UNCORRECTED TRANSCRIPT OF ORAL EVIDENCE To be published as HC 734-i

House of COMMONS

MINUTES OF EVIDENCE

TAKEN BEFORE

EDUCATION AND SKILLS COMMITTEE

 

 

CHILDREN'S TRUSTS

 

 

Wednesday 19 April 2006

MS NAOMI EISENSTADT, MS SUE HACKMAN and DR SHEILA SHRIBMAN

Evidence heard in Public Questions 1 - 90

 

 

USE OF THE TRANSCRIPT

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Oral Evidence

Taken before the Education and Skills Committee

on Wednesday 19 April 2006

Members present

Mr Barry Sheerman, in the Chair

Dr Roberta Blackman-Woods

Mr David Chaytor

Jeff Ennis

Helen Jones

Stephen Williams

Mr Rob Wilson

________________

Witnesses: Ms Naomi Eisenstadt, Secretary of State's Chief Adviser, Children's Services, DfES, Ms Sue Hackman, Chief Adviser, School Standards, DfES, and Dr Sheila Shribman, National Clinical Director for Children, Department of Health, gave evidence.

Q1 Chairman: Can I welcome our three witnesses this morning, Sue Hackman, Naomi Eisenstadt and Dr Sheila Shribman. I know two of you are known to the Committee, but I do not know if Dr Shribman has been before us before. Have you?

Dr Shribman: No.

Q2 Chairman: Welcome indeed. You all have a very impressive background in terms of your knowledge of the area. One of you is a relatively new appointment. Who is it?

Ms Eisenstadt: Sheila and Sue are both relatively new.

Q3 Chairman: We take our responsibilities under Every Child Matters very seriously. We wrote what I think was, without prejudice, quite a good report on Every Child Matters which was published almost a year ago to the day under a previous Committee and we went to British Colombia and we took evidence because they had a similar Children's Act that had been running for nearly ten years and so they had a lot of experience. I think we did a pretty thorough job. What we did realise was that this is a heavy new responsibility for the Committee and whether we did this on our own or we shared that responsibility with other Select Committees was something that we started discussing before the election and as a holding measure we have decided every six months to have a session on Every Child Matters as a minimum. In the autumn we will be talking to the two responsible ministers about this. It is an important area for us. Do any of you want to make a very quick opening remark?

Ms Eisenstadt: We thought we would all say just a little bit about our background and the role that we have currently.

Q4 Chairman: As long as you do not repeat your CV which we all have, just the relevant bits.

Ms Eisenstadt: Probably the most relevant bit of my CV that you would not know about is that in the past I worked for Save the Children and I was very active in the UN Convention on the Rights of the Child and I was also very actively involved in the voluntary sector commentary on the 1989 Children Act, so I have a very long history in the development of children's services in England. My current post is about developing an understanding of good practice at the front line and what we know about what really works because we have got a huge amount of information on teaching and learning but much less on best practice in children's services. An important part of my post is to stay in touch with practice at a local level and I do that through children's services advisers who have been recently appointed to work from the Government offices and I am the professional lead in the Department for the children's services advisers. My post is designed to work in close collaboration with my two colleagues.

Ms Hackman: I am Sue Hackman. I am the Chief Adviser for School Standards. I was appointed three months ago and so I am a relative newcomer. I bring to the DfES first-hand experience of having implemented government policies in the field and of having been a teacher. One of the privileges of my position is that I have worked from top to toe in the system. My typical working week would put me in contact not just with ministers but with headteachers and classroom teachers and all the others who work on raising school standards. I see it as a very large part of my responsibility to make sure that policies such as this are workable and really can deliver for children, so I bring an eye of realism. As you can see, Naomi, Sheila and I are busy forming an early partnership to make sure that we are as joined up and coherent as we are expecting the schools and local authorities to be.

Q5 Chairman: Which ministers have you worked with?

Ms Hackman: I have worked with all of the ministers from David Blunkett forward and most recently, of course, with Andrew Holness and Jacqui Smith in particular.

Dr Shribman: I am Sheila Shribman. I am a pediatrician by background. I bring to my role a continued contact with children. I do my clinical work on a Friday every week and I feel that is very important in terms of keeping in contact with colleagues on the ground. I joined the Department of Health as the National Clinical Director for Children in December and I am one of a number of national clinical directors in the Department of Health, some of whom have specific diseases to address such as coronary heart disease and cancer and others who have a care group. I have a group that covers maternity as well as young children and child mental health, so it is a diverse brief. I will bring my background clinical experience which is very wide. I will not repeat the information that you already have on that. My particular roles and responsibilities are in relation to supporting the implementation of the national service framework which, as you are already fully aware, involves a great deal of collaboration at all levels, both on the ground and at the highest policy levels. I was particularly pleased to find that there were new appointments such as Naomi's to mirror mine in DfES. We are in the early days of working together, but we are committed to doing that.

Q6 Chairman: How often do you meet?

Dr Shribman: We have met recently a couple of times and we are planning to meet on a regular basis. Perhaps more importantly, we are also planning to make visits together and to make joint presentations at conferences and at other opportunities where we can both demonstrate the importance of working together in practice out there with colleagues in the field, whether they are from an educational background, a health background or a social care background. That is part of our plan going forward.

Q7 Chairman: What would you consider as a mark of the success of Every Child Matters in operation? What will you be looking for when you do these visits and when you advise ministers on policy? What is going to be a success for you in this whole change in our legislative processes?

Ms Eisenstadt: The real mark of success is about what is happening at the front line with children and families and the extent to which services are working together. Some of the marks of success so far have largely been structural, ie the appointment of directors of children's services and the existence at local authority level of children and young people's plans. The kind of things I think we would look for - and we have not been on a visit together yet but we have one planned - is to what extent in a local primary school is there an inter-agency team that teachers can call on if they are concerned about a child and get a very, very quick response, or to what extent in a children's centre is there joint working between health, social care and early years education. The nice thing about us going out together will be what kind of eye each of us would be looking at in terms of front-line practice. I would rely on Sue to look at the quality of the primary education because that is not my background, but I would be looking around at the displays in the school and at the extent to which there is information for parents, how well parents are involved and engaged in what is happening in a school. We would be looking with slightly different eyes but trying to get a holistic picture of what is happening for children locally.

Ms Hackman: I think another answer to your question is that we would expect to see proof of it in the outcomes. We would hope to see fewer pupils excluded, we would hope to see success in examinations and tests increase, we would like to see Ofsted reports tell us that schools involve parents adequately, that parents feel well informed and that the pastoral systems are in good order and that the frequency of bullying is declining. We are prepared to be judged with a hard edge, we want to produce tangible results, but Naomi is absolutely right, we must look at the quality of implementation, but in the end this is all for children, we are in the service of children so that they get a better deal. In the end we want to look at hard edged outcomes.

Q8 Chairman: Would you go along with that, Sheila?

Dr Shribman: Yes, I would. There are the hard outcomes and examples of collaborative working. The sort of thing I would look at if we were to visit a children's centre, for example, would be the engagement of local health partners on the ground, midwifery, health visiting, if the services are co-located and communication between the two. I would hope that the staff that Naomi was particularly engaged with had a good knowledge of health issues in the broadest sense and I would look at the ways the health staff were able to facilitate discussions about health issues, because the point of working together is clearly to achieve the same ends albeit coming from different perspectives and gain the benefit of that individual professional expertise. We are not looking to replace teachers with midwives, that is clearly unrealistic and inappropriate. The sharing of information and working together for common aims is what we would be seeking to promote. Those sorts of issues would be the perspective I would come from.

Q9 Chairman: Running through the whole debate and through the legislation was this desire to narrow the gap between children from less privileged backgrounds and those children from better off backgrounds. You have not mentioned that in terms of how you interpret this. Is that still a priority for you?

Ms Eisenstadt: It is very much a priority and it is on the face of the Childcare Bill that is going through Parliament now in terms of narrowing the gap for children under five. Narrowing the gap means that the children in the lower quartile have to achieve faster. What we are trying to say in terms of bringing services together is that we have made huge improvements for a very large group of children, but the way that we are going to address narrowing the gap for the children who are particularly disadvantaged is by bringing more of the whole system towards the aim of narrowing the gap. Perhaps I could give the example of looked after children where the gap is absolutely massive. I have been very much involved in the work on the looking after children Green Paper which we hope to be publishing later in the year and one of the things that is really noticeable is that the system is not working towards attainment. The schools would be working towards attainment, although in some cases not for their whole group of children, but the health system is not thinking about how it could promote the educational achievements of these children. One of the things that we are trying to do by working together is being clear that in order to narrow the gap you have to build the system towards the goals, not just each of the individual bits of the system.

Q10 Chairman: In terms of how you see the system working, the system is not just this piece of legislation, it is in the context of other government policies and other pieces of legislation which have been successful or not. If you set this in the context of a policy that was introduced some years ago but which is working its way through and that is Sure Start, how do you assess how successful Sure Start has been in narrowing the gap?

Ms Eisenstadt: This is the Sure Start local programmes you are asking about, is it, and not the wider Sure Start programme?

Q11 Chairman: Either.

Ms Eisenstadt: If we start with the Sure Start local programmes, the evidence that we published in December said that, first of all, the children reached were very, very poor children, the average was just below the poverty line and significant numbers were well below the poverty line. In terms of where this resource was put in, it was in absolutely the right area. The other evidence we have - and I think that you will know that from your constituencies - is the enormous popularity of it. Parents love it. You go to these places and everybody says it changed their life. That is the good news. There is also good news on emerging outcomes for the vast majority. In 86 per cent of cases we have good child outcomes and we have good parent outcomes and particularly the parent outcomes that we know about from other research are the ones that will lead to better educational outcomes in the longer term. This has been a study of children who were between three and nine months when the evidence was taken so it is still very early days. The negative story which is very, very important is that it seems that Sure Start was inappropriately working with the very, very poorest and particularly teen parents. 14 per cent of the sample were teen parents and they were not benefiting. The very important lesson that I think we take from that, having run the programme for seven years, is that community development approaches can themselves be excluding. The vast majority who got engaged and love it and who you meet when you visit a programme are incredibly enthusiastic. Who you do not meet is who is not coming. What we did in response to that evidence is that when we published the children's centre guidance in December and just very recently the implementation plan for the PMDU report on Sure Start we got much more prescriptive about outreach and much more prescriptive about tailoring services to particular groups rather than everyone coming along saying this is wonderful, get involved. The people who could get involved did and the majority are benefiting, but a significant minority are not. When people keep saying to me "Doesn't that upset you terribly?" I say that of course it does. On the other hand, it is a waste of public money to do evaluations and not listen to what they say. This evaluation is giving us some very, very important lessons about Sure Start, about reach, about the very poorest and about tailored approaches.

Q12 Chairman: Sheila, you looked as though you wanted to contribute.

Dr Shribman: I was agreeing really with the importance of what Naomi was saying about taking the evidence from this and then moving forward and looking at how we engage those particular families who have not been engaged in the programme. I do see the opportunities of our working collaboratively at a local level as the way that we will be able to reach more of these families. In terms of universal services, health services are engaged with everyone, from pre-birth, birth and those early years, and it is therefore by working together that we hope to enable those who have not yet been engaged to be engaged more effectively.

Ms Eisenstadt: One of the very interesting bits of evidence was that there was a difference between the health-led programmes and they were better at reach and we think that is because health is the universal service for under-3s, so they had the data on where the children where and they had the data on new births. Again it illustrates the importance of the joining up.

Q13 Helen Jones: I wanted to ask a follow-up on that because what you said triggered something that I often think about our educational system and that is that we concentrate a lot on the supply side but we do not concentrate too much on the demand side and how you create the demand for those services and that is why we miss people, because the very people that we want to reach much more are those who are the least likely to demand better services for their children. How can we use what we know about health, which you are right in saying reaches the vast majority of people and knows where they are, to inform the rest of the work we do with very young children particularly, but to read that through then when those children start school, to engage with their parents, to get their parents to want more from the system, because that seems to me to be part of the key in improving the outcomes?

Ms Hackman: I think that is entirely sensible. I think there is a very strong will to put parents at the heart of all the policies that are in progress in education. I am thinking in particular of the new bill giving an essential role to parents in influencing schools, even the creation of new schools and giving them a much greater role in their child's education. Amongst teachers it would commonly be said that we have got a good idea of what we should ask parents to do with the youngest children. Everyone knows you have a small child, you pull them onto your knee, you read a book with them, you buy them games and you play number games. It is not so easy when your baby has grown into a 14-year old boy who is a lot bigger than you and he is probably less interested in school than some of his other interests. I think we have a particular responsibility not just at the youngest end but at the older end over how you reach out to parents and give them support. As a parent myself, I know it is not the easiest thing in the world to be a parent of a teenager. I think we have to address that across the age range. The other thing that occurs to me is the very large sums of money that are going into schools to support personalisation, which is trying to shift the emphasis from being less on doing onto them and more of trying to make what we offer tailored to the specific needs of individuals and to the specific needs of families. I think schools are going to enter a culture that is more like the culture in business and out there in the world, which is about a drawdown culture that is more based on the demand side than on the supply side. I think your comments are absolutely right. I think there are the beginnings of a shift of approach. I think it is less about money and more about approach.

Q14 Helen Jones: That is all very well but you have to ensure that the demand is there. If not, you do not narrow that gap, do you, you simply give more to those who are capable and ready to use the system? It is about creating that demand. The question is how we do that.

Ms Hackman: I think that is a really good point. I am thinking of a school that I visited recently in Liverpool where they have moved on-site all the services and not just the services that are the ones we are concerned with about children but council services also. I think there is something about being there in person and having contact one-to-one, where you meet those people when you go to collect your child at the door and where there are very strong levels of access. I think the chances of engaging those people are so much more likely in those circumstances. I put a lot of store by putting services right there on the school campus in one place and by teams working together with parents from the bottom up. All the same, you still have to have parents who are interested in their children and want their children to succeed and thankfully most of them are and with a helping hand even more will be. I think we have got to pay attention to a small minority of parents who perhaps are not giving their children the time and attention that they need. It is regrettable but true that there are some of those parents still. Our range of work has to address the most enthusiastic parents and also the parents who are less attentive than you would wish.

Q15 Chairman: They are not just less attentive. We all know, those of us who are constituency MPs, that the absence of parents is one of the great tragedies and that is a problem in itself, but there is also the real problem that there is a culture of under-performance, very good parents who just see the future of their children as their future, leaving school early, getting a semi-skilled job and not raising aspirations. What is interesting if you break out of the stereotype of good parent and bad parent is that there are a lot of people that consider themselves good parents but who do not aspire anything more for their children than they had themselves. Is that not part of the problem we are facing? Those parents are not pushing for their child to get the maximum out of their pre-school and their educational experience because they are pretty happy that the child may not stay on at 16 and may go into relatively low paid, unskilled employment.

Ms Eisenstadt: I had that exact experience years ago when I was working in a nursery and we did work on gender. We were doing books which were about boys taking the lead or girls taking the lead and all this stuff. Anyway, one of the mothers said to me - the nursery I was working in was on a low income estate - "This is really important because when he grows up maybe his wife will be working and he won't and I don't want him to feel bad". This was a very loving parent who was already depressing her aspirations for her four-year old son. When I give speeches I say that you do not have to be able to do the physics homework, you have to be able to say did you do your physics homework and that is what makes the difference. We have to develop with parents those aspirations, but telling them what to do does not work. There are a lot of parents who do have aspirations for their children. Interestingly enough, particularly immigrant communities have very high aspirations for their children and they have done extraordinarily well. This is a very powerful cultural issue and we have to work out ways through parents, school advisers, through involvement in the schools and through putting things like benefits advice on school campuses for the services that parents want to use to get them engaged and to have better aspirations for their children.

Q16 Jeff Ennis: I want to pick up the point about the failure of Sure Start to penetrate the teenage parent syndrome. Is it not the case that one of the main reasons for that happening or not happening is because in many instances you get grandparents acting in loco parentis and in many respects they are dealing with two sets of children?

Ms Eisenstadt: That is a very interesting question. I have to say that you could be right, I do not know. The evaluators have not said that to us, but I will go back to them and ask them if they have looked at that because that is a very interesting point.

Ms Hackman: I think we should avoid being grandparentist! I think grandparents are often a strength of support to children. I think grandparents have the patience and time that sometimes busy parents do not have.

Q17 Chairman: There is absolutely no prejudice by any member of this Committee against grandparents. We are right at the end of a very serious inquiry into special educational needs and after one more session of evidence we will be starting to write their report up. How does your responsibility touch on this whole area of special educational needs because the deeper we have gotten into it the more complex and challenging we have found the area? What is your view on how the whole notion of children's trusts is going to help us address those children who have a variety of special educational needs?

Dr Shribman: I have got a personal and professional interest in children with a disability, that has been part of my clinical career, so I am very aware of the general issues from a health perspective. Certainly in the Pathfinders children's trusts that we recently received feedback on there were some very positive examples of the way those children's trusts were bringing together services in order to improve all of the aspects of care and service delivery for children with a disability and this was within and outside the school, looking at respite care, looking at therapy services, looking at equipment provision, the whole picture in the round. For me it is very important that you take the whole picture because from a health perspective we need to actively address health issues that we can ameliorate or manage more effectively in order to ensure that the children's potential is maximised from their educational opportunities. From my point of view this is a very key area for collaborative working and a key area where we expect children's trusts to deliver over time. Again, you will be aware that it is early days, but there were some good examples from the Pathfinders. I was particularly impressed by some parents who had been involved in it who were saying how much difference it had made to them and their families and this was most encouraging.

Ms Eisenstadt: At an event that Sheila and I did together on celebrating the Pathfinders Trust there was a parent from Bolton who was particularly moving on the difference in quality of service of having one person who can co-ordinate and understand things for him. In terms of the ECM agenda and special educational needs, there are some very, very important principles, one of which is early identification. I have to say, it is early days. The intention is for much earlier identification of special educational needs and again this would involve health colleagues and also the common assessment framework so that you have a range of professionals who are using a common language when they describe the issues around the child. What we find, of course, is that the professionals see different things and use different language. The common assessment framework gives them a common language so that it is not the health visitor who sees the squint and the teacher sees the chewed book, they both see a child. We have already seen many examples of the children's assessment framework used in terms of special educational needs. Finally, I think the idea that we can bring services to bear around the whole child more quickly will make a huge difference in terms of the kind of service because the story we get again and again on the disability front and the SEN front from parents is that they knew there was something wrong but nobody would listen.

Ms Hackman: In the past I think SEN has been seen as a welfare issue and over here we have the standards and the curriculum agenda. I think tying them together gives those children a much better chance. I think they have been the victim of low expectations. I used to teach children with emotional and behavioural difficulties and there is absolutely no reason why those children should not achieve if on the face of it they were born with brains, they are completely capable, but circumstances have intervened and syndromes have been set up that are barriers to their achievement, but they are not insuperable barriers. There is no reason why those SEN children - I am thinking of children with emotional and behavioural difficulties, children with disabilities - should not be part of our everyday expectations and our energies should not go into removing the barriers to their achievement and holding them into the pace of learning. I think the standards agenda has quite a lot to bring to special educational needs and in the same way I think teachers need to know more and wish to know more about particular disabilities. The policies of inclusion are fine, but sometimes teachers do not know enough if they get a child who is dyslexic in their class or a child who is autistic. Sheila probably knows more than I do about the specific nature of autism. If you have got autism in your class you need to know how to deal with it. At the moment we are planning to revive and address special educational needs more vigorously as part of our agenda for raising standards at every level. Clause 1 in the new bill is the first time that the right of all children to have their educational potential fulfilled no matter what level they are at has been included, whether they are highfliers or low attainers. Every child has the right to that kind of high expectation. I am very hopeful that that is one of the areas where we can produce a joint effect.

Q18 Chairman: Would you consider that that high expectation might be better realised in an inclusive mainstream education or sometimes in a special school situation?

Ms Hackman: I have seen extremely good practice in both. Increasingly one finds both children who are maybe in a special unit on a school campus who are integrated into mainstream lessons as appropriate and who are taught separately when that is more effective and more appropriate. Having an education that is well tailored to your own particular needs is a good thing. Most special schools operate outreach systems now. The boundaries are a bit less hard than they used to be and I think this is a good move. To be fair, I have seen some excellent special schools cope with children who have been well provided for in mainstream schools. I think it is less about where and more about how and if you have teachers who are well informed and committed.

Q19 Chairman: Sheila, we have taken some very interesting and challenging evidence around autism. Is there research? Is this right or wrong? There seems to be increasing numbers of children with autism detected. We were given figures that it is five to six times more likely to be a condition that a boy has rather than a girl. Is there research on that? Can we explain why that is the case?

Dr Shribman: First of all, many conditions are more common in boys than girls, that is how it is. There are a few conditions where it is the reverse. There is research going on and it would be my view that we are going to need to do more research over time in order to make more progress with this condition. In terms of how common it is, it is certainly more common than it used to be. For some time there was a belief that we were simply more aware of the condition and that that was the sole explanation for the apparent increase. I think it is in fact a combination of both. I have been a consultant for over 20 years and certainly my experience is that we have better tools for earlier diagnosis and we are more aware of the needs of younger children. 25 years ago people would have said autism was a diagnosis you rarely made because of a variety of the implications. I think we are much clearer now that there is a spectrum of disorders, I am sure you have heard a lot of evidence on those aspects, and we can identify children with features early on. Even though we may not be entirely clear at the age of one or two, we can see early signs and we can therefore offer more support, more intervention and educational opportunity as we have been discussing, but the underlying neurobiology remains elusive. There are international collaborative programmes looking at autism research. I recently met with some colleagues from the voluntary sector who were promoting that research. It is indeed very important that we understand this condition and indeed a number of other disabling conditions in the broader sense that affect children and young people if we are to make further progress. We are much better able to manage a number of conditions. In terms of co-morbidities for example, we have better management of epilepsy these days than we used to have. We are able to offer support in a variety of ways, but the elusive underlying mechanisms remain unclear. Obviously our new genetics knowledge will offer us opportunities there over time as well because we are aware of family traits in relation to autism and there is more research going on on twins, siblings and family patterns.

Chairman: Thank you for that. It was a rather long opening session.

Q20 Dr Blackman-Woods: I have some general questions about where we are with the implication of the Every Child Matters agenda. Can you give us your view of where you think areas are with the development of children's trusts? What proportion do you think are quite advanced and what proportion are behind? Is it more or less where you expected it to be or not?

Ms Eisenstadt: In terms of what we have expected, it is better than we expected. All local authorities will have directors of children's services by 2008. At the moment 142 local authorities have directors of local services. All local authorities except the excellent authorities are required to do a children and young people's plan. Our evidence is that even excellent authorities are doing children and young people's plans because they want to, because they find it is such a useful tool. We are finding an incredible enthusiasm out there for the key principles. Where we are now is from design to delivery to real implementation, and a lot of the changes so far have been structural changes that were required to set the scene for the real changes at the front line. In terms of which ones are good and which ones are bad, some are very, very good.

Q21 Dr Blackman-Woods: It was proportions I was asking about. Where are we in terms of overall areas? Have you got a feel for where we are?

Ms Eisenstadt: On the children's trusts side, overall I would say that a good two-thirds are making real progress towards children's trusts arrangements in terms of joining up and there are very few where we feel they are very, very far behind. So it is better than we would have expected at this stage. Our evidence for that is the things I have just said but also things like engagement in extended schools. The Training and Development Agency has doubled the requests from schools that they were expecting. They were expecting around 2,000 and they have got over 4,000 schools who want the development training on becoming an extended school.

Ms Hackman: The annual performance assessment is a new procedure from Ofsted which replaces old inspection procedures where the educational and social inspections take place jointly. They reported in December on the state of play and they gave local authorities four scores: one was for their social care, one was for their educational opportunities, one was for both and the other was for their capacity to improve. We thought, bearing in mind the early stages, the results of that were very good. They found that three-quarters of local authorities consistently are well above the minimum requirements that they expected. With regard to just social care, they said 60 per cent were consistently above the minimum and that is up 50 per cent since the previous year, which must have been 2004. They said - and this was particularly pleasing - that a very high proportion had good or excellent capacity to improve and I think that is important because at an early stage the capacity to improve is a very significant score because some are just simply further along the road because they have been Pathfinders. I think that small authorities are well advanced and particularly well developed and that is just because they are small. A unitary authority is by nature already unified and had that flying start and I think they have found it easier for their staff to be together and to talk together. They have already developed some of the systems that are just still ambitions for large authorities and which are genuinely and practically much more difficult in larger authorities to establish. In the beginning that was a very good report. However, they did have some concerns, of which the first and most important one was the position of looked after children. I think we have to bear the criticism that with looked after children our performance just is not good enough. They pointed to attendance, attainment and the need for stable care for those pupils as really still terribly important. They reckoned about 50 per cent of local authorities were doing a good job, were getting a good performance out of those children and looking after them well, but they said that 50 per cent still had some way to go and amongst those some were better than others, obviously. I think we have got to pay big attention to that. In my own area of responsibility, for example looked after children, in the very best cases the difference in achievement between themselves and their peers at the end of primary school is as much as a 20 per cent gap and in the worst cases it is 50 per cent. We have to take the rap. We must try harder on looked after children and we are going to do so.

Dr Shribman: We are seeing increasing notifications of pooled budget arrangements which does show evidence of collaboration in children's trust partnerships. We have heard of examples of £9 million and £700,000 from different individual areas and a total of over £90 million and rising for these pooled budget arrangements which I think shows the contribution people are jointly making with half of the money coming from PCTs and NHS trusts and half from partners to take initiatives forward. I think that is an indicator of progress again along the line of working more closely together.

Ms Eisenstadt: And increasing numbers of joint posts across the PCT and the local authority.

Q22 Dr Blackman-Woods: You are painting a picture of really quite widespread engagement with the agenda. Would that be fair?

Ms Hackman: I think that is fair. I speak to headteachers every week and in a year I will get round half of the secondary headteachers and very many primary teachers and I have yet to hear anyone say they disagree with the policy. No-one is opposed to children being safe, valued, attaining well and enjoying school. It is a very popular policy. I think they also feel well supported financially with the money that is coming in via personalisation, extended schools and so on. If we hear anything negative, it is not about their willingness or their commitment, it is about having time. On that initial stage of the implementation of the policy, I think one has to say it takes time to change a system. It takes strength and energy to set up new teams and to make new ways of working and to establish new team spirit. We believe and they believe that the long-term benefits outweigh the short-term challenges.

Q23 Dr Blackman-Woods: What proportion of areas currently have functioning local safeguarding children's boards?

Ms Eisenstadt: They all do.

Q24 Dr Blackman-Woods: Do you think any of them are not up to speed, and what advice are you giving to the Secretary of State about that?

Ms Eisenstadt: I cannot say. It would be inappropriate for me to say. It would be very difficult to stand in front of this Committee and say they are all functioning perfectly because this is a very new arrangement. What I think we can say is that the changes in the arrangements in that they are statutory gives a much stronger lever to the quality of their operations because ACPCs (Area Child Protection Committees) were not statutory. I feel that great progress is being made, but it will be different from authority to authority and that is why processes like the APA and the joint area reviews are so important. Given that they had to be in place from 1 April, they have been functioning for 19 days, it would be inappropriate for me to say which ones were functioning well and which were not.

Q25 Dr Blackman-Woods: Can you remind us of what you said about the children and young people's plans?

Ms Eisenstadt: Virtually every single authority has their plan posted on their website. The plans do demonstrate very close joint working across the services. The really good news on the plans - and I am actually a non-executive director on a local Primary Care Trust so I was involved in my local plan as well - is the extent to which they work very, very hard to engage both with children and young people, local parents and the local voluntary sector in developing the plan so that the plan is not planned just by the public sector services, it is planned by the constituency that is interested in children's services. I think that the plans are a very good tool, they are a very good first step, but it is also about making the plan a living document that is then used. In my locality my criticism of my plan was that in some areas the targets were very clearly identified in terms of where we are now and where we need to get to, but in other areas it was just profit in without setting out where we are now. I think for the plans to really work they need to be done in the way that education plans were because the data in education is much better than our data in wider children's services. To make all this work we have to get better at data collection, we have to understand what the data means and we have to make sure that the kind of rigour that we have developed for education in schools over the last ten years really is now applied in a similar way to children's services because we just have not had the capacity for that kind of rigour.

Q26 Dr Blackman-Woods: We have talked a lot about planning and changing structures. Has this been getting in the way of or facilitating delivering on the outcomes, particularly this narrowing of the gap? Is all of this getting in the way of the focus on the outcomes or is it really turning the ship?

Ms Eisenstadt: I just do not think you could do it without those structural changes. That always makes it slower. It was a very interesting discussion that we had with Home Office people on respect, about the need for speed and then the need to make sure that you have all the key partners on board. To get all the key partners on board takes time because of cultural differences, language differences and all of that. On the other hand, we need to see some real results because local people will become very disenchanted if they do not see their services improve. Where we see the real results is on extended schools and children's centres and integrated youth support. We now have pilots on targeted integrated youth support for the most disaffected young people. Across the piece, which I always say is minus nine months to 19 years, through extended schools, through children's centres and integrated youth support, we are seeing real changes in communities, but I think for that to be universally applied we need the structure and the systems to change and for that to happen in parallel. We have not had the luxury of doing these things in sequence.

Q27 Dr Blackman-Woods: Can I come back to this issue about outcomes and narrowing the gap because we had a very long discussion on the Childcare Bill about the importance of reducing childhood inequalities and because of the way in which the legislation is structured it means the children at the bottom have got to achieve faster if we are going to narrow the gap because all outcomes for all children have got to be improved. I think it is fair to say that we had real difficulty convincing the Conservative opposition that that was something that should be aimed for. Can you tell us from your experience why narrowing the gap is so important for children, and do you see the Every Child Matters agenda really gearing itself to delivering on reducing inequality?

Ms Eisenstadt: I sat in on the committee debate when that clause was debated so I know there is real difficulty in convincing people of the importance of narrowing the gap. The point of narrowing the gap is about equity and opportunity because basically if children are going to have an equal chance at good employment and at good opportunities as adults then they have to be able to compete with their better off peers. Right now who you are born to determines your future in a way that is fundamentally inequitable. The principle behind it in terms of what our ministers want, in terms of what I know Beverley Hughes wants, is to make it fairer in terms of children's outcomes and in terms of where you are born and who you are born to not necessarily determining where you wind up as an adult. That is why narrowing the gap is very important. In terms of the policies and how they will contribute to narrowing the gap, my best area of expertise is early years. We have very, very good evidence on the difference that quality early education can make. One of the pieces of evidence that is quite interesting on it is that the effective provision of pre-school education, the research on which this is based, is we are still getting good educational outcomes up to age eight. Children's advancement at any level at school is highly dependent on their performance at a previous level, which sounds quite basic but that is a very, very important principle. So if you do not do well at Key Stage 1 your likelihood of doing well at Key Stage 2 is significantly reduced. What good quality early education does is it lifts the children in the poorest areas above the line at Key Stage 1, so their chances of then having a successful educational career are greatly enhanced because they are above that line, but below that you are less likely to do well through the rest of your educational career. How do we do that in terms of narrowing the gap? If we did that for all children then all the children would go up together. I think the key to narrowing the gap is the engagement with parents because that is where you get the biggest difference in terms of what Sue was saying about it being quite basic, we know it already. We know that babies that are read to, sung to and held and cuddled learn to speak quicker and better. We know what developmental opportunities are needed in under 3s, but how to get parents to do it in terms of the poorest communities I think has a lot to do with the Sure Start approach on addressing the other issues in families' lives. So if people are in poor health their ability to do that is much less. If people cannot give their children a decent diet their ability to do that is much less. The way in which we are working jointly with the New Deal for communities to address the wider issues of housing, environment and of parents' ability to do these things with their very young children I think will eventually narrow the gap. I know it is a great aspiration but we have to believe it and we have to keep the evidence flowing and the only way is to keep measuring whether we are doing it.

Ms Hackman: It is early days for seeing the results and some of it is faith, but we did have 14 Pathfinders to learn from. The 14 Pathfinder authorities did not cover the whole gamut of Every Child Matters policy. Some of them concentrated on particular aspects such as disability. Some of them concentrated on a certain number of schools rather than all of them. The results there are very optimistic. For example, in Hertfordshire, where they integrated their preventative services around probation and they ran that around 15 schools, the results that came out of that, not just on the services they were addressing but on the exam results of the pupils and reductions in truancy, were very noticeable, they were certainly statistically significant. For example, they did 3 per cent better at GCSE and that was a better improvement than other local schools. Similarly, at Key Stage 2 results went up by 6.5 per cent which is well above national and local averages, their permanent exclusions went down by 25 per cent and their fixed term exclusions went down by 28 per cent. Those kinds of figures I could cite to you from Portsmouth, for example, or West Sussex similarly on individual children. We do run a target setting process. We are asking schools and local authorities to look ahead and say, in the light of everything you know, what is your best expectation for how pupils will perform next year? The whole country is very optimistic and predicts rising results next year. To me that speaks of a certain amount of confidence amongst schools that not only do they support the policy but they do expect it to feed through into results. It takes 16 years to brew a child educationally up to GCSE and we will have to come back in 12 years and see if we were right! I think we are going to give it our best shot.

Dr Shribman: There is a very large programme to tackle health inequalities across the board. Our infant mortality rate is improving but again there is an inequalities gap. We have an opportunity over our forward programme this year where we will be looking at the child health promotion programmes. That is part of the national service framework for children. We will have an opportunity to look again at how we implement that in practice, and Naomi is going to join me on our group looking at this and it will give us a further chance to look at engaging families in all of those areas that Naomi referred to, in early language development for example. There is an opportunity there to get to the very early years where I think we feel it is a very important time.

Chairman: Stephen, you have been very patient.

Q28 Stephen Williams: We have talked so far about the relationship between different services for children, putting together education and social care, and so on. I want to talk a little bit about the relationship between children's services and adult services and in particular the danger that some people might fall in between the two. First of all, perhaps for Naomi, what guidance is the Department giving to authorities to make sure that people successfully transfer from being an adolescent to being a young adult?

Ms Eisenstadt: Interestingly enough, we issued some joint guidance through the National Service Framework because we have a lot in the National Service Framework for children on particular issues. First of all, there is the transfer between child and adolescent mental health services and making less rigid the age at which children would move from a child and adolescent mental health service to an adult mental health service, giving more flexibility at local level to decide when it is appropriate for a child to move because it can be very difficult and in my own area we have problems with this. There is also the issue which I think is as important, and again we picked it up in the NSF on things like adult mental health services and parenting, on services for adults with drug and alcohol difficulties and parenting, on domestic violence and parenting, and all of these are whole family approaches where the joint working on NSF, and also particularly with the Home Office, are enormously important. So we work very closely with the Home Office on issues of domestic violence and then what happens with the children. We work very closely with the Department of Health on issues of drugs and alcohol and what happens with the children. It has been an uphill battle but, again, I feel from my local experience we are making real progress on getting the adult psychiatric services to pay more attention to the adult patients' responsibility as parents in terms of treatment methodologies. So the kind of guidance that would come from DoH would be influenced by us and we would in the DfES have a chance to look at it and to comment on it before it goes out.

Dr Shribman: Just to tell you about a recent publication and initiative. We have been looking particularly at the transition and, as Naomi said, a referral letter from a children's service to an adult service is not always good enough. We have to look at a process for young people to transfer from children's services to adult services at the right time. We have held a major international conference on that recently and published Transition: Getting it Right, so we recognise through the National Service Framework that this is an area where more work is needed, and I am pleased to be able to say we have a lot of buy into this. The Medical Royal Colleges, for example, are very interested in improving this area of care for young people and they recognise that there is more to do as many young people are now growing up into adulthood with some of the rarer conditions where children used not to survive. There is quite a lot of medical, clinical and health care engagement that is needed with this as well as our partners, as Naomi has outlined already.

Q29 Stephen Williams: Can I ask a supplementary question on the whole family approach that Naomi mentioned. I had a good experience recently in my constituency of a meeting with a group of young carers aged from about nine to 13. It was probably the most impressive group of people I have met in the endless rounds of meetings that I have had as a constituency MP. Some of them supported a single parent with a disability, anything from MS to a physical handicap. Others looked after siblings with different disabilities or who were somewhere on the autism spectrum, and they did a wonderful job, but they definitely had practical problems with their educational experience and the lack of support, as they saw it, from social services. So what guidance does the Department give to children's services trusts to have joint assessments of families where there is a child who has a caring responsibility either for a fellow child or for their parent?

Ms Eisenstadt: Young carers have been of interest to us for quite some time, and it was certainly an interest of mine when I was in the voluntary sector as the voluntary organisation I worked for did a lot of work with young carers. I would expect that a common assessment framework for the young career would be in place for the kind of support they need, not just in terms of the adult's health but in terms of respite. The interesting experience I had when we worked with young carers is that they did not want permission to come to school late; they wanted taxi fares so they did not have to be late, and of course through pooled budgets we have a better ability to be able to offer that kind of support. Interestingly enough, in terms of the charity I worked for at the time the local authority gave the charity the money because the local authority could not give the children the money itself. However, at least the local authority was recognising that it was very, very important to engage with these young people themselves about what they thought they wanted, not what we thought was important. So there had been historically particular projects and a lot of work. I suppose what we want through Every Child Matters is to make sure that it is not patchy so that if you happen to live in this area where this charity operates you might get a good service. That is precisely what we are trying to do with Every Child Matters, to use those voluntary organisations, not to cut them out but to make sure that there is some standard level of service across the country. We would include young carers in that. In terms of specific guidance, the answer is I do not know but in terms of the discussions and the way we would want to make sure this policy process is about all children and all children's needs being dealt with as individuals, of course it would fit in perfectly.

Dr Shribman: Just to add to that, the recent health White Paper Our Health, Our Care, Our Say has a lot to say about carers and the importance of carers, so there is more work to do to support carers in general. Of course, that does include children who are carers. I agree with you, I have seen a number of children in these circumstances and they are a particular potentially vulnerable group, and although many of them are, as you say, extremely able and capable, we do need to provide that appropriate support but it does depend on the assessment of the individual situation. I do think that is particularly important for these young people; what is right for them and what they would like to have in order to improve their life situation is critical.

Q30 Stephen Williams: We heard earlier from both Naomi and Sue about the whole system "supporting attainment", which was the phrase that Naomi used, and Sue talked about barriers to achievement as well. Young carers, it seems to me, have these practical barriers in front of them so what processes are in place within schools to identify that there are young carers amongst the school population and what practical measures should a school then have in place to make sure that child is supported? You mentioned taxi fares. There were other things as well that were mentioned to me like use of the telephone or not being told to turn off their mobile phones and there is also the aspect of truancy as well. Some young people felt that they were being treated as truants if they were late or had to go home in the afternoon.

Ms Hackman: I certainly think with regard to truancy in the last two or three years we have shifted the emphasis away from simply finding truancy and punishing it to looking into the reasons why people truant and trying to resolve them, to take a more proactive approach. I think in that situation it is a good example of where joint services working together would find that child and not perceive it as a problem of just "truancy" as such but as a greater need that child has. So I think we are much more likely to pick up such issues. Is that what you were asking?

Q31 Stephen Williams: We have talked about looked after children and we know that there is a big gap in achievement there, but in children who look after there must be an under-achievement gap there as well. I just wondered whether the Department monitors that as carefully as it monitors other groups.

Ms Eisenstadt: We can check that for you.

Q32 Stephen Williams: That is two "don't knows" so far.

Ms Eisenstadt: I think this is a very interesting issue on young carers because my experience with them is that they really want to do it, and they are magnificent children because they want to do it, but the demands of doing it can prevent them from achieving at school, can prevent them from fulfilling their potential in terms of their own lives as adults, and of course can prevent them from the normal social life that children and young people enjoy. I think there is a very, very delicate balance here between children's wishes and children's rights and a future about what is good for those children and what is best for them and how that interacts with what their parents want for them. What I have just said is my own views on how I think we need to address the issue but in terms of how as a Department we are addressing the issue, I will have to find out and let you know.

Ms Hackman: It has been useful to have that raised.

Q33 Chairman: We like it when witnesses say they do not know.

Ms Eisenstadt: It is better to be honest.

Chairman: We welcome the honesty. There are some people we get as witnesses who know the answer to everything and we do not always believe that. We have got to move on because we are enjoying this too much and we have got to make progress. Helen is going take us through the management of the Children's Trust.

Q34 Helen Jones: The Committee has previously expressed some concern that most of the directors of children's services who were being appointed seem to be from an educational background. Do you have the data for what is happening now? Is that still the case? What proportion are from education and what proportion are from other areas, do you know?

Ms Eisenstadt: 98 have an educational background, 41 have a social services background and one has a private sector background.

Q35 Helen Jones: Does that bother you?

Ms Eisenstadt: No, it does not. It does not bother me because I think that the ones that I know, and of course like Sue I meet with them quite frequently, have taken on the wider agenda in a very, very serious way and understand it and are using their social care colleagues for the specific expertise. We were talking about it before we arrived in terms of the three of us before we came to you that at the end of the day no matter who does it someone has to do it and someone has to have some sort of background. The important thing is the leadership qualities to understand what you do not know - it is really exactly what you were saying, Chairman - and the leadership qualities to build the team around you to make sure that you have the particular expertise. I see great evidence of that, I really do, so it does not bother me.

Q36 Helen Jones: You do not think that many local authorities are still seeing this whole area of children's services/children's trusts as being simply an educational issue or an extension of education and therefore that affects who they appoint?

Ms Eisenstadt: In some sense the good news is that you get the rows on both sides so we must be doing something right because the education people think it is a social care takeover and the social care people think it is an education takeover. That is what happens when you bring stuff together. That is what people are going to think and that is why we have to bring it together because we have to break down that silo mentality if we can.

Q37 Helen Jones: Can we have a look at the management then. If we are, as we are doing, trying to bring together all these different areas of expertise, how in your opinion are directors of children's services able to manage that? If they are expected to co-ordinate people who are employed by other agencies - schools for instance or GPs (which is an area that we have looked at in the past here) how is that working on the ground? Are those agencies co-operating with this agenda in reality as opposed to saying, "Of course we want it and we co-operate with it", and what are the barriers in the way of doing that?

Ms Eisenstadt: I think the key question is what are the levers that the director of children's services and indeed the lead member, because of course there is a democratic accountability in this ---

Q38 Helen Jones: --- who is also often from education.

Ms Eisenstadt: --- what are the levers that they have at their disposal. There are some quite strong levers like duty to co-operate and some levers that they do not have. At the end of the day what we were trying to fix was that there was no clear accountability for children in a locality and the idea you have one person, shared with the lead member - the executive member and the political member - who has accountability for what happens to children in the locality, in my view, has to be right. I think it is the right thing to do. Then does that person have the authority and the power to bend the services in the way you are describing? In some cases, yes, in some cases, no, and in some cases it is about influence and knowledge and working together and building the capacity and the partnership, and in some cases it is "I'm sorry, mate, you have to do this". So on local safeguarding boards it is, "I'm sorry, mate, you have to do this". On extended schools it is, "This would be a really good idea. Wouldn't you like to do it?" and, lo and behold, lots and lots do. So I think that balance between the "must dos" and the bringing people on board because they feel a shared commitment is quite important, and I think it is psychologically important because the must dos only get you so far in real changes on the ground and the "must dos" do not let you feel like "this is something I really want to happen in my locality". I think that mix - and I read it in your report from last year - where you draw the line on the "everybody must do" and where you draw the line on "at local level decisions should be made" or where you draw the line on "at school level or neighbourhood level decisions must be made" will always be an issue for debate. Have we got it right? I do not know.

Q39 Helen Jones: Before I come back to schools I wonder if Sheila would like to comment on how GPs are working with this process because that is much more your area of expertise. What are you finding on the ground?

Dr Shribman: If I could start with primary care trusts in general because I think that is important in terms of the framework and then move on to GPs specifically. Obviously you will be aware that primary care trusts have a duty to co-operate in the new arrangements and they have to discharge their functions particularly in relation to safeguarding, so there are the specific and there are the general collaborative duties. Within a PCT's remit is of course the entire primary health care team in which GPs play an important part, as I am sure you would all agree, but not the sole part, so I think it is very important to focus on the whole of the team as well as GPs. From my point of view, I think this whole agenda has brought primary care in general into the co-operative arena in a more effective way than previously. I guess the worries that you have expressed and that people do express about GPs is how far are they engaged particularly in the specifics around safeguarding. It would help me to know what your particular concerns were around GPs.

Q40 Helen Jones: The reason I did not mention the rest of the health care team is that we have not really encountered problems there. There are problems about how far GPs are engaged in the process and there are problems about record sharing, for instance, that need to be addressed and I wondered what you had found about how that is working on the ground.

Dr Shribman: I think we will come on separately to information sharing because we have just published new guidance on that, as you know. I should perhaps declare an interest and tell you that I am married to a GP so I spend a lot of time talking to GPs.

Q41 Chairman: Is he earning £270,000?

Dr Shribman: I can tell you he is not earning that but I am sure he would prefer me not to tell you how much. I am sure you will be aware that the average GP earnings quoted yesterday were around £90,000.

Q42 Chairman: You do not mind me teasing you on that?

Dr Shribman: Not at all. I guess it is only to be expected. I feel that GPs are an incredibly important part of the children's agenda. Quite self-evidently they are dealing with children on an every day basis in relation to minor health problems as well as major problems and they are important, so in putting them in the context of the primary health care team I am not trying to say that they are anything other than important but they have a very large workload to address and a diversity of issues and I guess the concerns have been can we ensure that they are engaged on the children' agenda specifically. Going back to topical issues, the Quality and Outcomes Framework (QOF), on which they are remunerated in practice these days does have, for example, a requirement that individual health care professionals, including GPs, have information on local safeguarding procedures, so there are being built into the system more levers around ensuring that that engagement is there. Concerns were expressed by people that with practice-based commissioning, our new way of commissioning health services and engaging GPs and clinical front-line staff more effectively, that the children's agenda would not be taken forward. On the contrary, I think this is a great opportunity to engage GPs and other members of the team more effectively in the children's agenda. We are going to have some pilot areas for practice-based commissioning specifically looking at the children and young people's agenda so we can learn what could be best to take forward as GPC rolls out, and of course GPs as commissioners when they put forward their plans will have to have those plans overseen by the PCT who will look at the plans, taking into context the Every Child Matters agenda. I think the concern that people will be disengaged and be somehow able to go off in an opposite direction is untrue. I feel that the current framework enables more collaborative working and more engagement. I think in terms of working with GPs it is very important to be mindful of their variety of duties and to ensure that we as a system enable them on the ground to participate, for example, in child protection conferences. It is just a practical point but they have to be organised at a reasonable time of day to enable them to come. It really is not good enough to arrange it for first thing on a Monday morning when all of the patients are concerned from the weekend and so on. There are some practical ways of ensuring that GP engagement can work. In my own experience, as a designated doctor I have done a lot of lot training and education with named professionals and with individual GPs and I have always found them extremely keen to learn more. I have also done training on child health promotion and on children with disability and a certain amount in relation to child mental health issues, and again it is about meeting in the training opportunities the particular agenda that the learners have, so understanding what the GPs really need to know to do their job effectively and delivering the training in that way is key, in my view, to taking things forward. I understand the concerns but I feel that the opportunities are good with the positive framework that we now have to increase engagement rather than decrease it.

Q43 Helen Jones: We kept noticing when we looked at this topic before the need for training. You referred earlier to training across the piece and professionals working together. In your view, how well is that proceeding? I am thinking both right at the top of the children's trust but also right the way through because an issue we came up against in our special needs inquiry, for instance, was whereas you want to train teachers in recognising special needs you require the schools to release them for that training and that is down to the individual head teacher. What are you picking up about what is happening on the ground?

Ms Hackman: I think if head teachers were here they would say to you, "I understand what is happening with the local authority up there. I understand that this is integrated. I understand the intention of the policy. I understand what is coming," and I think they would have a very good grip on how it would work on the ground. If you look at extended schools most head teachers would have got as far as thinking "Who? How? How will I manage it? What about the time? What about the money?" They have got that. I think they might be more anxious about what it would mean for particular teachers in schools. For example, right now I would say your average year four teacher or your average head of maths in a secondary school has been briefed about the policy but the word "training" would not quite apply. They have been briefed and there is a difference between being briefed and understanding exactly what your role is. You may disagree with me but I would think at this stage that is probably where we would expect them to be. They know the idea, they know that something is coming, but I would say speaking for ordinary teachers outside the senior management team right now they would probably say, "I know and I agree with the policy but I am not quite sure right now how I will fit into it." That is an honest answer. That is what head teachers say.

Q44 Helen Jones: Is the real problem at that level not time? It is very difficult to release teachers for extra training.

Ms Hackman: It is difficult. You have probably got children in school. I have got children in school. I do not want their teachers out of the class all the time. I will be honest with you. I want them in the class teaching. For example, there are ideal opportunities when schools have closure days if they could put in those dates with colleagues in other services to have joint planning time and joint sessions. I think that would be ideal. That is better than taking teachers out of the classroom. If you have a policy you have to create time. Right now - this is my own view - I can see that there is money and I can see there is a well-understood policy but I think time might be the biggest issue. I think we have got to help them to see where the time might be created without forever taking teachers out of classrooms.

Ms Eisenstadt: I think there is a further issue of who needs to know what. I am not sure how much the secondary maths teacher needs to know. I would want the secondary maths teacher to know a lot about working with parents and information for parents and those sorts of things. I am not sure they would need to know the detailed workings.

Ms Hackman: I can tell we are about to disagree.

Q45 Helen Jones: They do need to know how to recognise a problem a child has and how to call in the appropriate support.

Ms Eisenstadt: That they do need.

Q46 Helen Jones: Our evidence is that that does not always happen.

Ms Hackman: That is it. If they are in your class they are your problem. If they are in your class the child with autism is your responsibility. Is that not the point of the policy that if it is in your class it is your problem?

Ms Eisenstadt: That is absolutely right but what I was thinking about was the structural changes in all that. What the teacher has to know is something about the children in the class and something about parents. I think we have to be careful that we do not overplay that everyone needs to know everything because everyone does not need to know everything because then you are duplicating and wasting. I think we do agree.

Ms Hackman: Let us just revise it to say that what we want every teacher to do and health care professional to do is to say, "I may not myself be the person, I may not myself know the answer but it is absolutely my responsibility if there is an issue at home, if there is an issue with health, and I am not a health professional, to make sure that it is attended to by someone somewhere.

Ms Eisenstadt: And to know of whom I need to ask the question. I think in the past that has not happened and in the past teachers have been quite nervous about asking the question because if they did not feel confident about getting the help, why do it.

Helen Jones: Thank you.

Chairman: We are now moving on to the involvement of schools. Jeff Ennis?

Q47 Jeff Ennis: Following on primarily from the line of questioning Helen has been pursuing latterly, the last report from the evaluation of children's trusts found that just one per cent of schools were involved in the management of trusts and only eight per cent were working with their trust. Do these findings concern you?

Ms Hackman: Yes, it is a concern. I am astonished, I did not know that, I am very sorry. It astonishes me and depresses me.

Ms Eisenstadt: I think the issue is about what exactly does the report mean and this is the 38 pathfinder trusts where for many of them the nature of what they were doing is very different to what we expect of trusts now. The way in which we have designed trusts now and the way in which within the current Education Bill the school has a duty to have regard to the children and young people's plan is the way that we are addressing that issue. It is exactly as we were saying before. We want schools to have regard to young people's and children's plans, we want the local authority and the children's trust key partners to engage schools in developing the plan. When that evidence was collected it was long before we had these wider strategies about the role of the local authority to organise strategically the whole range of children's services. I am less worried about it given the timing of the report than I would have been, say, six months ago and the issues that we have steps to remedy that situation because I think we have taken a lot of steps to remedy it.

Q48 Jeff Ennis: So we are rectifying that current situation?

Ms Eisenstadt: Yes.

Q49 Jeff Ennis: Do you think more needs to be done to secure a commitment from individual schools to the Every Child Matters agenda?

Ms Eisenstadt: Our evidence on the extended schools agenda in terms of their participation is very good and the other evidence we have is the Guardian Headspace Survey. 70 per cent of head teachers are very, very supportive of the Every Child Matters agenda. You could say that means 30 per cent are not but 70 per cent as far as I am concerned creates a critical mass in terms of peer relationships because I think it is much more likely that head teachers are going to be able to convince each other than they are going to listen to what I have to say and they are certainly going to listen more to what Sue has to say than what I have to say. The way in which we deal with that 30 per cent is the issue. I was very pleased about that Headspace result. I thought 70 per cent was very, very good. Sue, I do not know if you want to say more on that.

Ms Hackman: As I said earlier, I think the policy is popular. I do not come across people who disagree with it. If they have got anything to say that is negative at all it is about the practicalities of it, about finding time, about when the staff are going to find out about it. I think the policy is well supported.

Q50 Jeff Ennis: Do we need to consider taking sanctions against schools who do not participate in the ECM agenda?

Ms Eisenstadt: It depends what you mean by "participate" and "engage" because it is quite important to say that schools' responsibility is to their children and the parents and what those parents want. Given the relationship with schools, my view is that we should not take sanctions because they are clearly doing something that local parents want and if they were not they would lose kids and the school would be in trouble anyway. If it is a popular school and it has good results and it is doing what parents what then I think there are issues about convincing and cajoling. I do not think there are issues about sanctions. I think that goes against what we are trying to do with the rest of the system on users leading the system. You cannot have it both ways. You cannot say that parents have the role to play in leading the system so long as the school does exactly what we tell them to do.

Q51 Jeff Ennis: Moving on to extended schools, the logic of the extended schools programme is that such schools should draw their intake from the local community, shall we say. How can we reconcile this against the strategy based on academies and trust schools and the diversity that is being proposed in the Education Bill?

Ms Eisenstadt: It depends what you mean by "local community" because the community is the community of the school and I think that is a both/and not an either/or, in the sense that if you have got good IT facilities and good sports facilities of course they should be open to the local community, they should be open for adult education to local service users, but on the other hand schools will draw from a much wider catchment than their local area because that is what school choice is all about.

Ms Hackman: On the more general issue, I was going to say that trust schools, in common with all other schools, have to give due regard to the children and young people's plan and work within it. We are not without levers. For example, Ofsted inspections will take account of how schools perform against the final outcomes in Every Child Matters so it is not that schools will be completely free-floating and able to do their own thing. I think there are levers in the system. I do not know if you count this as a lever but there is always a very considerable field force to support the local authorities and schools to implement the policies, and I think probably giving constructive advice is more effective than applying sanctions. So I do think it looks like there is enough in the system but time will tell.

Q52 Jeff Ennis: Jointly sited facilities - such as children's centres in school buildings and extended full service schools - should mean that teachers and other school staff will be working more closely with those from early years and other sectors. What are the implications of this in terms of staff development needs and remodelling professional identities? I know we have touched on this briefly in the past.

Ms Eisenstadt: I think there is an interesting debate on the role of the head and to what extent the head is the head of a combination of services. I have seen children's centres literately in the school playing field and they are separately managed and they work really elegantly together and there is no problem at all. I have seen ones where the head runs the whole show. My best advice is to go to Millfields in Hackney and see Anna Hassan in action. When you see these schools that really do the lot they are awe-inspiring, they are amazing places. At the end of the day it does have implications for school staff, but it is not that unusual to have a two year old and a six year old and the idea that you can take them both to the same place for parents is fantastic and the idea that the teachers in the reception class can walk across to talk to the nursery staff and say "What was he like? I am a little worried", it allows for those sorts of relationships to develop. There are challenges to it, there is no question, but I think the benefits far outweigh the challenges.

Ms Hackman: There is a certain amount of training you can give to people to prepare them for the new world, but I think we have got, a radical and interesting plan for how we are going to spread good practice. We did do 35 pathfinders for that specific purpose so that we would have examples of how to make it work on the ground and people who could give testimony to how they found it, and we are going to try to spread that good practice very vigorously. Beyond that our plan is less to have top-down cascade training and a bit more to give people mentors who have, for example, already implemented the policy in another school or to pair schools together, one which has got experience and one which does not or for example to have open days at schools which have developed the policy very well so that other people can come and participate and watch and observe it in action for half a day and have training in the second half of the day. So we are imagining a much more vigorous field operation of sharing practice rather than an inert cascade model because there is a difference between being told and being shown, and we think probably the latter is going to be more effective in this case.

Q53 Jeff Ennis: On the issue of children's centres, it seems to me that you are favouring a children's centre being sited on a joint campus rather than in a separate location from schools. Can I draw that conclusion?

Ms Hackman: You cannot from me. I can think of examples either way that are good. I just suppose it is geographical logistics. Schools are places where children are and they gravitate towards. I can see why there is an inclination to locate there.

Ms Eisenstadt: It depends on the nature of the children's centre. There will be a lot that are developed from local Surestart programmes where there has already been significant capital investment and it would be mad not to continue to use that significant capital investment. That investment does allow for the join up with health and it does allow for a much more integrated service for young children. I think where schools are particularly beneficial is on the lighter touch model of children's centres and where if it is an extended school the inter-agency support can be across the whole age range. I am saying that it would be really wasteful not to do that. As Sue says, it is horses for courses and areas are so different.

Q54 Jeff Ennis: Do we have a statistical breakdown of the number of children's centres that are on joint campuses as opposed to not?

Ms Eisenstadt: I am sure we do but I do not have it on me.

Q55 Chairman: How many children's centres are there?

Ms Eisenstadt: Right now there are over 800.

Q56 Chairman: How many do we expect to have?

Ms Eisenstadt: 3,500 by 2010.

Q57 Jeff Ennis: Can you provide that information to us?

Dr Shribman: That is straightforward, yes.

Q58 Chairman: In the idea of the extended school what kind of activity goes on?

Ms Eisenstadt: Out-of-school childcare, breakfast clubs, opportunities for stretch, homework clubs, maths clubs. It is a mix of child care with the kind of activities that always happened in schools and after school anyway but on a basis where it is more regular and more dependable. So sports activities, arts activities, academic stretch activities.

Q59 Helen Jones: Do you include relaxation?

Ms Eisenstadt: We talked about that, too. I have said that. I think a place to sit and watch TV would be very good, but for other people sports is often relaxation.

Q60 Chairman: There is a fear that the extended school might deteriorate into kicking an old football in the playground rather than giving kids opportunities. I do not always take that much notice of teachers' conferences but one of the things that did come out at the weekend was the imprisonment of a curriculum that does not allow the stretch, so what are you going to do about making sure that stretch, the things you cannot do within the curriculum, could occur after school or in the extended school.

Ms Eisenstadt: Give them lots of money so they can do it, first of all. It is the personalisation agenda, but I go back to what we were trying to fix. Historically we had some schools that provided really good after school activities and there would be a maths club and you could go along to the maths club but if the maths teacher was off sick you did not go to the maths club, you just got sent home, and for the working parent that simply is not good enough. The difficulty we had is that the children who were in out-of-school clubs could not go to the maths club because they were somewhere else in the out-of-school club and the children who were in the maths club if their parents got jobs could not go to the maths club any more. The idea was you had all these out-of-school activities but they were not organised around the dual needs of working parents as well as the children's stretch and educational needs and it is about trying to get a both/and rather than an either/or. Making sure that we bring those things together is one of the key things we are trying to do with extended schools and why the Prime Minister has a commitment to the eight to six offer.

Q61 Chairman: But do you believe that this is an essential part of addressing the Every Child Matters agenda?

Ms Eisenstadt: I absolutely believe that. I absolutely believe that it should be a choice of activities for children, but also making it easier for working parents. At the end of the day when we talk about closing the gap, the gap is largely a poverty gap and, unfortunately, as I say on public platforms all the time, the best way not to be poor is to have a job. I wish there was another way not to be poor but I have not figured it out yet. The only way we can have employment opportunities for parents is if we have reliable, affordable, good childcare. Parents themselves really like it on school sites because they trust the schools.

Ms Hackman: For children who are very disadvantaged we have had a long-standing problem which is if you want to give them catch-up help or stretch help you have to take them out of classes and then they become doubly disadvantaged because they are not only having to catch up in one subject but they are falling behind in the subject from which they have been withdrawn. I think extended schools offer us a really good opportunity, particularly in key stage three where the curriculum is congested, to offer them extra help which is additional help and which does not disadvantage them by taking them out. Also I am thinking of a language college which is intending to offer extra languages with native speakers as part of the extended school and to offer Internet access to parallel classes in I think it is Canada (but I may be wrong) as a liaison activity on the computer after school hours. I think it is one of the areas where there are some very exciting ideas in development for how to use that time productively. However, I do agree with you, I feel I need a rest when I get back home and I do want space for children to relax.

Q62 Helen Jones: We do not have to control every single moment of a child's day. In fact, there is increasing evidence that they benefit from that not having that control. All you need is a safe environment for them to develop interests of their own.

Ms Eisenstadt: And to have choices.

Ms Hackman: And to talk to adults. I think talking time to adults might be one of the benefits.

Dr Shribman: I was just going to add something on the health opportunities here. I could not agree with you more. Random football kicking is fine but there are also other activities that we could have that are more structured in terms of physical opportunities. We are always talking about increasing physical activity in children to help tackle our obesity problems, and there is dancing and musical activities and other ways of being physically active rather than, as you say, the random kicking of a football approach, which is not enough. So again there are opportunities there for health activities. You have mentioned breakfast clubs and there is healthy eating and other things we can weave into this, I think.

Chairman: David, you have been patient.

Q63 Mr Chaytor: Could I ask Sheila to what extent is the current financial restructuring of the NHS impacting on the pace of the implementation of partnership working?

Dr Shribman: You have referred to financial restructuring. I think there are two elements to that. There is the Health Service restructuring in terms of reorganisation of strategic health authorities and primary care trusts and then there is the current financial position. So to take the latter first, the current financial position, as I am sure you are aware, despite the large amount of publicity, the number of trusts that are financially out of balance is around the seven per cent mark and the total financial problem is around less than one per cent of the whole NHS budget. A large amount of money has been put into the NHS and is due to be put in further up to 2008, so the present position is turbulent in the media but in reality has to be brought back under control in terms of achieving financial balance and kept in proportion. Was it that aspect?

Q64 Mr Chaytor: I take the point about the specific issue of deficits but leaving aside the deficits that apply to six per cent of NHS trusts, is not the whole process of implementation of the payment by results system in itself a deterrent to increasing co-operation between different agencies or not?

Dr Shribman: No, I do not see the implementation of payment by results as a deterrent to co-operative working. Payment by results is a new way of resourcing and financing the NHS. It has to be developed further over the next few years and clearly it is of great importance to look at the resourcing of children's services in general. You will doubtless be aware of the publicity surrounding some of the specific specialist children's hospitals and at the moment the tariff in relation to them is being discussed to see what else needs to be done. This is an evolving picture so, no, I do not see payment by results stopping collaboration. It is very important.

Q65 Mr Chaytor: So it is not holding back the pooled budgeting arrangements, for example?

Dr Shribman: I do not think PBR is. I think on the restructuring side, where SHAs have been reduced in numbers and PCTs are going to be re-organised, there has been some anxiety about whether that will hold back collaborative working, but in fact that is all being implemented very quickly and the new arrangements will be in place for the new PCTs by October and the new SHAs have recently been announced and there are transitional arrangements for those. So, no, I do not think that will hold things back. Indeed, the data on the pooled budgets that I was referring to earlier shows an increasing amount of pooling of budgets going on at the present time. Clearly there will be some different people in different posts and that will take some bedding down. We have to be realistic about that but the policy direction remains the same.

Q66 Mr Chaytor: If the 300 PCTs are to be merged into 100 PCTs, each of those 300 will already have established its own local delivery plan, and they may not be entirely harmonious with the adjacent PCT's local delivery plan to which they are now being merged. Is there any evidence that this is causing disruption?

Dr Shribman: We do not know the final number of PCTs as yet, that has not been announced, but clearly there is to be a significant reduction, and I welcome that because I know that there will be greater co-terminosity with local authorities as a result of this restructuring and that that in fact gives an opportunity to further enhance our collaborative working arrangements rather than reduce them.

Q67 Chairman: Please visit Huddersfield, my constituency, and look at what a difference there is between the distinct communities of Dewsbury and Huddersfield. Do you really think that having one PCT for four and a half constituencies, with two very identifiable, different communities, is going to make better sense?

Dr Shribman: I cannot comment on Huddersfield because I do not know it but I would be happy to come and visit it.

Q68 Chairman: You speak very warmly and glowingly about the co-terminosity of local authorities with PCTs. That sounds wonderful until you come to a real part of the world where real communities are so distinct it makes a nonsense of PCTs being representative of any community.

Dr Shribman: I do not know the final outcome of what will happen with PCTs in your local area so I am not sure what the conclusion of that will be. I want to finish the point because it is terribly important.

Q69 Chairman: I have put my complaint in. Carry on with David.

Dr Shribman: The co-terminosity will increase significantly but we do not know what the final outcome of that will be. That in principle is important. I agree there are specific issues in particular areas. Of course the newly formed PCTs have to pay regard to what local communities require and need and therefore there has to be an approach towards localism that is important. The reason I am in favour of fewer PCTs is because I think we will see greater expertise in commissioning and because we are going to see enhanced expertise in commissioning (which is crucially important, particularly for this partnership agenda) I see this as being the correct way forward. Overall, that is why I welcome it because I think it is the right thing to do. I understand why it causes anxieties in areas, particularly where strong arrangements have developed, but these have to be built on and not abandoned and that is the opportunity that people have to take.

Ms Eisenstadt: I have to say that I warmly welcome co-terminosity because of the joint planning. The difficulties I have seen are where in a local authority there is a director of children's services who has to work with three different PCTs. Sometimes they do not share the border so one PCT will be split between two local authorities and the director of children's services has different PCTs. I think co-terminosity is absolutely key to the delivery of this agenda.

Q70 Chairman: Whatever the size of the local authority?

Ms Eisenstadt: That is an ODPM question. It is very interesting because Sue mentioned that in her experience the small unitaries do better on this. It is my experience that the small unitaries do better as well for those same reasons.

Q71 Chairman: Mine is a big new unitary.

Ms Eisenstadt: I think that the unitaries work better in terms of this kind of agenda because you are not dealing with two-tier authorities where you have got play and leisure at district level and you have got children's services at the upper tier level. I think the opportunity for a chief executive of a health trust to have that key relationship with the director of children's services and for the chair of the primary care trust to have that relationship with the lead member is absolutely fantastic. I, too, am a very enthusiastic supporter of it and was very concerned when these changes were going to happen that we were not going to get more co-terminosity.

Q72 Mr Chaytor: So in terms of the PCT delivery plans that have already been published, are you confident that the relevant directors of children's services have been fully involved in those plans even where the PCT has not been co-terminous with the local authority and PCTs have had to work with two or three different directors?

Dr Shribman: I think that takes us back to the previous discussion on the children and young people's plans and the engagement there has been in the development of those, because that was clearly the vehicle to get everyone together to look at what the local need for children and therefore what locally people need to do in terms of their priorities. Different priorities have been set by different local planners and that has fed into the last round of local delivery plans. Clearly the new PCTs will be in place by October and the autumn is the time for producing the next round of those plans. In the recent health White Paper Our Health, Our Care, Our Say, I am sure you are aware it has been signalled that bringing together the budget cycles between local authorities and health is one of the key directions of travel. I think that will be a very important enabler to improve local planning. It has been a source of frustration to people for a long period of time because planning cycles are not aligned, so I think the co-terminosity and the planning cycles being aligned will help facilitate rather than hold it back. I agree there is change in the short term and change has some disruptive element to it so one must be realistic about that, but nevertheless I still think it is the correct direction of travel. If you would like me to come to Huddersfield, Chairman, I would be delighted.

Q73 Mr Chaytor: In terms of the SHAs to date, are you confident the SHAs have been fulfilling their performance management responsibilities?

Dr Shribman: Yes, there have been children's leads in the SHAs and my colleagues and my predecessor in the Department of Health were involved in bringing together those children's leads. Since I have been appointed I have been to two of the events where the children's leads have come together over a two-day period to discuss crucial issues in relation to children's services. There has been engagement and they are at the moment looking at how they might usefully share their performance management approaches. Clearly there are now going to be ten SHAs instead of the previous 28 but we expect to bring together those children's leads in the same way. They have much to discuss and learn from each other and that is one of the facilitating things a department can do.

Q74 Mr Chaytor: There has been some suggestion that the performance targets for children's health are less stringent than the performance targets for adult health care. Would you agree with that?

Dr Shribman: I would say that targets are targets and they are all stringent. I guess the question is are there as many targets or enough targets. There are key targets, as I am sure you are aware and I have referred to them before, on the infant mortality issue. We have shared targets around obesity and targets around teenage pregnancy, and the success of local authorities is dependent on the Health Service playing its part and vice versa in terms of delivering a number of these targets. There are targets specifically to do with maternity services and manifesto commitments around maternity and some targets related to child mental health to be delivered by the end of this year. So in some areas of children's services there are quite a lot of targets. I know some of those comments have come as a result of a change in emphasis towards more local decision-making and away from more centrally driven targets, which were particularly strong and still remain strong for reducing waiting lists and for accident and emergency four-hour targets, and that sort of thing. There are targets in children's areas. As we implement the NSF we need to be clear about the milestones we expect to see achieved.

Q75 Mr Chaytor: So your feeling is that there ought to be more targets for children's health or better developed targets for children's health?

Dr Shribman: I think we need to be clear about the milestones we are expecting people to achieve. Speaking about the health specific side of it - and my colleagues may want to contribute to that - I think it is very important in terms of any targets that we have that they go well together across the individual sectors. It would be foolish if the targets we were looking at in health did not marry with other targets being looked at, so jointly looking at what we are trying to achieve and jointly inspecting against that is particularly important. We have moved away from specific targets so I do not think there would be more very specific targets around children's health, but I do think that we need to focus on the ones that have been chosen because they have been chosen for a particular reason. We know that there are aspects of children's health that need to be tackled but we cannot have a target for everything, that would be unrealistic, so you have to prioritise and you have to choose key areas to focus on.

Q76 Mr Chaytor: Earlier we touched on the area of GP commissioning. Do you think the onset of GP commissioning provides a stronger argument for GPs having to comply with a duty to co-operate? To date they do not have that duty, as other parts of the system have, or do you think the co-operation of GPs will emerge organically?

Dr Shribman: I think that much of the policy work that has been done across children's services and other areas seeks to engage GPs in the wider public health agenda as well as the agenda related to the individual patient in front of them, which is clearly their core activity, so yes I think that general direction of travel in relation to health promotion, prevention of problems, and looking at wider community needs is very helpful in terms of our agenda on children so this does all fit together. Re-engaging GPs in commissioning (because I think they have become less engaged) is extremely important. There are so many contacts GPs have with members of the public every day and they are in a key position to influence people's health, as we know, and to prevent problems as well as to deal with sickness. I see them as core and crucial and, yes, I do think this will enable further engagement. Clearly there will be some early priorities related to adult health. You will be aware of the need for us to reduce the number of adults who are admitted to hospitals and provide care closer to home and the community because that is what people want. Of course that accords well with the children's agenda because that is what families want. They want the services provided closer to home in local venues, in children's centres, in youth clubs, and so on.

Q77 Mr Chaytor: But GPs as a profession traditionally have not always been noted for their outgoing, enthusiastic co-operation with other professionals. How can it be that when the PCTs were responsible for commissioning it was felt necessary to have a statutory duty to collaborate but now GPs will become responsible for commissioning it is not felt necessary for them to have the same statutory duty?

Dr Shribman: It is hard for me to judge GPs as not outgoing and collaborative because I suppose my experience has been of a lot of collaboration and co-operation. GP commissioning is not the sole commissioning that is going to go on. There will be the PCT overseeing these plans. I think the really important thing in this is about clinical engagement, be it with GPs or other clinical staff, and the same applies in the hospital sector or the community paediatric sector or elsewhere. We are going to deliver on health outcomes within the health sector if we engage the clinicians in the direction of travel, and to do that you have to have mutual respect and discussions and so on. This is an opportunity to improve clinical engagement of GPs and indeed others and that opportunity has to be grasped.

Ms Eisenstadt: I think there is another major issue and I think we all fall into the trap. It is very interesting for me sitting where I sit between schools and health, and my job sits that way as well for Every Child Matters, and that is to say that the debates around GPs are very, very similar to the debates around schools and they are always the debates about why do we not make them do X. I think there has to be a different debate. When I talk to GPs, as occasionally I do and I speak to the Royal College of General Practitioners, their difficulty in terms of the wider service agenda is knowing if they say to a patient, "I can get you in contact with X and they can help you on this other stuff" whether that will happen for them. Any GP, like any teacher, if it happens to them twice that they make a recommendation to a parent or a patient and it does not happen, they get very irritated, and quite rightly because they are at the front-line and they are getting the complaints. I think our job is not to keep moaning about they will not join in. It is to get a much better communication system on what is the repertoire at the GPs' disposal that they can really rely on to help. In many GP practices you do see welfare rights advice and in many GP practices you do have a social care input. It is about just making sure that where you see the good you make that more widespread and you use collaborative methodologies to make that happen. We just cannot go on saying we must make them do it. We have to think of other strategies which are about convincing and cajoling and building a system more to what would make life easier for them rather than harder. I think the GP story and the school story is very similar in that. They will read the press too.

Q78 Mr Chaytor: The new GP contract has very specific obligations on GPs and financial incentives attached to those obligations. Why can that model not be used to encourage the increasing co-operation and information sharing that is necessary if the Every Child Matters agenda is going to be properly fulfilled?

Ms Eisenstadt: Interestingly enough, on the QOF, on the Quality and Outcomes Framework, the local duty to safeguard is within the QOF, so we have a hook and we have a hook that is most critical in terms of child outcome and in terms of what GPs do.

Q79 Chairman: I think the difference between us and your colleagues if you represent an average constituency with an above average number of single practitioner GPs is that is a very different situation from an ideal model of a modern practice with modern GPs. That is very, very different.

Ms Eisenstadt: I am sure you are right.

Q80 Chairman: Sometimes some of the single person practitioners need a much more ----

Ms Eisenstadt: Forceful approach. I am sure you are right.

Chairman: There is one more section. Stephen has been very patient, again, and he is going to lead us through the last section on improving outcomes and assuring quality.

Q81 Stephen Williams: I want to focus on one of the five Every Child Matters measures, which is on achieving economic wellbeing which is all about child poverty. When Ofsted did an interim report on children's services in July 2005 their key conclusion was this was the area of the five that local authorities were least able to deliver on. Do you accept that finding? If you do, do you think local authorities could improve that perception or will it always be the case that that will be the area where local authorities can achieve the least?

Ms Eisenstadt: I am going to ask Sue to talk about 14-19 in a minute. Again, I have a very robust response. I get quite irritated by this. I do not understand why at every level, including my own department, we do not champion childcare as part of economic wellbeing because the massive increase in childcare has allowed for employment and the changes that we have done in terms of affordability have allowed for employment. Indeed, we have very good evidence in areas where we have increased childcare that we reduce workless households. If we talk about child poverty now in terms of the current generation of children, I think we have a pretty good story to tell. I do not understand why people do not make that link between increased childcare, employment and poverty reduction, and clearly economic wellbeing is poverty reduction. I think the next bit is about the 14-19 agenda which I will pass on to Sue.

Ms Hackman: You know those kids who are in poverty and we want to dig them out of it and give them a future, I think what those kids most need from us is not our bleeding hearts or our liberal sentiments, they need to be taught to read, to write, to manipulate number, to have the disciplines of education about them so that they can get into a workplace and have a job. That is the way to dig people out of poverty. It is a bit long-term, I understand that, but ultimately I think our biggest vested interest is in equipping them for future life. Our small role in that at the moment is that we are going to try to do a much better job with children once they are past Key Stage 3 to equip them for a future that is not just necessarily going to university but equips them with vocational skills. Twenty years ago employers used to say, "You send them here and they cannot event write their own names" and now they say, "They come here and they have got a C in GCSE English but when I ask them to do a particular job they cannot apply it to this particular situation". I think some of our responsibility is to equip pupils with skills for life, the kinds of skills you can use on the job, employability skills if you like, but in particular functional skills in English and mathematics. I think that is going to be our lasting legacy from this particular period, that the way we addressed poverty and closed the gap was by teaching them. We cannot change who their parents are, we cannot change the colour of their skin or their gender, what we can do is teach them to read and write, those are the things we know about in school. If we can secure their health and secure their wellbeing and do our very best by their parents, as long as we have got good teaching plans in place and good adequate teachers I do not see why we should not be ambitious for the social agenda as well as the educational agenda.

Ms Eisenstadt: We can change the parents' side by opportunities for employment. A key requirement within children's centre guidance is active engagement with employment opportunities.

Q82 Chairman: Having looked at special educational needs and having personally addressed a lot of parents of children with special educational needs, one of the challenges that comes back is it seems there is a great deal of emphasis, quite understandably, on early years, the young child, but what about the upper end of the age group in Every Child Matters? A child is a child to 18 whilst many parents of children who have special educational needs find that the degree of help and support they get tails off definitely at 16 and there is very little out there post-16 and nothing post-18, and in a very real sense many of those children will be children when they are adults. There is that continuing level of responsibility where people feel absolutely deserted, certainly post-18. Does Every Child Matters reach out to every parent who has what is realistically a dependant child?

Ms Eisenstadt: Certainly we are looking at that in terms of looking at proposals on leaving care and at what age children should leave care unsupported and how to improve that. Sheila has spoken at length on the transitions issue, on how the health system responds to those sorts of needs and this balance between the child with special educational needs, where their need is for their own independence and what their parents want for them, can be given attention. I think overall you are right, on the parenting side we are weaker on older children. We have done a lot in terms of the Youth Green Paper and the responses to the Youth Green Paper and we now have pilots on integrated targeted youth support, so we are beginning to look at it but we do not have the models for parenting support for older children because the issues they face are so different and so much more difficult. It is what Sue said about the stroppy 14 year old. It is very easy to ask for help if you are worried about weaning or toilet training; it is much harder to ask for help if your ten year old is taking sweets from Woolworth's.

Q83 Chairman: What do you say to the woman who asked me a question recently who said, "I face a future that when I am 68 he will be 48 and still entirely dependant. My partner has left because he could not stand the stress"? There was a whole group of these people in the same situation.

Ms Eisenstadt: The issue is what Sheila was saying about a much closer liaison and a much smoother transition between child and adult social care, because we cannot take on the lot. Organisationally you have to break it up and manage it in some ways. We need much more work on those transitions and the appropriate ages for those transitions and what suits individual families, both the young adult and the parent.

Dr Shribman: We have to be mindful that young people with a disability are living longer. Success in health terms leads to longer life for this group of young people as well as for the older age range, so there is future planning to do around this group as well.

Q84 Stephen Williams: If I can pick up my thread on child poverty. The Government set a couple of ambitious targets: one was to lift a million out of child poverty by April 2005, which they have gone a long way towards achieving but have admitted they have fallen short of, and then to halve it again by 2010. What analysis has been done to measure what impact Sure Start and children's centres is having on achieving that target by 2010?

Ms Eisenstadt: We are just waiting for the DWP figures on workless households. I have to say we have been waiting for some time. We have a PSA target on workless households. I cannot give you the figure because I do not have it yet but it is very, very carefully monitored because it is a PSA target. There is a target on reduction in children living in workless households and there is also a target on uptake of formal childcare by low income families. Both of those are very specific PSA targets and as soon as we get results they will be published as part of the DfES Annual Report in terms of the way we report our PSAs. That has been a very, very strong driver in terms of what we are looking at.

Q85 Stephen Williams: Could I just clarify the number of children's centres? How many have we got at the moment? I think I heard Naomi say there are going to be 3,500 by 2010 and in our brief it says there are going to be 2,500 by 2008. Are both of those figures correct?

Ms Eisenstadt: Yes.

Q86 Stephen Williams: So there is going to be an acceleration toward the end. How many have we got now?

Ms Eisenstadt: We have got just over 800.

Q87 Stephen Williams: Our researchers have helpfully given us a quote from the Guardian from an article written by Naomi - I read her own words back to her - where it says, talking about Sure Start: "they have been very successful in creating the conditions for integration, but the challenge now is to work out how that translates into front room services". What did you mean by that?

Ms Eisenstadt: I did not mean Sure Start in that, I meant Every Child Matters. It is actually a typo; it is "frontline services" not "front room".

Q88 Stephen Williams: A Guardian typo.

Ms Eisenstadt: It is an embarrassing typo. Can you imagine, it never happened before! What I meant by that quote was precisely what we have been describing. We have structures and systems in place but what we have to do is make sure that we keep reminding ourselves why we did it and, therefore, the outcomes that we expect come true. As in the way I described in terms of Sure Start, we have to reanalyse and reflect on is it achieving what we expect it to achieve, if not why not and how do we make it better. I think the basic systems are right but that does not mean that bits are all going to work perfectly, that would be highly unlikely. The issue is, are we measuring the right things, how do we know what is happening out there, and a key part of our collective role is what is happening out there both in terms of core data but also in terms of what people are telling us.

Q89 Stephen Williams: Finally, on a slightly different issue. We have talked a lot about what the Government is doing with Sure Start and children's centres but can I put a couple of questions on the voluntary sector. First of all, do you think there is a danger that some voluntary sector work in this area is going to be displaced by more formal Government intervention of children's centres? There is certainly a fear about that in my constituency in St Paul's where a children's centre is on the way and there are some voluntary organisations who think they are doing the job already and they are worried they are going to be displaced and what comes in their place is going to be more expensive. Secondly, what monitoring takes place of voluntary sector contributions?

Ms Eisenstadt: First of all, it is written into the Bill on the childcare side that local authorities should be the provider of last resort and lots of the children's centres use private sector providers to provide their childcare. If you look at the amount of funding from Government to the voluntary sector over the last five years, it is a massive increase just because so much more money is going into children's services of the kind of stuff that voluntary organisations do. I think the really interesting thing is plurality in terms of the private sector as well. If you look at the rest of Government we are looking for more and more plural services in terms of health and education. The childcare world is one world where we have had an incredibly plural system. In going from a plural system that was largely voluntary to a system where a local authority has to take steps to ensure that there is adequate childcare, will the local authority then become the key provider, which is your question? We have taken significant steps in the legislation and in the guidance we have produced to make sure that does not happen, to maintain what Government wants across other services that we already have in childcare, which is significant engagement of the voluntary and the private sectors.

Ms Hackman: Can I say that we have opened up our training offer to the voluntary sector at the foundation stage so that they do get the benefit of the training that is on offer along with schools.

Q90 Chairman: Can I thank you for your attendance. I am sorry but you have made a very big mistake in coming before us: we have enjoyed this session so much you will probably get an invitation sooner than you would like to come back! We have learned a lot and it has informed us both in keeping up-to-date with what is happening with Every Child Matters and informed a great deal in terms of our current interest in special educational needs. I am sorry that Sheila had to put up with me teasing her a bit about Huddersfield and GPs.

Dr Shribman: I look forward to the visit.

Chairman: Thank you very much.