Examination of Witnesses (Questions 1140-1159)
THURSDAY 23 JANUARY 2003
MS HAZEL
BLEARS MP AND
MR STEPHEN
TWIGG MP
Andy Burnham
1140. When we were in Sweden, we heard that
young people are in education up until 18—I think 95% or
more. Is that not a crucial difference between Sweden and this
country, do you think, in terms of young people? In my constituency
less than 49% stay on post 16. What evidence do you have that
the increasing staying-on rate impacts on these issues in particular?
(Mr Twigg) It must do. We have seen very considerable
progress in this country probably over a period of ten years towards
far more of our young people staying on after 16, but it is still
the case that if you look at a table of the advanced industrialised
countries, we are almost at the bottom with a figure of around
72% nationally, which obviously varies greatly between different
communities, and Sweden is right at the top with I think something
like 98 per cent of their young people staying on and that must
have implications for issues we are talking about here today.
(Ms Blears) The connection of that with teenage pregnancy
is absolutely there. It brings us back to that issue that we talked
about: if people think they have life chances and that getting
an education is worthwhile then they will not get pregnant so
early.
1141. And if there is an expectation that you
will be staying on in education till 18 it changes your whole
life, and raising the staying-on rate may be a way of tackling
this.
Julia Drown
1142. One of the clear messages we heard from
young people was that yes, it was partly up to the personality
of the teacher whether sex education was effective or not but
that even with the good teachers they preferred a one-to-one sort
of session if they were really going to ask questions, and clearly
there are some issues of practicality there, but what they all
agreed was that they would be prefer to be taught by their peers.
Now, in your guidance do you talk about that at all because it
did seem to be one of the most effective ways of getting the message
across, and also empowering the peers you are training to do the
teaching. Also, on teenage pregnancy, what was clear from the
teenage mums who spoke to us was that they found the electronic
dolls they had experience of, after they had become pregnant,
were a really practical way of learning about some of the realities
of being mums, a practical way that is not reflected by sitting
up and listening to a lecture. Is there any prospect or have you
any plans for those electronic dolls to be made more widely available,
particularly in the areas of high teenage pregnancy rates?
(Mr Twigg) On the peer education point, that is absolutely
central and it is part of our guidance and there is some really
good practice going on on this in schools already. On the electronic
dolls I know there are different views and our colleagues at the
National Children's Bureau are somewhat sceptical about this one.
I visited a project in Rawmarsh in South Yorkshire where they
certainly swear by these as a method that can actually reduce
the levels of teenage pregnancy there. I would say that personally
it seems quite a persuasive argument but I am not sure that the
evidence is conclusive as to how effective it is.
(Ms Blears) I think that is right. I have been up
to a project in the North East and seen the young mums with the
dolls and apparently they cry incessantly, you cannot switch them
off, and they found that very persuasive. The evidence is not
totally conclusive on that. In terms of peer educators, I met
a whole range of peer educators on the teenage pregnancy programme,
some from Wakefield, some from Sheffield and also, interestingly,
some from New York who had come over to share their experience
with us and they were some of the most effective educators that
you could hope to meet because they had been there, they had the
experience, and they talked to the young people in terms that
they understood. I think you make a very, very important point.
We have just published a peer education good practice guide to
try and draw on this information and I really do think it is what
young people want to hear in a way that is effective.
Sandra Gidley
1143. We heard from teachers, educationalists
and young people themselves last week that issues to do with homosexuality
are not addressed adequately by schools, if they are addressed
at all. Many of the witnesses thought that this was down to Section
28, but given that young homosexual men bear a disproportionate
burden of the incidents of sexually transmitted diseases, are
there plans to address this?
(Mr Twigg) I think there is a number of different
aspects that we need to deal with here. One is, of course, issues
around bullying and one of the concerns that I have got is that
although we have been saying as a department that schools should
adopt policies specifically addressed at different forms of bullying,
including racist bullying but also including homophobic bullying,
the numbers that have actually done so are very, very small. This
is an area that we certainly need schools to address as a much
greater degree of priority. That is on the particular issue of
bullying. On Section 28, clearly technically Section 28 does not
any longer apply to schools but in practice Section 28 does act
as an inhibitor, I think there is absolutely no doubt about that.
Not only is it, I think, symbolically a badge of prejudice it
is actually in practice leading some teachers to feel that they
have to hold back in terms of dealing with issues around homophobia
and issues around sex education and, therefore, the sooner that
we see the successful repeal of Section 28 the better that it
will be. I think that if we can create an atmosphere in schools
where prejudice is seen as unacceptable then it is going to be
easier not only to tackle homophobia but to teach honestly in
terms of gay sex and lesbian sex within the sex education curriculum.
I do think that the citizenship strand is very important here,
that a key part of citizenship is not simply the political literacy
but is actually about community, about values, about tolerance
and tackling prejudice. I think that will make a difference to
do that as well. I think one thing I need to do is to look at
whether specifically on the sex education as distinct from relationships
education and citizenship perhaps there is more that we need to
do in terms of the curriculum materials that are made available
to schools.
1144. Repealing Section 28 is something that
I would generally support but that only goes so far.
(Mr Twigg) Yes.
1145. You said earlier that you do not want
to make anything compulsory.
(Mr Twigg) Yes.
1146. I can see that a lot of people are going
to feel very uncomfortable teaching and dealing with this material.
How do we get around that? I can see that lots of schools will
just duck out of this issue. Have you any plans to tackle that?
I agree with all you have said so far but I just wonder how you
will do it.
(Mr Twigg) The interesting thing is the history of
this document, of course, which was when the attempted repeal
of Section 28 was happening in the previous Parliament, in tandem
with that this guidance was developed. The idea was to have this
guidance, which includes some of the things we have been talking
about, in tandem with the repeal of Section 28 but we ended up
with just the guidance and without the repeal. Certainly I was
not seeking to suggest that simply repealing Section 28 on its
own would be sufficient. I think there is a lot of good that is
in here and in the content of the citizenship curriculum and what
I think we have to do from the DfES point of view is to ensure
that that is being given proper treatment and proper priority
within teacher education and in particular within initial teacher
training. Having seen some of the young people who are training
to be citizenship teachers, for example, the issues around various
forms of prejudice and discrimination are part of that initial
teacher training and I think that we will start to see an improvement
coming as a consequence of those people coming into the classroom.
Chairman
1147. One of the points that we have picked
up in evidence from witnesses, and specifically I can think of
two witnesses who were gay, was the question of the age at which
it is reasonable within the school setting to be discussing orientation.
I think certainly both of those witnesses were of the opinion
that as far as they were concerned sex education was non-existent.
One of them was a young teenager, so he has had fairly recent
experience. At what age would you think it reasonable to expect
a school to be discussing the issue of orientation, bearing in
mind that one of the witnesses said he felt that he would have
been helped had it been addressed in primary school?
(Mr Twigg) Clearly it is an area that needs to be
handled with sensitivity. Certainly I think it is right to say
that in primary school it is proper that there is an awareness
of the different forms of orientation, different forms of sexuality,
different ways in which people live their lives.
1148. But at the moment that is not taking place,
is it?
(Mr Twigg) Mostly it is not. I think there are positive
examples where it is happening and where it is handled in a sensitive
way in the school with the support of parents, but I do not think
that is the norm and it is an area where we need to do more work.
The health in schools programme, Safe for All, is providing
training for teachers on a number of issues, including around
sexuality and homophobic bullying. That has been a very positive
example of the Department of Health and the Department for Education
and Skills actually working together. The guidance that we issued
in 2000 does give encouragement to schools to deal with questions
about sexuality in an open and honest way and really that is what
has not been happening in the past and still is not happening
in many schools and is where further work is required.
Jim Dowd
1149. Reference has been made by other colleagues
to our visit to Sweden, Stockholm in particular, and I am sure
both of you are familiar with the approach they have there through
youth clinics, which although they seem to be on a semi-statutory
footing seem to work fairly well, certainly the ones that we saw
around the Stockholm area. Is that an area for further development
between schools and health services? Are there plans to do so?
(Mr Twigg) I think very much so. I referred to the
extended schools programme and the aim there is to have on a school
site a lot of other facilities that make the school much more
a hub of the community and not simply a place of learning for
the school age children. Twenty of those 25 projects have a health
service element within them and bring some of the benefits that
Hazel was describing earlier on. The other area which I think
is relevant here is our Connections Service which seems to bring
together all of the different agencies that 13-19 year olds are
working with and I think issues to do with health, including sexual
health, are an important part of what would be a successful Connections
Service. That is happening in some cases. I know you went to Paignton
and saw the Tic Tac Centre—
1150. We are going.
(Mr Twigg) Actually the Devon and Cornwall Connections
Service has been one of the most successful in really bringing
together some of the different agencies and not simply being a
replacement for the Careers Service.
(Ms Blears) That is the intention, that we develop
more of these facilities. Of the ones that are in place now the
feedback is tremendously encouraging. I think you have to be aware
that although people do want to access services at schools, we
then need to have confidentiality and trust and the fact that
going to have a personal one-to-one consultation with the school
nurse is not going to be done in the full glare of the rest of
the school, therefore handling those issues with sensitivity is
extremely important. People really do value having a range of
primary care facilities in the schools environment as well but
we have to handle that with sensitivity.
Jim Dowd
1151. The clinics that we saw in Stockholm were
all off-school sites.
(Mr Twigg) That is different.
1152. A slightly different approach. One of
the other points referred to by the Chairman as well was in Sweden,
in the Netherlands, in the places you mentioned yourself just
now, they seem to have a different attitude, the parents talking
to their children. Although all the evidence on this is anecdotal,
most people in Britain seem to think we are particularly bad at
this. Are either of your departments doing anything to attempt
to redress this, even though I am sure it may be very deeply culturally
entrenched, or do we just accept that as an inevitable fact of
life?
(Ms Blears) I think one of the important things that
we are trying to do with our sexual health campaign is to be more
overt in saying these are important issues for the whole community
and providing points at which people can enter into discussion
about it you create a talking point and, therefore, it becomes
a more normalised thing to talk about amongst the generations
and amongst the wider community. I think there is a history in
this country of almost having hidden some of these issues and
that is partly why GU services are sometimes around the back of
the hospital in a very isolated place, there was a view that you
could not be seen to be using these services, it was not a normal
part of the NHS. I think that we have got a long way to go on
bringing these services into the mainstream. There is a cultural
issue and finding hooks on which parents and children can enter
into a discussion, maybe through reading an advertisement, maybe
seeing something on the television, that then promotes that kind
of conversation is incredibly important, I think. We are encouraging
Parent Line's own campaign which is encouraging parents to talk
to their children about some of these issues. It is difficult
but I think as the generations grow up who have had access to
really good sex and relationships education then we hope to be
laying the foundation now for future generations not to be embarrassed
and to be able to discuss these things with their families.
(Mr Twigg) I think from an Education Department point
of view this actually is a broader question about how we can engage
parents more effectively in terms of schools. There is a great
deal of evidence that some of the most successful programmes in
tackling under-achievement in schools are those which go out of
the school and work with parents and work with the wider community.
I would put that in this context, that it is one of the number
of ways in which we look at greater parental involvement. As I
mentioned before, the Ofsted report places particular emphasis
on the issue of boys and I noticed from your evidence last week
that a lot of the boys feel that sex education primarily is not
aimed at them, it is aimed more at girls. That is something that
we are addressing at the moment. We are doing some work with the
National Children's Bureau where we are going to have new, detailed
guidance for teachers which will be available later this year
looking at a number of aspects, sexual health, parenthood, but
in particular looking at how we can engage boys in sex and relationships
education. We also have as a broader campaign in the Department
our Dads and Sons campaign which is to do with engaging fathers
in their sons' education and as part of that we have addressed
through the website and the magazine that we publish issues around
talking about sex and relationships father to son.
Chairman
1153. In a sense you have taken me on to the
next question because I wanted to ask you what work was being
done in relation to boys and men. It is very apparent that we
have a huge problem in getting men to engage with the system at
all. You have partly answered the issue on education and I wonder
whether you have any initiatives relating to sport? I was very
impressed with a project that was on testicular cancer that involved
London Broncos and it was a very effective way of projecting this
as an issue. In a sense it was a very effective way of attracting
attention. I wonder whether you are looking at the way men may
be more influenced by approaches, shall we say, outside the mainstream,
mainly through sport, or other ways of attracting their attention?
(Ms Blears) We are currently funding the Men's Health
Forum to do work on a whole range of men's health issues and they
are particularly looking at ways in which you can engage men.
One of the publications that they have just produced—I do
not know if Members have seen this—is along the lines of
a car manual. It is a manual about the body and they have done
it in terms of, if you like, the engine, the lubrication system
and the chassis, looking after your body. It is the most brilliant
publication. It is like a Haynes Manual, done in exactly the same
way that you maintain your car but this is about how you maintain
your body. It covers sexual health and a whole range of issues.
I think it is one of the most effective pieces of health promotion
work that I have seen in a long time. With our sex lottery campaigning
we are also placing adverts in magazines particularly designed
to appeal to young men. We have got a number of projects going
on where we are trying to take health promotion work out to pubs,
to football matches, to places where you can engage with men in
a non-traditional setting. I think traditionally men have not
been good at going to the GP, going to the doctor, looking after
their health, and I think we have a huge amount of work to do
on this to get men to really want to look after themselves a bit
better.
1154. One of the areas that I am aware of that
is going to affect male access to health is the recruitment to
medicine which, as you well know, is in the main female. The majority
of people in the country gaining training are women. I imagine
most of the men that I know, if they had some sexual problem would
not want to see a woman, but maybe I am wrong. There are one or
two dissenting voices on the Committee. Maybe we have some cultural
differences and geographical differences. Let me tell you, in
my part of the world I reckon that the majority of men would be
much more comfortable, and we have got evidence that a third of
men suffer from some form of erectile dysfunction, if it was something
of that nature perhaps talking to a male doctor. What policies
are you considering to address this as an issue if you have got
more and more women doctors? I welcome that because I think the
boot has been on the other foot for too many years where women
have had to talk to male doctors.
(Ms Blears) In the past it has been the reverse problem
in that it has been difficult to get a female GP.
1155. Absolutely.
(Ms Blears) Therefore, solutions have been brought
forward to have more nurses, practice nurses, more health care
advisers and I think the same is true in relation to where there
are only female GPs and attracting more men into a wider range
of health service professions is increasingly important. I am
not aware of any specific evidence that says that men on sexual
health matters would simply want to talk to men. I would be quite
interested to look at some of that evidence and whether or not
they find it easy to talk to women as well. That would be quite
an interesting area to explore. I think we do have a duty in the
NHS to try to ensure that if people, with whatever problems they
have got, want to have access to a particular gender of health
professional we must do our very, very best to ensure that happens
because unless we get the consultation right then we do not get
the outcome for the patient at the end of the day. I am not aware
that there is an overwhelming number of all-female GP practices
in the country at the moment but clearly perhaps this is an issue
that should be on our horizon for future development.
Dr Naysmith
1156. One of the factors that young people themselves
raised with us was the strong influence, they said, of alcohol
on sexual health related diseases. You only have to wander around
any city in this country at about 11 o'clock on a Saturday night,
nowadays most nights, and you can see fairly clearly that there
must be some sort of link there. There is obviously peer pressure
as well. Especially since we have got the Minister for Alcohol
here with us today, I just wonder is there any research going
on to look at this, especially in the context that we are slackening
off and relaxing licensing laws as a matter of policy?
(Ms Blears) I am actually the Minister for Sex, Drugs
and Alcohol. The only thing I do not have is rock and roll.
Jim Dowd: That is typecasting.
Dr Naysmith
1157. It is certainly something that we need
to take a great deal of interest in. Is there any research going
on in that area?
(Ms Blears) It is a very interesting area. The proportion
of young people between the ages of 11 and 15 who drink has actually
remained at roughly about the same over the last decade or so,
around about a quarter of them.
Chairman
1158. How does that break down male to female?
Certainly my impression is that a lot of young women are drinking
far more than used to be the case.
(Ms Blears) I think that is the case but that is amongst
the older teenagers, if you like. Amongst the very young people
between 11 and 15 about a quarter of them are drinking. The worrying
issue is that when they were drinking initially, 10 or 12 years
ago, they were drinking about five units a week but that has gone
up over the last 10 years to about 10 units a week, so they are
actually drinking more, or there were not more of them drinking
but the ones who were drinking were consuming more. I think that
evidence is quite clear. When you look at their reasons for drinking
they are the same as everybody else's: to relax, to relieve stress,
to be with their friends, to get a buzz and have a good time.
The evidence is not clear about the links with risky sex behaviour.
It is still not a clear picture. Obviously we are now engaged
in the cross-government alcohol harm reduction strategy, so we
have not commissioned any new research at the moment because we
want to see what comes from that consultation process in terms
of the links between alcohol, sex and drugs as well because I
think all of these are evidence of different kinds of risk taking
behaviour and the project on alcohol harm reduction that we have
should produce some very interesting observations for us to look
at in developing our longer term policy. Members will be aware
that the licensing policy is really around the issue of trying
to make sure that we do not have fixed determined hours when everybody
comes out of the same club and causes the kind of anti-social
behaviour that we have seen in many of our cities, and therefore
we hope that having some staggered hours is going to result in
less of that kind of behaviour. The things we are identifying
at the moment are binge drinking and increased drinking amongst
young people and increased drinking amongst those and older teenage
young girls as well. These are very important issues for us.
Dr Naysmith
1159. Moving on to the older teenage girls,
because we are interested in sexual health in its wider context,
not just teenage pregnancy, do you think it does have an effect?
Is there any evidence of this?
(Ms Blears) I am not aware of any evidence that has
specifically looked at the links. If you look at the number of
young women under 20 who have now got chlamydia I think it is
something like over 30% of young women over 20,[1]
which is a very interesting statistic, but I am not aware of any
specific research that has linked that with the increasing consumption
of alcohol. We could all form our own anecdotal views, I am sure,
but I do not know of any existing research on that issue.
1 Note by Witness: The data actually shows that
36% of females with genital chlomydial infection were under 20
years of age. Back
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