House of Commons - Life lessons: PSHE and SRE in schools

Life lessons: PSHE and SRE in schools - Education Contents

2 Why teach PSHE and SRE in schools?

11. In this chapter we explore the reasons why SRE and PSHE are taught in schools. Some witnesses did not believe that they should be taught at all. Others put forward arguments as to why such lessons are important.

Outcomes-based arguments: does SRE 'work'?

12. Evidence from the National Survey of Sexual Attitudes and Lifestyles (Natsal) indicates that the proportion of young people citing school lessons as their main source of information about sexual matters has increased from 27% in 1990-91 to 33% in 1999-2001, and to 39% in 2010-12. Despite this increase, just over half of men and just under half of women still report a non-authoritative source as their main provider (i.e. neither school, parent, nor health professional).[18]

13. Some witnesses described the importance of SRE in terms of having an impact on a range of outcomes for young people such as teenage pregnancies and sexually transmitted infections.[19] Crucial to this argument is finding evidence that SRE 'works' in some way.

SEXUAL BEHAVIOUR

14. We heard that there were a "vast variety of findings" in studies exploring a link between the provision of SRE in schools and changes in sexual behaviour.[20] Meta-analyses give an overview of the range of evidence available. A review in 2007 of 48 US-based SRE programmes found that two-thirds of the programmes had positive effects on behaviour, with 40% delaying first sex, reducing the number of sexual partners, or increasing condom or contraceptive use.[21] UNESCO's 2009 technical guidance for education ministers and curriculum developers on sexuality education, which drew on 87 studies from a range of countries, surmised that "sexuality education can lead to later and more responsible sexual behaviour or may have no discernible impact on sexual behaviour".[22] Evidence for a connection between school SRE and sexual behaviour is therefore weak.

15. The most recent data from Britain comes from Natsal and is more encouraging. Analysis by the Natsal team shows that men and women who said that lessons at school were their main source of information about sex were more likely to have started having sex at a later age than those for whom parents or other sources were their main source, even after taking account of age and educational level.[23]

16. Despite the fears of early sexualisation expressed by some parents, there does not appear to be any significant evidence of a negative impact of school SRE on sexual behaviour. UNESCO's analysis was clear that "sexuality education rarely, if ever, leads to early sexual initiation".[24]

TEENAGE CONCEPTIONS

17. The under-18 conception rate in England in 2012 was "the lowest since 1969", having fallen by over 40% since 1998 to 27.7 conceptions per thousand women aged 15-17.[25] While teenage conception statistics—as opposed to birth rates—are not widely available in other countries, it is clear that the UK as a whole still compares poorly with many of its European Union neighbours in terms of the number of live births to women aged 15-17, at 9.2 per 1,000 women in 2012, well above the EU average of 6.5.[26]

18. Witnesses drew quite different conclusions from this information, arguing variously that the comparatively high rate of teenage conceptions was proof that SRE doesn't 'work',[27] or that this was proof that comprehensive SRE was needed.[28] Some cited the Netherlands as an example of a country with early sexuality education and a low teenage birth rate,[29] although the details of this were queried and a causal link was questioned by others.[30] Lucy Emmerson and other witnesses argued that changes in policy in Finland provided evidence of a causal link, as positive effects on health outcomes such as teenage pregnancies followed the introduction of compulsory sexuality education.[31]

19. Others argued that the connection between school SRE and teenage conceptions was weaker than other possible influences. Professor David Paton, professor of industrial economics at Nottingham University, told us that:[32]

There is considerable agreement in the peer-reviewed literature that teenage pregnancy rates are strongly correlated with underlying socio-economic factors such as poverty, educational achievement, religious practice and family stability. There is less agreement over the impact of policies aimed directly at reducing unwanted pregnancy and, in particular, the role of school-based sex education (SRE) and access to family planning services.

Professor Paton's view was that "investing in socio-economic factors is likely to have a much greater effect on sexual outcomes than further improvement of sex education or sexual health services",[33] and he suggested that "if you want to improve sexual health outcomes for young people, teach them maths; help them get their qualifications; keep them staying on at school."[34]

20. Professor Paton summarised the evidence base for a link between SRE and teenage pregnancy as follows:[35]

[…] we have a diversity of different evidence, different outcomes—some programmes do show some adverse outcomes. Probably it is fair to say the best-designed studies—the really tight randomised control trials, and the policy studies that have tried to control for causality in looking at the causal effect of sex education—find the least effect. It is not that it necessarily makes things worse, but there are no particularly good effects in terms of outcomes, certainly in terms of teenage pregnancy.

21. Professor Roger Ingham, Director of the Centre for Sexual Health Research at the University of Southampton, disputed Professor Paton's characterisation of the research base.[36] He told us that "the evidence [for a connection between SRE and improved outcomes] is pointing in the right way", although he accepted that "it is hard to say one particular programme works".[37]

22. Similarly, the Department of Health has stated that "while teenage conceptions may result from a number of causes or factors, the strongest empirical evidence for ways to prevent teenage conceptions is: high quality education about relationships and sex; and access to and correct use of effective contraception".[38]

SEXUALLY TRANSMITTED INFECTIONS (STIS)

23. Data from Public Health England shows that in 2013 over 61,000 13-19 year olds were diagnosed with chlamydia (19.1 per 1,000) and over 4,000 were diagnosed with gonorrhoea (1.3 per 1,000).[39] The Faculty of Sexual and Reproductive Healthcare noted a 5% increase in STI diagnoses in England between 2011 and 2012.[40] In 2012 Lisa Power, Policy Director at the Terrence Higgins Trust, described London as "the STI capital of Europe", but the European Centre for Disease Prevention and Control has noted that "international comparisons are hampered by differences in surveillance systems because the quality and coverage of national surveillance are not consistent".[41]

24. As with teenage conceptions, witnesses drew a variety of conclusions from the rates of sexually-transmitted infections (STIs) in young people, with SRE cited as both a cause of the problem and its solution. One witness argued that "SRE cannot be seen as a success when the numbers of young people engaging in early sexual activity (which they often later regret) continues to rise as does the number of STIs".[42] Natsal provides evidence that men and women citing school as their main source of information about sex were less likely to report unsafe sex in the past year and less likely to have been diagnosed with an STI, although the same was true for those citing parents as their main source.[43]

WIDER HEALTH OUTCOMES

25. Young people report a link between PSHE and the way they think about health issues: 74% of respondents to the Health Behaviour in School-Aged Children survey in 2014 felt that PSHE classes helped them to look after their own health and improved their skills and abilities to consider the importance of their own health.[44] Public Health England told us that "providing high quality PSHE including SRE continues to be the most efficient route to 'universally, comprehensively and uniformly targeting adolescent populations' with the potential to contribute to a range of health outcomes".[45] They added that:

School-based interventions, including delivery within the curriculum, derive cost-benefits for society. Interventions to tackle emotional learning, for example, are cost saving in the first year through reductions in social service, NHS and criminal justice system costs and have recouped £50 for every £1 spent. Drug and alcohol interventions can help young people engage in education, employment and training bringing a total lifetime benefit of up to £159 million.

26. The 2012 NatCen survey of 7,589 pupils in 254 secondary schools in England found that:[46]

· Around three in five pupils recalled having attended lessons about smoking, alcohol and drugs, although almost all schools who provided information on their teaching reported that such lessons had been provided;

· Around seven in ten pupils thought that their schools gave them enough information about these topics;

· Pupils were less likely to be smokers if their school provided lessons about smoking to Year 11 pupils at least once in the school year, but the frequency of teaching alcohol and drugs was not significantly associated with whether or not pupils had drunk alcohol in the last week or had taken drugs in the last year.

The Institute of Health Promotion and Education told us that:[47]

[…] there is very little research into the effectiveness and success of educational interventions on children and young people's lives. Other than empirical research undertaken as part of major projects on smoking, alcohol and drugs, very little is known about the wider impact of PSHE education.

EFFECTS OF PSHE ON ACADEMIC ATTAINMENT AND 'RESILIENCE'

27. Many arguments based on the outcomes of PSHE and SRE focused on the avoidance of negative outcomes for young people, but we also heard evidence of PSHE promoting purely positive effects, including in terms of academic attainment. Public Health England told us that PSHE "adds to pupils' knowledge and resilience, and will help them achieve at school".[48] The DfE told us that "children with higher levels of emotional, behavioural, social and school well-being on average have higher levels of academic achievement", and that PSHE "supports and extends other subjects in the school curriculum, developing children's resilience, confidence and ability to learn".[49] Ofsted's 2013 report on PSHE noted that there was a close correlation between overall effectiveness grades awarded to schools and their grade for PSHE.[50]

PROMOTING 'WELLBEING'

28. In 2013 Professor Dame Sally Davies, the Chief Medical Officer and Chief Scientific Advisor at the Department of Health, said that PSHE "forms a bridge between education and public health by building resilience and wellbeing".[51]

29. A 2012 research report for the DfE described the elements of pupil wellbeing as:[52]

· emotional (including fears, anxiety and mood);

· behavioural (including attention problems e.g., finds it hard to sit still; activity problems e.g., forgets things, makes careless mistakes; troublesome behaviour, e.g., plays truant, lies, steals things; and awkward behaviour, e.g., blames others for mistakes, is easily annoyed);

· social (including victimisation i.e., being bullied and having positive friendships); and

· school (including enjoyment i.e., likes school and engagement i.e., stimulated by school).

The report concluded that children with higher levels of emotional, behavioural, social, and school wellbeing, on average, have higher levels of academic achievement and are more engaged in school. Coram Life Education told us that this was "powerful evidence […] of the value of placing the effective teaching of PSHE and wellbeing education at the heart of a school's business".[53]

Rights-based arguments

30. Article 17 of the UN Convention on the Rights of the Child states that "children and young people have a right to information that is important to their health and wellbeing". Article 29 also refers to encouraging children to "respect others", and Article 34 requires governments to protect children "from all forms of sexual exploitation and abuse".[54] Dr Graham Ritchie argued that these rights were relevant to the discussion of providing PSHE,[55] and the Sex Education Forum describes good quality SRE as "an entitlement for all children and young people".[56] Young Enterprise also saw the wider topics of PSHE such as "communication, teamwork, creativity, problem-solving and resilience" as "a right and not a privilege" and argued that "this education should come as standard".[57]

Safeguarding arguments

Child sexual exploitation and vulnerable young people

31. Witnesses also argued that SRE was important as a child protection measure—highlighted by recent child abuse cases in Rotherham and Greater Manchester[58]—on the basis that children need to be able to recognise and report when they are being abused or groomed.[59] Alison Hadley reasoned that:[60]

If you have really good, comprehensive SRE, you talk about consent in a meaningful way with young people. You tell them about age gaps and predatory behaviours, so they start to recognise that. If you are not giving them any ammunition to understand these things, no wonder they are ending up in very dangerous situations.

Janet Palmer, the National Lead for PSHE at Ofsted, drew an explicit link between a school's provision of SRE and its fulfilment of its child protection duties: "safeguarding is a statutory responsibility of all governors and teachers in schools, and I find it difficult to see how safeguarding can be high quality without high quality SRE".[61] The Minister agreed that "good-quality PSHE in a school will help combat child sexual exploitation. There is no question in my mind about that".[62]

32. Dr Graham Ritchie drew our attention to the fact that looked-after children are particularly vulnerable to sexual exploitation, and that their school may be their only reliable provider of SRE.[63] Dr Zoe Hilton, Head of Safeguarding and Child Protection at the National Crime Agency's Child Exploitation and Online Protection (CEOP) Command, suggested that LGBT children were a particular target for abuse, and that "[CEOP] also have resources for LGBT, because I think that is a specific vulnerability that offenders look for".[64] CEOP also produces resources for children with learning difficulties,[65] and Dr Hilton explained that "a lot of the time, kids in situations such as care homes have gone beyond the utility of universal programmes and universal products […] They need access to more specialist resources".[66]

CYBERBULLYING AND SEXTING

33. PSHE can also be seen as a way of tackling bullying in schools, and in particular 'cyberbullying'. The Department for Education's advice on tackling bullying in schools noted that:[67]

The rapid development of, and widespread access to, technology has provided a new medium for 'virtual' bullying, which can occur in or outside school. Cyberbullying is a different form of bullying and can happen at all times of the day with a potentially bigger audience, and more accessories as people forward on content at a click.

34. Witnesses argued that parents may be less aware of the mechanisms of cyberbullying than more traditional forms of bullying, and unsure how to help their children. Lauriane Povey, author of Veil of Anonymity, told us that "it is impossible to educate every single parent about Facebook, Twitter and all the other social networks. School is the easiest way to do it", although "pupils are more educated about cyberbullying than their teachers".[68]

35. 'Sexting' was also raised as a problem relating to cyberbullying. Sexting has been defined as "the exchange of sexual messages or images" and the "creating, sharing of forwarding of sexually suggestive nude or nearly nude images" through mobile phones or the internet.[69] A report for the NSPCC explained that "sexting does not refer to a single activity but rather to a range of activities which may be motivated by sexual pleasure but are often coercive, linked to harassment, bullying and even violence. There is no easy line to be drawn between sexting and bullying".[70]

36. Dr Hilton said that "we have reached the point with older teenagers where sexting is a normative behaviour" and that "we need to recognise when it is abusive, harmful, or linked to exploitation or the beginning point of an exploitative relationship".[71] Similarly, Lauriane Povey said that "it has become normal for 14-year-old girls to have as their profile picture them stood in a bra, and the whole world can see that".[72] A 2012 survey of 1,000 people in the UK aged 13-25 for the anti-bullying charity Ditch the Label found that 30% of 15 year olds had sent a naked photo of themselves at least once.[73]

37. The NSPCC told us that "SRE can encourage children and young people not to engage in potentially harmful behaviour such as sexting […] and enable them to recognise what is abusive behaviour and how to get help".[74]

CONSENT AND ABUSIVE BEHAVIOUR BETWEEN TEENAGERS

38. Sexual abuse between teenagers was identified as a third safeguarding angle, and we received evidence that young people's understanding of issues relating to consent and healthy relationships was insufficient. Research for the Office of the Children's Commissioner found that "young people generally understand what is meant by giving consent to sex, but have a very limited sense of what getting consent might involve. Young people are able to describe what consent means in theory, but real life contexts make a significant difference to their perceptions of what non-consensual sex looks like".[75] Heather Robinson, a school nurse, told us about her experience of working with young women who had experienced rape, sexual abuse and sexual assault:

Similarly, Barnardo's said that victims of sexual exploitation "often find themselves vulnerable to abuse as they are unable to identify when they are in an abusive relationship".[77]

39. Evidence from Girlguiding suggested that it was not simply a case of correcting the behaviour of those who are abusive, since some elements appear to be accepted by young people:

40. Oxfordshire County Council told us that consent was a "complex area" and that consent and healthy relationships needed a greater emphasis in SRE.[79]

What parents and young people want

41. Witnesses argued that SRE in schools is also justified by popular demand, and that surveys consistently show a high level of support for SRE in schools. In 2011, a Mumsnet survey found that 98% of parents were happy for their children to attend school SRE lessons,[80] and the National Association of Head Teachers reported in 2013 that 88% of parents of school-aged children wanted SRE to be compulsory.[81] A petition led by the Everyday Sexism Project and the End Violence Against Women Coalition calling for statutory PSHE to address issues such as sexual consent, healthy and respectful relationships, gender stereotypes and online pornography has received over 36,000 signatures.[82] The British Youth Council's Youth Select Committee work on A Curriculum for Life, published in 2013 found that "life skills education was something pupils wanted, because they recognised that it could help to enable independent living, and improve skills for the workplace".[83] Teachers and young people in Bristol told us that SRE was the one subject that young people consistently called for as part of their education. Girlguiding UK told us that young girls "want and need" PSHE and SRE to be provided in schools.[84]

42. Nevertheless, a small but vocal minority of parents argued strongly that PSHE, and SRE in particular, should be seen as the responsibility of parents rather than the state. They point out, correctly, that the legal duty for children's education lies not with the state but with parents,[85] and that, although the overwhelming majority of parents delegate most education provision to a state or independent school, parental primacy should be recognised. Yusuf Patel, founder of SREIslamic (a grassroots Muslim organisation), reasoned that parents were the best providers of SRE "because they are emotionally invested in their children. They have spent the most unstructured time with their children, and they are with their child forever, from when they are born".[86] Similarly, Sarah Carter, a Trustee of the Family Education Trust, argued that "schools should not be compensating for bad parenting", and that it would be better for parents to be provided with resources to enable them to provide SRE themselves.[87]

How should the effectiveness of PSHE and SRE be measured?

43. Some witnesses suggested that a practical measure of the effectiveness of PSHE and SRE was through outcomes such as teenage pregnancies or STI rates,[88] while others argued that this presented a superficial view of the purposes of SRE.[89] We asked witnesses whether some form of 'destinations' measure could be applied at a local or national level as a means of holding schools to account for the effectiveness of their provision, to complement existing destination measures of progression to employment or further and higher education. Professor Ingham warned that it would be hard to tie outcomes to individual schools without compromising confidentiality,[90] but Alison Hadley suggested that confidential discussions with schools prompted by local data had "woken the school up" to issues with teenage conceptions that might otherwise be hidden by abortions.[91] Joe Hayman, Chief Executive of the PSHE Association, was cautious about the use of outcome-based justifications for PSHE in general:[92]

With PSHE we have to be really careful not to overpromise. We are talking about massive social issues […] We need to be aware that the school is just one component of a wide range of factors that will impact upon children's behaviour, most noticeably the family and their community.

44. Several witnesses suggested that levels of parental satisfaction was a key measure of success,[93] particularly in terms of the extent to which parents were consulted by schools on SRE,[94] or the number of children withdrawn from SRE lessons.[95] The levels of student satisfaction were also suggested as a relevant measure, or an assessment of the knowledge that young people gained as a result of PSHE.[96] Ofsted told us that[97]

The effectiveness of sex and relationships education is best measured through surveys and research. These should gather the views of young people on how appropriate and effective the sex and relationships education they received in school was in informing them and developing their understanding and skills.

45. Pupil wellbeing can also be considered as a proxy for the effectiveness of PSHE. The Education and Inspections Act 2006 places a duty on school governing bodies to promote the wellbeing of pupils at the school,[98] but does not specify how this is to be measured. A report by Gus O'Donnell suggested that schools would give greater attention to wellbeing if a standard metric were used,[99] and the UK Faculty of Public Health recommended the use of the Warwick-Edinburgh Mental Wellbeing Scale and the Stirling Children's Wellbeing Scale in monitoring "ability to cope, resilience, self-confidence, self-worth and other related factors".[100] New Philanthropy Capital also told us about its work on developing a wellbeing measure, and argued that "SRE is at the heart of protecting [young people's] emotional health […] NPC hopes that rigorous ways to measure wellbeing can be used to develop the most effective SRE into the future".[101] While measuring wellbeing was not a key focus of our inquiry, we believe that this area is worthy of further investigation.

Conclusions

46. There are a number of ways of evaluating whether PSHE and SRE should be taught in schools; focusing primarily on its impact on teenage conceptions and STIs means insufficient emphasis is placed on safeguarding and young people's rights. It would also detract from the focus on the 'whole child' implicit in recent DfE work on "character, grit and resilience".

47. Measuring specific positive outcomes from the provision of PSHE is challenging but the context is the wide range of pressures and risks to health to which young people are exposed. They have a right to information that will keep them healthy and safe. Delivering this is particularly important for the most vulnerable children, including looked after children, LGBT children and those with special educational needs. Schools need to provide this information, and to develop the resilience and character of young people.

48. While a minority of parents strongly object on principle, it is clear that a large majority of parents and young people feel that schools should provide SRE.

49. Trends in teenage conceptions and STIs are driven by factors far outwith the provision of SRE in schools and provide little insight into the usefulness of such education. Instead the quality of PSHE and SRE should be measured through Ofsted inspections and through levels of student and parent satisfaction. This should be the focus for the Government.

50. We recommend that the Government explore how pupil wellbeing could be measured in schools.

18 National Survey of Sexual Attitudes and Lifestyles (Natsal) team (SRE 472) para 2 Back

19 E.g. Kingston Adolescent Health Team, Royal Borough of Kingston-Upon-Thames (SRE 256) Back

20 Q5 [Professor Paton] Back

21 Lucy Emmerson and others (SRE477) para 5 Back

22 UNESCO, International Technical Guidance on Sexuality Education: An evidence-informed approach for schools, teachers and health educators (December 2009) Back

23 National Survey of Sexual Attitudes and Lifestyles (Natsal) team (SRE 472) para 4 Back

24 UNESCO, International Technical Guidance on Sexuality Education: An evidence-informed approach for schools, teachers and health educators (December 2009) Back

25 ONS Statistical Bulletin, Conceptions in England and Wales 2012 (25 February 2014) Back

26 Office for National Statistics, "International Comparisons of Teenage Births", 15 October 2014, accessed 20 January 2015 Back

27 E.g. Richard Morriss (SRE 128) para 2 Back

28 E.g. Faculty of Sexual and Reproductive Healthcare (SRE 360) para 2.6 Back