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Postcards from Scotland

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Posted 21/03/2011 | 1 Comment

Since the Scottish Parliament was re-established there has been an expectation that some big idea would help to galvanise the Scottish population. That we would have a: Liberty, Equality and Fraternity moment.


We face a long line of seemingly intractable problems. But the more that you look at violence and school failure and alcohol and drug abuse and teenage pregnancy  - you realize that these are not different problems. They are the same problem manifested in different ways.


Our response, to date, has been to intervene at the point of impact, when things go seriously wrong. Too little, too late.


Perhaps we do have a uniting slogan for Scotland: Liberty, Equality, Fraternity and…Too Little, Too Late.


But there is a practical way forward. The problem is inter-generational.  All parents struggle.


It is time we talked about babies and families. 


In too many households, the role of women as the last line of defence has gone. Burst pay packets and a paralytic man is a long tradition in Scotland. But now we have a new epidemic, a mother on the booze and a dad on drugs.


Policy makers seem to think of Early Years as being about mums and children playing. Real men prefer to discuss the constitution, tax powers, targets and efficient public services.


Where we are now on early years in Scotland is between two colliding waves. 


In the first large wave it is helter skelter, get money out of the system quick, do what is statutorily required and deliver what we can to meet our main targets. In this wave early years does not have much muscle, statutory powers are weak and there are not a lot of big beasts taking up the early years case. In local authority or primary health care measures early years outcomes hardly feature


In the second wave, coming directly in the opposite direction and smashing into it is the weight of evidence including the neurobiological. Medical evidence comes from Scotland’s own Chief Medical Officer, Harry Burns. In economics James Heckman the Noble prizewinner has demonstrated the clear economic benefit of investing in early years. Evidence is with this wave.  But so is the principle: investing in early years is morally and practically the right thing to do. The UK and Scotland are the odd ones out in the context of northern and central European countries. But we are beginning to waken up. 


As the waves break will our Scottish society be a piece of flotsam or will we have more of a common purpose?


Over the past few months the Finance Committee of the Scottish Parliament has been conducting an inquiry into “Preventative Spending and Early Years” and it has now published its report. Informally, members of the committee have indicated that the exercise produced a strong consensus that could lead to a strong commitment right across the political parties. The report from the Finance Committee is available on line at the Parliament web site. 


In order to give more push to their findings the Finance Committee organized a conference in the chamber at Holyrood. This blog draws on the talk I gave to the conference.  


I set out, as the Finance Committee chairman asked, four practical, proposals selected for hard financial times, to take us forward.


Teenage Mums: Support every teenage mother in Scotland from as early in pregnancy as possible. Support them with a health visitor or nurse with extra training and support. Have that nurse form a relationship with the mother, and father where possible, and support them till the baby is 2 years old. We know from Nurse Family Partnership programmes that have been running for 30 years that:

  • there is improved parental care
  • there are fewer injuries to children and better infant emotional and language development
  • mothers go onto have a better life with fewer subsequent pregnancies, greater participation in work and less welfare dependency
  • at 15 years of age the children have fewer convictions, less substance abuse and less promiscuity.

Fortunately we are into year three on a large trial of the Nurse Family Partnership in England and have started one programme in Scotland. We do not have to exactly copy the Nurse Family Partnership but we do need to put more health visitors on the job and they need fewer families to support. 


Primary Health Care: pregnancy and the first months of life is the most important period in life for health and well-being. It is the next step on in public health from providing clean water and a sewerage system. Go to Finland or Holland and you find support for all mothers and fathers during pregnancy and a dedicated Mother and Baby Wellbeing centre in every neighborhood. As well as home visits mother would expect to visit such a clinic 8 times a year and pop in for other support or to air concerns. Most usually there is a continuity of care between specific nurses and doctors and mothers and fathers. At this critical stage we expect, in Scotland, our Health Visitors to have telepathic powers. 


Adoption, Fostering and Children at Risk: Alcohol, drugs and domestic violence contribute to us having more neglected and traumatized children than ever before. When a child is removed from a home, it is not unusual for the baby or child to be circulated between 4-8 places each year. The traumatized child becomes the tortured child. In the USA, the Safe Families Act and Fostering for Success, intensifies the support for a family and shortens to a maximum of 18 months the decision about what is best for the child. In Holland a process has been introduced that comes out more in favour of the child interests, speeds up the process and supports the foster parents. What we currently do is not civilised. 


Community Family Centres: The Jeely Piece in Castlemilk or the Stepping Stones Centre in Girvan run parenting sessions, do child day care, organize speech therapy and reach out into the community. We used to have more of Community Family Centres and we could do with supporting the ones we have and getting more established.



In February I spent two weeks looking at early years in Holland. Historically much of the support for babies and mothers in Holland came through left and centre-left social democratic parties. The last government, lead by a right wing coalition, introduced a proposal for Youth and Family Centres throughout the country to compliment the Well baby Clinics to counter violence and the growing incidence of mental health problems. Three months ago a new government took over, more to the right, and they have signaled that, even with the spending cuts, the roll out of the Youth and Family Centres would continue to expand.


I was thinking about this at Amsterdam airport exactly 2 weeks ago when I read in the New York Times that one of the cuts being proposed by the Republicans in America was to advocate reducing nutritional payments to pregnant women and very young children.


To Liberty, Early Years, Equality and Fraternity. 


Comment By Comment
Bob Waugh
Joined: 26/09/2011

Comment Posted: 26/09/2011 10:21
There's very little here that any reasonable person can disagree with. There is a good preventative case for such long-term 'investment' in child development from the earliest years, and parent support is essential to that. And as Alan says, this proposition has the political advantage of being attractive to left and right for different reasons.

What worries me though is the possibilty that we may be expecting too much from such policies, for two reasons.

Firstly, while investment in support for children and families (however constructed) in the early years is essential, it may not be sufficient. What needs more discussion is how Western cultures, especially 'Anglo-Saxon' ones, handle adolescence - the tranition to adulthood. How indeed do we concieve adulthood these days?

Once it was all simple.(Or at least simpler.) Most poeple got a basic (3Rs) type schooling and went out to work. There was a well-trampled path from that first pay packet to acceptance by older workers to adulthood, often symbolised by leaving the parental home to establish a new family as soon as possible. (And if you married young, your high fertility would soon make you a parent in your turn....)

For how many people is that now a way of life? We now inhabit a labour market where credentials are increasingly important (or seen as being) That has led us to prolong the formal schooling process (arguably mass higher education is part of that) thus postponing the impact of entry to the adult world. At the same time, an insistent consumerism, an integral part of post-1945 capitalism, seeks to develop overgrown children as 'niche markets'. When those whose lack of paper qualifications excludes them from the consumer nirvana loot the high street stores for 'the latest stuff' the media label them as 'feral'. There is more to develop here - a culture that protracts 'childhood' while seeking to 'adultise' (Is there is a word?) that phase of life. I'm not sure that early years investment will fully preclude young people losing their way in this contradictory scene.

Secondly, we need to note an imporatant element of life in our Continental neighbours - and especially the Nordic societies. These are societies whre the extremes of wealth and poverty are less marked than in the UK and Ireland (and of course in the USA where inequality is hard-wired into the capitalist DNA). In their provocative book The Spirit Level (2009) Richard Wilkinson and Kate Pickett argue that children riased in such societies, with less sense of a steep hill to climb, are more likely to have a positive attiude to life and of themselves.

Unlike investing in 'innocent' little children, I suspect that a political consensus on these issues will be more difficult to achieve.
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