Memorandum submitted by the Policy Research
Bureau
UNIVERSAL SERVICES
The research suggests that universal services,
available to all irrespective of level of need, play a vital role
in preventing poor outcomes for children. Universal services in
the UK currently range from those provided by statutory health
and social care agencies (eg antenatal care and the health visiting
service for families with pre-school children) to various forms
of parenting support services provided by the statutory sector,
the voluntary sector or both in partnership (eg some SureStart
services, a national telephone helpline [Parentline Plus], newsletters
and leaflets.
The research shows they can perform the following
functions effectively:
— Increase parents' knowledge about
aspects of child development and child care through provision
of basic information and advice to parents—for example,
safety in the home, nutrition and diet, the importance of inoculation
against early childhood disease.
— Achieve change in simple parenting
behaviours.
— Act as a gateway to other services—for
example, provision of information on where to get further help.
— "Boost parents" informal
networks where group activities are offered, by providing a place
to meet and interact with other local parents
The research base on open access, universal
services is extremely weak, however, and should be improved as
a matter of urgency, given the costs of providing such services.
There is a strong case for providing universal
services as research shows that the majority of parents admit
to difficulties with or lack of knowledge about child care and
parenting at some point in their child's lifetime. In addition,
it is generally thought that universal services can contribute
to the acceptability of services amongst the public by "normalising"
service use. However, there is also considerable evidence that
these services are not always experienced in a positive way by
families who use them. They need to guard against seeming to preach
or teach and to ensure they work in a partnership model with users.
Research also shows that despite the label,
"universal" services will frequently fail to reach all
parents. They often do not reach those in greatest need who have
more serious problems in parenting. For example, the national
study of 1,750 parents in poor neighbourhoods (Ghate and Hazel
2002) showed that in the poorest areas of Britain, around two
thirds of parents said they had never received a visit from a
Health Visitor.
Therefore, universal services need to be complemented
by targeted services aimed at those with particular needs.
TARGETED SERVICES
The research evidence is clear that targeted
services, when properly designed and delivered with care by appropriately
trained and skilled professionals, can be effective at:
— Changing attitudes to parenting and
child care, and boosting parents' confidence.
— Changing parents' behaviours (for
example, reducing the use of harsh discipline) and fostering problem-solving
skills and more constructive interactions between parents and
children.
— Improving parent-child relationships.
— Reducing the incidence of problematic
child behaviours.
— Supporting children's learning and
educational progress.
The more entrenched and serious the problems,
the greater the intensity and duration of targeted services required
to achieve change. Targeted services always run the risk of seeming
stigmatising to those to whom they are offered, which can be a
powerful disincentive to uptake. Therefore targeted services have,
in particular, to pay attention to how they reach and engage with
parents. There is mounting evidence that the skills and specific
training of staff that deliver these interventions is critical,
and that poorly or inadequately trained staff do not achieve effective
results.
CONCLUSIONS
The research so far supports the general approach
described in Every Child Matters of promoting and improving universal
services whilst also ensuring access to more specialised help
when required.[25]
Both types of service are essential. The boundaries between the
two types of service need to be kept permeable, and is important
not to think of users of targeted services as a somehow different
group from those who use universal services. The same families
may move in and out of the two groups depending on lifestage,
and on changing family and personal circumstances. Universal services
can however play an important role in preventing difficulties
escalating to the point where targeted services are necessary.
However, to achieve genuinely integrated services it will be essential
to focus attention on the ways that universally available services
achieve identification and onward referral of families and children
in need.
REFERENCES
Moran P; Ghate D and Van der Merwe A (2004)
What works in parenting support: a review of the international
evidence Research Report 574 London: DfES.
Ghate D and Hazel N (2002) Parenting in poor
environments: stress, support and coping London: Jessica Kingsley
Publishers.
25 Paragraph 1.2, Every Child Matters: Change for
Children London: DfES 2004. Back
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