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25 Mar 2009 : Column 421

Unplanned Teenage Pregnancies (Nottingham)

Motion made, and Question proposed, That this House do now adjourn.—( Ian Lucas.)

7.18 pm

Mr. Graham Allen (Nottingham, North) (Lab): My constituency has the highest teenage pregnancy rate in western Europe and my city has one of the highest in the United Kingdom. We are now tackling that issue, and no one should doubt that we have serious changes to make and serious challenges ahead.

In Nottingham in November, we created a teenage pregnancy taskforce, which is designed to be a high level, motivating leadership body to drive our effort in the city. It is made up of myself as chair, the chief executive of the local health service, the director of our children’s services, the chief executive of our city council and the lead council member on children’s services, as well as a representative from the Department of Health’s national support team. The taskforce is designed to provide the co-ordination and the impetus to ensure that our locally agreed plan is turned into action.

The first task that we set ourselves was to produce a plan of action, which is now done. The plan takes the form of 50 action points, each with an accountable officer who is responsible for implementing it and for reporting to the taskforce on their activity. Many found having a direct line of account to the taskforce a novel approach, but everyone is now making this philosophy work. Each of our monthly taskforce meetings has had four or five reports on action points and progress is reported and encouraged.

The second thing that we set about doing was appointing at a high level a teenage pregnancy co-ordinator capable of dealing directly with the big players locally, so that the issue can be taken seriously. Interviews for that post will take place in a couple of weeks. The final thing that we did in the burst of activity on teenage pregnancy in Nottingham since November was to employ an outside pair of eyes to examine how the leadership and delivery structure should work and to ensure that all partners—but particularly the local national health service and children’s services—mesh together effectively. The structure has sometimes been unclear or duplicated. A report on clarifying those leadership structures will be acted upon within about one month.

The choice is not between silo working and assimilation; it is just about effective partnership working to tackle a serious problem. To some extent that confusion has been replicated at the national level. It is sometimes difficult for those of us on the ground to know where the responsibilities of the Department for Children, Schools and Families end and those of the Department of Health begin. However, we are beginning to find our way around those structures. All the big structural difficulties are being addressed. We now need to move on to the next phase and address both the general and the particular policy answers to teenage pregnancy in our city. However, we do so under the general umbrella of our early intervention strategy in Nottingham.

Teenage pregnancy does not stand alone. It sits alongside drug and drink misuse, low educational aspiration, low work aspiration, low self-esteem and many other symptoms. All those stem from one root cause, which One
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Nottingham’s early intervention strategy seeks to address by creating a much stronger social and emotional bedrock in the babies, children and young people of our city. Capable, rounded individuals, well parented, will lead to a dramatic reduction in the symptoms that we see around us. Our pioneering circle of early intervention from zero to 18 is now well developed. It is not rocket science; it is just good, solid help, not 10 years late, but when it is needed—good parents, great kids, better citizens.

On finance, we are not just looking at work over the short term. Rather, we have a long-term approach. Will the Minister consider supporting us in negotiations with the Treasury as we look for long-term sustainable funding? We are considering approaches such as an early intervention bond issue, so that Nottingham’s early intervention package can have the assured, long-term future that will be necessary if we are to make the inter-generational change that we need.

The other specific and unique policy being pioneered in Nottingham, where our early intervention circle overlaps with work on teen pregnancy, is on 11-to-16 life skills. There are many disparate efforts to help young people with the skills that they need to make important life choices, which include personal, social and health education, sex and relationship education, and social and emotional aspects of learning—PSHE, SRE, SEAL and other bewildering acronyms.

The Government have rightly recognised that there needs to be more coherence in that area. Sir Alastair McDonald and his team are conducting a review, which included a recent visit to Nottingham. However, given the seriousness of our local problems, we cannot wait until parliamentary time is found for a Bill to give life to the Government’s intention to have a statutory life skills curriculum by 2011. The problems need to be tackled now, so we are, with the understanding and consent of everyone involved, going ahead with an 11-16 life skills programme.

One Nottingham is funding training and curriculum development, which is taking place as we speak. This will be a natural continuation of our family-nurse partnership, Sure Start children’s centres, primary, social and emotional aspects of learning, and all the rest of our circle of early intervention policies. Life choices may literally be made in the teenage years, but they are, in reality, affected by the influences received from birth onwards, and our policies must reflect that.

Of course, we must continue to help with contraception and advice on pregnancy and child care, but the real answer to unplanned pregnancies is to be found in building the individual’s social and emotional capabilities more than a decade before any sexual activity begins. Some further actions are necessary beyond the very helpful framework set by the national teenage pregnancy support team, to which I pay tribute for the assistance that it has given us in the task that we have set ourselves.

First, as well as the volume of activities around early intervention, we need to be much clearer about the target group that we must engage with to prevent teenage pregnancy. Given that last year—or the last year for which figures are available—there were 344 teenage pregnancies, we should, by accurate analysis of real-time data, be able to identify if not the next 344, perhaps the broader group or penumbra of about 700 families and develop a serious engagement with them from the earliest
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possible age, so that life choices can be made effectively. We are a long way from doing that—it is one of the areas on which we need the hardest work. The sentiment has traditionally been that we deal with the problem in a caring and compassionate way once it has arisen, but that is no longer a viable long-term strategy. We need to intervene much earlier with the target groups and tackle the culture and attitudes that lead, almost inevitably in some cases, to early and teenage pregnancy.

The second issue is the transfer of data into intelligence and action—something with which I am sure Whitehall is familiar. An immense amount of data has been collected, much of it several years out of date, but for us to have active and directed policies, there needs to be a much more nimble transfer from real-time data collection into intelligence and policy action. We will then see real things happening much faster on the ground than we do now. We are examining how that can best happen, and hope that the Minister will tell us tonight that the Government will support us in those efforts.

Thirdly, we need to be much swifter at producing activity to meet specific local circumstances. Commissioning locally has to follow a nationally required legal process that is inspected, scrutinised, monitored, risk-assessed and has a gestation period sometimes longer than a pregnancy itself. Perhaps we can all look at the balance around the word “commissioning”. It should be an incontrovertible good, but it is not always perceived that way on the ground.

A fourth specific area that needs attention—one on which I hope to obtain a second Adjournment debate if I am fortunate enough—is our whole approach to absentee fathers. In areas such as mine, the father, often a teenager, will disappear from view as soon as the girl is pregnant, and we need to address the life skills that could lead to those young boys, as well as the young girls, thinking more seriously about sustainable relationships, about raising a family together and about the consequences of single acts that affect both lives—and, indeed, the life of the child—for ever thereafter.

The relaunch of the Child Support Agency in its new guise provides a great opportunity to improve the life chances of our youngest and most vulnerable by ensuring that absentee fathers of babies born to teenage mothers meet their obligations. Nottingham is engaging with them and they are coming to talk to us about the possibilities. I hope that we can move that forward and perhaps even suggest one or two ways forward for the Government.

To improve the interaction with the public, our target group and the media, we need to take one or two progressive steps. Often, when public service bodies stray beyond direct service provision, they feel uncomfortable with the concept of needing to communicate with those wider groups. That has been evident in Nottingham and we are keen to develop a process of permanent messaging to those groups, not only to reach out through imaginative means such as texting, social network sites, teen magazines and so on to those who need the services, but to give profile and confidence to those professionals and others who work in this area, so that they know that things are being done, too, and feel supported.

We also need to reach the parents and others in the wider public who set the culture and the attitudes within which we all work and where young people pick
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up the attitudes that sometimes lead them to make the wrong choices. Those key issues arise from the work that we are doing. Further work on them will take place in Nottingham and I hope that when I meet with the Minister in a few months, I might be able to report some progress and work closely with the Government on them.

We have made a good start, but we are conscious of the enormousness of the problem that we are trying to address. It is essential that we do not feel that there are quick answers, magic bullets or short-term fixes. Tackling teenage pregnancy, rather like the other difficult social symptoms that are evident in constituencies such as mine, requires thorough and sustainable analysis that leads to action over a generation. This will not happen in two or three years’ time. There will be no big change in the trend lines in a couple of years. This requires people to set out their stall for the long term, and that means over a generation.

Many of the problems that we face in constituencies such as mine are intergenerational. Therefore, it will take a generation to burst out of them and to create a different culture and a different set of attitudes. There are innovative approaches to the issue, and in Nottingham we wish to explore those and use them wherever appropriate. However, innovation cannot be a substitute for getting the basics right and ensuring high-quality joined-up delivery of the approaches that are tried and tested. Our teenage parenting strategy tries to ensure that we balance doing the basics well with introducing groundbreaking new ideas. The problems need to be tackled by effective long-term finance and by long-term cross-party and social consensus, which we are all trying to build at One Nottingham.

Like those in Sweden, we must ensure that measures last for 40, 50 or 60 years and are not prey to short-term electoral cycle considerations or points scoring. I congratulate my right hon. Friend the Minister on the way in which she has conducted the debate at a very high level. I hope that other parties match that and put the children we are trying to help ahead of any partisan political points scoring.

Setting out our stall for the long term is what has distinguished our efforts in Nottingham during the last three or four years. Our early intervention policies are well established and we hope to bring that cultural and attitudinal change to our efforts to tackle unplanned teenage pregnancy in our city. So far, so good, but we have much to do. I hope to report greater progress to the Minister as time goes by.

7.34 pm

The Minister for Children, Young People and Families (Beverley Hughes): I congratulate my hon. Friend the Member for Nottingham, North (Mr. Allen) on securing tonight’s debate. More fundamentally, I commend the leadership he has shown on the issues—not just teenage pregnancy, but early intervention and prevention, reducing inequality and poverty, and leadership of the local strategic partnership. His work on teenage pregnancy falls under that broader umbrella. The lead that he has shown is very important to his city.

As my hon. Friend said, teenage pregnancy can have serious impacts not only on individuals but on families and communities, for generations. It is both a cause and
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a consequence of social exclusion and health inequalities, while all too often markedly reducing the life chances of the young people involved and the children whom they produce. That is why the Government are absolutely committed to reducing the number of conceptions among those aged under 18.

As my hon. Friend knows, I visited Nottingham again very recently to observe the work being done by the youth sector. I was delighted to learn not only that the local authority has included teenage pregnancy in its key priorities under the local area agreements, but that my hon. Friend has committed himself to the important task of chairing the city’s teenage pregnancy taskforce for the next few years. As he said, Nottingham saw a 6.1 per cent. reduction in teenage pregnancy rates between 2006 and 2007. That is extremely encouraging, but he recognises, as he graphically explained—as I do—that there is more to be done if it is to be turned into a consistent, long-term trend in the city. His taskforce will play a key role in that. It is vital for a senior team to be in place to drive such a strategy forward. I was also pleased to hear that the taskforce would encourage all local secondary schools to agree on a common life skills programme for 11 to 16-year-olds.

My hon. Friend rightly highlighted the excellent work already being done by local authority staff, schools, doctors, nurses, people in the voluntary sector and many others. Further promising initiatives in Nottingham include nurse-led outreach projects, a condom distribution scheme, and the sex and relationship education that is taking place in many of the city’s schools. I was glad to learn that all that good work was being underscored by additional support from the Department’s national support team, which I hope will provide extra impetus.

The recent drop in Nottingham’s teenage pregnancy rates shows that, given those projects and the support that is being provided, the problem, although difficult, is not intractable and we should not give up on it. I know that my hon. Friend does not propose to do so. It is clear that when teenage pregnancy strategies are applied rigorously and robustly, with strong leadership such as that provided by my hon. Friend, they work very well. For instance, since 1998 Newham’s rate has been reduced by nearly 25 per cent., Oldham’s by over 29 per cent., and Calderdale’s by nearly 30 per cent.

In Nottingham my hon. Friend is leading a rigorous and robust implementation of the national strategy on teenage pregnancy, which we want every local area to adopt. It is based on the very best international evidence, and includes key recommendations and pointers from other countries. First, it emphasises the need for strong senior champions. My hon. Friend’s development of the strategy has taken it a step further. I should like to pursue the requirement of naming individuals to be accountable for various elements, because I am sure that it will drive developments even faster and further.

Secondly, the strategy recommends a well publicised contraceptive and sexual health service for young people which can reach the most vulnerable, who may be apprehensive about visiting such services. Thirdly, it recommends that a high priority should be given to sex and relationship education in schools, with real support from local authorities. Fourthly, it stresses the need to focus targeted interventions on the young people whose
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risk of teenage pregnancy is highest. As my hon. Friend said, those young people will be individuals if we can identify them, but otherwise they will be groups of young people. It should be emphasised that all these measures need to be applied to boys as well as girls. That has not been a strong element of the strategy in some areas.

Clear messages should be conveyed to young people about the best ways of resisting peer pressure to have early sex, and about the need to delay sexual activity until they really understand and are ready for it. That, too, applies to boys as well as girls. We must also encourage them to use effective contraception and condoms when they do become sexually active. Fifthly, we must try to reach parents and support them in talking to their children about these issues, because young people say that ideally they would like to get the information and advice from their parents. Many say that their parents do not give it to them—that is particularly what boys tell us.

Lastly, although it is important to focus on young people in their teenage years when they are sexually active, it is even more important both to consider the context of universal services, so that we provide opportunities for activity and for raising the aspirations of all young people, and to start decades earlier. That is why the Government spent such a lot of time and effort in developing services for younger children, starting with the early years—with Sure Start centres, extended schools, focusing on early intervention and prevention—and dramatically increasing support for parents so that good quality parenting is really possible.

I want to say a few words about sex and relationship education—SRE—as it is clearly one of the key factors. We recognise that the quality of SRE across schools is still too patchy, which is why we have announced our intention to make SRE and personal, social and health education statutory. I hope that that will increase the priority schools give to teenage pregnancy and sexual health more generally, with a clear link to specialist health advice either on the school site or in the community. We expect to provide new guidance for schools on delivering SRE by January 2010.

We know that the vast majority of parents—86 per cent.—want schools to provide good quality SRE for their children. Some people argue that if we give young people SRE, that encourages them to be sexually active. The opposite is shown to be the case, however. All our international evidence shows that SRE encourages young people to delay sex, while giving them the knowledge and skills they need to make informed choices, not only about sexual health, but about related issues such as alcohol, which can have a strong influence on the potential for unplanned pregnancies and unprotected sex.

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