SRE0366

Written evidence submitted from the Terrence Higgins Trust

Executive Summary

• Terrence Higgins Trust recommends that SRE be made statutory for all schools as part of a broad and balanced curriculum.
• The current system is failing to ensure all young people receive comprehensive Sex and Relationships Education (SRE).
• We welcome the Government’s support of the supplementary guidance but the Government needs to go further by making SRE statutory for all schools.
• The Government should ensure SRE is provided for all children and young people by making Personal, Social, Health and Economic (PSHE) education statutory for all schools.
• Terrence Higgins Trust is a core member of the Sex Education Forum and supports the ‘SRE: Its my right’ campaign calling for party leaders to make SRE and PSHE statutory.
• The Government should make PSHE statutory in order to support teachers and schools with the resources, training and timetable they need to effectively deliver SRE and PSHE.
• We also recommend that the Government provides a definition of SRE for each Key Stage, covering age-appropriate topics of sexual health, relationships social skills and awareness, and accessing local services.
• The Government should ensure there is assessment of the learning development of pupils in relation to these SRE topics.
• Statutory and comprehensive SRE will help equip all young people with the skills, knowledge and confidence they need to make informed relationship decisions, have fulfilling relationships, and maintain their sexual health.

1. Introduction

1.1  Terrence Higgins Trust is the UK’s largest HIV and sexual health charity, with 32 service centres across the UK. We are a campaigning and membership organisation which advocates on behalf of people living with or affected by HIV or poor sexual health.

1.2  We provide services for people living with HIV to manage their condition and access emotional and practical support, such as counselling and peer support groups. We have young people’s services that provide safer sex resources, information and guidance for all young people that is inclusive of LGBT identities and relationships. These services also deliver sex and relationships education in schools and colleges. We also deliver community based clinical services, such as chlamydia screening and rapid HIV testing, and health promotion campaigns and initiatives which target populations most at risk of HIV and poor sexual health.

1.3  Terrence Higgins Trust welcomes the opportunity to respond to this consultation on Personal, Social, Health and Economic education (PSHE) and specifically Sex and Relationships Education (SRE). We support making SRE a part of the National Curriculum within a framework of PSHE. In addition, we support making PSHE statutory as part of a broad and balanced school curriculum. 

1.4  We further urge the Government to introduce required learning outcomes for all schools to equip young people with the skills, knowledge and confidence to maintain their sexual health and prevent unwanted pregnancy and the onward transmission of HIV and other STIs.

Response to Points to Address

2. Whether PSHE ought to be statutory, either as part of the National Curriculum or through some other means of entitlement.

2.1  We believe that SRE should be statutory for all schools with a comprehensive definition and assessed learning outcomes.

Ensure all schools provide SRE by making PSHE statutory

2.2  Making PSHE, with comprehensive SRE, statutory will improve young people’s knowledge, confidence and skills to make informed judgements and keep themselves healthy. Statutory PSHE in all schools will ensure sufficient time, training and planning is given to the teaching of SRE. Statutory PSHE will incorporate SRE into the teaching timetable, providing consistent and age-appropriate development of pupils’ understanding and knowledge of relationships and sexual health. Ofsted will also be able to carry out ongoing assessment of pupils’ knowledge and skills development.

2.3  All children and young people have a right to learn how to make informed decisions and stay healthy. Making PSHE and SRE statutory in all schools is the best means we have to support them to do so.

Comprehensive SRE to reflect the age, maturity and needs of students

2.4  Children and young people should learn about their bodies, puberty, and how to protect their wellbeing and sexual health at a developmental pace that reflects the maturity and needs of their age group.

2.5  Primary schools have responsibility for educating children up to the age of 11. There is no timetable when it comes to puberty, and many children will start puberty while still attending primary school. All primary school pupils need to learn age-appropriate and accurate facts about their bodies and the physical changes they will experience before they start to happen. 

2.6  Sexual health is important to everyone, and therefore all young people have the right to know about their bodies and how to maintain their health. We cannot know when young people will start engaging in sexual activity. However, UNESCO research shows that when taught properly, SRE can delay sexual activity.[i] Schools should equip their students with the information they need to make informed  judgements and maintain their sexual health before they start sexual activity. Providing accurate facts about the human body, reproduction, HIV and STIs and how to assess and reduce the risk of sexual activities should not be optional for any school.

2.7  As well as the duty to educate children and young people, schools have a safeguarding responsibility to the pupils in their care. SRE fulfils this function by letting pupils know that they can report problems. We cannot prevent abuse from happening, but schools can teach children and young people about their right to privacy. By teaching children about their body, accurate names for their body parts, about what is appropriate and what is not we can help children understand boundaries. SRE lessons can also teach children what to do if they experience abuse.  

2.8  It is essential that all children and young people get the knowledge and skills to negotiate healthy relationships. Statutory SRE in all schools will allow these knowledge and skills to be developed in line with pupils’ maturity.

3. Whether the current accountability system is sufficient to ensure that schools focus on PSHE.

3.1  The current accountability system is insufficient to ensure that all schools provide comprehensive SRE and PSHE.

3.2  PSHE, and in particular SRE, is inconsistent throughout England. Some schools are failing to prepare young people for the biological, social and emotional changes they will face in their lives. This problem needs to be addressed as a priority.

3.3  For primary schools, academies and free schools, there is no requirement for SRE to be a part of their school curriculum. There is therefore no accountability for schools that do not provide young people with knowledge and information about their bodies, positive relationships or sexual health.

3.4  While maintained secondary schools are required to have a SRE policy, the contents of that policy and how SRE is delivered is left up to schools. Schools must have regard to the Sex and Relationship Education Guidance but there are no learning outcomes, time constraints or required topics. Schools are therefore left to decide how to teach SRE without accountability. Balancing this alongside other subjects that have clear requirements and objectives often leaves schools under pressure with timetabling. Consequently, SRE is not given sufficient time and attention.

3.5  Whilst the lack of accountability means that some schools provide good SRE, it is not enough to ensure all schools provide a satisfactory education. Ofsted found that more than half of schools are providing adequate or better PSHE and SRE. However, PSHE required improvement in 40 per cent of schools, and SRE in over a third. The report found that the weakest aspect of teaching was the assessment of pupils’ learning “which was often less robust for PSHE education than for other subjects.”[ii]

3.6  Making PSHE and SRE statutory, with defined learning objectives, will help schools understand what they are accountable for teaching with a clear framework for schools to assess SRE as robustly as in other subjects.

4. The overall provision of Sex and Relationships Education in schools and the quality of its teaching, including in primary schools and academies.

4.1  The provision of SRE is variable across the country, as is the quality of the teaching. Ofsted found SRE required improvement in over a third of schools.[iii] In secondary schools SRE required improvement in almost half of the secondary schools inspected.[iv]

4.2  Young people give consistent feedback of poor SRE in almost half of schools. The UK Youth Parliament surveyed over 20,000 young people, finding that 40 per cent thought that their SRE was poor or very poor.[v] The young people’s sexual health charity, Brook, commissioned a survey of 2,000 young people which found that almost half of secondary school pupils say their SRE doesn’t cover what they really need to know about sex.[vi] A survey by the Sex Education Forum found that one in five young people aged 16 and over had not learnt anything about HIV.[vii]

4.3  Ofsted found that some of the best schools “delivered creative curriculum models that were reviewed and revised in response to pupil and teacher evaluations.”[viii] However, in the 40 per cent of schools that had poor PSHE, there was ineffective monitoring and evaluation of the quality of teaching, poorly trained teachers and insufficiently coherent or comprehensive curricula.[ix]

4.4  The best way to ensure that all children and young people receive high quality SRE is to provide schools with required learning outcomes so that they can structure their teaching and resources to meet clearly defined objectives. This allows for learning to be ongoing and developmental. This helps build on and solidify existing knowledge making it more likely than young people will be strongly equipped to make informed decisions and  maintain their sexual health across their lifetimes.

4.5  The THT/UNICEF survey, Young people’s views on sex and UK sexual health services, 2009, found three quarters of young people said they would use the internet to get information on sexual health, making it the most popular option. The second most popular source was friends, cited by half of respondents. Most used search engines to find out information on the internet, which risks inaccurate information.[x] Five years on from this survey, more children and young people will have personal smart phones that provide them with instant access to the internet. There are accurate and informative website resources that young people can utilise to expand their knowledge. However, there is no guarantee that these will be the websites that young people find. Therefore, they are at risk of accessing and relying on inaccurate or misleading information. Without statutory SRE in all schools there is no assurance that young people will be provided with accurate information.

4.6  Even where adequate SRE is provided, there continues to be significant gaps around issues that will affect members of the student population, including HIV and sexually transmitted infection (STI) transmission, prevention and treatment, and same-sex relationships.

Young People’s Sexual Health

4.7  Young people below the age of 25 remain one of the two populations most at risk of poor sexual health. This age group experiences the highest rates of STIs;  young people are just 13 per cent of the population, but accounts for more than half of the over 400,000 STIs diagnosed in the UK in 2012.[xi] Although teenage pregnancy rates have been decreasing in the last decade, the UK still has one of the highest rates of births among women aged 15-17 in the EU.[xii]

4.8  Public Health England’s report on STIs found that “too many people are still putting themselves at risk through unsafe sex, especially young people.”[xiii] This is reinforced by the third NATSAL report findings that found 16 per cent of young men and 14 per cent of young women had had sexual intercourse without a condom with at least two partners in the previous year. [xiv]

4.9  These risks in young people’s lives and the spread of STIs has a financial as well as a personal cost. The estimated treatment costs of new STI diagnoses in the UK in 2011, according to the Brook and FPA Unprotected Nation report, was £620 million, of which young people would account for nearly a half.[xv]

4.10                       The Department of Health’s A Framework for Sexual Health Improvement seeks to redress the nation’s poor sexual health, and one of its key recommendations is to “ensure people know how to prevent sexually transmitted infection”.[xvi] Without full and comprehensive SRE, there is no guarantee that this goal will be attained, and there will continue to be young people who are unequipped with the knowledge of how to protect themselves and others from contracting easily preventable infections.

HIV Education

4.11                       From 2003 to 2012, there were 7,849 HIV diagnoses of people aged 15 – 24. This is an average of 785 every year, and represented 11 per cent of all new HIV diagnoses.[xvii]  These young people will have to manage living with the infection for the rest of their lives, at a considerable cost to their personal health and wellbeing and a financial cost to the state. The costs over a lifetime for one infection of HIV are between £280,000 and £360,000.[xviii]

4.12                       While teaching about HIV is a requirement, there is no clear definition of what should be taught. Knowing that HIV is a blood borne sexually-transmittable virus does not mean that young people are made aware of the realities of the condition. Myths around HIV continue to be widespread and the plurality of the myths are of great concern. Terrence Higgins Trust conducted a survey for World AIDS Day 2013 of over 500 people living with HIV about the myths they had encountered. Over half had spoken to someone who believed HIV and AIDS were the same thing and that a HIV diagnosis is a death sentence. Over a third had spoken to someone who believed there is a cure for HIV or that it was only a “gay men’s issue”.[xix]  These myths perpetuate young people’s inability to assess the risk of sexual activity accurately, the reality of living with (and being unable to cure) HIV or know when they need to take a HIV test.

4.13                       Even if the medical facts of HIV are taught, this does not mean that young people are taught how to prevent HIV transmission. This is especially true of young men who may be gay or bisexual, or who in the future may have sex with other men. Men who had sex with men accounted for half of all new HIV diagnoses in 2012, but there are still one in five people living with the condition who are unaware.[xx] Young people need to learn that a person may not know they have HIV, and be able to make informed judgements on sexual activity and HIV/STI testing.

4.14                       The Select Committee on HIV and AIDS asserted that “a statutory basis for SRE is essential. It would… support the integration of HIV and AIDS teaching into SRE, avoiding reliance on the science curriculum to provide all teaching on what is a wide and complex subject.”[xxi] The risks of sexual activity between people of any sex, how to reduce the risk, and how to access sexual health supplies and HIV and STI testing are vital to good SRE.

4.15                       Comprehensive SRE must cover same-sex relationships so that young LGBT people can have the knowledge and confidence to have fulfilling relationships and keep themselves healthy. It will also challenge homophobic bullying in schools that leads to social isolation and mental health problems in young LGBT people.

5. Whether recent Government steps to supplement the guidance on teaching about sex and relationships, including consent, abuse between teenagers and cyber-bullying, are adequate.

5.1  While we welcome the supplementary guidance as it is only for optional reference it does not adequately ensure that all young people are equipped with the skills and knowledge they need to have positive relationships and report problems.

5.2  Terrence Higgins Trust welcomed the opportunity to contribute to the supplementary guidance produced by SEF, Brook and the PSHE Association. Since 2000, when the current guidance was written, the issues surrounding sex and relationships have moved on considerably making the guidance no longer fit for purpose. The internet has expanded access to pornography which is ever easier for young people to discover. Mobile technology has brought new means of communicating and sending images, leading to phenomena such as cyber bullying and sexting. Treatment for HIV has improved to the point where it is a manageable long-term health condition if diagnosed early enough. Same-sex relationships are now allowed to be talked about in schools, and same-sex couples can get married. The supplementary guidance was a good opportunity to address some of these new or developing issues.

5.3  However, optional guidance will never be adequate to fulfil our duty to young people to provide them with the skills, knowledge and confidence they need to have positive and healthy lives. Without clearly defined learning areas that all schools have to cover, there will continue to be young people missing out on vital information they need to have positive relationships and good sexual health.

5.4  Ofsted found that in just “under half of the schools, pupils learnt how to keep themselves safe in a variety of situations but not all had practised negotiating risky situations or applied security settings to social networking sites.”[xxii] Ofsted found the deficiencies in teaching about abuse and personal safety arose from “inadequacies in subject-specific training and support for PSHE education teachers.”[xxiii]

5.5  To ensure all young people, regardless of their sexual orientation, know how to handle experiences of non-consensual sex, abuse, and bullying, and health issues within relationships, SRE must be a requirement for all schools. Teaching about sex and relationships, including consent, abuse, bullying, and same-sex relationships will only be adequate when there are required learning outcomes, dedicated time in the teaching calendar, and sufficient teacher training on delivering SRE lessons.

6. How the effectiveness of SRE should be measured.

6.1  The effectiveness of SRE should be measured with required learning outcomes for all schools.

6.2  For SRE, we believe the specific core outcomes for every pupil should be:

• Personal knowledge about the body, puberty and growing up.
• Skills and confidence to enjoy healthy and loving relationships
• Knowledge about how to maintain good sexual health
• Understanding of risks associated with sex and the arguments for delaying sex.
• Understanding of religious and secular perspectives of sex, sexuality and sexual health.

7. Summary

7.1  Terrence Higgins Trust believes that good sexual health should be a right and reality for all people. Knowledge of HIV and STIs, how they are transmitted, prevented, tested for and treated is essential to realise this reality. All young people have the right to the knowledge, skills and confidence development to be able to make informed judgements and maintain a good level of sexual health.

7.2  Statutory SRE in all schools will help ensure that all young people are equipped properly for adult life and healthy relationships. As individuals their quality of life will be improved through avoiding negative relationships and poor sexual health. The country as a whole will benefit from the social, health and economic advantages of better sexual health.

8. For Further Information

8.1              For more information please contact Daisy Ellis, Head of Parliamentary Affairs and Policy, daisy.ellis@tht.org.uk or telephone 0207 812 1632.