Examination of Witnesses (Questions 60-79)
22 JANUARY 2007
DEPARTMENT FOR
EDUCATION AND
SKILLS AND
DEPARTMENT OF
HEALTH
Q60 Mr Khan: Let me deal with that.
How do you deal with the criticism made by the most disadvantaged
families, whom you may not have been able to reach, that all you
are doing is providing a subsidy to the middle-class articulate
lot, who already knew where to go to get the services, and that
you simply subsidise things for them?
David Bell: I think the Report
makes clear, as does the Sure Start evaluation to date, that this
programme is reaching disadvantaged groups. It may not be reaching
all the hardest to reach and the most disadvantaged, but as the
report properly says, just saying you are not reaching the hardest
to reach and the most disadvantaged does not mean to say that
you are reaching only the advantaged. This programme has done
much to reach disadvantaged families and children, but we recognise
and accept entirely that there is more to be done to reach those
who are hardest to reach.
Q61 Mr Khan: The Chairman referred
to a concern about ring-fencing. The Report tells us that £700
million in 2006-07 will be devolved down to local authorities
to allocate on children's centres. How do you know that money
will not be spent elsewhere?
David Bell: Part of the agreement,
if you are referring to what has gone into the local area agreements
pot, has been a memorandum of understanding that has been agreed
between central Government and local government to be clear about
what is expected. However, within that there is room for discretion
broadly across the children's services area, because that is part
of the reason for putting it into the local area agreement.
Q62 Mr Khan: So a local authority
could have been spending, for argument's sake, £200 million
on "children's things". Let us use the smaller figure
of £5 million to be spent on children's facilities. Local
government have now received £15 million from central Government
to spend on "children's things". That means that they
can stop spending the £5 million they were already spending
and use it to do whatever they like while using your £15
million to cover that gap.
David Bell: As far as the money
that has been allocated via the local area agreements, local authorities
should use that according to the conditions that are expressed
in the memorandum of understanding. We cannot prescribe what local
authorities spend in addition to what has come via the local area
agreement. Local authorities should make the decision about how
and where they spend.
Q63 Mr Khan: So how will local people
know whether the value added has come from central Government
investment or from a local council?
David Bell: To be frank, that
is virtually impossible to tell. That would not just apply to
this set of services, but right across the piece.
Q64 Mr Khan: Just going down a further
stage, if a mainstream school has been given additional money
to provide a children's centre, how will we know that that school
is not using the money to subsidise facilities in the mainstream
school?
David Bell: There is a requirement
in relation to the outcomes that we expect from children's centres
that I specified earlier. There are certain requirements on all
children's centres that mean that any school has to be able to
demonstrate that it is doing what it is expected to do under the
children's centre programme. That is not something that they can
say that they will only do a very small part of. Certain conditions
that apply to being a children's centre will be specified.
Q65 Mr Khan: My final question as
my time is up is: if a mainstream school is failing and there
are issues about what has happened to that school but there is
a children's centre attached to it that is doing very well, what
will happen?
David Bell: In those circumstances,
the school governors will still have responsibility and accountability
for the children's centre provision and they will carry on with
that.
Q66 Mr Khan: Say one of the problems
and one of the reasons for that failing school was poor governorship?
David Bell: That would be a decision
for the local authority in relation to how to deal and intervene
with a failing school. Actually, if in the example that you cite
the children's centre was doing well, one would hope that some
of the best practice in the children's centre would be better
applied across the rest of the school.
Q67 Annette Brooke: Would you agree
that the local health visitor is likely to be an important point
of contact in terms of identifying disadvantaged families?
David Bell: Yes.
Q68 Annette Brooke: Can we just return
to the health question that we had earlier? The Report raises
issues, notwithstanding the previous answer—for example
it states, "Most centres we visited were working with health
via referrals but two-thirds of centres we visited had difficulties
working with health organisations."
Chairman: Can you tell us what page?
Annette Brooke: I am sorry; that is on
page 30. On page 32, the Report states: "Centres considered
that shortages of health visitors and funding pressures within
Primary Care Trusts had contributed to difficulties in gaining
commitment from health organisations to prioritise the work".
I add to that a parliamentary answer that I had a short time ago
that told me that the number of health visitors actually fell
between 2004-05 and was certainly much lower than in 2001. Can
we really be assured that there is good working at both national
and local level between health and education?
David Bell: Perhaps I can begin
the answer and then ask my colleague to supplement it. On the
national level, I can give one or two very clear examples of working
together. As I indicated earlier, there is a new statutory requirement
on involvement and engagement of health services and Jobcentre
Plus in the provision of children's services. There is a joint
programme board that involves colleagues from various Government
Departments. We have worked closely in providing advice and guidance
and recently sent information out to all PCTs identifying the
benefits of working together. We will be supplementing that next
year with more guidance. In actual fact there is a strong commitment
centrally. At a local level, there are many very good examples
of health services working with those who work in children's centres.
In many cases, health service staff are actually co-located in
the children's centre. As Hilary mentioned earlier, some programmes
are planned for next year whereby we can develop further the health
engagement and involvement.
Having said all that, I would not pretend that
everything in every situation will be perfect. It would be foolish
to do so. There is still a strong commitment on the part of health
professionals nationally and locally to make the system work.
Health colleagues recognise that if you can provide those services
locally alongside other services, families are most likely to
benefit.
Q69 Annette Brooke: I think the facts
are that PCTs are not putting the money in or providing the health
visitors. As we roll out to the bigger programme, there are problems.
I accept that one of the great strengths of the original Sure
Start programmes is that most have a strong buy-in from health
visitors, but I do not think that that is happening in the expansion
because of the financial pressures on the PCTs.
Hilary Samson-Barry: If I can
pick that up, in a lot of places we are seeing the PCTs reviewing
their early-years and health visiting services. In County Durham
and Somerset, they have reorganised the health visiting services
into geographical teams, so that they can work as part of the
early-years teams in the children's centres and can reach out
through the children's centres at the same time.
Q70 Annette Brooke: But there are
fewer of them.
Hilary Samson-Barry: The number
of health visitors fell nationally in 2004-05, but that is still
significantly higher than it was in 1997. The number of health
visitor vacancies in March 2006 was the lowest that it had been
for the previous six years. Recognising the importance of health
visitors, the Secretary of State for Health has asked the chief
nursing officer to initiate a review of health visiting, which
is led by Ros Lowe. It is taking place and will report in April
to the Secretary of State. We have a national programme, too,
of regional roadshows called "Let's talk about health visiting".
We are finding, through those roadshows, examples of good practice
and are hearing a commitment from health visitors to work with
and through children's centres.
Q71 Annette Brooke: I am pleased
that more work is going on in that direction.
Can we touch briefly on the subject of children
with disabilities, which does not take up a big proportion of
the report but is nevertheless important, particularly following
on from the Childcare Act 2006? How much more do you think needs
to be done if we are genuinely to provide those specialist services
for disabled children that are patently not available across the
country as we speak?
David Bell: We have been working
with a national charity called Contact A Family, which provides
specialist support to families with disabilities. It has launched
a service to support children's centres and how they might reach
out to families with disabled children. We also know some good,
practical examples of centres that provide respite care for parents
with children with disabilities and provide on-site physiotherapy
and other kinds of services and support. A lot can still be done
and it is one of the hard-to-reach groups that we have identified
that need greater attention, hence the work with Contact A Family
to try to roll that out.
Q72 Annette Brooke: May I specifically
mention one disability in which I am interested? Page 17 of the
Report shows that the Government have to date struggled to measure
speech and language difficulties and that targets have not been
met. Clearly that is of vital importance when we hear that 50%.
of children enter school with insufficient listening and speaking
skills. What priority is being given to give greater support and
to ensure that qualified speech therapists are employed?
Sheila Scales The advice and guidance
that we give on working with disabled children covers both that
vital early engagement with families on things such as speech
and language difficulties, which can cause long-term problems
unless tackled early, as well as the longer-term and more intense
support that a family with a child with severe disabilities needs.
We hope to improve that, and we are working with the Council for
Disabled Children on improving that element of our good practice
guidance. We are trying to balance both those types of support,
but we have also made it clear in the good practice guidance that
such early support—particularly in speech and language—can
be vital, working with the health service to ensure that help
is available and can solve problems that can otherwise be very
expensive to deal with later.
Q73 Annette Brooke: Will that mean
more resources in the future?
Sheila Scales: The push towards
investing in things that make a real difference will move things
in that direction. The development of children at age five is
one of the key performance indicators for these centres. Children's
speech and language development at age five will be critically
dependent on that sort of help.
Q74 Annette Brooke: Thank you. I
am running out of time, but there is one other issue that I would
really like to touch upon and that Mr Dunne has already touched
on, and that is working with private providers. In my area, there
is good partnership working, although I had probably underestimated
the strength of the National Day Nursery Association's submissions
about an uneven playing field. The report says on page 26: "Well
over half of the local authorities had also consulted voluntary
organisations, but fewer... had consulted existing private providers,
who reported that they had not been consulted enough". The
National Day Nursery Association mentioned that aspect. The association
says that it feels that its members have been knocked out of business
sometimes, when children's centres have provided child care and
there has not been enough communication between the providers.
There is also the fact that the children's centres obviously have
the extra money from Sure Start, on top of the fees from those
using the child care. Given that evidence, would you say that
there is indeed an uneven playing field?
David Bell: The picture is mixed
but, just to be clear, the Childcare Act 2006 is absolutely to
the point in saying that the role of the local authority is to
commission child care services, with the expectation that the
services will be provided by the private and voluntary sectors,
and that it should provide such services only where there is no
other provision.
Q75 Annette Brooke: I am running
out of time. I know what the Childcare Act says and I have always
gone along with that, but I was quite shocked with this statistic,
because it seems to underpin some of the submissions that are
made to us. Is sufficient account being taken of the submissions
from such bodies as the National Day Nursery Association?
David Bell: I know that the Minister
for Children and Families wrote to local authorities last year,
again emphasising the need to ensure proper consultation with
all providers, including private and independent providers. The
point is emphasised all the time to local authorities that they
have to ensure that they consult widely.
Q76 Sheila Scales: The performance
management guidance that we put out has quite an explicit contestability
checklist to ensure that local authorities actually go through
proper procedures to consult private and voluntary providers,
which, according to our latest survey, provide the majority of
child care in children's centres.
Q77 Mr Bacon: Mr Bell, can you just
remind the Committee when the Sure Start programme started?
David Bell: The original programme
began in 1998.
Q78 Mr Bacon: With the name Sure
Start?
David Bell: Yes.
Q79 Mr Bacon: So it has now been
running for eight and a bit years. How much money has been spent
so far?
David Bell: As I indicated to
Mr Khan, I shall submit a letter outlining the total expenditure
from 1998 to the current time.[4]
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