Uncorrected oral evidence: Role of public services in addressing child vulnerability
Wednesday 13 October 2021
Members present: Baroness Armstrong of Hill Top (The Chair); Lord Bichard; Lord Bourne of Aberystwyth; Lord Davies of Gower; Lord Filkin; Lord Hunt of Kings Heath; Baroness Pinnock; Baroness Pitkeathley; Baroness Tyler of Enfield; Baroness Wyld; Lord Young of Cookham.
Evidence Session No. 53 Held in Public Questions 257 - 268
I: Dame Rachel de Souza, Children's Commissioner for England; Martin Lennon, Senior Advisor on Children’s Services, Children’s Commissioner’s Office.
USE OF THE TRANSCRIPT
Dame Rachel de Souza and Martin Lennon.
Q257 The Chair: Welcome to our meeting this afternoon; it is a real pleasure to welcome you. It is the first time a House of Lords committee has had you as Children’s Commissioner, and we welcome you to the meeting and to the House of Lords.
Dame Rachel de Souza: Thank you very much. I am really pleased to be in front of such a distinguished committee on such an important topic.
The Chair: Yes, we have had a very interesting inquiry and a lot of interesting witnesses. It is very fitting that you conclude our evidence as the person who will want to interrogate much of what we will be saying and, I hope, follow some of it up. You have just published a very important and large report. It is only right that we ask you, before we go into our detailed questions, to make an opening statement.
Dame Rachel de Souza: I came into this job after a lifetime of working to improve the life chances of disadvantaged children as a teacher, a head teacher and a trust CEO. I was one of Tony Blair’s first academy principals back in 2005; I think I was number 57. There was too much acceptance at that time that the poorest areas had the worst schools, and the academy movement then was a direct response to that.
I am very proud of what my schools achieved for pupils there and what the wider academy movement achieved. The school reform movement is the biggest public sector improvement in the past 15 years. I say this, because I can demonstrate that my own school, which I just referred to, made a huge difference to the lives of children. That first academy went, in three years, from the bottom 200 schools, with only 17% of children achieving five A to C grades, including maths and English, to 63%, and 100% achieving five A to C grades. It remains good today after having years of underperformance. This shows that good-quality public services can significantly improve the life chances of children.
The school improvement journey is not finished. The Leader of the Opposition commented in his speech that there were 200,000 children in primary schools that are still not good enough, overwhelmingly in the most disadvantaged communities without access to a good school. This is absolutely right. I also felt, personally, that we had got to a point in our journey where school improvement had reached the glass ceiling unless we looked to the services for children—the mental health services, SEND support, help at home and more.
That is why I wanted to be Children’s Commissioner: to be able to take the child’s perspective and think about service improvement across the wider set of services. That is why I started my tenure by conducting the Big Ask, the largest ever survey of children for response, not only in England but across the world—apart from the US census, I believe. As we came out of the pandemic, I wanted to ask children what, coming out of lockdown, they needed now in order to thrive, what they hoped and dreamed for, what they needed in order to be successful in their futures, and how they viewed society.
A major theme that has come out of the Big Ask is that our children are ambitious for themselves, but they often do not feel supported when they need additional help. To give you a sense, cutting down that 550,000 who responded, 78,000 had additional needs, 3,800 were in care and we had 2,800 Gypsy Roma students. We have looked not only at getting the biggest survey of England’s children but at being able to drill down into the groups to get their view on what they need now and going forward.
This is just part of a package of work I am doing across government to raise the issues facing children. I am working on the SEND review and the cross-government concerted work on school attendance and mental health following Covid. I have been commissioned to undertake a review of the Online Safety Bill to ensure that it delivers better safety for children. There has been lots going on.
I believe, though, that we need to take the ingredients that have brought about school improvement over that last 15 years and focus on the most disadvantaged, on accountability for outcomes and on a willingness to take a new approach, and apply that right across the system working with children. If the committee will allow, I have three very brief points about that with regard to vulnerable children.
First, our understanding of childhood vulnerability has improved significantly over the past decade, but it is still evolving. From CSE to county lines, we understand far better the warning signs and how mental health and SEND issues manifest as challenging behaviours. However, I would contend that the ability of systems to respond has not kept pace. This is the challenge I want to focus on as Children’s Commissioner. In particular, as we learn more about the overlap between risk factors inside or outside the home, mental health and SEND particularly, we need to be applying a much more health-focused lens in responding. Limitations on CAMHS have severely impeded this.
Secondly, in response to vulnerable children, we put far too much focus on policy and not enough on practice. There are few quick wins in supporting vulnerable children. Instead, we need to direct far more of our energy to the slow and complicated job of improving the quality of individual public services. School reform is, for me personally, 15 years in, and there is still so much to be done, but the starting point was a determination to tackle the tyranny of low expectations and presumed failure in the most deprived areas of our country.
As Children’s Commissioner, I am the voice for those vulnerable and voiceless children, and I want to demand more for them. I am restructuring my office at the moment, and I want us to be a champion of innovation and public sector reform. That is why I am so pleased to be here. I would like to see myself working with this committee for the years to come aimed at vulnerable children. I am joined today by Martin Lennon, a senior leader who is assisting me in this work and leading on lots of it.
Finally, we do not talk enough about outcomes for vulnerable children. We talk about the risks they face and sometimes about their experiences, and that is good, but not enough about their potential. As a former teacher of many children you would describe as vulnerable, I see missed potential. This is what I want to challenge. By illustration, I would like to draw the committee’s attention to two outcomes we should pay more attention to.
About 14% of children fail to reach half or more of their 17 early development goals in reception. They are, in effect, beginning school a year behind where they should be and at a point from which they will probably never catch up. This is a strong proxy for identified and unknown vulnerability. About 18% of children get to age 19 without a level 2 qualification, the most basic benchmark, which opens the most basic doors into the workplace.
I am going on the record here. I genuinely believe that, with concerted effort, we could half both these figures. This would transform the life chances of thousands of vulnerable children. I also believe focusing on these outcomes could galvanise the system, drive integrated improvement and make a compelling case for funding. This is why system-wide outcomes and accountability measures are one of the first things I am looking at and are projects that are under way in my office, as I commence as Children’s Commissioner.
Q258 The Chair: We are now going to move into our questions. You have been given an indication of the broad themes and so on, but I can assure you that colleagues will have supplementary questions that may not be in the briefing. They have been really committed to this inquiry and this subject, and have some very strong views and questions that I know they want to pursue.
I will start by asking you to develop something that you said to us in your written evidence, which is now six months ago. It just tells you how long we have been going on this. You stated that there were three fundamental challenges that the Treasury needed to address if the Government’s policy on vulnerable children was to be effective.
First, it needs to put the structures in place to evaluate the wider economic and social benefits of investing in early intervention. You have touched on that.
Secondly, it must consider the implications of reductions in adult services, such as addiction, mental health and domestic violence support, for the demand for children services.
Thirdly, the Treasury needs to map out how multiple spending decisions such as cuts to universal credit or national insurance rises can affect vulnerable families with children. Following your work, ahead of the 2021 spending review, are you now confident that the Treasury understands what is happening and that it is listening?
Dame Rachel de Souza: What a great first question and not an easy one. Let me tell you what I have been doing. Out of the Big Ask came a number of things that I felt we needed to do now. When we published the Big Ask back in mid-September, we put together nine policy papers with some very clear asks in the key areas that were coming out of what the children had told us. I spent the summer with my team working with government departments on those asks and on what they were going to do. That is what I have been doing.
I have written to the Chancellor and shared those with him, and written to the Treasury team. I hope I will get a response and a chance to talk to them about it. I cannot prejudge what the spending review is going to do, but I have managed to have very strong, focused and positive conversations with government departments, and I hope that the Treasury is listening.
Lord Young of Cookham: Could I follow up what you just said about the dialogue with the Treasury? You said a few moments ago that we could halve the underperformance of certain benchmarks of children. Does this have a cost figure attached to it or is it simply achieved by reforming how schools operate? If there is a cost figure for getting those figures down by 50%, are you able to share with us what that might be?
Dame Rachel de Souza: What I gave you was an ambition for my term. If you look at our policy papers and, I am sure, some of the questions you will ask me today, where I am talking about the things that will enable us to achieve that end, for example investment in mental health or work around family hubs and educational catch-up, we have done detailed costings and shared those.
Lord Hunt of Kings Heath: Clearly, there is a cost. Long term, if you are successful, I assume there will be a financial benefit to taxpaying individuals.
Dame Rachel de Souza: Absolutely, and there is something important here about the Treasury understanding children and children’s lives. That is why we undertook the Big Ask: we wanted to be able to give it the data to understand the nation’s children. We have 6% of children from 151 local authorities. We can look at all the outcomes by geography, ethnicity and gender, and we have done the data on that. I want the Treasury to be able to understand children in the context of their lives and their families rather than just in terms of services delivered for children.
The trouble is that it is very difficult to say, “If you did X, you know that Y wouldn’t have happened”. I am hopeful that the Treasury recognises that investment now will pay off later, most importantly for children’s lives. We should not limit our ambition. We should try to create a response that is as big as the ambition of the children who have responded to me, who want great careers and the support to have great opportunities. In short, my hope is that Treasury will think of children in the round and in the context of families, and the huge potential that investing in children has. You cannot put a figure on it, can you?
Martin Lennon: Just to follow up on the specific measures, they have been chosen because they are very clear as a point from which you can project forward to say, “If X then Y”. Particularly in the EYFS measure, there is a whole catalogue of very well-proven interventions under five in speech and language et cetera, which you can link to the individual indicators that children are failing.
To your point on costs, we have talked about the basket of target indicators you would make, but a lot of the work that needs to be done there is about lining up the children who need the services and the services. It is thinking about which group is most likely to fail half of its development indicators, and that could be picked up at two and a half. You would look at the siblings of children who have done that and think, “Are they getting the services that are available? Are they attending nursery?” Nursery is now for three year-olds and most of that group would also be eligible for two-year-old nursery. Are they attending it? Is speech and language getting there?
Some of it is about new provision, but a lot of it is about thinking, “Who are the children who most need this provision?” and matching that group. That has really undermined early years provision for years, even when we had a wider Sure Start centre.
Q259 The Chair: The first provision is what, in loose talk, we would often call “school readiness”. How do you make sure that, by the time a child gets to school, they are not so far behind that they are going to spend the rest of their school life trying to catch up? As you say, even if the school is brilliant, that is a huge challenge and, mainly, it is not one that we succeed in.
It seems to me, from all you have said, that you want to see much more integrated action across government. One of the struggles we have had is contradictory evidence from government, civil servants and so on about whether it is going to be possible to get proper integration. I wonder where you now feel you and the Government are in terms of how they get decent integration out of the silos that mean we cannot work as effectively with children, for example, for school readiness.
Dame Rachel de Souza: There are two parts to my answer to that one. An integrated bid or response from the Treasury would be helpful, but it is not a silver bullet. We need to prioritise funding for early intervention in its broadest sense. We are all agreed on that, but we also need to look more fundamentally at the structures of services to be able to pivot them away from late intervention. For years, across multiple sectors, we have heard, “If we get more money, we’ll spend it in early intervention”, and often this has not happened. That is no individual’s fault, but it points to the systemic pressure towards investment in late intervention. That plays to my point around systems reforms.
To your point about whether the Treasury would accept joint bids on early intervention, because I think that is where you were going, and that there have been different responses from civil servants and Ministers, I have not been around long enough to talk about the past, but if Ministers decide what they want to do, I would take the Ministers’ view on that one. Martin, I do not know whether you want to hop in, because you have had experience in the office of joint and integrated bids before.
The Chair: It is not just the bid. It is the strategy and the working together, however the money is coming to you.
Martin Lennon: There are two things there. First, in terms of the Treasury perspective, there seemed to be a move towards that in the last budget, so quite a lot of prominence was given in the Green Book to joint bids. There was not quite as much allocation, given the prominence in the book, so it suggests that the Treasury was moving in that direction, but the structures of government had not quite caught up.
Secondly, in trying to drive integration, we need outcomes that are agreed across departments. There is too much siloing because, for example, no one can decide who owns school readiness. If you could set a cross-government school readiness indicator, that might drive the integration between education and health that is needed.
Baroness Wyld: This is sort of linked. If we look at the period of childhood, we have taken a lot of evidence on early years, including from you, all of which I support. There is a lot of support for intervention in early years and things that are measurable, but obviously things then go wrong for children at a later stage of their childhood. I was struck when you mentioned CAMHS. Do you think that is fully understood across government? I imagine you would not want to prioritise one over the other, not to put words into your mouth.
Dame Rachel de Souza: No, they are both absolutely essential. I do think there is an urgency. I was pleased to be able to work directly with Michael Gove in his CDL role. He had focused the public sector catch-up on CAMHS, so was really trying to understand that, but we need both.
Q260 Lord Filkin: Hello, Dame Rachel and Martin. I am sorry I am not with you in person. I have two questions about the relationship between poverty and vulnerability, which is an important policy question. In other words, how important is poverty to driving vulnerability? To start with a topical question on that agenda, what effect, if any, do you think the Government’s decision to end the £20 a week universal credit uplift will have on the number of children living in poverty? How will that decision affect children’s services? I welcome your thoughts. Clearly, you cannot necessarily quantify it, but I would welcome your analytic of that.
Dame Rachel de Souza: Can I take the second question first and then move to the relationship question second? That is the ending of the £20 a week universal credit uplift. As Children’s Commissioner, I am really concerned about the conditions in which children live. I have worked with children in poverty and in disadvantaged areas my whole life, and we have to do more about this. I have been very clear. It is one of the first things I tackled government on when I came into post, and I published a detailed paper on what I want to see from government coming out of what the children have said themselves.
We heard from children about this in the Big Ask and it is very touching. Even children from the most disadvantaged areas often did not talk about their own situation and the poverty they were in; they talked about other children. In this generation, they are very caring about each other, so they talked about the impact poverty has on other children and their parents. They were very concerned about that. I am clear and have been consistently clear with government that we need to look at material conditions in which children are living. I want a package of support and services for children and families.
Now, a major part of this is a benefits system that is more focused on families. Children are the group of the population most likely to be in poverty and they are the children that I am focused on. The UC uplift was not focused on families. In fact, it was of greater proportionate benefit to those without children and that is why I have been clear in my paper that I want the UC uplift to be moved to the child element of UC. This will focus resources on children and still be of particular help to single-parent families, the group most likely to be in poverty. I am not wedded, necessarily, to this policy, but I am still hoping we will see something in the spending review. I want this to be part of a package of support for families.
I spent the summer going out and looking at the holiday and food programmes, which I really do think could be continued. They were very good. I went round the country and looked at them. Kids were both eating and having really good positive experiences, the sort of things we would like to see in extended day programmes, so I would like to see that kept and rolled out. I am very keen as well on breakfast clubs, activity clubs and longer days. I have always run them in my school. It is very cheap and easy to put tea on, to have lots of activities and to allow parents to work and not need extra childcare.
You asked me specifically about the impact of the UC cut on children’s services. That is complicated. We cannot confuse causation and correlation, but we know that poverty is associated with high rates of vulnerability and demand for children’s services. We are hearing that in some calls from various children’s services. The evidence now is strong enough to say that this is causal and that an increase in poverty leads to an increase in vulnerability.
I am very pleased that the Government introduced more localised hardship payments during Covid. That was positive, and I know children’s services teams welcome that. I really welcome the announcement of the family support fund. I called for it, so I am going to take that as a win. We were pleased to see that announced.
Your more complex question was on the relationship between poverty and vulnerability.
Lord Filkin: Could I just pause you before we leave the universal credit one? Is there any modelling at all that indicates or estimates the number of children who will move into poverty as a consequence of the removal of the £20 uplift?
Martin Lennon: There is modelling on that, but I am afraid we have not done it. We could write to the committee on it. I think Policy in Practice had done some modelling and, possibly, the IFS, but I would have to come back to you with the figures.
Lord Filkin: Could you send us the figures? Do you have any recollection of, approximately, what we are talking about?
Martin Lennon: Sorry, I could not give you any. I have various figures in my head for which are households and which are children, and I do not want to speculate at this point.
Q261 Lord Filkin: We would like that, because it gives us an understanding. Could I then move on to the next question, which is the estimation? Clearly, you have set out that there is a relationship between poverty and the risk of vulnerability. Therefore, it is important for us to get some sort of handle on what percentage of children living in poverty are vulnerable.
Dame Rachel de Souza: That is a good question. For me, the issue is the overlap between poverty and secondary vulnerabilities, and what we are talking about when we talk about vulnerability. SEND particularly and risks at home are both very strong. Our best estimate is that about 60% of children in poverty have a secondary vulnerability, either SEND or risks at home.
When I go back to my experience as a head teacher in disadvantaged areas and my own childhood experience as someone who was brought up in a poor family, I do not want us to equate not being well off with being problematic. I want us to look at the potential there, and that was what some of my opening remarks were about. I might not have had more than one pair of shoes, but I did have a very supportive community and a great education that allowed me to create the life I had. That is a story that many children who have worked in our schools would be able to tell you.
When I say vulnerability, I am thinking about children at risk. We see that that 60% then comes into play, things such as family breakdown plus poverty, or SEND plus poverty. That is why I get to that 60% figure. It is with that preamble, because we would be making a mistake if we saw those in poverty as problematic. For example, a middle-class child with a mother with mental health issues might be perceived as a young carer, whereas, from a poor background, it is quite likely that they would be perceived as a child in need with a problem. We need to think carefully about what we are doing there. I think my point is made.
Lord Filkin: That gives us a good us an indication of the percentage of children in poverty who have some form of vulnerability. I know from my own family, turning it around, that not all vulnerable children are in poverty. Can you give us an indication of that figure?
Martin Lennon: I can—two seconds. I think it is about 30% of children.
Dame Rachel de Souza: I have 31% in my head, so good.
Martin Lennon: The way we calculate that is the number of children who have been on a child in need plan or with social services in the last six years. About 30% of them are not on free school meals.
Q262 Lord Filkin: Thank you. That is very helpful. I totally take your point, Commissioner, that you do not want to typecast poverty or low income as automatically guaranteeing vulnerability or failure, because that is quite a negative mindset. It is important for us to get an understanding of the extent to which income deficiencies increase risk and propensity to either vulnerability or failure.
Can I ask, then, the final question in my clutch of questions before colleagues come in? What package of measures would you like to see the Government introduce to reduce child and family poverty?
Dame Rachel de Souza: That is pretty clear from my policy paper on poverty. I have eight of them and I am very happy to rehearse them.
Lord Filkin: We will read them, but just give us the flavour of the main ones.
Dame Rachel de Souza: They would be moving the UC uplift from the adult to the child element, targeting the uplift at children, maintaining local discretionary funding streams for families, increasing the number of schools offering breakfast clubs, and increasing the holiday activity and food programmes. I would engage schools with that so that it can be a much wider and better planned rollout. I would facilitate auto-enrolment of free school meals. We lose so many children by making it something that a parent has to come in to do. Just auto-enrol it; that is much easier. I want those children identified at the beginning of their school careers. We can remove stigma and we can get them fed.
I would maintain the FSM eligibility of families without recourse to public funds, and bring in a package of changes to the way UC supports care leavers. I am working on that at the moment with the ministerial care board and care leavers boards. I would want a wider review of the cost of living, because what really came out of the Big Ask was the financial strain on a much wider group of children than we expected in terms of recovery from Covid. That would be my last one.
Lord Filkin: It is a great list and we would all wish for that to happen, I am sure. In the real world, before any of my good colleagues asks the question, I am sure you have costed that and know what the total cost looks like. I am pretty sure that one is not expecting it all to happen at the spending review. Let me ask you the more focused question. If, as there is, there is limited funding, which of those eight do you think gives the best cost-benefit? Cost-benefit is a rather crude term, but you know what I mean by that. Which meal is most important? Per billion pounds of extra spend, what would get the greatest benefit?
Martin Lennon: It is hard to track outcomes, but the return on breakfast clubs is very good. I do not have the figure in my head, but the Education Endowment Foundation has looked at that in detail and the return on investment there is very well proven.
Dame Rachel de Souza: I would do them all though.
Lord Filkin: That is very helpful. We would welcome a note on that giving us where you have a return on yield, because that helps to make a case in the real world for where you can make progress without it being completely impossible.
Q263 Baroness Tyler of Enfield: I would like to pursue a little further this point about the relationship between poverty and vulnerability. Taking account of everything you have just said, I wondered what your thoughts were about the impact within the benefits system of the two-child limit as part of the benefit cap and how this impacts larger families. The specific point is whether you have a take on the relationship between vulnerability and larger families.
Dame Rachel de Souza: I have not included that in our SR asks, because what I tried to put in the SR asks, despite the previous Lord’s challenge to me, were things that I hoped we could actually try to get done. I did not think that we would be able, given the particular political context around the two-child cap, to move that one. I do not know if the office has done any analysis on it. I have not.
Martin Lennon: We have not. I am trying to think what our data sources are where you could match vulnerability and poverty, and whether you could look at large families within that. My thought is that it would probably would not be possible within the data. There may be something you could do with the NPD for older children. I can come back to the committee in writing on whether it is possible to do that analysis. We have not.
Baroness Tyler of Enfield: Do you know of any other charities or think tanks that have done any work in this area, if you have not?
Martin Lennon: Policy in Practice, because of its relationship with local authorities, would be the group that has access to data that we do not and that could do that kind of family-level modelling.
Q264 Lord Davies of Gower: I have a very basic question. In your Big Ask, you said that one in five pupils between nine and 17 had mental health issues. Can you, in this context, tell me what a mental health issue is?
Dame Rachel de Souza: The response was to a question that asked what their biggest barrier to getting back to normal life was, and it was indeed 20% who said “mental health”.
Lord Davies of Gower: Do they understand what “mental health” means?
Dame Rachel de Souza: That was particularly marked in older and teenage girls. They are definitely using the term “mental health” in the way we would use “physical health”, so everything from a scratch on the knee to a serious illness. I do not mean to diminish that in any way. Members of the younger generation are extremely articulate, and talk about their well-being and mental health in a way that my generation did not. They prioritise it. They have heavily prioritised it as one of the things they want for their future.
I think, in that 20%, you have everything from feeling quite bad about lockdown, feeling anxious, feeling concerned, being worried about not seeing your older relatives, how they are going to make friends again, and the anxiety and worries that come with that, to quite serious things. It is the entire spectrum. We are doing lots of work in digging down into that, checking against all responses.
I have also been right round the country in April and May talking to children in both youth settings and mental health settings, talking to care leavers groups, but also in schools. This is the language that they would use about the biggest problem coming out of lockdown now. I do not want to go too far if you want me to stop, but a large part of what they identify as necessary to get their mental health better is someone to talk to, digital counselling and support from school. They certainly see school as the place to get help, but it is also about being together with their colleagues, being able to play—“play” was one of the words they used most—and getting back to normal activities, which is why I have tried to make a case for the extended day in terms of education recovery to include that element.
I checked with Sarah-Jayne Blakemore and a number of Oxford University neuroscientists and experts on children’s mental health, and they said that the one thing that can show causality to good mental health in older age is having good-quality relationships in teen age, so the desire for the extended day, the longer day and more activities is not a pie in the sky.
Martin Lennon: On the question of data, I should say that our survey is backed up with the NHS’s child psychiatric morbidity survey, which has the slightly lower number of about one in six children with a mental health condition. That is on a clinical scale and they will have taken out what they call low-level anxiety and depression from that. What is really shocking about that is that rates of mental health conditions among children have been going up very slowly for some time. Between 2004 and 2017, they went up very slowly, and that is a global pattern.
Since the pandemic, we have gone from one in nine children to one in six children. That led the NHS to repeat the survey this year and it has stayed at that level. That is a very marked increase in children’s mental health conditions over the last three years, which is quite unprecedented not just in the UK but around the world.
Q265 The Chair: Our next colleague asking a question was meant to be Lord Hogan-Howe, but unfortunately his connection from where he is today is not working, so I will ask his question. It comes from some of the work that you were doing in the Big Ask, but, also, I know that you have been asking very closely with Sir Kevan Collins. Some of your responses in the Big Answer are closely aligned with what Sir Kevan said in his report.
Really, I wondered whether he felt that £1.4 billion was not sufficient to pay for what you have just been describing: the extra hours in the day, the longer day and other things to meet the scale of the challenge that we now have. I wondered what you think we need to do in order to properly invest in that recovery programme.
Dame Rachel de Souza: I was, indeed, on Kevan Collins’ board and provided challenge and support to him during the process. I was very sad to see him step down and talked to him about that. The best way to answer the question about what we need now is to understand what “now” is in terms of education. During Covid and lockdown, I was in school, so I went to school every day and we kept our schools open for vulnerable children. I started this role in March, so, until March, I went to school every day.
What were we doing then? That helps us to understand what needs to happen now. Yes, we were preparing online learning and my trust supported a national academy. We were getting computers into schools, setting up the internet and making sure learning was happening. That was very important, but we were doing so much more, and in fact that so much more gives me heart for some of the changes I am trying to suggest to public services. We learned so much more about children’s lives because we were looking into them through the internet.
We were also calling our most vulnerable students, and students at risk of abuse and in difficult areas, making sure we saw them every day or actually turning up at their houses, and making sure that we could see them and their parents online. We were doing that kind of work. Some of my schools were running food banks. We were delivering beds. We were doing a range of things because my schools are in particularly disadvantaged coastal areas.
As we came out of lockdown, it was interesting because children told me in the Big Ask that they needed to and wanted to catch up. They are an ambitious generation. For 71% of them, the most important thing that they want, their biggest goal, is a great career. These are some of the mental health anxieties that we are talking about: “If I fail my exams or I can’t get on this internship, I’m not going to get to college or wherever, I’m not going to get my training and I’m not going to get my great career”. That is where some of the anxiety is coming from.
They want catch-up support, and that was clear, but the word that they came up with most was “support”. They are not afraid of hard work, but they want to be supported to achieve, and I hope that came through in my Big Ask chapter there and in the things I have asked for.
Coming out of lockdown, what do we need? We need to catch them up. How do you catch up your academics? You catch up by having time in front of a good teacher. It is as simple as that. As head teachers, we know how to catch children up. Tutoring is a way of getting that time as well. It is an evidence-based way of getting a bit more time, so I was very supportive of that.
At this point, we need so much more too. We need to sort out their emotional well-being and their attendance so they can get into class and learn. That is where, in my asks, I am slightly different from Kevan’s asks. You will see that I prioritised attendance support, the family support to get children in. The best thing for vulnerable children is to be in school where we can look after them, teach them, and ensure they can have a positive future, so you can see that in the asks that I have put in my policy paper. That came first.
Then, yes, high-quality teaching and more teaching time. I am an absolutely keen proponent of the extended day, both for catch up and for wider activities, cultural activities, teenagers and young children doing things themselves. I have delivered it for years in disadvantaged areas, and I know that makes children and young people stand taller and be more able to achieve. It is incredibly positive.
I do not, however, think we need a universal offer there, because some schools and good trusts are doing this already. However, when I go round the country, I see there are still left-behind schools, schools where this is not happening, and I am sorry to say it is often in the most disadvantaged areas. If you look at the costed asks I have made, you will see some things that were in Sir Kevan’s submission. You will see that Geoff Barton, ASCL chief exec, and a number of good MATs have put together a proposal. My proposals are more similar to that, except that I have focused even more on attendance and emotional support catch-up first. That is a long answer.
Lord Bichard: There may be some difference between the package that you are proposing and Kevan’s, but they both cost money.
Dame Rachel de Souza: Yes, indeed.
Q266 Lord Bichard: I cannot remember the cost of Kevan’s, but he did not get it. Why should you think you are going to get it? Not treading on the Chair’s toes, to take a positive issue, mental health support teams have more money. Is it enough? Are you confident that you can unleash the resources required to do what you want to do? Could you just muse upon why it is in the most disadvantaged areas that the things you would like to see happening are not happening? Is it because the schools lack ambition, aspiration and good leaders, or is there something else happening in those areas?
Dame Rachel de Souza: On mental support teams, the funding has already gone to the NHS and the issue is the prioritisation of money to children, and training and staff. We can go into that. I see no reason why we cannot have 50% coverage of schools with mental health support teams by 2023. It needs some tweaks in the programme.
Lord Bichard: Do you mean with the existing money?
Dame Rachel de Souza: Yes, I do. It is about prioritisation of the money that has gone to the NHS. This was always planned and—Martin will tell me off—it just needs to speed up. You would talk about some training issues there. Do you want to jump in on that one?
Martin Lennon: On the mental health support teams, we would see that as core NHS business, and the NHS just received £12 billion of additional funding. NHS England’s actual reason for slowing down the rollout of mental health support or the cap on mental health support teams is staffing. Without getting too technical, it has created a whole new staffing role for mental health support teams, which is band 5, for which it has had to create a new workforce from scratch. That has really not played to the strengths of the existing mental health network in the UK.
It has always been a bit of a patchwork—some school, some local authority, some NHS—so there is a network of very good charities and existing providers. Instead of working with them, the NHS is creating this whole new workforce from scratch, which is slow because you have to design a course and then recruit them.
I say they are band 5, because that is a particular problem. Most mental health staff will come in from another profession. They will have been psychiatric nurses or social workers. They will have done something else like that. You cannot get band 5 from other professions because it would be a pay cut, and you will not have existing mental health staff at band 5 who can go in. By having this very rigid, very prescriptive national system, you are slowing the rollout rather than playing to the assets in communities, using other parts of the workforce and building on the charities that are there.
Dame Rachel de Souza: On education, I am hopeful we will get a good settlement. I have been working with the DfE, government and the public sector NERT. There has been lots going on. It will never be enough for me, I am always going to want more, but I hope we are going to see it. I am hopeful that, with the impetus of a new Minister seeking the spending review we have been supporting, we will see more money.
There are some excellent trusts and families of schools working in the most disadvantaged areas delivering excellent outcomes for children, but we still have cold spots. If Covid has taught us anything, certainly from my perspective as a formal educationalist, it is that families of schools that worked together and shared resources fared better, were able to cope with the storm of Covid and could make the case for their existence far better. There are far too many tiny primary schools not in a family of schools. There are far too many areas where educational quality is not right and we need to invest in it.
This is one of the things I challenged Kevan on: “Tutoring, yes, but let us get it. How are we going to get that?” It is the practicality of delivery of public service. How are we going to get the right tutors to cold spots in Carlisle? It is the practicality of delivery and that is the same with the answer to why there are schools that are still not. How do we get great leaders there? How do we develop the trust there? That is a question that I am hoping the new schools White Paper will focus on. In fact, I have been meeting regularly with those working on that to address that question.
Lord Bichard: Your answers suggest that you believe that progress is about improving the quality of teaching and leadership in schools, and not about the social deprivation that exists in many areas around the country, but that can be dealt with by better leadership in schools. Is that right?
Dame Rachel de Souza: That was not what I was saying at all. I was saying that, in areas where there are the challenges that you are talking about, so disadvantaged areas and particularly outside cities, it has been more difficult to get the trusts, the leaders and the support we need for those schools there. It is not either/or. Deprived areas need great schools.
Q267 Baroness Pitkeathley: Can I take you back to the answer you gave about mental health? You were both tactful about the money going to the NHS, but we could not fail to see your disappointment about that. Was it a question of government suffering from the “not invented here” issue—that they always have to do something new? Were you in any way consulted about those decisions?
Martin Lennon: Are you talking about the recent funding announcement for the NHS in September?
Baroness Pitkeathley: Yes, and you were talking about the NHS inventing a whole new system.
Martin Lennon: On the NHS inventing a whole system for the Green Paper, the idea of creating mental health support teams and how they would work within the system is pretty good. I do not really know where the temptation to have this top-down model came from. That is where the problem is. The idea of a mental health support team—actually, the Green Paper is not particularly prescriptive on it—is a good one. When you go round the country, you see lots of charities and other providers that are doing something very similar already.
I do not know where the demand for that workforce strategy came from. It is a tendency of NHS England as a national organisation to be overly prescriptive, but it goes back to the issues that integrated care systems are trying to look at, which is how you understand that community in which you are working and particularly the environment around children. There are multiple players. How do you have that relationship with schools and with local authorities to understand the assets in your community?
I should also say that a lot of individual CCGs are doing that. We do an annual survey and an annual index of that. There are CCGs funding far higher levels than the NHS benchmarks and more than twice the NHS expectation, which have brought in the voluntary sector. It is not doom and gloom everywhere because there are so many good examples to show what could be done. That is partly why we are so confident you could get to that 50% everywhere.
Dame Rachel de Souza: There are some very practical, simple ways of doing this, such as rolling out mental health support teams slightly more thinly, but providing clinical governance for all the counselling programmes and local councillors that have been used and employed by schools, or digital counselling. If you saw disappointment in my face, it was much more about CAMHS. I am very worried about the more acute end of CAMHS provision.
The Chair: We need to move to our last question. We are pushing the boundaries of your time and the broadcasters’ time.
Q268 Lord Hunt of Kings Heath: It is very tempting to stick with CAMHS because it is such a pressing issue, but can I ask you about family hubs? You mentioned them earlier and we had evidence from Dame Andrea Leadsom. We visited the Bessborough family hub in Pimlico. How important do you think the development of family hubs is and how far should we go?
Dame Rachel de Souza: I am very supportive of it, but I would also advise—and this has perhaps been a theme of the things I have been saying—that we should not just say, “Family hub equals silver bullet and will solve this problem”. They are very good things. A strong theme from the Big Ask was that children worried about the pressures their families are under and that basic family support. I work quite closely with Andrea, and I am very keen on her model of starting young and supporting parents there. I experienced Sure Start and there are some things from Sure Start that I think we should embed.
There are some things we should learn from to do differently, for example the local community openness. A lot of the family hub work I have seen is very agile, close to families and provides advice when needed. I saw a great model in Leeds; I have seen some great work in Blackpool.
My biggest worries about family hubs are that we spend our money on capital programmes for it and do not think about the people. Getting family hubs right is about getting the professionals and people who are needed in the local area, even if it is family workers and support workers working together, using the public buildings that we have and being able to meet the needs of those particular communities. The needs of my young parents in Great Yarmouth were very different from the needs in Norwich and that is only 20 minutes away, so it is shaping the family hub around what is already available and what is needed there, but I am a big fan.
Lord Hunt of Kings Heath: Could we make a direct link between the glass ceiling you referred to in your opening remarks and family hubs? To what extent can we argue that this is the foundation from which you can really start to do great things as children become older?
Dame Rachel de Souza: In many ways, I think that should be part of the answer to Lord Bichard’s question where he was challenging me a bit on that. It is not only the foundation, but this is also the moment, because many professionals who work with young people in schools and elsewhere have suddenly realised the importance of wider services and working from a very young age, so, yes, absolutely. You have done the data, have you not?
Martin Lennon: The crucial thing there is that they do not work, really, unless the services behind them are integrated. There needs to be an opportunity to bring in the services around them. For example, I was talking to a great family hub during the pandemic and the first lockdown, which was doing this great scheme, “Nobody should have nobody”. It was trying to map who its families were and getting to them door to door.
There was a referral scheme into the family hub that was twofold. You either got referred to the family hub or got referred to children’s services. Children’s services did not tell the family hub what it did with that referral, whether it supported it or whether it was closed. You had a system of mapping out your families that excluded the most vulnerable who were going to children’s services and might not be getting help, so voluntary sector provision is only as good as the statutory co-operation with it. That is also crucial to the funding because we do not want to fund them all as a new thing. We want them as a delivery model for existing services.
The crucial thing is to talk about the bits Rachel mentioned—being agile and community-embedded, and having those relationships—which is such a strength of the community model, but to bring in the statutory services behind it so that they are a model of delivering family support and health visiting.
That is also the way of answering some of the problems with the Sure Start model. There are two problems you always hear about Sure Start. One is in the analysis trying to work out what impact it had because you do not know which families went in. That long-running work from the IFS tries to answer that. Secondly, if you talk to social workers and professionals on the ground, they are saying, “Actually, the most vulnerable families never went into a family hub or a Sure Start”.
If you have your health visitors, for example, in the family hub, knowing who the most vulnerable families are, and they can make that concerted effort to establish the patterns of bringing them in, you are a really genuine protective factor and you can link it to some outcomes. Without that statutory framework, it is very hard to have an outcomes framework for them, to have a funding model for them or to meet the needs of the most complex family.
Lord Hunt of Kings Heath: That was my big takeaway from Bessborough about the hugely important input from the professional services to really make it work. Could you say a bit more about CAMHS? What are you saying to NHS England at the moment? What can be done to reprioritise those services?
Dame Rachel de Souza: I am afraid, on this one, I would say, “Don’t move the deck chairs around the deck anymore; we need to rebuild the ship”. I say that from the perspective of someone who has been working in normal schools and watching CAMHS with our more serious cases. I could make all of you weep by giving you some of the examples of children with multiple suicide attempts or impossibly long waiting times. Although we could point out a number of places that are seeing kids quickly enough and a number of areas that have prioritised provision here, I have talked to the old Health Secretary of State at length about what needs to be done here.
I was working with public sector recovery, with NERT, on what should be done about CAMHS and making a serious and consistent case. I hope that work will continue. It is a desperate situation for many young people. Again, we just do not prioritise the young quickly enough. I spoke to the Royal College of Psychiatrists recently and they just nodded through all of it. We need to invest. We need to deal with this. We know what to do. It needs investment.
The Chair: Thank you very much. There is a lot that I would love to come back on, but we do not have the time or the opportunity. I have to say, Martin, that your point about health visitors was why I insisted that we had a health professional in every Sure Start centre, believe it or not. The issue was the level of co-operation and involvement, so you could go to some where they took that very seriously and every vulnerable family was visited. Even if they did not come in, they were still part of the outreach of the centre. It is that that we need to be universal and, I would say, one of the basic principles of a family hub, but there you go.
We could go on for a lot longer. We have already overstretched your time and we have been very indulgent, but thank you very much indeed for coming along. I hope that we will be able to continue because, even when we are doing other issues, they will still affect children. I am sure that we will want to come back to you and continue to work with you, so thank you very much indeed.