Memorandum by Barnardo's (HA 9)
Barnardo's works directly with more than 100,000
children, young people and their families in 361 services across
the UK. These services are located in some of the most disadvantaged
neighbourhoods where child poverty and social exclusion are common
features. We work with children affected by today's most urgent
issues: poverty, homelessness, disability, bereavement and abuse.
Some of our services have sexual health as a special focus; others
include this perspective in their overall approach to children
and young people. We support families affected by HIV and Aids,
encouraging safer lifestyles, and we have a number of projects
for young people who are sexually exploited.
This evidence addresses the second of the terms
of reference of this inquiryie progress to date in implementing
the recommendations of the Committee's inquiry into Sexual Health
(the Committee's Third Report of Session 2002-03).
2. MAKING SEXUAL
Many of the children and young people we see
are isolated within their families and schools and have few links
with the health services. Their self confidence is low and they
are at risk of developing partial or abusive understandings of
their own sexuality and sexual relationships with others. So it
is encouraging that sexual health is now a priority on national
and local government agendas and that major initiatives have been
launched in the last few months, taking up many of the Committee's
For example, Choosing Health (the Public
Health White Paper) identifies improving sexual health as one
of government's overarching priorities. Three developments are
The new national campaign targeted
at younger men and women about the real risk of unprotected sex,
and the benefits of using condoms to avoid the risk of sexually
transmitted infections (STIs) or unplanned pregnancies.
Piloting, from 2006, health services
dedicated to young people designed around their needs, including
Provision of targeted material for
specific groups such as disabled children, young people in public
care and care leavers.
The National Service Framework for Children,
Young People and Maternity states:
"Health promotion for young people is
targeted to meet their needs, and in particular, to reduce teenage
pregnancy; smoking, substance misuse, sexually transmitted infections
and suicide. Young people are actively involved in planning and
implementing health promotion services and initiatives. "
Barnardo's supports the aims of both the White
Paper and the NSF. However practical progress will depend on whether
the resources and staff are available to implement the proposals,
and on how quickly this can be achieved. We know that the planning
and setting up of the right kinds of services takes time. Nevertheless
the issue is increasingly urgent and some of the timescales proposed
in the White Paper seem to us worryingly slow. For example, the
White Paper sets out the goal that by 2008 everyone referred to
a GUM clinic should be able to have an appointment within 48 hours.
Three years is a long time to wait for such a basic service to
be available. All delays place young peopleand othersat
risk; in boroughs where a high number of young people are vulnerable,
every effort should be made to achieve this goal well before 2008.
We urge the Select Committee to use its influence to speed up
the planned changes.
4. THE LINK
The evidence from our work with children abused
through prostitution is that the sexual exploitation of children
can only be reduced if sexual health services are readily available
and user-friendly. Young people tell us that:
They value Barnardo's non judgmental,
confidential and young person centred services. When they need
sexual health services they want to talk to a worker whom they
have already checked out, whom they know and trust and who approaches
them as a whole person.
They think that services should be
where they feel most comfortable to access them. They do not want
to sit in waiting rooms where they feel judged and made to feel
guilty that they have sex.
They want multi-agency partnerships
to work for them and provision not to be random. This means that
local strategic partnerships have to make sure their services
are joined up on the ground; multi-agency services to young people
must be properly resourced and there must be services for the
young people as well as their babies.
They want the advice and information
services that they use regularly to be holistic and able to respond
to connected issues such as substance misuse. They do not want
to have to go from service to service repeatedly asking for help.
They want to have a say through their
focus groups or committees on how those services should improve.
In our local partnerships Barnardo's is already
taking forward the principles outlined in the National Plan for
Safeguarding Children from Commercial Sexual Exploitation. We
are committed to the multi-agency working emphasised by standard
5 of the National Service Framework.
5. SEX AND
Barnardo's is a member of the Sex Education
Forum, which has argued for many years that SRE should be statutory.
The Public Health White Paper recognises the importance of SRE
but disappointingly keeps it at the level of guidance. This affects
the status of the subject in schools and the confidence of staff
responsible for teaching it. Some schools deliver SRE very competently.
They encourage students to look at sexual health in its widest
sense, covering sexual boundaries, respect for others, keeping
safe and the risk of STIs. Other schools treat the subject in
a nervous and limited way; they confine SRE to the physical, biological
and reproductive elements in science lessons and fail to address
wider relationship aspects.
6. SUPPORT FOR
The Committee report emphasised the need to
support parents in this area and to help them feel confident in
talking to their children. Again this recommendation is taken
up in the proposals of the White Paper. Our experience is that
in a highly sexualised culture it is increasingly important that
young people learn how to draw sexual boundaries between themselves
and others, and are helped to become more assertive about what
they want and need. Professionals do have a role here, but parents
clearly have a large part to play in helping their children develop
healthy approaches to sexuality and relationships.
The provisions of the Children Act 2004 and
the Change for Children programme offer many opportunities to
bridge the traditional divides between health, social care and
education. The link between health and education is crucial. Many
young people would be greatly helped by being able to get confidential
advice from sexual health professionals visiting or based in their
We also notice that the young people we work
with often been excluded from school or have poor attendance records;
they have therefore missed out on SRE. For them preventive multi-agency
work in the community can be crucial. For example Barnardo's and
Brook Advisory Centre have jointly run a weekly drop-in sexual
health session in a homelessness hostel in London for 10 years.
The session is well attended. Lead by the young people themselves,
it has enabled many of them to talk about sex and relationships,
and make up for what they missed at school.
8. THE INTERNET
One of the most troubling developments since
the Committee last reported on this issue in 2002-03 is the growing
threat to children's and young people's sexual health posed by
the internet. Barnardo's report Just One Click (2004) demonstrated
the risks that internet and mobile phone technology can pose.
Although the internet can be a source of useful information and
advice for children and young people, it can also be used by adults
for abusive purposes. The evidence is that the children involved
in this form of abuse are getting younger, the abuse more severe
and the settings more everyday.
The Committee in its report described sexual
health in this country as being "in crisis" and identified
it as a major public health issue. Despite the recommendations
at the time, funding remains precarious for many sexual health
services, including our own. Some of our services receive money
from the Teenage Pregnancy Unit but this does not cover the important
work with young men, especially young gay men. Small but important
matters make the work more difficult. For example one of our projects
used to be given free condoms so that young women who wished could
be to some extent protected from unsafe sexual activity. Now the
condoms have to be purchased by the service itself, thus using
up valuable resources.
Finally, we record our experience that sexual
health policies and provision still vary considerably from one
part of the country to another.