Select Committee on Health Minutes of Evidence

Examination of Witnesses (Questions 840-859)



  840. The reason I asked that of course is that Denise and Helen, I presume, are older than you. I know it is difficult to say this in front of them, but what you are really looking for is what young people think. They are older than you, so do you think it was your ideas really driving it forward and that there are older people who can sympathise and empathise with what you are trying to do and that they would fall into that category?
  (Ms Nicholls) Yes, Denise and Helen never put their own opinions forward while we were doing this at all. It was all our opinions and it was all young people's opinions. We went out into the streets and interviewed young people and Helen and Denise were really good with us. It was really good the way they worked because they never tried to push us towards something, but it was always, "Right, you tell us what you think", and then we always knew if we had missed something out because they would say, "Come and sit down", but they would never push us towards somewhere we did not want to head as a team.


  841. Emma, can you just say a word or two about the Parliament that you have formed?
  (Ms Henderson) Yes, the Youth Parliament is obviously a group of youths being a parliament which is supposed to echo the main central government. In 2000 they collected a survey of 1,463 people all asking about sex education. There were five issues, but sex education was one of them, so we got a response from young people. There were 586 males and 877 females. That was all around Bucks, so it was all of the three main areas and from that we got loads of statistics about what they feel about sex education, how they feel it is taught and how they feel about sexual health problems. We basically did that because the south-east region has the highest teenage pregnancy rate in Europe and it is quite a worrying statistic. It promotes a negative image, to be honest, of the country as well and it has implications in terms of committing resources and local communities. It has an individual impact on young people's lives and their immediate families and friends, so it impacts on everybody, so it was quite an important survey and especially because it is not just a few people's views, but it is the views of everybody, individual people from youth clubs, from youth councils, from schools. There is a wide variety of people in there.

  842. You identified the sex education question as a big issue. Would you concur broadly with what your Wakefield colleagues have said about their findings from their peer research?
  (Ms Henderson) It is basically what they have said. The only difference is that we have statistics to prove what they have said, and I can take you through them, if you want me to.

  843. I would be interested, particularly if you could briefly summarise the key points, so we are aware of them. Sex education, I have noticed from your evidence, was very important.
  (Ms Henderson) Yes. The majority of people in Bucks were aware that there is the highest teenage pregnancy rate in Europe, so they are aware of it, but they do not know what to do about it and they are not really that bothered about it. Nearly 50% consider that sex education lessons in school need to be improved and lots of people think that they are inadequate or that they should start earlier, and 798 people felt that they should start earlier, so from Year 6 primary school onwards and then continuing throughout the school as a compulsory lesson, something that is incorporated into the PSHE programme. Forty-four per cent felt a lack of confidence to ask question in sex education lessons, so that means that 44%, which is nearly half, do not get to ask relevant questions and they do not get the relevant information that they want to know about because they feel uncomfortable asking their teachers.

  844. Do you pick up the point which was made by either Lorna or Tara, I cannot remember which, that perhaps somebody other than a teacher might be more appropriate?
  (Ms Henderson) I think that is definitely one of the points which has come forward. I think at the minute sex education is just like a token thing in schools in that it is taught, it is there, but it is not really taught, not the way it should be. We have English teachers to teach English, but we do not have sex education teachers to teach sex education, yet surely that has a bigger impact on our lives, so it is really not doing the job properly to have an English or geography teacher teaching sex education.

John Austin

  845. I think Sarah has probably answered this because the research that you have done was clearly led by you with adult professional advice and support, but led by you. You have made a number of recommendations for change. How important do you think it is that those initiatives to improve sexual health should be peer-led or involve young people themselves?
  (Ms Nicholls) We at the Peer Group think it is quite a big issue. I could go through the report, but basically when we have been talking and asking people who they spoke to about sex, who they spoke to about sex education, it has always been, "I have found it off my friends", "I talk to my friends about it". "If you have a problem, who do you go and see?" "I go and see my friends", and everyone goes to see their friends. Young people feel comfortable talking to people of the same age, we have found throughout our report, than they do when talking to someone older, so peer education and peer research, we felt, was a really big point in sex education. There is a quote in the report where one person actually said, "There should be more people like you coming into schools to teach us things that you already know". Because we have been educators of it, I find myself being able to help my friends and I think if I can help my friends when they are in a situation, why can I not help everybody. I do know that my friends do feel comfortable talking to me about it and, from our report, it is shown that young people feel more comfortable talking to young people, so we developed on that somewhere down the line.

  846. Is that Emma's view as well?
  (Ms Henderson) Yes, definitely. One of the things that has come through is that most people get their information from friends in school or magazines, so they do not feel comfortable talking to teachers or adults about it. Most of the time the atmosphere is not right to talk about it, it is not relaxed enough, and they do not feel confident to ask.
  (Ms Hall) We have found that only 19 out of 202 would actually speak to a teacher about a sexual health issue as they would much rather speak to their friends, but they do think that sex education should be provided by the school.

  847. But possibly not by teachers?
  (Ms Hall) Yes.
  (Ms Nicholls) Picking up on a point that Emma made, if you can have a teacher to teach geography that you might never use again, why can you not have a teacher to teach sex education that you need throughout your life?

Julia Drown

  848. Is actually what you are suggesting that we should recommend maybe not having specific teachers, but actually having a programme whereby we ensure that there are people like you who can actually go into schools and each year group and then you actually have young people directly doing the teaching, not even a health visitor or somebody else? Would that work?
  (Ms Nicholls) Yes.

  849. I want to pick up on some of the statistics from Emma's survey and I have two questions. The first is where you said you would ask young people if they knew where to obtain, and what to do with, contraception and 21% of people knew about condoms and 50% the pill. Did your survey go into details of those who were sexually active? Did you get an impression that those who were sexually active knew where to get contraception or did it not distinguish between those who were sexually active and those who were not?
  (Ms Henderson) I do not think the actual survey distinguished. It does not really matter if you are sexually active or not because at one point you will be, so you should know beforehand or while you are doing it, it does not matter, but it should be a well-known fact.

  850. We have just got this summary here, but one of the points was about the morning-after pill and it just says that 53.5% do not agree that the morning-after pill should be available on prescription. Can you just clarify what that means? Does that mean that it should be more freely available than that or what?
  (Ms Henderson) I think what that statistic means is that although a certain amount of people do not agree with the morning-after pill, 53.5% or actually 41.5% do agree that it should be available. I think mostly the 53% could be for religious reasons or moral reasons.

  851. So they were saying that it should not be available at all, not that it should not be available over the counter?
  (Ms Henderson) Yes.

  852. Because it can be interpreted both ways.
  (Ms Henderson) I think it could be, but I think also the fact is that some people felt that if you needed the morning-after pill, you should have to go to your doctor to discuss the issue. It is a big thing to do.


  853. I found that a very interesting answer and I was quite surprised by the number who appeared to feel quite strongly about that. Sarah and your Wakefield colleagues, was that something that you looked at at all? Were there any opinions from the people you talked to about the morning-after pill?
  (Ms Webley) No.

  854. Would you guess that the feelings of the people in your area were similar to Emma's? From talking to your peers and talking to the people that you go around with, would you feel that was so? I would have expected a far lesser figure to have said what young people in Buckinghamshire have said.
  (Ms Webley) I think people would rather be able to go to the chemist and say, "Look, I need it", without having to explain why because they might just have had an accident, they might have been stupid, so they are not necessarily wanting to explain it all to the doctor and feel even worse about it. Then the cost of it is another thing.

  855. That is a good Yorkshire opinion there! You may not go along with the findings of Emma's group possibly on that then?
  (Ms Webley) No.

Julia Drown

  856. You said that you do not think that the current education system is dealing very well with sex education, but can you outline for us what you think are the main worries, fears, questions and concerns for young people in the area of sex education and sexual health?
  (Ms Nicholls) Sex education within school?

  857. I should say sex and relationships really. What are the main concerns that you think young people have?
  (Ms Nicholls) Well, we were asking about the services and what they actually thought about the services. The two biggest concerns about talking to someone about the services and talking to somebody else about relationships and things like that was what other people would think, and the second biggest issue was confidentiality. We found a lot of young people who were frightened to go to their clinic or talk to someone about it because they were frightened that they might go and tell somebody else. The confidentiality was not pushed for them. The attitude of others, obviously we personally cannot recommend anything to change that, that is a taboo, and everyone is always going to be worried about what other people think, that is society today. On the confidentiality, it is little things like we recommend in the Peer Group that it is put into practice that when a young person accesses a service, the confidentiality statement is gone through with them and it does not even have to be a big, formal one. We had a confidentiality statement which was about six lines long and took 30 seconds and in most clinics in Wakefield they had a TV-video combi. We made an advertisement about relationships and what-have-you and sex, and if you get young people together to do something on TV about confidentiality and the confidentiality statement within the clinic, you can put it on the video player and it can play through, so while they are sat in the waiting room, there is constant reassurance. That was one of the highest things which was of concern to young people.

  858. And, Emma, in the work that you have done?
  (Ms Henderson) I think most people are concerned about confidentiality. I think that is a main issue. Also I think they are concerned about what people think of them and they are concerned about how they will be viewed if they ask certain questions. I think they are embarrassed to ask certain questions as well. If they want to ask questions and obviously if they do not feel confident in themselves in the way that they are going about things, they are embarrassed by themselves, not by the other person, and that is a hard thing to get over, so they need to be reassured. What came out is that people in Bucks do not really know where the agencies are and 92.6% do not know any support agencies for sexual health, so if they do not know about them., they do not get the support from them or the reassurance.

  859. In some parts of this country there are specific youth clinics and also in some other parts of the world they actually have clinics associated with schools. Do you think that would get over some of the confidentiality problems or would young people be equally embarrassed to go into the clinic, thinking, "I might see one of my friends", compared to thinking, "It could be somebody much older than me, like my mum or my mum's friend could be there"? Would it help if it was around the school and if it was specifically a youth clinic?
  (Ms Nicholls) In Wakefield we have our own clinic, a family planning clinic and the Options clinic which I was speaking about earlier. From the response that we got, people do feel more comfortable being in that environment where there are other young people, but our problem in Wakefield is that people do not know where the services are and they do not know the contact numbers. That picks up one of our recommendations where we are saying with the school planners, everyone gets the same school planner, so why can we not put the contact numbers in the school planner. It is a page in a book. With the Options clinic, when they changed the waiting room around, because you have the family planning clinic and then it changes on one night to the Options clinic, they changed the waiting room around a little bit for the Options clinic and I know personally from talking to friends that people do notice a difference in it and they do feel a lot more comfortable. It is one of those same old taboos which really needs breaking. "I saw her in the Options clinic", but at the end of the day that person who saw you there is there for the same reason as you. This is what we are trying to get through and I personally would like to try and work on this to get it through to people that it is not a bad thing that they are there, it is a good thing that they are there because they are doing the right thing, so the Options clinic works well.

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