HC Deb 23 June 1999 vol 333 cc1109-29

11 am

Mrs. Teresa Gorman (Billericay)

I am grateful for the opportunity to open a debate on this subject.

The Government have just published a report on teenage pregnancy prepared by their social exclusion unit. The standard of the document makes it easy to read, and it has lots of useful diagrams and heartfelt comments from concerned adults, like the Prime Minister, who talks about our shameful record—rather like a Victorian parson pontificating in the pulpit. The best bits are the quotations from teenagers themselves, which illustrate the reality of their predicament. I fear that the rest of the report is much of the same: it refers to more task forces, more focus groups and more concerned adults who will minister to those teenagers, while studiously avoiding some of the simple remedies offered by the pharmaceutical industry, most essentially, emergency contraception and possibly easier terminations. There are one or two novel bits, such as punishment for teenage fathers, including losing their car or having their benefit cheques docked by £5 a week.

If we are to discuss a subject as serious as this, we must put it into perspective. When devising solutions for perceived problems, it is important to look, first, at the comparison between this country and other parts of the world and, secondly, at the number of people involved. Although it has often been said that we have the worst record in Europe, we do not have the worst record in the world. Other English-speaking countries, particularly the United States, New Zealand and Canada, have higher numbers than ours. In England, there are some 1.7 million teenage girls in the 14 to 18 age group. The report says that 90,000 of them become pregnant each year; it does not say that they are all unmarried or not in partnerships. However, that is only 5 per cent. of that age group. If we take the 14 to 16 age group, about which there is a great deal of concern, the figures are 880,000—under 1 million—and 8,000 live births, which is less than 1 per cent.

I am not sure that I agree with the Prime Minister that that is an altogether shameful record. I agree that it is 8,000 too many births to girls in that age group, but the fact remains that 99 per cent. of our young girls are not getting pregnant each year. It is important to bear those facts in mind because we sometimes become quite hysterical and get things out of proportion, which does no good.

The experience of pregnancy and birth for those very young girls may be extremely traumatic. No one would pretend that, at that age, they are ready to raise children: they are hardly more than children themselves. However, we cannot marry them off or expect them to set up partnerships with the fathers of their children, who are usually just as young as they are. Nor can we simply walk away from the problem.

I am not altogether scornful about or averse to the Government's suggestion that hostels may have a role to play in helping those young people to get their act together, get back into education and begin to pick up the threads of their young lives so that they do not find themselves stuck in the groove of early and continuous maternity until it is almost too late.

Lorna Fitzsimons (Rochdale)

First, may I congratulate the hon. Lady on securing this debate? Does she agree that when we talk about hostels, it is important to point out that the report specifically refers to independent supported accommodation for under-18-year-old single parents? Does she agree that, as politicians, we must act responsibly and be specific, because the media have not?

Mrs. Gorman

Yes, I agree with the hon. Lady. I am sure that she is aware that many of those young children are in care homes to begin with, so the prospect of their being in an institution—I hate that word—or some kind of accommodation where they can be looked after and which specifically caters for their new maternal condition has merit.

The very best solution would be for those young girls to stay with their own families—with mum. It would certainly be much cheaper. According to the Joseph Rowntree Foundation, a single parent raising a child alone will cost the taxpayer at least £83,000 in benefits from the child's birth to when it reaches the age of 18. That is without the cost of housing benefit, if that person lives alone, is unable to work and therefore cannot support herself as she might like to.

A child raised in a conventional family costs some £50,000 from birth to the age of 18. About a fifth of that—£10,000—is met by child benefit, so it seems perfectly obvious, from a financial perspective, that the best policy would be to support and encourage the families of those young girls to keep them at home instead of paying the teenagers to tough it out on their own. The plans that the Chancellor devises should take that into account.

I should like a pound for every time that I have been to a Chancellor in the run-up to a Budget to try to make that point to him. I say "him" because it is always a him. We are yet to have a woman Chancellor, who might be more sympathetic to that point of view. The best place to raise children is within the existing family, and that is also the most cost-effective course.

Mr. John Healey (Wentworth)

Although it is true that we have a male Chancellor, does the hon. Lady not concede that for the first time we have three female Ministers in the Treasury team? That must be a step forward.

Mrs. Gorman

Yes. The hon. Gentleman makes my point for me: we are always the bridesmaids, never the bride. I shall wait to see the outcome.

How do teenagers view these matters? Girls who find themselves pregnant are often obliged to leave their family home, simply because, in that way, the welfare system will pick up the bills. Why should parents who live in crowded accommodation encourage their daughter to stay at home, with the extra costs, the inconvenience and a noisy mouth to feed—the new baby—when the welfare state dictates otherwise? When Governments do more, people do less, and when something is subsidised we tend to get more of it.

I do not believe that young women have babies to get flats. That is a calumny; it is not true, and we should stop saying it. I certainly do not support the tabloid press, which often makes that extremely chauvinistic point. However, we must stop subsidising teenage sex so much and must promote the role of the conventional family both in dealing with their own teenage children and in taking in their children's children wherever possible.

That is what used to happen—perhaps before the welfare state began. Although the welfare state means well, it does not always produce the right solutions to the problems that it perceives. We should not take the line that because the welfare state has not achieved its goals, we need more of it. Sometimes we need to stand back and ask ourselves whether we can do things better. There are other options.

Shona McIsaac (Cleethorpes)

Does the hon. Lady agree that we should not just stand back, but take a step back? Is not the most cost-effective solution ensuring that young women do not become pregnant in the first place? Really good contraception education would give them the self-confidence to say "No" or "Not yet".

Mrs. Gorman

I could not agree more, but I feel like saying "I wish". In fact, there is a great deal of education of this kind, but it seems to go over the heads of school children. One teenager is quoted as saying, more or less, "Our religious education teacher gave us the facts. She was shaking with nerves, and I felt embarrassed for her." That, I imagine, was the end of the lesson.

Not all girls who become pregnant come from conventional homes. Some, possibly quite a large number, are already in care, and we should consider the nature of the places where they are in care. I recently visited a very nice, very modern care home for children from difficult backgrounds, which contained one young teenage girl and six boys. They all slept in the same corridor; admittedly, the girl's room was at one end and the boys' room was at the other. The staff told me how much "teasing" the girl received from the boys, and expressed doubts about the merits of the arrangement. Their solution was to admit a few more girls to balance things out. Mine would have been to take the girl out of the hostel and put her with other girls.

I am a great advocate of allowing girls to grow up together. I went to a girls' school, and I do not think that it did me much harm. Girls often thrive when they have the support of their own sex. Politically correct ideas about modelling care on the orthodox, traditional family mix of the sexes are not always right. Young girls and boys in care are being brought up by people who are basically strangers, and who work on a rota basis, coming in for eight hours and then disappearing again. We should ask ourselves whether the social services have got it right, given the inordinately large number of children who come from disturbed, dysfunctional or broken homes.

The report quotes one young woman as saying: It sometimes seems as if sex is compulsory but contraception is illegal". Quite. Young people have more than enough exposure to sex as a supposedly jolly pastime, but, as the hon. Member for Cleethorpes (Shona McIsaac) pointed out, an obstacle course awaits them when they need access to contraception in emergencies.

Our abortion rates are much higher than those of other European countries. They are particularly high in the leafy suburbs of the southern counties, where families are more clued up and girls are more ambitious. When a girl becomes pregnant accidentally, her family ensures that she is given treatment so that she can get on with her young life and develop her career and prospects, rather than having to raise young children before she has completed her own preparation for adult life.

The cheapest contraception of all—if it is made available quickly enough—is emergency contraception, which costs just £1.35. Some girls, however, wait much too long before drawing attention to their pregnancies. Some go through with it, give birth and then dump the baby.

Pontificating on its high horse the other day, the Daily Mail observed that at the beginning of the last century about 5 per cent. of young women were becoming pregnant, whereas 40 per cent. more were becoming pregnant nowadays—although 40 per cent. of a relatively small number is not a huge amount. Girls today, however, do not face the prospect of the workhouse. They do not smother their children at birth, as they frequently did in those barmy early Victorian days, or dump their babies on the steps of workhouses. If the numbers have risen, that is partly because girls are no longer intimidated and made to feel desperately ashamed, as if becoming pregnant was all their own fault. They are more open about it. We should welcome that, and not prate too much about the high incidence of pregnancy.

We are told that the number of such pregnancies is much lower in Holland. That is generally believed to be because Dutch society is much more open: parents discuss all aspects of sexuality with their children, and access to general practitioners is much easier, as is access to help for those who unintentionally become pregnant.

I do not think that we can change our own society overnight. Our prurient attitude is demonstrated by the amount of bonking that we see on television: it is far more frequent than the weather forecasts. Moreover, we are not given the gloomy news; we are only given the jolly news. These television sessions always seem to finish with a burst of pleasure for the parties involved. In real life, that might apply to one of the parties, but young women often find that they are not as thrilled and delighted as they expected to be. They take part in sexual activity because of peer pressure, but it may not turn out to be such a treat as they were led to believe.

Shona McIsaac

This country may have given the world page three, sex on television and saucy seaside postcards, but are we not still phenomenally prudish when it comes to discussing sexual relationships and contraception? Our teenage girls still believe the myths that were around when we were young—"You can't get caught the first time," and so forth. I return to my main point: the solution is good sex education and contraception advice at a young age, so that the problem can be sorted out before girls start having sex.

Mrs. Gorman

As the hon. Lady may or may not know, I got quite a lot of stick for signing an early-day motion tabled by the hon. Member for Richmond Park (Dr. Tonge), and saying that I thought even children in the top forms at primary schools should be given some information of this kind. Given that they can switch on the television any day and see such activities—whether or not they register—there is something to be said for more openness.

The hon. Lady brings me to my next point. The report deals at some length with education. It is clearly part of the Government's aim to improve education, and there is no doubt that children are receiving mixed messages; but if we beef up sex education in schools, will youngsters take any notice? Frankly, I doubt it.

Young men—driven by their testosterone hormones, and in a condom culture—seem still to be oblivious of the damage that they may be doing to their partner, whom they obviously sought, or to have any sense of responsibility for the end product—the child—of the partnership. However, as I said, we cannot expect young boys to settle down with their young girlfriends or wives—the mothers of their children—to set up a conventional child-rearing environment.

Mr. Phil Hope (Corby)

I congratulate the hon. Lady on initiating this debate. However, do not the report and its appendices—using studies from across the country—establish and state pretty comprehensively that more effective education on sex and relationships and preparation for parenthood reduce sexual activity among young people, increase their ability to feel less compelled to have sex at an early age, and increase the likelihood, particularly among boys, that they will take their responsibilities and obligations more seriously?

Mrs. Gorman

The hon. Gentleman may believe that, but he should not forget that, according to the Prime Minister, our record is shameful and getting worse. I believe—although I have not been a teacher for a very long time—that we have done a great deal to open up the subject in schools. Nevertheless, as I said, I do not think that youngsters are listening. I believe—being very sensible about it—that, at puberty, young people, driven by the rush of their hormones, often become overwhelmed by the situation. I therefore believe that, very possibly, too much stress is being placed on sex education in schools.

A quote from one young girl provided some extremely important information. She said: If someone came and gave me a baby to look after for a day, I would never have fell pregnant. Perhaps that gives us a clue as to what constitutes real sex education: the reality of what happens after the mechanics of sex are finished.

The United States—which has a bigger problem with teenage pregnancies than we do—is trying that type of approach. Reports from the United States suggest that young women who go back to schools with a young baby—to explain to students the consequences for one's life, 24 hours a day, seven days a week, of taking care of a fractious child—are possibly having a bigger impact and doing more good in dissuading other young girls from simply conforming and undertaking the mechanical aspects of sex without thinking about the long-term problems.

In the past, we should have advised young girls who became pregnant to put up their babies for adoption. It is still an option which reasonably should be brought to their attention. Young girls should not be pressurised into keeping their babies. If a young girl is not ready, able or willing to raise her own child, there are many excellent families without children who would love to take in those babies, who would perhaps then be given a better start in life. I am not judgmental on those issues, but acknowledge that we have consistently made it more difficult for people to adopt. Although we complain that there has been a great increase in the number of babies, there is also a great shortage of babies for adoption. We should examine the causes of that situation.

Mr. Hope

The hon. Lady made a point about parenthood education. She may not be aware that, on the same day as the report on teenage pregnancy was published, the Government published a report on personal, social and health education which specifically described how we might introduce parenthood education into the school curriculum. She may also not be aware that the new national framework on personal, social and health education in schools includes specific learning outcomes on family life and the responsibilities that parenthood brings. Does she not agree that the Government are grasping the issue quite firmly?

Mrs. Gorman

As I said, 95 per cent. of our teenagers do not become pregnant, and less than one per cent. of teenagers in the younger 14 to 16 group become pregnant. Should we therefore spend so much time in schools trying to give them a warning which, presumably, they have already taken on board? Although it is important that the matter should be brought to their attention, I do not think that it has to be done only in school lessons.

As I said, teenagers can be informed through magazines and by their own social activities. Moreover, perhaps witnessing the reality of child rearing would have a greater effect on them, without necessarily filling their heads with lots of stuff about biological matters and the mechanics of the sexual act—which they often regard as rather amusing or completely irrelevant. Knowing about ovaries and testes and what can be got up to with them is not necessarily of much help to a child who is under pressure from the boy sitting next to her to go round to the bicycle sheds for a little bit of rum-ti-tum.

I do not think that the Government's proposals—for more of the same—as stated in the report, will achieve a desirable conclusion.

We must, of course, try to raise young women's level of self-respect. If we tell it to them straight and teach them that their whole future may be decided on that one act, perhaps they will develop a little more resistance and reason to say no. It is true that the incidence of pregnancy among young people is much greater among those who are less well educated and from less-well-off families, neighbourhoods and parts of the country. There is therefore something to be said about the need to raise their level of self-respect. If we could do that, I believe that it would have a great impact on the teenage pregnancy rate.

We do not need yet another task force, as the Government propose, or more talk about relationship education and feelings. For most teenagers, sex is a quick business—a physical and transient experiment that is not about permanent relationships. As I said, I do not think that those young people are ready to settle down into conventional family home life, or that it would even make sense for them to do so.

I should like to deal with the issue of contraception, although some other hon. Members present are much better qualified to do so. Last Sunday, the Minister for Public Health appeared on the "Dimbleby" programme, and I must say—I hope without seeming smarmy—that she generally acquitted herself very well. Nevertheless, she went out of her way to say that the morning-after pill—which, as I said, is the cheapest way of dealing with the problem—is: a prescription medicine only and the report makes no recommendation about changing its status because … changing its status would involve its licence, re-assessing its medical effectiveness"— as if that could not easily be done if the Government were of a mind to do it. Those are excuses.

The morning-after pill is an effective remedy that has been tried and tested and is widely used in France. It has proved that it can play an important role in helping young women who become pregnant, realise their situation and want to do something about it. We should not place obstacles in their way.

On the morning-after pill, I think that the Minister was bowing a little to those sections of our society who do not approve of any form of abortion, or who even—in extreme cases—do not approve of contraception. Those people would rather see a young woman go through with an unwanted pregnancy, or even with more than one such pregnancy—changing her life and robbing her of her teenage years—than give her the chance to develop into a fully rounded adult. That position seriously needs to be reconsidered. I should like the Government to address the issue in an intelligent and adult way.

Let me say one last word, about the future. Many of the sons and daughters of teenage mothers grow up in a fatherless environment. I personally believe that families need fathers. Mothers need help with raising their children. Boys in particular need role models. They need someone to discipline them and help control them so that they do not grow up into permanent adolescents. In some societies in other parts of the world, single-parent families are almost becoming the norm. America has a particular problem. In such societies, there is a problem of permanent adolescence. Young males never settle down into normal adult life patterns of work, bringing home the salary and helping to support a family. The pattern of mother-run families is perpetuated generation after generation. That pattern is reflected on some of our inner-city estates, where single motherhood is not uncommon. Teenage boys rampage through the streets, vandalising, terrifying other residents, stealing cars and much else and vying with each other in laddish and loutish behaviour. They are a menace. That is an offshoot of our failure to tackle the problem at its roots.

The recent football world cup was a good example. We saw on television grown males behaving like uncontrolled adolescent children. I believe that to be one result of young people growing up without a strong male influence. There is no doubt in my mind that all Governments have a lot to answer for in these matters. Sentiment is not enough. Common sense and counselling may be called for, but tough love is also needed. If we want to reduce the misery and mayhem caused by some of our policies over the years, it is important to consider examples from the past and see whether we cannot do more to re-establish the conventional permanent family relationship and, if need be, direct more financial resources in that direction so that it becomes an attractive alternative to raising children alone.

Taking responsibility is part of living in a civilised society. That does not mean leaving one young woman responsible for bringing up children. It means re-establishing the role of the male in bringing up children, making him feel that it is an important part of his job. We should not simply lecture teenage girls in schools. Sometimes we must lecture ourselves, because we allow sentiment for the child in the predicament to overcome our common sense. It is the policy of the Conservative party to reinstate the role, importance and responsibility of the conventional family unit.

Marriage, even though it does not always work, is by and large a good thing for families. Long-term partnerships are next best, although sadly the statistics say that they do not last anything like as long as marriages. I do not want to see people locked into miserable, unhappy marriages for the rest of their lives, but if the Government seriously put their mind to it, they could do a great deal more to make marriage an attractive option. In the end, is it not the children of teenage mothers whom we should think about? If you ask the children, they say that they would prefer to be in a family in which mum and dad at least come home to see them, talk to them and help them now and again.

11.34 am
Mr. Brian Sedgemore (Hackney, South and Shoreditch)

I begin by congratulating the hon. Member for Billericay (Mrs. Gorman) on obtaining this important debate. I agree with a lot of what she said, although not all of it. May I declare an interest, not as a pregnant teenager but as a member of London Brook, an organisation that gives advice to young people on sex, contraception and abortion. I am also a member of Population Concern, an international charity that runs projects in India, Pakistan, Bangladesh, Bolivia, Peru and South Africa.

I am sure that the whole House will welcome the publication of the report of the social exclusion unit on teenage pregnancy. On the whole, it adopts a pragmatic and positive approach to the highly sensitive issues of sex, teenage pregnancies, contraception, sex education in schools and abortion. None of us can be happy with the fact that teenage pregnancy rates in the United Kingdom are twice as high as in Germany, three times as high as in France and six times as high as in the Netherlands. The 90,000 teenage pregnancies a year in England alone create an awful lot of misery and wreck many lives.

None of us can be happy about young people's lack of accurate knowledge about contraception, which is in part responsible for the fact that among under-16s over half the pregnancies are terminated and that a third of conceptions in the under-20s end in abortion. Prevention has to be our top priority. We cannot carry on living in a country in which many teenagers have such low expectations for themselves and are so ignorant and so confused by mixed messages from society which, as the hon. Member for Billericay said, suggest that sex is compulsory but contraception is undesirable.

I welcome the response of Ministers at the Department of Health to the report. Their commitment to the £60 million strategy to galvanise work across government to prevent teenage pregnancies seems absolute. I hope that Ministers at the Department of Health will push harder, as the hon. Lady argued, to press for over-the-counter sales of emergency contraception, sometimes referred to as the morning-after pill. I hope that they will discuss with their colleagues in Northern Ireland the need to introduce the provisions of the Abortion Act 1967 into the Province to ensure that young people there have the same right to abortion as their sisters in mainland Britain.

The Department of Health must realise, too, that access to services and contraception needs to be expanded. I am sure that they know that the health authorities are currently cutting grants to organisations such as London Brook and others. This is a problem that cannot be neglected, especially in the light of the report.

Judging by the performance of the Department for Education and Employment in this area and the scarcely concealed negative attitude of the Secretary of State, there is even cause to doubt the intention of the Department to implement some of the policies suggested in the social exclusion unit report to reduce the number of teenage pregnancies. Indeed, I would go further: having followed the subject for the past 15 years or so, I have little doubt that if there were an Ofsted report on the performance of the Department, it would be deemed to be failing.

We have to ask whether it is right that young women should continue to suffer and lead miserable lives because of the biblical self-righteousness and dark 1950s morality of a few people in the Department for Education and Employment. Let us take the issue of school nurses handing out contraceptives. The Secretary of State is reported to have said that it would be allowed only over his dead body. I hope that it will not come to that; we really do not want blood on the floor, especially my right hon. Friend's blood. I hope that he will carry on doing good work in other fields. It is just that he needs to do some more good work in this area.

It is clear that Parliament will need to monitor closely the activities of the Department for Education and Employment to ensure that there is no backsliding. I feel that we should consider making personal, social and health education, to which my hon. Friend the Member for Corby (Mr. Hope) referred, compulsory in schools and part of the national curriculum. Bizarrely, at the moment few girls in primary schools are told anything about puberty.

There is also the difficult position of the Catholic Church. The theology of the Vatican on contraception is out of line with the practice of many Catholic worshippers in the United Kingdom. Like everyone else, I wish the Holy See a long life, but when the present Pope dies I hope that the new incumbent will do what is long overdue and moderate the theology, which after all in historical terms is relatively new, to allow young Catholics to use contraception without the guilt of sin, hypocrisy and lies. It is time that the Catholic Church woke up to the fact that for the young, sex can be fun.

I was delighted to see Geri Haliwell, formerly Ginger Spice, promoting the use of contraceptives in the Philippines in her new role as United Nations ambassador. Surely she was right when she said: I believe that if you can't control your fertility, you can't control your life, and if you're having sex, you've got to be protected against unwanted pregnancy and infection. It's everybody's fundamental right. Of course, given the current state of Catholic theology, no one can object to the priesthood in the Philippines criticising Geri Haliwell. However, to refer to her, one of the icons of youth, as " blasphemous" and to hint at violence by saying, In a Muslim country she would be clobbered", seems uncharitable and unchristian. We must remember that, whereas the Pope is an icon to the past, Geri is an icon to the future. I hope that Catholic theology on this subject will change.

I know that other hon. Members want to speak so I shall conclude by congratulating my right hon. Friend the Prime Minister and the social exclusion unit on producing a wonderful report. It is a pity that it has 185 footnotes referring to 185 research documents. I have read the report in full, but I have not yet read the research documents—I hope that I soon will.

In truth, the report could have been published 20 years ago. For two decades, British society and the political establishment—mainly Members of Parliament—have ducked the subject. It is time for action.

11.41 am
Dr. Jenny Tonge (Richmond Park)

I congratulate the hon. Member for Billericay (Mrs. Gorman) on obtaining the debate. I looked forward to reading the social exclusion unit report, but I was instantly depressed by the Prime Minister's letter at the beginning. Yes, we do have the worst teenage pregnancy rates in Europe-90,000 each year, 8,000 of whom are under 16—but as the Prime Minister goes on he begins to sound more and more like the Vicar of St. Albion. He may disapprove of young people's sexual activities and I do not believe that it is a good idea for young people to have sex at all, but they do, frequently. We are dealing with reality. They are following the message in every magazine, film, television play, soap opera or advertisement. Renault is now advertising its cars by saying that size matters and I understand that Haagen-Dazs ice cream tastes much better licked off one's partner. I will not go on because I do not want to excite you too much, Mr. Deputy Speaker, but such things must be taken into account.

The hon. Member for Hackney, South and Shoreditch (Mr. Sedgemore) mentioned the Spice Girls. I am delighted that Geri Haliwell is now promoting contraception worldwide. However, their image of immature sexuality has been pushed at young people, particularly those under 10, for several years. They knew what they wanted, what they really, really wanted, and they pushed it on to young people. However, to do justice to them, they are trying to do something about it now.

In contrast, the hypocrisy of this country is breathtaking. We tut-tut about young people's sexual activity while, in comparison with other countries, we provide very little sex education and contraception advice. I should like to bet that some of those who are tut-tutting are rejoicing as share prices soar because of some commodity having been promoted with a sexual message. They are not worried about taking the profits, but they do not want to do anything about the consequences.

However much we might want to turn back the clocks to an imagined age of innocence where no one had sex until they were married and then only under the blankets with the lights off, we cannot do that. The genie is out of the bottle and we must equip our young people to cope.

In many ways, it is an excellent report and I congratulate the Government on the fact that, backed by wonderful tables and statistics, it spells out clearly the major reasons for teenage pregnancy. It includes low expectations, disadvantaged children, children from broken homes or care homes, and ignorance. Study after study has shown that sex education does not make young people more sexually active. In fact, the reverse is true and the report backs that view.

I have already dealt with the problem of mixed messages and the Government accept that that is a reality. They intend to deal with the ignorance and to spend a great deal of money on a campaign to warn against teenage pregnancy and parenthood and the importance of contraception. That is excellent. Local campaigns and the media are mentioned and we are told that there will be more sex education, starting in primary schools—full marks. It sounds great, but it is a little bit woolly.

Will we have advertisements for condoms? We have advertisements for everything else on television, but do we ever see an advertisement for the antidote to all this sex? Why not have a message before "Neighbours" or "EastEnders". For goodness' sake, let us have condoms on television. We are talking about not just pregnancy but sexually transmitted disease, which is another serious problem.

We have the inevitable mention of joined-up action—I hate that phrase. It talks about local joined-up action and national joined-up action. The problem is that teenagers already know about joined-up action, because that is what they are doing all the time.

The report talks about local and national support co-ordinators with an implementation unit and monitoring. It all sounds a little ominous. Where is the detail? Where are the extra teachers and school nurses? School nurses are a rare breed and their numbers have been cut horribly recently. Where are the family planning doctors—another disappearing species? I was one of them for 30 years and I have disappeared into this House. General practitioners and teachers do not have time to do this work. Parents still have the option of removing children from sex education classes.

According to the report, sex education will not be a statutory requirement. Citizenship will be statutory, so why not sex education? It is a basic activity of every human being if the species is to survive, but it is not statutory in our education system. It must be. The recommendations are not strong enough.

Teenage mothers are dealt with in great detail in the report and I thought that that section was superb. However, that is only a small proportion of the problem. We have heard no mention of the view held by many hon. Members and those outside the House that young women become pregnant to get a council flat. My hon. Friend the Member for Northavon (Mr. Webb) recently tabled a parliamentary question asking how many new housing association lettings—we could not get the council figures—out of a total of 30,000 new lettings per annum had gone to young mothers with babies. The answer was 2,000. So we are talking about a small proportion of teenagers. We all know of cases where we think that someone has got pregnant to get a flat, but it is anecdotal evidence and the figures do not support it.

Like other hon. Members I welcome the proposals for hostels. That is much better than a lonely council flat in a tower block. The Minister and I know all about tower blocks. I used to work in Hackney and Islington and I know that they are grim. However, the use of hostels must not be compulsory and I hope that the Minister will emphasise that.

I am concerned about the section on prevention. That is understandable because I spent 25 or 30 years in birth control clinics dealing with sexual health. I spent five years in the Brandon centre, which is a good youth advisory centre in Kentish Town. I was a co-founder and trustee of a similar centre called Off the Record in my borough and I know very well the Magic Roundabout in Kingston, which is mentioned in the report. They all give excellent contraception advice and counselling.

The specialist centres for young people are excellent and we need many more, but many more young people go to ordinary family planning clinics, which are anonymous and efficient, with properly trained doctors and nurses who give a rigorous service; but sadly, they have been a soft option for local authority cuts over the past 20 years and are disappearing fast.

Young people are told by their health authorities that the GP will provide the services but in my experience they do not want to go to the GP because they will see Mum's friend in the waiting room, the receptionist knows Dad or the GP might tell Mum, however much he is discouraged from doing so. Young people are happier to mix with all ages in general clinics.

There has been a meeting this morning in the Jubilee Room, organised by the Pro-choice Alliance and Marie Stopes International, which have conducted a survey on access to abortion for young people; 20 per cent. of our GPs are still anti-abortion and many of those will not refer young people on to doctors who will deal with them sympathetically. We all know that the provision for abortion nationwide is very patchy. That is not dealt with very well in the report.

As an experienced doctor in the field, I warn against too much preaching at young people; they get put off, especially at the first visit. The report says that the advice to doctors is to be strengthened. That frightens me, because doctors are already nervous about advising under-16s. We should give non-judgmental help first and deal with the emergency, and then gain young people's confidence and counsel and direct. We must not preach in the first place. I know that it does not work, because I have the experience.

Mr. Hope

May I draw the hon. Lady's attention to page 90 of the report, which says: Preaching is rarely effective. Whether the Government likes it or not, young people decide what they are going to do about sex and contraception. Keeping them in the dark or preaching at them makes it less likely they'll make the right decision."? The Government have already taken on board the message that she is offering.

Dr. Tonge

Yes, but in other parts of the report it is emphasised that GPs will be given more guidance. Colleagues in general practice have told me that they are afraid of dealing with matters in a straightforward way and feel that there is pressure on them to counsel, which neither they nor the young people want.

The young person who meets a barrage of advice and counselling at the first visit is never seen again, in my experience. In my capacity as a senior doctor, I have had to tell off colleagues for putting young women off. The people about whom one is most worried, one does not see again. The same applies to young men. We must expand family planning facilities generally and leave it to the very well-trained doctors and nurses in those clinics.

The Government have already chickened out of making it easier to obtain condoms, emergency contraception and the regular contraceptive pill. Why cannot school nurses and GPs dispense condoms? Where is the progress on the morning-after pill, which I prefer to call emergency contraception? It needs to be available at pharmacies and from nurses, whether in schools or at GPs' surgeries. It is safer than aspirin and paracetamol. Why is it not simply on sale?

In Spain, one can buy the regular contraceptive pill from a chemist's. Why cannot we accept that some drugs are safer than drugs that are already on sale in pharmacies? Why do not we let people have a free choice? That way, many unwanted pregnancies can be dealt with and young people will be guided to clinics where they can get proper advice and counselling.

The Government are good at dealing with the consequences of teenage sexual behaviour but weak, in the report, on preventing pregnancies and sexually transmitted disease. The priorities are wrong. The Government are running scared of the tabloids and all the zealots who fill our mailbags, accusing doctors and nurses of encouraging immorality. They have the opportunity to tackle those people, and I wish that they would do it.

11.55 am
Mr. John Healey (Wentworth)

I congratulate the hon. Member for Billericay (Mrs. Gorman) on securing this debate. Her speech was informative and refreshingly iconoclastic.

In the area that I represent—Wentworth is part of Rotherham—we have a problem with high rates of teenage pregnancy. In parts of my constituency, one in six of all pregnancies are of women between 15 and 19 and one in 20 are of under-16s. The most telling index of the problem is the fact that eight out of the 22 wards in Rotherham have higher rates of pregnancy in those between 15 and 19 than in all the other age groups put together. There is a direct correlation with unemployment rates and other local deprivation indices.

Teenage pregnancy is both a symptom and a cause of social exclusion. In Rotherham, unemployment is the highest in Yorkshire and double the national average. The staying-on rates at school at 16 are 8 per cent. below the national average and the attainment at 16 of five or more GCSEs at grade A to C is 10 per cent. below.

As my hon. Friend the Member for Barnsley, East and Mexborough (Mr. Ennis) will testify, the problem is the same in Barnsley, Doncaster and Rotherham, across the former coalfield areas, where the teenage pregnancy rates are the highest in the Trent region, with the exception of the south Humber. The new health action zone in the South Yorkshire coalfield communities is therefore especially important. It will be a major way of co-ordinating efforts to tackle public health priorities. The health action zone has a specific objective to reduce the number of unintended under-16 conceptions and reduce the number of young people risking their health through smoking, alcohol and sexual behaviour.

I think that the comments of the hon. Member for Billericay constituted a welcome to the social exclusion unit's report; I certainly welcome it. It identified three key factors that contribute to our internationally high rate of teenage pregnancy: low expectations about the future, which are the most important factor; ignorance about contraception and the reality of life as a parent, as the hon. Lady ably illustrated; and mixed messages from adults about sex and relationships.

I want to bring those three issues down to local level and talk about the Rawmarsh baby doll project, which exemplifies the difficulties and challenges that we face. The conception of the project—if I may use that term—dates back to the end of 1996 and stems from a concern among local youth workers and teachers who were finding a change in attitude among young girls—from expressing a rather vague desire to have a baby to declaring that they were actively trying to conceive—accompanied by a local rise in teenage pregnancies.

The project was created and co-ordinated by two youth workers, Ann Brown and Karen Kirby, based at the Rawmarsh youth centre, with funding of only £250. The aim is to improve the understanding of what it means to be a parent and change the attitude of 14 and 15-year-olds towards the prospect of parenthood. It involves a lifelike doll that is heavy to hold, is always hungry, cries to be changed and wakes up several times in the night. It involves planning and preparation lessons covering sexual health and relationships, the problems and embarrassments of having a baby, costs and budgeting, dressing, feeding, changing, bathing and putting down a baby and trying to get it to sleep. The course culminates in the student taking the baby doll home on a Friday evening and returning to school on a Monday morning having looked after it over the weekend.

The evaluation of the course showed some success, but it highlighted some of the difficult dimensions of the problem. It was clear from the start that many of the under 16-year-olds had up-to-date information about contraception and sexual health. However, 20 per cent. believed that having a baby would have no effect on a relationship, and 70 per cent. believed that it would improve a relationship. The lack of information was not to do with sex, but with practical parenting.

The average age of the sexual partners of these girls was 21 to 26, so they were not their class mates. The majority of those men were unemployed, often living independently in rented accommodation. Some were involved in drug misuse.

Seven out of 10 of the young male students that participated in this project thought that responsibility to rear a child was nothing to do with them, whereas all the girls involved in the project stipulated that it was a shared responsibility. The majority of the male pupils did not complete the exercises and tasks, and only one took the baby doll home over the weekend. The parents of his school mates made all sorts of excuses about why their son could not participate in the programme and could not take the baby doll home, ranging from "the family is going to a christening at the weekend" to "we are going on holiday in the near future" or "we have to go shopping for new clothes." One father was abusive to a youth worker, and insisted that babies had nothing to do with his son.

The outcome of the pilot project was that half the 14 and 15-year-olds who took the baby doll home said that it had significantly increased the age at which they wanted to have children. The families by and large said that it was a useful exercise, and that all school pupils should undertake such a course.

This pilot was the first of its kind in South Yorkshire. It was replicated elsewhere in my constituency in Wath upon Dearne, and with health action zone funding the exercise it will now be extended right across Rotherham.

We need national targets and the political priority that the social exclusion report provides. We need to develop local services, such as those that the health action zone gives us the opportunity to deliver. But in the end, it is work with individual boys and girls while they are still at school that will make the most telling difference.

The social exclusion unit plan is a good start. I particularly welcome a special feature of the report. For the first time, it has an edge to it which is directed at boys and men. For once, young men are singled out as also having responsibility for teenage pregnancies. The blame and shame that too often is directed only at girls, is also turned on boys. When girls get pregnant, they give up education or give up their baby for adoption or to their grandparents to look after, whereas boys go up in the estimation of their mates down the pub.

The proposal for the Child Support Agency to pursue fathers of children born to teenagers is important, because it underlines the fact that they have a responsibility for their children, including a financial responsibility, and that these babies are their children.

I welcome the plans on educational advice, the emphasis on fathers, and the approach of the social exclusion unit working across Departments. However, the test will not be how well the social exclusion unit's own plans are put into practice, or how well Ministers link up under the chairmanship of my right hon. Friend the Minister for Public Health, but whether funding through mainstream programmes, such as health action zones, sure start, excellence in cities and the ONE service, make a major impact on information, advice and support for young people, and, above all, on the opportunities available to them.

It is important to dispel ignorance surrounding sex and to improve advice, information and support services, but success in education and improved life opportunities will in the long term be crucial in helping us to tackle this problem.

12.5 pm

Mr. Phil Hope (Corby)

I congratulate the hon. Member for Billericay (Mrs. Gorman) on securing this debate. I declare a minor interest having produced parenting education materials for use in schools, which have been successfully implemented and have had an impact on young people's lives. The local authority in my constituency is identified in the report as having the 29th highest rate of teenage pregnancies, so it is a local concern as well as a matter in which I have had a personal interest in the past.

As a member of the Government's personal, social and health education working group, I am delighted that this report has come out in conjunction with the report of that group so as to focus attention on the problem of teenage pregnancies in the broader context of mainstream changes to the school curriculum and the work of other organisations to reduce the number of teenage pregnancies.

Teenage pregnancy is not an easy issue for us to tackle, either as individual Members of Parliament or as a Government. People hold strongly held beliefs on this issue. Some people have deeply held religious beliefs, so we must tackle this subject with care. Young people and their parents have to make intimate decisions. However, the cost of doing nothing is high. The statistics in the report show that teenage mothers have poorer education opportunities, poorer jobs and often bring up their children living in relative poverty. Their babies have poorer health—there is a higher infant mortality rate among those babies—and that imposes wider costs on the community. Doing nothing is not an option. We must find solutions, however difficult they may be.

It is particularly interesting that the risk factors associated with high levels of teenage pregnancy identified in the report include poverty and education problems. The young people involved are not in education, employment or training; they live in areas of deprivation and are excluded from other sources of education or health service support. Those factors must be addressed. It is interesting that young people told the social exclusion team that there were three causes of becoming a teenage parent. The primary cause was that they felt that they had nothing to lose. They had low self-esteem and did not feel valued as individuals. They felt that they had no future and no hope, so they became pregnant as a way of feeling valued. They had something to which they could give unconditional love and which would give them unconditional love back. That is our failure. Why cannot we provide those young people with a sense of optimism, hope and self-esteem for the future, so that they do not make that difficult and probably wrong choice.

Those young people also described the cause of their pregnancy as ignorance. It is not good enough, as we approach the 21st century, for people to become pregnant through ignorance. Hon. Members have spoken about the mixed messages that young people receive. The media bombards them with messages that it is almost compulsory for young people to have sex, but they do not talk about it at home because it is too embarrassing and difficult. The result is not less sex, but less protected sex. The risk is not just of becoming pregnant, but of infection from sexually transmitted diseases.

Action must be taken to tackle the causal and risk factors associated with high levels of teenage pregnancy. The report is right to refer to two strands of activity. The first is prevention: we should try to prevent young people from becoming pregnant, but if they do and they have a baby, we should provide them with the support they need for their own development and for the care of their child.

The difficulty is that many teenagers do not know how easy it is to get pregnant or how hard it is to be a parent. Education in sex, relationships and parenthood is required from schools, youth services and other providers.

The report is right to say that that should start in primary school. I was at a broadcast of a Central Television programme called "Weekend Live" on Friday night that focused on teenage pregnancies. There was a 14-year-old mother with a two-year-old daughter. She had her baby when she was 12 and had become pregnant when she was 11. We have to start sex education at a younger age if we are to prevent very early pregnancies. The report clearly recommends that.

The report demonstrates statistically that effective sex education can reduce sexual activity among young people. I particularly like the idea of peer education. As the hon. Member for Billericay said, older young people talking to younger people about their experiences is an effective way of getting the message across at school or in community projects.

The report places particular emphasis on involving parents in school policy on sex education and trying to change the climate in which they talk to their children about the subject. The message given to boys should be strengthened. Page 97 of the report says: Young men are half of the problem and the solution. Sex and relationships education in and out of school should bring them more into the picture. Young men also need to be targeted with information about the consequences of sex and fatherhood, including their financial responsibility to support their children. However hard that educational process may be, it is up to our schools and our teachers to find ways to make it happen.

Most teenage parents go back to live with mum to be looked after with their baby. That works. I met a number of such families on Friday night and the mums of the teenage parents seem to enjoy having their daughter at home with the baby and being the grandmother who brings them up. That is fine when it works, but three out of 10 of the 15 and 16-year-olds do not have that option. We cannot simply abandon them. Too many teenage parents find themselves in bed-and-breakfast accommodation or in council flats on faraway estates with no family and no support. The Government's strategy of semi-independent supported accommodation with a mentor, advice on parenting skills and health education is the right way to provide the support that those young people need at the time when they are most vulnerable and do not have other people around them. It has been unfortunate to say the least that certain parts of the press have referred to those arrangements as hostels or some form of punitive measure. The aim is to support young parents. The National Council for One Parent Families, Gingerbread and others have been actively involved in pilot projects showing how the policy can be implemented and have supported that aspect of the report.

The target is to reduce teenage conceptions by 50 per cent. by 2010. That is an ambitious target, but it is right to set ambitious targets. The Government have pledged £60 million in the first few years. I congratulate the Government and the Ministers involved on taking the report seriously and putting money behind the work that needs to be done. I urge them to take the matter forward with as much speed as possible.

12.14 pm
Mrs. Caroline Spelman (Meriden)

I shall not take more than a few moments to make my points, because these Adjournment debates are principally for Back Benchers. I congratulate my hon. Friend the Member for Billericay (Mrs. Gorman) on calling for the debate. We all knew that she would be straight-talking. I give her full credit for pointing to the family obligations. The new life created for the teenager concerned has around it a raft of adults who have responsibility for it.

Only the hardest of hearts would not have sympathy for the young teenage girl who finds herself in that predicament, but I urge the Minister to look closely at some of the statistical evidence in the report. The clear overall message is that Britain lags way behind other European countries, but the more worrying fact is that we are going against the trend. We have been going backwards during the 1970s, the 1980s and the 1990s while the situation has improved in other European countries.

There are other key points in the report that are worthy of closer examination. Why is the rate of teenage pregnancy 70 per cent. higher in Shropshire than it is in Cambridgeshire? There must be a reason for the statistical irregularities. I urge the Minister to look more deeply at the analysis.

We welcome the report, which identifies some of the causes of teenage pregnancy, but there are deeper layers of reasoning behind the rising incidence. We should face up to the mismatch between girls and boys. It is acceptable for lads to go out and sow their wild oats and the girls feel that they have to say yes. We must empower girls so that they feel comfortable to say no and we need to ensure that our young men play their part.

Without being overly party political, I must point out to the Minister that the messages that the Government send are important. Doing away with the married couples tax allowance and using the money to increase child benefit is tantamount to saying that it is okay to have babies, but it is not important to get married. The signals that we give to society are important.

Young people are bombarded with information about sex and reasons for having sex. It has been turned into a sport, decoupled from the emotions and responsibility that go with it. The situation is not helped by the way in which the subject is taught. Perhaps the British are particularly handicapped in this respect and find it too difficult to talk about. We have to address that. In many ways, the parents need to be taught about how to teach it. Many of us who are parents had dire experience of being taught about sex in schools, but that is the only experience that we had, and perhaps our parents did not do a very good job either. It is important not just to teach the youngsters, but to teach the parents how to talk about it.

I strongly endorse the suggestion of my hon. Friend the Member for Billericay that young mums should be taken into classrooms. A young mum telling her classmates or those just a little younger than her about the constraints that have come upon her will give a strong message not to do it.

The issue is what we teach in school and how and when we do it. The hon. Member for Cleethorpes (Shona McIsaac) talked about teaching at a young age. Several hon. Members have mentioned primary school children. There is a big difference in primary school ages. I have three children aged eight, six and four. They vary in their ability to understand anything about the subject. I counsel strongly against the suggestion that there should be across the board sex education for four-year-olds, which simply reveals ignorance about the lives of very young children. There is a danger that they will try something out. We all know that young children have an unnerving ability to identify things that parents are awkward about.

Dr. Tonge

rose—

Mrs. Spelman

In view of the shortness of time, I ought to continue so that I leave enough time for the Minister.

We have discussed the weaknesses of sex education, but we are still left with large numbers of women who, after the health visitor's final visit, are left alone with the baby, isolated and afraid. Surely they still have parents. Members of the family should be encouraged to take more responsibility for young women in that situation.

In a spirit of constructive opposition I support the idea of hostels, but I urge the Minister to consider the mentoring available. An older, more experienced woman should be on hand to help the younger women. We should find ways of creating a surrogate family setting so that the young women have babysitting opportunities and chances to go out, complete their education and, if possible, get into work. Without that support, they can end up in a cycle that all too often spirals into deprivation.

12.19 pm
The Minister for Public Health (Ms Tessa Jowell)

We have had an extremely good debate and I join those who have paid tribute to the hon. Member for Billericay (Mrs. Gorman) for initiating it. It gives us grounds for a fair degree of optimism and hope in respect of the extent to which the report of the social exclusion unit, with its intensely sensible and practical recommendations, has been broadly welcomed and the fact that the debate represents the progress that has been made from the rather pathetic hand wringing about moral decay that characterised so much of the debate about teenage pregnancy in the past.

My hon. Friends the Members for Cleethorpes (Shona McIsaac) and for Corby (Mr. Hope) set out clearly why we need to be concerned about teenage pregnancy rates in Britain. I would add only two points. First, 30 years ago the rate of teenage pregnancy in Britain was more or less in line with those in other European countries. However, while in other European countries the rates of teenage pregnancy have fallen, that is not the case here. Even parts of the country with the lowest rates of teenage pregnancy have a worse record than other European countries that we should aspire at least to match.

It is also clear that teenage pregnancy is far more prevalent among the poorest. That is why it is central to our range of strategies to tackle social exclusion. A young girl in social class 5 is 10 times more likely to become pregnant when she is little more than a child herself than a girl in social class 1. The other risk factors that reinforce the likelihood of teenage pregnancy include having been in care, having been excluded from school, having mental health problems and having experienced sexual abuse.

Teenagers who become parents, and their children, face additional health risks. The babies have a greater incidence of low birth weight and perinatal death and the mothers have a greatly increased risk of post-natal depression.

As my hon. Friend the Member for Wentworth (Mr. Healey) made clear, there are three broad reasons for our current position. The first is ignorance. All too often, children learn about the mechanics of sex from school, but precious little else. That must change. Throughout the consultation on the report, young people said time and again that they did not want to learn only about the physical aspects of sex; they wanted to talk about feelings and know more about how to handle relationships and the emotional aspects of sex. They also need to know about the cost—the extent to which unprotected sex leads to pregnancy and, increasingly, to sexually transmitted diseases.

We have to listen to young people. Had we done so 10, 15 or 20 years ago, many of the issues that we are addressing today would not include an unacceptable rate of teenage pregnancy and the social exclusion associated with it.

The costs of ignorance are great. One reason for the high rate of teenage pregnancy is that Britain has the lowest contraceptive use of any of our neighbouring European countries. The rates of sexually transmitted infection among teenagers are rising fast.

Three in four teenage pregnancies are unplanned. That is why we shall build on the work with Sexwise and NHS Direct to provide a nationally available advice line for teenagers to give advice and counselling and to signpost them quickly to other services that can provide help. We will also be funding a national publicity campaign that will address directly the issues, questions and concerns that young people have. It will also get the messages across to parents.

We have to make it clear that advice and help is available. One of the clear deterrents to young people in respect of seeking advice about contraception is that some 60 per cent. of them are not aware that confidential advice is available.

The second reason for the problem is low expectation. The great challenge to our programme of action is to provide reasons for young girls not to become pregnant—to convince them that life holds more for them than having a baby at 14, 15 or 16.

A number of hon. Members have referred to the third reason—mixed messages. We live in a society where children are bombarded with images of sex, which is used to sell them everything from ice-cream to videos. The message is clear: being sexually active is the norm—come and join the club. Yet the rest of adult society gives a quite different message about sex. Either we do not discuss it at all or—as the report graphically testifies—we discuss it in an embarrassed and diffident way. We hope that if we do not talk to teenagers about sex it will not happen, but we have to accept that all the evidence is stacked against that view.

No young person got pregnant from knowing about sex. Equipping our young people with information about sex, relationships, access to contraception and the risks of sexually transmitted disease is the best way to put them in charge of the decisions that they are often forced into making. We have to be realistic. As hon. Members have said, we have to see the world as it is, not as we might want it to be.

The plan for action is clear. It begins with a new blueprint for sex and relationships education for young people in and out of school. It addresses the fact that such education needs to start in primary schools and must be set in context. Sex and relationships education must include negotiating relationships, knowing how to say no, equipping children with information about puberty and how babies are conceived and born, recognising that something like 10 per cent. of girls start their periods while they are still at primary school. It sees parents as the first and principal teachers, who must be better equipped to talk to their children about sex. In secondary school, it ensures that advice about access to contraception is properly available.

The risks of unprotected sex are high. Only about 50 per cent. of teenagers use contraception the first time that they have sex. We are taking forward work on that. The sexual health strategy will play a critical role in reducing teenage pregnancy and improving understanding about teenage sexual health.

Improving access to emergency contraception is important, but young people need not be exposed to the risks that they would face if at the age of 13 or 14 they were able to use emergency contraception as an alternative to proper protection, advice and support.

I end on a word of caution. It is all too easy to stigmatise teenage parents, to point the finger and blame them for the ills of society. I finish with the words of one young woman who contributed to the consultation—

Mr. Deputy Speaker(Sir Alan Haselhurst)

Order. We must now move on to the next debate.