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29 Jan 2008 : Column 37WH—continued
The Government have identified key factors for reducing teenage pregnancy. For example, the active engagement of all the key mainstream delivery partners is important, as are a strong senior champion, effective sexual health
advice services and the prioritisation of sex and relationships education. The Minister will not be surprised that I want to home in on that point for a few moments, because I have taken every opportunity since coming to the House to raise the subject of compulsory sex and relationships education, which must be appropriate for the age group and for both males and females. That is really important, especially relationships education.
In a survey of 20,000 teenagers conducted by the UK Youth Parliament, more than half rated the teaching of sex education in school as poor, very poor or merely average, while only a quarter said that it was good. Furthermore, nearly half of those questioned said that they had never been taught about the effects of teenage pregnancy and would not know where to find their local sexual health clinic. The survey also revealed that 55 per cent. of all 12 to 15-year-olds and 57 per cent. of girls aged between 16 and 17 had not been taught how to use a condom. Of all those who took part in the survey, 43 per cent. said that they had not been taught about personal, social relationships at school. We should also note the rise in sexually transmitted diseases. The study by the Government’s teenage pregnancy unit cited poor sex and relationships education as a reason for high levels of teenage pregnancy in general.
Not so long ago, Davina McCall hosted a television programme in which she went to Holland with teenagers and teachers to look at what happens there. Sex and relationships education was very up front, and we know that it has not led to rising teenage conception rates. The Minister was interviewed for that programme, and I hope that she will be more positive about considering whether to make that important subject compulsory.
Another reason for arguing that such education should be compulsory is my concern about child abuse. If a seven-year-old is being abused at home or within the family, how can they know what is normal behaviour unless they are taught that at school? It is vital that such education is undertaken by qualified professionals and I agree with the Government that it must be of high quality. Currently, we are not equipping young people to make health decisions about their lives. We must offer them better opportunities, so that education must be compulsory, but it is important that relationships and parenting, as well as sex education, are included. Only then can we hope to support young people effectively.
I agree that parents need support in talking to their children, and that point also came out in the television programme. That has always been a focus of mine, for a number of reasons. However, a multi-faceted approach, as well as education, is important. We know that we must have action because of the poorer outcomes that teenage parents and their children experience, and we have heard about that clearly this morning. When considering the factors for our high teenage pregnancy rate, we see the early alienation from school and education. We must ask why. Are girls being offered the right sort of courses, and do we still have gender stereotypes? I recently met a young girl with the YWCA. She said that, at school, she had wanted to do car mechanics, but she was laughed at. That is still happening now. She is now settled with her two-year-old, and she has started her car mechanics course, but why could that not have been available at school? It was what she wanted to do.
I agree with the many hon. Members who have said that having a child when a teenager can be a positive experience, and we must work towards that. Teenage mothers who have a positive experience may have an extended family or a positive partner relationship and they may be in employment or are supported in education. That is what we must aim for. On the other hand, we must think about those teenage mothers who end up receiving means-tested benefits, being locked into the system, and not having any qualifications or incentive to take up extra hours’ work. We must be clear that teenage pregnancy accompanies social exclusion, but does not need to cause it, and that much more can be done.
I want to highlight one or two points that the YWCA has made. It identified the excellent care-to-learn scheme, which supports teenage parents in work, but it is worried about the age at which the support is cut off. A teenage mother may not necessarily get her act together and be back in education by the age of 20. It may take longer, so why cannot the care-to-learn scheme be extended?
Similarly, when supporting young people into work, child care is all important. The Education and Skills Bill will present many challenges, but the role of teenage mothers must be considered. Given that they will be among the cohort, it may be more appropriate for them to re-enter education or training at a slightly older age, and I hope that flexibility to enable that will be built in.
12.10 pm
Mrs. Maria Miller (Basingstoke) (Con): I congratulate the hon. Member for Rhondda (Chris Bryant) on securing this debate. It has given us the opportunity to hear a number of thoughtful and compelling speeches from hon. Members on both sides of the House. The hon. Gentleman painted a powerful picture when he related the first-hand experiences of some of his constituents. He mentioned the sense of lost opportunities that they had when they became mothers at a very early age. He may or may not know that I was brought up very close to his constituency and I know, first hand, the challenges faced by those tight-knit communities in the south Wales valleys.
The hon. Gentleman also referred to the correlation between the map of poverty and deprivation and the one of teenage pregnancy. He quite rightly said that the two echo each other, but I urge him to consider the aberrations that exist. Some would suggest that pockets of teenage pregnancy problems exist in all constituencies throughout the country, and that is something that we should remember. The hon. Gentleman drew on his experience with tight-knit communities and talked about the importance of having a consistent message delivered in the most appropriate way to yield the best results for people locally.
My hon. Friend the Member for Isle of Wight (Mr. Turner) reiterated the point that individual support is needed to reflect the community in which these young people live. Whether we are talking about a tight-knit community in the south Wales valleys, or a different type of community in the Isle of Wight, each has its own needs. It is important that we deliver solutions that reflect the needs of the children and the parents in those areas.
The hon. Member for Crawley (Laura Moffatt) talked about the importance of the aspirations of young women. I could not agree more with her point. I am sure that she is aware of the YWCA campaign, which stresses the importance of careers advice for young people. The hon. Members for Bristol, East (Kerry McCarthy) and for City of Durham (Dr. Blackman-Woods) both picked up on the importance of supporting young parents, and ensuring that they do not accept that teenage pregnancy is a social norm. That particular point was made very powerfully by the hon. Member for Bristol, East. The hon. Member for City of Durham talked about the importance of involving fathers at an early stage.
The Government clearly have a strong commitment to cutting teenage pregnancies. Their 10-year strategy started in 1999 and they have spent more than £250 million on trying to halve conception rates. Therefore, there is clearly no shortage of ambition from the Government in this area, which is critical in determining the life chances of young people in this country. Yet in the six years between 1999 and 2005, and after a lion’s share of expenditure going into this area, we have seen the conception rate among the under-18s fall by just over 11 per cent. That is devastatingly little progress given the Government’s commitment to reduce the inequalities that exist in the country and to give young people the best start in life. The stark facts remain that we have one of the highest rates of teenage pregnancy in western Europe, with more than 20 girls a day becoming pregnant in this country. While we welcome the modest progress that has been made, the Government surely should be looking to change their approach to enable them to reach their target. I will echo the question that was asked by the hon. Member for Mid-Dorset and North Poole (Annette Brooke). Do the Government feel that their target is achievable?
I will turn now to two areas that we have not touched on in the debate. I know that the Minister has looked in detail at the growing crisis in sexual health among teenagers. Last year, the UNICEF report showed that too many young people are sexually active too young. In the report, four out of 10 15-year-olds said that they had had sexual intercourse. The figures from the Office for National Statistics confirmed that one in three 16 to 19-year-olds does not use any form of contraception. Little wonder that we are not seeing much progress on the pregnancy rates and that we are seeing an alarming growth in sexually transmitted infections among teenagers. The Health Protection Agency’s figures show that the incidence of herpes has grown 13 per cent. among 16 to 19-year-olds. The diagnoses of genital warts have also grown among this group.
Abortion is another issue that is worth considering. I know it is a highly charged topic among hon. Members. When one looks at the figures, a trend emerges that is of concern. Abortion now seems to be used more regularly among a specific group of women. I am interested to hear what the Minister has to say about that. Despite a 16 per cent. fall in conceptions among under-18-year-olds, we have seen an increase in abortions. Even more worrying is the 40 per cent. increase in second abortions. Perhaps the Minister can outline the Government’s response to that problem and tell us what plans there are to tackle it. There are no Department of Health guidelines for abortion clinics or other organisations to provide contraception services immediately following an abortion.
Perhaps that void could be filled and constructive advice offered to that group of women.
Despite the very well thought through 10-year plan and the significant expenditure, why are the Government so wide of the mark? Perhaps it is because the Government have found it hard to deliver on their policy beyond increased access to contraception, which we all know is only part of the answer. As my hon. Friend the Member for South Cambridgeshire (Mr. Lansley) noted, when the noble Lord Darzi in the other place announced the Government’s pilot scheme that allowed pharmacists to offer the contraceptive pill over the counter, any such proposals need to be subject not only to professional advice but more effective sexual health education. We must encourage young people to take more responsibility for the decisions that they take about their relationships, sexual intercourse and contraception otherwise we will not see the results that we all want to see.
In 2006, the Minister identified sex and relationship education in schools as the key to lowering under-18 conception rates, particularly as school is a primary source of information for young boys. Yet the Youth Parliament’s research, which the hon. Member for Mid-Dorset and North Poole has gone through, shows that there is still a woeful shortfall in what is being delivered on the ground.
The Government launched the teenage pregnancy unit as an integral part of delivering such vital education. Yet the unit’s staffing level has been cut from 16 people to three-and-a-half people. Is the Minister convinced that that will give her the effective support that she needs in this important area? Sex needs to be put into the context of relationships and emotional development, as the the hon. Member for Rhondda pointed out in his report. To be successful in cutting teenage pregnancy, improving the understanding of contraception needs to go hand in hand with an ethos that builds up the confidence of young people to see that early parenthood is not the only way to adulthood. Parents and schools have a critical role to play in working with our young people to establish that confidence and ethos and ensure that more young children can go forward and have successful lives. I congratulate the hon. Gentleman again on securing this debate and hope that his contribution to his party’s efforts will help to improve the situation.
12.19 pm
The Minister for Children, Young People and Families (Beverley Hughes): I add my congratulations to my hon. Friend the Member for Rhondda (Chris Bryant) on his article and on securing the debate. Indeed, I congratulate all hon. Members on the thoughtful and committed contributions that they made on a very important subject.
My hon. Friend and my hon. Friend the Member for City of Durham (Dr. Blackman-Woods) and others were right to point to the consequences of teenage pregnancy. I might say to the hon. Member for Isle of Wight (Mr. Turner) that that is why the Government are so concerned not only about under-16s but about over-16s if they become pregnant. Clearly, it is right to be concerned about the very vulnerable young people under 16, and we are, but some of the disadvantageous consequences also apply to young people aged 16 to 18 and can affect them for the rest of their lives, so it is right that the Government are taking a lead across the board.
Many of my hon. Friends and the hon. Members for Mid-Dorset and North Poole (Annette Brooke) and for Basingstoke (Mrs. Miller) outlined some of the consequences, with which we are all familiar. The infant mortality rate for children born to teenage mothers is 60 per cent. higher; the rate of smoking is three times as high; teenage mothers are much less likely to breastfeed; and the rate of post-natal depression, which my hon. Friend the Member for City of Durham mentioned, is three times as high. That is not to mention the legacy of low expectations, wasted talent and, often, very poor prospects for the babies. Clearly, that is not the case for every girl, but generally those are the consequences.
That is why we need to focus both on cutting the rates of teenage pregnancy across the board and on supporting those who do get pregnant in ways that do not encourage teenagers to accept the idea of pregnancy as a career choice. We need to do that for a very practical reason as well: 20 per cent. of teenage pregnancies are second or subsequent pregnancies, so there is a real prevention imperative in focusing on young people when they get pregnant. Those principles have been at the core of what we are trying to do. That involves effective prevention—including early intervention, which was mentioned by my hon. Friend the Member for Nottingham, North (Mr. Allen), who could not stay for the end of the debate—as well as targeted support for those who get pregnant, including the fathers of those children.
Nationally, the rates have been coming down. They are not coming down as fast as I would like. None the less, we have to put the issue in context. Hon. Members compared Britain with other European countries. The fact is that this country has had higher rates of teenage pregnancy for the past 30 or 40 years. Before 1997—for the 25 years before that—there was very little difference between us and most other European countries, but during the 1980s and 1990s, those countries focused on this problem, so they have had 30 years of dealing with it. We have had only 10 years of a Government who have made that a priority. None the less, I am not complacent, because I think that it is a very important topic.
Nationally, there has been progress: 80 per cent. of local authorities areas are seeing a reduction, because they have had a national strategy that we want them to apply to their local areas. It is not a one-size-fits-all approach, but we do need them to take the resources and the intelligence and learning that we have given them and apply that locally. If all local authorities were performing at the level of the top 25 per cent., we would have doubled the reduction nationally and would be well on our way to the 2010 target. There is no magic bullet at local level, despite views expressed on both sides of this Chamber. We need to get local areas to drive this action as hard in every place as they are doing in the best. I am talking about a strong national strategy delivered locally, by local authorities, primary care trusts, schools and voluntary organisations together.
What that strategy has been designed to do is, first, encourage parental engagement. All the research that we have done says that young people prefer to get their advice from their parents, and the evidence shows that, when they do, they start getting involved in sexual activity later, and when they become sexually active, they are much more responsible about protection and contraception and they have much more self-respect
and respect for others. That is about engaging parents through the time to talk initiative and the helpline and about schools enabling parents, and we will want to consider some of the ideas mooted today.
Secondly, as hon. Members have said, schools must take a lead. That is where young people are every day. I expect schools to take the lead in garnering consensus among parents and governing bodies that sex and relationship education in schools should be taught to a high level. We know that it is not everywhere, although we have heard excellent examples and I have seen excellent examples of schools that are making creative strides forward. We know that provision is patchy. That is why we have initiated, in the first instance, a review about how we can make delivery of such education more secure and ensure that it is of much higher quality and is delivered more consistently across the piece.
Chris Bryant: It is good that the Government are reviewing sex and relationship education—incidentally, I hope that the same will happen in Wales—but will the review allow for putting it on a statutory basis?
Beverley Hughes: That is not a primary focus of the review but, as my hon. Friend knows, we are doing the review very much in conjunction with young people; the Youth Parliament was mentioned. The issue raised by my hon. Friend is not the primary focus. The review is about delivery and quality as a first step forward, but I am sure that we will be asked to consider that and we will have to consider what people say.
Nationally, we have had a number of very effective awareness campaigns, with which hon. Members may be familiar. Indeed, they have been so good that they have won awards. The campaigns called “Are you thinking” and “Want Respect? Use a condom” for older teenagers have been based on three messages. The first is delay, delay, delay, particularly for younger young people. Secondly, when young people do become sexually active, they should use protection and contraception. The third is respect yourself and respect others. Those are important cornerstones.
Youth workers and social workers are also important. The areas that have been most effective have shown that where workers across the piece feel comfortable talking to young people about sex, that is more effective. The next element is access to health services and contraception,
including in schools if that is appropriate; they make that choice. Another element is addressing underlying factors such as alcohol, poverty and low aspirations—all the issues that hon. Members raised. A further element is support for teenage mothers, and not only through specialist provision. My hon. Friend the Member for Crawley (Laura Moffatt) mentioned children’s centres and there is support for teenage fathers there.
That is the national strategy, but it depends entirely on effective delivery at local level. Where the best local authorities are doing well, they are doing spectacularly well. People can look in any region at the variation in performance. The under-18 conception rate in Barking and Dagenham is up 18 per cent.; in Hackney it is down 26 per cent. In Tameside it is up 11 per cent.; in Oldham it is down 27 per cent. In Torbay it is up 10 per cent.; in Poole it is down 23 per cent. I could go on. Some of the most deprived areas have achieved some of the most dramatic reductions: the rate is 21 per cent. down in Newham, 30 per cent. down in Thurrock and 24 per cent. down in Darlington.
Let me say where I perhaps do not agree with my hon. Friend the Member for Rhondda. He did not say this today, but he said in his written piece that he feels that reducing teenage pregnancy is an intractable problem. The evidence from the local authorities that I mentioned tells us that it is not an intractable problem and that, if we can garner senior championship from directors of children’s services, chief executives of PCTs, schools and parents, we can make tremendous inroads into the problem locally. It is a question of people using the national strategy to drive progress in their area.
That strategy is making progress. It is patchy. We need to up the pace if we are to meet the 2010 targets, but, as I said, if all local authorities were performing at the standard of the best 25 per cent., we would be on our way there. There is no doubt that, apart from any other, moral imperative, the investment that we have made in reducing teenage pregnancy is cost-effective, because for every £1 spent, we are saving money further down the line in terms of consequences. Because all local areas need to grasp the challenge, I will publish again today the rates for local areas throughout the country, by region, so that hon. Members and people in those local areas can compare the best and the worst performing local authorities and, I hope, bring their support to bear to get those local authorities that could do better actually to do better and help us to make more rapid progress.
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