being of the child in all kinds of ways, including monetarily. So this is about fathers as well as mothers and it is about grandparents and support from the wider family—but it is also about ensuring that we connect with the community. I commend this small but important contribution to a wider debate about how we get this right and I commend the noble Lord, Lord Farmer, for his initiative.

10:28:00

My Lords, it is a great pleasure to follow the noble Lord, Lord Blunkett, and his very positive comments. Indeed, I congratulate the noble Lord, Lord Farmer, on using his high position in the ballot to continue his long-term campaign to secure a firm foundation for young families. The Bill’s intention is excellent; my concern is that, given the extreme financial constraints on local authorities at the moment, loading them with extra duties may not be very easy or realistic. However, I hope that this Bill progresses and that I will have the opportunity to propose some constructive amendments to progress an absolutely foundational area for babies that impacts on their health for their entire life. The noble Lord, Lord Farmer, mentioned this, and it is, of course, feeding. How babies are fed in the first months of their life is absolutely crucial. I am sure that noble Lords here do not me to spell out the advantages of breastfeeding in terms of health. But the shocking statistic for this country is that 81% of mothers start breastfeeding but by six months—and the World Health Organization and all the health organisations suggest that it should go on for six months—only 1% are still breastfeeding. There was an infant feeding survey, which was discontinued in 2012 but then restarted in 2023, which is positive. Can the Minister tell me whether the results of that survey are expected shortly and whether the Government intend to continue this survey from now on? We need to do all we can to help those who breastfeed, at least for those first six months. At the moment, however, the push all comes from the other direction, and has for 40-odd years—well, more. That was why the World Health Organization brought in the International Code of Marketing of Breast-Milk Substitutes, because the heavy way that the substitutes are marketed means that the incentive to breastfeed, the image of breastfeeding and the positive aspects of it are really undermined. In 2007, the previous Labour Government recognised how important this was and brought in the Infant Formula and Follow-on Formula (England) Regulations, which attempted to put the code on the books in the UK. The UK legislation on infant formula incorporates some but not all of the code into law. Would the Minister consider incorporating more of it into law? UNICEF has some really helpful ideas specifically for the UK, including: “Develop a National Infant Feeding Strategy Board … promote, protect and support breastfeeding in all policy areas”— as the noble Lord, Lord Farmer, mentioned—and: “Implement evidence-based initiatives that support breastfeeding”. In 2023, the Lancet ran a very interesting three-paper series about the impact of the amount of advertising from the commercial formula manufacturers, which is used to target parents, healthcare professionals and policymakers. There are marketing practices which, on the face of it, comply with the law but actually undermine breastfeeding—that is the fact. The Lancet found that the monitoring and enforcement of UK legislation is very weak, which means that companies are rarely prosecuted for breaking the law. I cannot remember a case and I have been following this since about 1980. That is an area where I would like us to be able to table some amendments to this very constructive Bill and make sure that the work of the WHO, the Lancet and UNICEF is underscored by our legislation.

10:32:00

My Lords, it is a great pleasure to be able to congratulate my noble friend Lord Farmer and my friend, the right honourable Dame Andrea Leadsom, formerly of another place, on this proportionate and timely, but none the less hugely important, measure. One thing that I have noticed throughout my adult life is a change in political vocabulary—a semantic shift—whereby the word “investment” has tended to lose its literal meaning of an outlay that produces some kind of return and has become a general euphemism for any kind of public spending. This, however, really is an example of investment in the most literal sense, where, for a tiny sum relative to what government spends, we are investing in the most important resource we have: human development. There is a wealth of evidence, as my noble friend suggested, that the first years are the critical time. It is when the prefrontal cortex of the brain is forming and when all the neural pathways are being formed. Being able to reach parents and, particularly, more vulnerable children in that time is not only a monetary investment but of course an investment in human happiness. I will not repeat what the Bill will do, because the noble Lord, Lord Blunkett, and my noble friend Lord Farmer set that out very well, but the value of having one place, either physically in a hub or through the virtual side-effects of this, where you can learn about all these things—antenatal classes, midwives, breastfeeding, what is available for children with disabilities or special needs—is hugely important and valuable. I say all this with feeling. I remember when our first child was on the way, 23 years ago, being very reluctant to go to antenatal classes; I thought there would be way too much information and that they would be talking about disgusting things that I really did not want to hear about. I said to my wife by way of compromise, “Look, I will come to one”. I had only recently been elected to the European Parliament and I thought that that would be my excuse: “I can’t be there on Monday nights, darling, but I’ll come to the first one”. In fact, I turned up to the first one and there, sitting in front of me and looking unusually glamorous, was the brilliant actress Cate Blanchett—this was 2001, when she was at the height of her fame with the first of the “Lord of the Rings” trilogy having just come out. I told my wife that, actually, I had better support her through the rest and would turn up in future weeks. I am jolly glad that I did because, 14 years later, when our youngest child was born in our remote farmhouse, the midwife did not turn up on time—talk about “You had one job”— and I found myself falling back on a great deal of the information that I had picked up at those antenatal classes in order to take charge of a quite stressful situation. These things really do matter immensely. I hope that there will be a measure of cross-party support for what I think is, just in terms of the ratio of investment to outcome, an extremely well put together proposal. Two principles have guided me all the way through politics: localism and political frugality or economy. Decisions should always be taken as close as possible to the people they affect, and we should try to get away from the culture that we sometimes have in both Houses of people airily demanding things without any talk of who is paying for them. This proposal, it seems to me, plainly passes both tests. It does not impose new, burdensome duties on local councils; all it does is require them to tell people what they are already doing and thereby, in some cases, enable people to shop around and go to neighbouring local authorities if a particular service is not available locally. We have seen already the huge success of some of these schemes, as the noble Lord, Lord Blunkett, discussed earlier. As for the cost, Dame Andrea tells me that the cost is something like £750,000. That is what the Government spend every 21 seconds. Indeed, in the time that I have been on my feet, the Government have spent something like £9.5 million—so I had better sit down.

10:37:00

My Lords, I am most grateful to the noble Lord, Lord Farmer, for having brought this measure back to the House and indeed for all the work that he has done in looking at the investment in new life for the next generation. Clause 5 is particularly helpful by defining what an infant is and being clear that the first 1,001 days of life are particularly important. Of course, there is the time before the child is born as well, before that clock starts ticking, which is very important. As the noble Lord, Lord Blunkett, has said, this builds on communities. We live in an increasingly fragmented society, and many women are pregnant a very long way away from any relatives or even friends. They may find themselves in a community that they do not know well, and those community attachments and links can be established if there is somewhere to go. Another important point, which I will cover as I go through, is that this will take some of the burden away from the NHS. The panicking parent who does not know what to do phones 111 and gives a bizarre description of what is going on and then ends up in an emergency department. That is not an appropriate place for a panicking young mum, particularly one with feeding difficulties. I am most grateful to the noble Baroness, Lady Miller of Chilthorne Domer, for covering breastfeeding, so I will not repeat the very important points that she has made. Many women think that they will try breastfeeding, they start and then they give up. There are huge pressures to give up, as if it is somehow better or more fashionable to use formula when, actually, the convenience of breastfeeding, particularly in the long term or if you are travelling and going places, is really never advocated. Mothers are not told what they are doing well; they keep on being given advice as to what they should do differently. Certainly, for myself, the most helpful thing when I was breastfeeding was my mother-in-law saying, “You are doing really well, dear.” That was very reinforcing, because I was worried about what I was doing. A friend of mine just said, “Why don’t you put the baby in a different position, on a cushion under your arm, and you’ll be more comfortable.” Those were really simple things, but the thing about that peer support is that it needs to be available out of hours, at nights and weekends—somebody you can contact. Concern has been expressed—I am grateful to the NSPCC for its briefing—about messaging and the problem with the digital divide. As the noble Lord, Lord Blunkett, said, people have mobile phones and we are very used to getting advertising messages on the mobile, or messages about NHS appointments, so once a woman is known to be pregnant, some of the messaging can just go in short messages by mobile phone, with who to contact, where to contact them and where to go locally. This should not involve any great expenditure. On hubs, the work done so far has already evaluated very well. On investment, the Sure Start programme has shown that individual educational outcomes, especially for disadvantaged and racially minoritised children, have seen a huge benefit. Those eligible for free school meals who grew up near a Sure Start centre outperformed their peers by three grades at GCSE, so this is a really long-term investment in society and in the future for these children. Worryingly, a recent survey of over 1,000 expectant mums by the Parent-Infant Foundation found that 73% of women surveyed said the information and advice they had about bonding with their baby was not given throughout their pregnancy, and that 71% would have liked much more support to help them bond with their baby. Yet this is a crucial time. We know that perinatal mental illness is a real scourge: 27% of new mums end up with some mental health problem. That is a huge number, and we know that suicide is the leading cause of maternal deaths. We cannot ignore that distress and the need to do something about it in our communities. There is also evidence that one in 10 fathers experience depression during the time of pregnancy or after a birth, and we know that that is a time of high risk of domestic abuse as well, both towards the mother and the new baby, and any other children in the family. There is evidence that the attachment, which can be enhanced by good support, of mums and dads to the unborn baby also has an effect on siblings and the emotional relationship between siblings. There is a real need to make sure that support is available right the way through so that, by strengthening our communities, this does become an investment for society. I turn to financial investments. Insecure attachment to mothers costs one-third more than cases where children have secure attachments, and that amounts to an average difference of about £3,500 a year. The cost difference for insecure attachment to fathers is even more substantial, running at about £12,700 a year. Insecure attachment is fundamentally linked to an increase in antisocial behaviour, conduct disorders, violent offending, drug misuse, teenage parenthood and reliance on state benefits. The estimated cost in adulthood for typical conduct disorder cases in the UK is £260,000 per person—more than a quarter of a million pounds per person. This makes financial sense, quite apart from the emotional and societal impact. I should declare that I chair the Commission on Alcohol Harms, and it would be remiss of me not to remind your Lordships that the UK is estimated to have the fourth highest rate of alcohol use during pregnancy in the world, with an estimated 41% using alcohol during pregnancy. All the evidence around foetal alcohol syndrome and all the harms that go along with alcohol intake is really powerful, but the messages are not getting through to the parents, and they are not accessing the support they need to tackle alcohol and drug abuse during early pregnancy. Research from the Alcohol Health Alliance UK indicates that one-third of people are unaware that it is safest not to drink while pregnant. I hope that the Bill progresses and that we do not try to over-amend it, which might result in it not progressing. There may be some imperfections—we can always want something slightly better somewhere—but this is a really important initiative and we need to support it as it goes through, because all the evidence is that these programmes work for the child, for the parents, for the siblings and for the future of our society.

10:46:00

My Lords, it is a privilege to follow the noble Baroness, Lady Finlay, and all the other powerful contributions to this debate. I welcome the Bill and I thank the noble Lord, Lord Farmer, for introducing it and for so eloquently describing the complex nature of services required to support parents. I take this opportunity to commend Dame Andrea Leadsom for her continuous commitment to women’s services. Parents and mothers require a wide range of care and support during pregnancy. I should know: I gave birth to five children. I love the idea of the noble Lord, Lord Hannan, coming along as a fathers’ champion and bringing Cate Blanchett; I think she might still attract many fathers from different quarters. Ideally, there should be a seamless structural system of care in place as the child navigates their new world. The discourse surrounding parental support and infant care may have gained some momentum, not least from these debates; however, a holistic framework tailored to the needs of parents and children remains inconsistent and erratic, and absent in some communities. Parents’ and families’ voices need to be heard and reflected in the diversity of our communities. We do not need to reinvent services or programmes; there are countless pockets of best practice for us to reference and to inform national standards of care. I want to highlight the work of one such organisation, which has lasted for 40 years. In the early 1980s, a group of women of Bangladeshi, Somali and Vietnamese heritage set up an advocacy scheme as a response to a lack of adequate prenatal and postnatal maternity care. At the time, urgent attention was required to prevent postnatal deaths and trauma. Research was conducted by Jean Taylor, a Tower Hamlets midwife who highlighted the immense deficit in maternity care for a significant group of black and Asian women, which led to establishing the first women-led advocacy scheme in the country. It was enthusiastically supported by visionary leaders in the NHS and local government, with funds, who recognised that structural discrimination was a harmful factor that significantly impacted the physical and mental well-being and health outcomes for the mother, the family and the child. Through the advocacy service, at the point of entry, each woman would receive a comprehensive and detailed plan for the family for the duration of their pregnancy and up to the age of two years, with a holistic plan for postnatal support taking on board the physical and mental health needs of mothers. Each woman received a detailed package of information on how to access health visitors, postnatal check-ups, mental health screening, support for breastfeeding, such as breastfeeding buddies, and infant care. The evidence demonstrated that early intervention was conclusive with regards to empowering parents. This was possible due to the statutory role of health visitors and the associated community health services in place at the time. In addition, there was a broad range of NGOs that provided a wraparound system of support for families, including advice on housing, finances, social care, training, language and leisure facilities. All of these, incidentally, address the first 1,001 days of children’s lives, providing a vital foundation for both the emotional and physical well-being of mother and child and for the early indication of any vulnerabilities and complex needs of mother and child in their family setting. Overall, there was regular co-operation and co-ordination with statutory and voluntary organisations, with an agreed referral system to flag up any concerns, as well as successes, which evidently resulted in confidence and trust among parents and professionals alike. There were no smartphones or emails for communication, and I can still remember the many handwritten posters and leaflets, in many languages. We were all willing to do it, whether as volunteers or paid workers. We have to accept that many such organisations that took decades to develop have suffered from neglect and deep cuts; this, along with essential community centres shutting down, has had huge long-term negative consequences on parents’ and children’s welfare and health. It must be said that most women of affluent backgrounds or from affluent areas may not experience similar challenges, unless, of course, they have a black or Asian heritage, when their education or social economic advantage may still be overshadowed by discrimination in the services. Even now, many women I have spoken to are not sufficiently aware of the information they are entitled to and, more so, are not given it with consistency. Many women are simply instructed to find information on Google or on a website, when advice and guidance from properly trained and skilled staff who are present for the duration of new parents’ and children’s lives is more impactful. In addressing support for all parents and children, it is imperative to consider the detrimental effect of continuous and persistent inequalities and discrimination experienced by a substantial number of women in the maternity care services. It is nothing short of a crisis. The facts have been well-recorded, again and again, in countless research, that black and Asian women in our statutory system are four times more likely to die during childbirth than their counterparts. The status quo continues unabated. As the mother of a son who suffered injury during birth 46 years ago, I am shocked at how many parents still say that they did not have sufficient support or information about birth trauma and its prolonged consequences. Incidentally, I spoke to the mother of Tafida Raqeeb, who is currently residing in Italy; she is waiting for her daughter to return to the UK to be supported in our system. She referred to other parents who feel unsupported by hospital administration and staff during critical care crises. Many women are grief-stricken, in their own words, due to systemic racism and failures which profoundly impacted their maternity care and mental well-being. We seem to be living in the dark ages when it comes to the treatment of certain groups of women, who feel dismissed by healthcare professionals, their concerns ignored and their pain undertreated. We know that the result is often delayed diagnoses and treatment, resulting in complications that could easily have been avoided. It is a tragic outcome that should be unthinkable in a modern healthcare system. If we are speaking here about proper information, there has to be clear messaging about a safe route for parents to raise their concerns in confidence and safety. I did not see that in the Bill. The transition into parenthood can be emotionally and physically overwhelming. Postnatal care remains woefully inadequate in the UK, particularly for women of my colour and faith. Women’s voices and participation in shaping services is fundamental to best practice. It is about their right to dignity in care. Also fundamental is investment in the workforce for midwives, health visitors and advocacy staff, without which we will not tackle persistent social determinants of poor health as it disproportionately affects women and their families. All parents are entitled to the highest quality of services and information. That is the mark of a just and civilised society. Given the pressures on the NHS and all other public services, does the Minister agree that holistic statutory provision will safeguard parents and their children’s well-being and be cost-effective in the long term?

10:55:00

I congratulate the noble Lord, Lord Farmer, on this very simple—you could almost say dumb, in the best sense of the word—concatenation of a Bill, which brings together things that should have been brought together hundreds of years ago, or certainly since the creation of the welfare state. I will give an example which is not from the area we are talking about. About 20 years ago, in Bakersfield, down there in southern California, a doctor noticed that there were lots of homeless people living on the streets. He worked out one of the problems. The police were involved in the disorder that came from street living, the doctors were also involved, as were the psychologists, the local authority and all sorts of others who had a vested interest in concatenating all of the services. That is the dumbness, so to speak, of this thing; the cleverness of simplicity, is how I would describe it. What actually happened is that, in a very short space of time, they managed to dismantle poverty and homelessness for many hundreds of people in southern California. This thing which is now called Housing First is all over the world. The people who lead on it are the Finnish, as the noble Lord, Lord Farmer, referred to. They are in love with the idea of putting things together—why deal with things by themselves? Why say that people should go here for breastfeeding and there for psychological support? When I read the Bill I thought, “Great! We are entering a new period of government”. In my opinion, we are entering a new period where we might all try to concatenate ideas; joined-up thinking, as John Battle talked about 30 years ago—a wonderful man who tried to get all of the homeless organisations back together. I pat the noble Lord on the back—this is great. What is hidden behind all of this—dare I come back to the issue I am always trying to address?—is poverty. Clause 1(2)(c) mentions “services promoting positive relationships between infants and their parents or carers provided by or on behalf of a public authority”. We have to do something about turning the tap off. Most of the people we are referring to have problems because, largely, with some notable exceptions, they have inherited poverty. I pat the noble Lord on the back and praise him, because what we are doing here—and, God willing, it will go through—is putting one brick in the wall of dismantling poverty. However, we will not dismantle poverty unless we actually tie that in with other things. For instance, I suffered when, aged five, my mother took me to the school gate at our little local Catholic school in Notting Hill and said, “Get in there and behave yourself”, not, “Get in there, get educated and get socially transformed, so you can have a full and complete life”. The problem is that we can try to address questions of breastfeeding and various other things but, if we wanted to do something really dramatic and dynamic, we would begin to turn off the tap. In spite of the fact that we have a social security system, an education system, and a prison system—where people go in bad and come out worse—we are not addressing poverty. Instead, we are responding to the problems of poverty. I am not saying that every poor person will have problems with breastfeeding. I am saying that until we intellectualise this argument into one about education, social justice and training people on how to be parents before they are even parents, we will be playing catch-up. This Bill is unfortunately a catch-up, because the social training that most people in the middle and other classes get was not there. The people who are left behind are the people we are talking about now. I now move on to my favourite subject, which is the ministry of poverty prevention. I have been banging on about this, and I have just enlarged its remit to become MOPPAC: the ministry of poverty prevention and cure. We have eight different government departments not concatenating over poverty, but that all have a finger in the poverty pie. If this Government—or the next Government—were to work on concatenating poverty and bringing it together, it would save 40% of the cost of government. Looking deep into the figures, we see that 50% of those who present themselves to the hospital service in cardiac arrest suffer from food poverty. These are the majority of people we are talking about now. I have advocated—and will continue to advocate—for this. When are we going to dismantle poverty? When are we going to turn the tap off? I am very happy to say to the noble Lord, Lord Farmer, that I am in the process of building a simulated government department outside Parliament. I would love for his work to be one of the bricks in the wall that we need to create, because we need to end the inheritance of poverty. That is the big issue today.

11:04:00

My Lords, it is impossible to disagree with anything said in this debate so far. The motives and thinking behind the Bill cannot be questioned: seeking to support the physical and emotional development and security of any child’s crucial early years, and underpinning initiatives already in place. The Bill would require a local authority to make information available about existing support services in their area, but it should be recognised that the proposed duty would not make support available from local authorities which would not otherwise be provided. Moreover, beyond the primary duty to publish the information about services on a local authority’s website, the duty to go further in bringing information more directly to the attention of parents and carers is qualified by the terminology used in Clause 1(4), which leaves a discretion with expressions such as “by any other means it considers appropriate” and “such steps as it considers appropriate”. In most normal situations, new parents will have only limited contact with those who might provide the information the Bill wishes them to have, so local authorities will have only limited opportunities to convey it to individual parents and carers. Presumably, this can and will be done through the NHS, involving midwifery and health visiting services, and, I suggest, on registration of birth, which still requires a face-to-face appointment. In addition, social media and messaging will play a part, but I suggest we resist the temptation to see that as a panacea and certainly not as a substitute for direct contact, where possible. Clause 1(3) refers to services available to prospective carers, as well as to others. It is therefore to be hoped that the benefits of the Bill will extend to other family members who find themselves taking responsibilities of kinship care or are considering doing so, not necessarily just in respect of children under the age of two. Kinship carers may be called on at short notice and will need to be supported as soon as they are known to the local authority. I do not wish to take more time on the mechanics of the provision of information, which no doubt will be covered by guidance. Rather, I wish to raise questions about the reach of the information and support on offer. I look at the Bill by reference to my experience as a family court judge, dealing mainly with public and private law cases relating to children, which inevitably have a short and long-term impact on those children, their parents and wider family. They also have severe financial impact on hard-pressed local authorities. It is estimated that the total cost of care proceedings to the state each year is £1.2 billion, with a single public law case costing a local authority on average £120,000. This total annual cost incurred by central and local government represents 10% of all direct annual expenditure on the children’s social care system. Anything the Bill can do to prevent litigation and to mitigate those costs must be of value. However, it has to be recognised that there are limitations. Some of the most complex cases that come before the family courts concern newborn children with mothers who have unaddressed drug or alcohol addiction, or mental health difficulties. The baby’s early weeks in hospital may have to be spent withdrawing from the drugs ingested in pregnancy. The noble Baroness, Lady Finlay, referred to foetal alcohol syndrome, which of course causes even worse long-term problems. Typically, the mother will not have had or kept prenatal appointments, even if her pregnancy was known to the health services, which is not always the case. There may be little or no reliable family support available to her; there may be a background of intergenerational problems. These are the parents who are likely to be resistant or indifferent to the provision of advice and information. It is not through any fault, but they can lack insight and tend to make things more difficult for themselves. They can be mistrustful of children’s services, and resentful and dismissive of advice and help, fearing stigma and outside involvement. Sadly, those parents and their wider families—who are difficult to identify and engage—can also be the people most in need of the support which might be on offer. Accordingly, all those who receive and might benefit from the information to be provided in accordance with the Bill will need to be given the confidence to find and use the support services offered. Visible and accessible support services will depend on the further development of the network of local family hubs. In the area in which I was the designated family judge, there is an excellent and well-regarded family hub aiming to provide holistic support from pre-birth onwards. The guide for all such hubs, issued in August 2022, set a high bar when it stated: “The workforce should proactively reach out to vulnerable and seldom-heard families”. It is therefore to be hoped that the present Government will extend the distribution and reach of family hubs, particularly, but not exclusively, in areas of deprivation and confirm a commitment to those hubs. I will make two further points. First, the saddest statistic relating to care proceedings is that at least one in four women will return to court having had a previous child removed. The struggle to prevent recurrent removals has been highlighted by research done by the Nuffield Family Justice Observatory. Too often, some mothers have reacted to the removal of a child or baby with an ill-considered decision to have another baby, with all too often the same consequences. These are often mothers who find it so difficult to seek or accept help. For the courts, they can be truly wretched cases to deal with. Therefore, I repeat the hope that this Government will endorse the intensive support from, and expert work by, the charity Pause in the prevention of the cycle of removals. Pause has pointed out that the point at which a child is removed is also the point at which the mothers lose access to support and information, leaving them more vulnerable to further removals. These may not be “prospective parents” within the meaning of the Bill as currently drafted, but they are clearly parents who may later have children again in their care and who clearly have a continuing need for information, support and advice. I therefore hope that consideration is given to the use of this Bill to address the predicament of these parents and to reduce the misery and expense of their cases. Secondly, I ask that the Government indicate their response to the powerful recent report by the Centre for Justice Innovation about Family Drug and Alcohol Courts—FDACs. They are truly problem-solving courts which achieve considerable savings and better outcomes for children and their families. This Bill is to be applauded, but I suggest that some modest amendments could be made. These should be seen as steps that will greatly add value and save the costs of later and more complicated interventions by local authorities when children are older and the family’s difficulties more entrenched. The provision in Clause 3 for an annual report is welcome; it will allow for monitoring of compliance and will provide an overview, as the clause itself states. As to amendments, I agree with what the noble Baroness, Lady Finlay, said about trying to avoid overloading the Bill. However, I cannot help noting that the short title contains the abbreviation “etc”. I remember a legislative purist telling us to be wary of any Bill that contained that abbreviation in its short title; however, in this case, perhaps the use of that wording may give permissible scope for the sort of amendments suggested. The Government have stated their wish to “fix the foundations”. If this Bill helps to reinforce the stability of children and future generations, it will indeed help to fix the foundations for children and underpin relationships within families.

11:14:00

My Lords, I apologise to noble Lords for speaking in the gap. I did not expect to contribute today, but listening to the contributions so far, I was struck by the crossover with work underway by the Church and the Mothers’ Union, particularly when the noble Lord, Lord Farmer, mentioned the role of churches and faith communities. I welcome the Bill and congratulate the noble Lord, Lord Farmer, and the right honourable Dame Andrea Leadsom on their work on this issue. Churches across the country offer support to new families and parents, providing spaces for parents to meet, share experiences and be directed to support, if needed. They provide child development services through toddler and children groups, which are essential for the formation of children before they start nursery or reception classes in school. Through Messy Church and these toddler groups, hundreds of churches are already implementing many of The Best Start for Life recommendations. Churches are delivering perhaps more than 18 of the 24 recommendations and are often partnering with local authorities to develop joint working on issues that affect all our communities. I have seen work such as the project “Who Let the Dads Out?”. The noble Lord, Lord Hannan, mentioned his attendance at antenatal classes, which brought back many memories for me, although I imagine that my wife would say that they were not much use. How we support dads to be good dads is an important area for a national conversation. We must enable good role models, where being a good dad is about love, support, patience and commitment, all aspects that are very important in fatherhood. That was identified in the Archbishops’ Commission on Families and Households report Love Matters and the recommendations it raises. A copy of that report is in the Library. It recognised that we must value families in all their diversity, that we need to support relationships throughout life, that we need to honour singleness and single person households, that we need to empower children and young people and that we must build a kinder, fairer and more forgiving society. The noble Lord, Lord Bird, spoke about the scourge of poverty. In my own diocese, in Dersingham in the west of Norfolk, a wonderful charity, Baby Basics, fills Moses baskets with all the essentials for those first few weeks of being a parent. An incredible group of volunteers does that work. Its referrals have increased hugely from 49 in 2019 to around 400 last year, supporting some of the poorest young families in west Norfolk. There is much to be commended in this Bill. I congratulate the noble Lord, Lord Farmer, on bringing it forward, and I give it my support.

11:17:00

My Lords, sometimes, when you deal with a certain piece of legislation, you get the feel that it is very close to a finished and polished article, and that is what I get here. Thought has clearly gone into it. It is not trying to reinvent the wheel. Although all politicians have that Christmas tree urge to ask, “What can we stick on this?”, I encourage noble Lords to resist on this occasion; the decorations are fine. We must make sure that we can get this through. If the Government are willing to accept this, which I hope they will be, they will be doing a good thing, and they are not doing something that costs a lot. The Bill is merely bringing together everything the Government are doing and letting those who should access them know. As has already been mentioned, there are different groups of people. Those who most need to know what support is there are those least likely to look for it or to understand it. I am afraid that that is a circle we have not yet squared, but it is true. However, if you have it in one place, you stand an infinitely better chance of doing it, or allowing those who are trying to support them to do it. This is something that this Bill addresses, so that people have a chance of finding the support that is out there. The noble Lord, Lord Meston, added necessary cold water in saying that there is a group of people who have persistent problems. The noble Lord, Lord Bird, used the word “concatenation”; I had no idea it existed, so it has expanded my knowledge. Everything he said was right. He described this as a brick in the wall to build something better. Although I would have said that it is a bit of the foundations, I agree that it is a good thing. I could go on at considerable length on this, but I will resist that temptation. Anything that has guidance coming out to deliver it and the Secretary of State reporting back afterwards in order to make an asset to be used in all these things has to be positive. I think that anybody who has been involved in any part of politics or government knows that we have bits of government going off at tangents and not talking to each other. I hope that the Government will give a positive response to this and tell us the timetable so that we can all cheer it on the way through, because it is good. It will not solve all the problems of the world, but it might be that little bit of foundation of doing things a bit better. I wish the Bill well and look forward to the Government’s response and to the assurance that they will make sure that it becomes law.

11:21:00

My Lords, I begin by congratulating my noble friend Lord Farmer on securing time for his Private Member’s Bill. I also pay tribute to his work over many years on family policy, preventing family breakdown, and on the welfare of children, and especially to his work on creating and growing the family hubs network, supported by Dr Samantha Callan. I also pay tribute to my right honourable friend Dame Andrea Leadsom, who has worked tirelessly on this subject. There is no doubt that my noble friend’s passion and commitment are behind the Bill today, and his belief, shared by many noble Lords, that we need to give all newborn babies the best possible start in life, no matter what their background. The importance of the Start for Life approach cannot be underestimated. It ensures that there are welcoming family hubs, usually run by local authorities, through which new parents of newborns can access a wide range of family support services such as parenting support, help for relationships between new parents and between parents and new babies, health visitors, breastfeeding and other infant feeding services and mental health services. These services are provided by local authorities, the voluntary sector and private sector partners. My noble friend Lord Farmer has highlighted how local authorities that receive Start for Life funding are required to publish their offer. Indeed, it is one of the conditions for local authorities receiving transformation fund money. The Bill is in some ways simple in its aim, which is to ensure that they contribute to offer Start for Life beyond the end of that fund. Of course, this will require additional funding, but in the context of some of the larger sums of billions that we debate in this Chamber, we are speaking about only £500,000 per annum across England. As with any taxpayer spending, my noble friend Lord Farmer proposes that there should be a proper procedure in the Commons to make this relatively small sum available. It may be argued by some noble Lords that, with £500,000 here and another £500,000 there, pretty soon we are talking serious money. However, against this we need to consider the cost of family breakdown in the UK. Aside from the emotional, social, mental health and societal costs of family breakdown, the Centre for Social Justice think tank estimates that the cost to the Government and ultimately the UK taxpayer is at least £51 billion a year. In terms of societal costs, the Centre for Social Justice also found that those who experience family breakdown when aged 18 or younger are more than twice as likely to experience homelessness, twice as likely to be in trouble with the police or spend time in prison, almost twice as likely to experience educational underachievement, and almost twice as likely when they themselves become parents to break up with the other parent of their children. They are also more likely to experience alcoholism or teenage pregnancy, suffer from mental health issues, fall into debt or experience being on benefits. Much has been said by my noble friend Lord Farmer and noble Lords on all Benches about the importance of support for newborns and their families to give our nation’s children the very best start in life. My noble friend has committed his political life to founding and growing the network of family hubs to help parents and children of all backgrounds, and for this reason, I commend him for his equally noble work in this area. Some noble Lords may say that we should leave this to the decisions of integrated care boards and partnerships or health and well-being boards. However, giving the best start in life to children involves far more than just being health focused. From speaking to my noble friend Lord Farmer, I understand that he believes that it is important to keep Start for Life as integrated as it currently is, with a wider remit than just health. In preparing for this debate, my noble friend Lord Kamall contacted the office of the Minister, asking for an indication of whether the Government are inclined to support the Bill. The Government were not able to tell him whether they will do so. However, that fateful—but we hope not fatal—day for my noble friend Lord Farmer’s Bill has now arrived. I have a few questions for the Minister. Do the Government intend to support or reject my noble friend Lord Farmer’s Bill? If the Government are not minded to support it, where do they disagree with it? If the Government are not supportive, are they considering introducing their own Bill for Start for Life? If so, what timeframe can we expect for such a government Bill, and in the meantime what will happen to the funding for the Start for Life programme? My noble friend Lord Farmer has devoted his life to family hubs. He has made a compelling case for the Start for Life programme. I am sure that he and other noble Lords, including the Opposition Front Bench, are looking forward to the Minister’s answers to these questions.

11:26:00

My Lords, I thank the noble Lord, Lord Farmer, for his thoughtful introduction of the Bill, and I pay tribute to him for his work not just on the welfare and well-being of children but on prison reform over many years. It is also a pleasure to see the right honourable Dame Andrea Leadsom on the steps of the Throne today. I am grateful for the many contributions to this debate, and I have listened closely to them. This debate shows just how passionately your Lordships’ House feels about early childhood development, and I very much welcome that, because nothing says more about us as a nation than the health and well-being of our children —the noble Lords, Lord Evans and Lord Addington, were good enough to thoughtfully acknowledge that. I assure your Lordships’ House that the Government absolutely recognise the importance of the earliest days of an infant’s life and that we are committed to raising the healthiest generation of children in our country’s history. In general answer to the noble Lord, Lord Evans, we will be going beyond simply the provisions of a Bill such as this, and I very much look forward to being able to update your Lordships’ House when I am able to do so. However, as regards this Bill, I absolutely recognise the good intentions in the Bill, and I also want to acknowledge the importance of information and guidance which it shines a light on. However, as the noble Lords, Lord Farmer and Lord Evans, are aware, the Government have reservations about the detail in the Bill itself, which I explained in discussion to the noble Lord, Lord Farmer, when we met earlier this week. I was most grateful to him for his time but also for the manner of our discussion. This Government need to do things differently from the last Government, and will indeed do so in order that we can improve the lives of all our children through our health and opportunities missions and by driving long-lasting and sustainable change for children, both now and in the future. We need the time and we need to be able to roll out our own cross-government package of support for infants, children and families, as noble Lords have today asked us to do. This needs to be comprehensive, rather than piecemeal. Unfortunately —and I do not like to disappoint the noble Lord, Lord Farmer—while the intent of the Bill is certainly to make a contribution in the right direction, it does not align with how this Government intend to deliver the comprehensive change that our children need, not least because we do not wish to limit ourselves in how we deliver on our commitment to raise the healthiest generation of children ever. The need for change is compelling. England compares poorly with other nations on a range of child health outcomes, while children in the most deprived areas suffer far worse health outcomes than those in better-off areas, and we have an absolute duty to close that gap. The noble Lord, Lord Hannan, the noble Baroness, Lady Miller, and other noble Lords referred to the situation in regard to local authorities and the fiscal state in which they find themselves and how the Bill would manage any additional strain on them. I agree with noble Lords that we exist in a very challenging fiscal environment, which is exactly why we must consider our child health action plan in the round, ensuring it is sufficiently considered and funded. We are very conscious of introducing new burdens, no matter how small they might appear, given the reductions to local authority budgets and the constrained finances—a situation that has been the case for many years. Over 4 million children are growing up in low-income households and, last year, a million children experienced destitution. This cannot go on. It not only harms children’s lives now but damages their future prospects and holds back our economic potential as a country. The noble Lord, Lord Bird, was very energetic on this point—and rightly so. I hope he will be pleased to know that we have set up a cross-government child poverty task force to develop an ambitious strategy to reduce child poverty, and its work is under way. I was proud to serve in the Government who did not just pioneer Sure Start, to which my noble friend Lord Blunkett led the way, but brought in the indoor smoking ban in 2007. Through the Tobacco and Vapes Bill, we will continue the task of improving life chances for children. We will continue to tackle the harms of smoking, break the cycle of addiction, and pave the way for a smoke-free UK. I know from the debate today that your Lordships’ House is well aware that this Government were elected on a mandate to deliver change. As the Prime Minister said just last week, this will not happen overnight. We will not cover up the problems; we will lay the foundations. We will do that ensure that we raise the healthiest generation of children ever through our work to tackle childhood obesity, improve mental health and ensure that children have good oral hygiene. I very much look forward to debating these important topics and others over the coming months. To the points raised on alcohol and drugs by the noble Baroness, Lady Finlay, it is right to acknowledge the growing problem of alcohol and drug use among parents and carers, which affects their capacity to parent well. The Government are absolutely committed to addressing that. This year, we will make over £300 million of additional investment in this regard. I thank the noble Lord, Lord Meston, for bringing the matter of the family drug and alcohol courts to my attention, and I would be very pleased to meet him to discuss it. Furthermore, I can assure the noble Lord that the Government are aware of the work of Pause, which indeed met officials at the Department for Education just this week. We will continue to work with Pause to ensure that a better system is built for all children and parents in future. The noble Baroness, Lady Uddin, raised a crucial point about inequalities in maternity care. I thank her for her powerful contribution in this regard. She is right to describe the ongoing inequalities as truly shocking. I can assure her that I have already met officials and asked for urgent advice on immediate action to tackle inequalities for women and for babies, addressing racism in maternity services and determining what ambitions are needed and how we might get there. To the noble Baroness, Lady Miller, I am pleased to share that we will publish the infant feeding survey in summer 2025. To the right reverend Prelate, I want to acknowledge the contribution that not just churches but synagogues, mosques and other faith institutions make to supporting the well-being and development of children and infants. In conclusion, while we are not supporting this Bill, I am very grateful to the noble Lord, Lord Farmer, and to noble Lords who have taken such an interest today in how we might seek to raise the healthiest generation of children ever—which is, I believe, however noble Lords regard this Bill, exactly what we all want.

11:36:00

My Lords, I should start by welcoming my right honourable friend Dame Andrea Leadsom. I was not aware that she was on the steps of the Throne, and I welcome her here today to hear this debate. Obviously, I am saddened and disappointed by the Government’s response. However, I want to thank all noble Lords who have contributed to this debate, which has been wide-ranging; a lot of deep thought has been put into it and there has been agreement from all sides of the House on this matter. In answer to the Government, we are talking about information. I understand the Government’s argument that they are working on a comprehensive plan for families and children for addressing poverty among children, but this is just a small point about getting information out, and information can deal with a lot of problems quite quickly. The noble Lord, Lord Bird, talked about poverty, and we have heard from other people. I have found throughout my life that poverty is caused by a lack of information. When we learn something, it helps us to deal with it. I ask the Government, if they are not supporting this Bill, that they might nevertheless instruct departments to encourage councils to improve information given to families on what services are available for the whole natal area—prenatal, perinatal and antenatal. It seems to me that it would not be that difficult without a statute to get departments of government to see this as important, because lack of information is causing so many problems—I come back to the poverty issue as well. I thank all noble Lords. I was very honoured by the noble Lord, Lord Blunkett, saying that it was a granddaughter of Sure Start. I should mention that I once attended a Labour conference in Brighton on a very blustery day. I was placarding a meeting about family hubs. I was being blown about all over the place and all of a sudden I heard, “Lord Farmer, what are you doing in enemy territory?”. I turned around and there was the noble Lord, Lord Ponsonby. I said, “Family hubs, family hubs. Building on Labour’s Sure Start centres.” That is what family hubs are doing, so I really press that point. I thank noble Lords for some very good contributions; I hope that the Government will pay attention to them and move quickly, even in this area. I would be very happy to work with the Minister. I thank her for the meeting and the advice. Obviously, it is disappointing—this is a simple Bill that could be enacted quite quickly and would bring immediate benefit—but things are as they are. With thanks to all noble Lords who contributed, I would still like to press on.

Bill read a second time and committed to a Committee of the Whole House.