Select Committee on Health Minutes of Evidence

Examination of Witnesses (Questions 122-139)


10 FEBRUARY 2005

  Q122 Chairman: Good morning, everybody. Can I explain that this morning's session is partly reviewing our Sexual Health Report and the progress made since we produced that report 18 months ago and looking at certain issues around HIV and AIDS. For the first part of the morning we have got a witness, Julie Bramman, from the Department for Education and Skills. We are very pleased that you have been able to come before us. Would you briefly introduce yourself to the Committee, Ms Bramman.

  Ms Bramman: I am Julie Bramman. I am Head of Curriculum, Specialism and Collaboration at the DfES.

  Q123 Chairman: I think you are aware that when we undertook our inquiry, we did take evidence from your Department and one of the areas of concern to us in sexual health was a feeling that part of the problem that we have in what we described as a `crisis' at the time and what our witnesses in the last couple of sessions have said has got worse was partly down to the lack of preparedness among children and young people, and I think there was a feeling that our sex education is too little and it is too late. We certainly got evidence that where there was good-quality education, it appeared to delay the onset of sexual activity, so, despite what people think, that if they are explicit and talk to children at a younger age, they will "do it", the evidence actually was completely the opposite. As you are aware, we made some recommendations about including sex education in the core curriculum. Obviously I am aware that since we made those recommendations the Ofsted report has come out a little while ago which was quite critical. What do you feel can be done arising from the Ofsted report and arising from our thoughts about this issue, bearing in mind that we certainly see that what is happening appears to be even worse now in terms of STIs and STDs, the overall problems of sexual health, than it was when we looked at the situation 18 months ago?

  Ms Bramman: I think the key points that come out of the Ofsted report are around teacher confidence and teacher competence in actually teaching sex and relationship education within PSHE. Where they were looking at specialist teachers, they found really good practice there both across the primary and the secondary sectors, and I think that our priorities have been to increase the level of competence we have and the number of specialist teachers we have who have PSHE as a specialism. Within that, we are running a continuing professional development accreditation process and we have 2,000 teachers on that this year and we have places for a further 2,000 next year. We think that that is really what we need to be doing, making it part of a specialist process, which it has not traditionally been, with geography and history, as it is quite clearly a specialist subject, rather than leaving it to form tutors which seems to be the majority of practice at the moment.

  Q124 Chairman: Are you weathered to the concept that it has to be teachers because one of the things that we generally wrestled with was whether there might be more appropriate people from outside to come into schools? I have talked to health professionals in my own area where use is made of them by the schools and I think some of them feel that they may be better able to do the job, which is not in many areas being done, than teaching staff. The picture we got from many of our young witnesses was that the staff were ill-prepared and embarrassed, and the pupils picked that up, and that often the feeling was that perhaps somebody from outside would be more appropriate. I have seen in the past in young offender institutions health visitors and midwives go in and talk to some of the lads in, I think, a very helpful way from an outside perspective, not somebody based within that institution, and I felt that that offered a model which we might be looking at.

  Ms Bramman: Most certainly. We are also running an accreditation programme for community nurses now and have in the first year over 300 community nurses on the scheme to enable them to teach in schools or present in front of a class, as they are not to use the word "teach", as well as encouraging co-location of health services into schools for our Extended Schools programme, including the full service of extended schools, of which there are over 100 at the moment. We have set out in our strategy in one of the five aims that the Department has for young children and young adults, that of being healthy. I think we are forging much closer links with the Department of Health to achieve that objective and clearly it is very much in our minds as a way forward. The general workforce reforms that we are looking at, as a Department, encourage lots of para-professionals into schools so that it is not so much the domain of teachers.

  Q125 Chairman: In terms of the relationship between education and health, can you just briefly describe whether the steps that are being taken which you have just mentioned are primarily being driven at national and ministerial level or is it that you are encouraging these relationships at a local level with schools and PCTs or is it both?

  Ms Bramman: I think it is both and I think, particularly through the Healthy Schools initiative that we have where it is regionally based and we have set out some very clear strands and objectives that we have within the Healthy Schools agenda, that is encouraging local networking. It is one of the things that the Ofsted report picked up on, that very good connections were being made locally between the health services and schools and that was a good thing on both sides.

  Q126 Chairman: So at a ministerial level, and obviously, as you appreciate, we have got the Minister coming here, who do you relate to in the Department of Health? Where is the connection? It is a big department, so who are the people who are driving it forward from your point of view?

  Ms Bramman: It is very wide-ranging. The two departments now have a protocol on how they will work together and what their joint priorities are. With regard to the curriculum in schools, we are setting up a joint Healthy Schools team which will sit within the Department of Health building, but will have DfES officials as part of it as well, so it really is very much joint working and we work closely with our Young People health colleagues on a wide range of issues, not just sexual health obviously, but drugs and many other aspects that come within the PSHE and other parts of the curriculum.

  Q127 Chairman: So there is a good working relationship between the departments in moving this forward?

  Ms Bramman: Yes, there is.

  Q128 Chairman: In terms of structures that you work to, the Public Health White Paper proposed certain changes at Cabinet level. I am not going to ask you to comment on those, but can you anticipate all the changes that might take place structurally that would be helpful to that working relationship moving forward, as we are talking about this morning?

  Ms Bramman: Structurally, in the Department we are looking at how we can better co-ordinate across our own structure on health issues because clearly it covers from early years, from SureStart right through to Lifelong Learning and we are very aware that at the moment we have, for want of a better word, lots of silos that could be far better co-ordinated in our interface with the Department of Health, but officials have met recently to discuss how we might restructure ourselves so that we can interface better and reporting through to individual directors general.

  Q129 Dr Taylor: You mentioned that you are getting some accredited community nurses and you are getting accredited teachers. Is there any evidence, any pointer, as to which are more effective?

  Ms Bramman: Not to my knowledge.

  Q130 Dr Taylor: Any comments from students who have had both types of teaching?

  Ms Bramman: The only feedback I would know about is around the confidentiality with community nurses. It is clearly easier in some respects for young people to talk to someone they are not in contact with within the school full-time and, therefore, I think it is a different relationship.

  Q131 Dr Taylor: With the 2,000 teachers in training for accreditation, are these from a wide range of other subjects or are they people who are going to be absolute specialists in teaching PSHE?

  Ms Bramman: It is both. Some are taking it as their main specialism, so they will be PSHE teachers and will teach across the school age. Others are taking it as a second specialism.

  Q132 Dr Taylor: Would the pure specialists go round different schools or would they just be attached to one school?

  Ms Bramman: They will be attached to one school, but we encourage very much collaboration between schools through many of our other programmes, such as the Specialist Schools and Leadership Incentive Grant and Excellence In Cities, very much on the theme of collaboration.

  Q133 Dr Taylor: So if you had got a specialist, you would make the most of that person?

  Ms Bramman: We would expect the most to be made of that person, yes.

  Q134 Dr Taylor: The paper we had from Ofsted dated January 2005 actually said that some schools do not provide PSHE in any form and it goes on to say that the position of these schools is untenable. What are you doing about that?

  Ms Bramman: That would be picked up in the individual school's report. This was a subject report of course, but when Ofsted visits for a whole school inspection, it will be picked up there and become part of the conversation that we had under the new relationship with schools and we will clearly have to have very serious conversations with the school about ensuring it has adequate PSHE just as in the same way as if it did not have adequate mathematics or English.

  Q135 Dr Taylor: So that would be enforced pretty quickly?

  Ms Bramman: It would be enforced pretty quickly. The report was unhelpfully not specific.

  Q136 Chairman: I think you have also accepted in what you have said before that having a form tutor doing the PSHE role as well as everything else he or she has got to do is not acceptable.

  Ms Bramman: What I said is that it is probably not best practice. I had not said that it is not acceptable.

  Q137 Dr Taylor: And you will aim to replace that by these accredited teachers, so how far will 2,000 accredited teachers go across the country?

  Ms Bramman: There are around 3,000 secondary schools, and many more primaries of course.

  Dr Taylor: Moving on, we talked to a number of young people during our inquiry and there was the definite feeling that it is okay to talk about sex and sexual health, but you have got to have the round, full picture and you have got to go into relationships because one without the other is certainly lacking something. Is there any evidence to say that this is actually being covered by PSHE or SRE—I get muddled up with the initials—that it is the relationship that leads to the sexual activity which is so incredibly important, so is that being taken up?

  Q138 Chairman: Can I just say that we actually suggested that SRE should become RSE for reasons that you might understand. Maybe it is indicative of the age of the Committee, I do not know, and probably we are a bit old-fashioned, but we put that forward as a serious suggestion.

  Ms Bramman: Well, it is sex and relationship education and we do underline the relationship aspects within all of the guidance that we produce. That is why it is so important to teach it within PSHE rather than as something that is separate or just the science aspects of sex.

  Q139 Dr Taylor: The fact that young people raised it with us made us wonder how effective that amalgamation was, but obviously you are aware of it.

  Ms Bramman: We are aware of it and it is something, as I said, that we cover in all resources and the guidance that we produce.

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