HC Deb 24 March 1999 vol 328 cc359-66

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Dr. Jenny Tonge (Richmond Park)

I want to address a problem that I consider to be a national scandal—teenage pregnancy. Many hon. Members will have heard on Radio 4 this morning about the Childline report which states that more 14 and 15-year-old girls call in about pregnancy and the fear of pregnancy than about any other issue. I am well aware that the Government have promised a review on the subject. It was promised last October, but it has not yet been produced. I am sure that we shall now be told that it will be published very soon, but I applied for today's debate none the less because I am sick of promises. I want some firm commitments. Twelve or 18 months is long enough to wait. How much longer will it be?

In 1997—the last year for which I have figures—95,000 teenagers became pregnant. Of those, 8,300 were under 16. A total of 33,381 of those girls had abortions. It is a huge tragedy that 95,000 young lives were ruined in some way and 62,000 babies were born to mothers most of whom were still at school and unable to support them.

It is even more shaming that the United Kingdom is top of the league in Europe for teenage pregnancies. In the most recent population trends published by the Office for National Statistics, the United Kingdom was top in respect of births per 1,000 women aged between 15 and 19. Our current rate is 30 per 1,000 girls. In Denmark, the figure is only eight per 1,000 girls and in the Netherlands only four girls in 1,000 become pregnant.

Thirty years ago, there were 50 pregnancies per 1,000 girls, so the figure has fallen. But in Denmark 30 years ago the figure was also 50 per 1,000, and that country has managed to reduce teenage pregnancies to eight per 1,000 girls. As I said, the incidence of teenage pregnancy is a national scandal and I am ashamed that it is happening in my country.

Let us look at the reasons. There is no doubt that we live in a society that flaunts sex at every available opportunity. Cars, chocolate bars, deodorants—you name it—are frequently sold using sexual images. Newspapers, magazines and television programmes are full of the antics of Presidents, royalty, pop stars and, dare I say it, some hon. Members. Films, plays and television shows all contain sexual activity. It is everywhere. Even Cardinal Hume has noticed. At the weekend he declared that society is obsessed with sex and falling apart because of it. I am inclined to agree with him, but there is no turning the clock back. We are approaching the 21st century. Society has changed. The genie is out of the bottle and cannot be put back.

Is it any wonder that, surrounded by sexual images, young people join in? They do not want to be left out of the excitement. Nobody on television is worried about contraception, sexually transmitted diseases or AIDS, so why should they worry? When they add to the brew copious amounts of alcohol on Friday and Saturday nights, they are away.

All that is common to other European countries. So why do so many more teenagers get pregnant in the United Kingdom? Are parental attitudes or education to blame? Unless we provide proper sex education and services that give teenagers a balanced message and counteract the excitement factor, things will never change.

Let us get rid of one myth before we progress any further. I have heard it said so often—it was said again on the radio this morning—that young girls get pregnant so that they can claim benefit and get council flats. In fact, the majority of teenage mothers have no idea about housing or benefits before they get pregnant. There is no need to take my word for it; the Policy Studies Institute has conducted several studies on the subject. Once a teenage mother has a baby or two, however, we have to do something about her housing, looking after her babies and giving her benefit.

Let us dispel another myth—that teenagers get pregnant because of sex education, contraception and abortion advice. The right hon. Member for Maidstone and The Weald (Miss Widdecombe), who I hoped would be here today said during last Sunday's "On the Record" that the rise in teenage pregnancies in this country has gone hand-in-hand with increased sex education and family planning advice. I respect the right hon. Lady. She is honest and resolute in her views, but she is wrong on this issue.

Despite the best efforts of me and my colleagues in the national health service, the Conservatives cut family planning clinics by half countrywide. We all know that general practitioners became overburdened and the number of school nurses was severely reduced. I cannot find the national figure, but in Cambridge, for example, not only are there no school nurses, but there are no health visitors either. What does the Minister intend to do about Cambridge?

According to Childline, the majority of the 7,000 youngsters who had rung in about pregnancy-related issues said that they were not aware of having received any sex education at school.

Sex education still remains at the whim of school governors. Some education authorities and schools do their best, but, countrywide, sex education is scanty, rarely repeated and hardly ever linked to the essential advice to teenagers about where to go for advice on sexual matters, contraception, abortion and sexually transmitted diseases. The link between education and advice on where to find services has been highlighted in many studies on the issue.

Mrs. Teresa Gorman (Billericay)

I agree with the hon. Lady that family planning units are a vital part of our services to the community and I deplore the fact that they were run down. Does she agree that the Government should encourage initiatives such as that between Boots the chemist and the local health authority in Glasgow, whereby youngsters can go into Boots and get advice?

Dr. Tonge

I thank the hon. Lady for her intervention and I entirely agree. In fact, I was about to mention the experiment that Boots conducted in Glasgow. Incidentally, it has been very successful and many young people have used the service. We need more such projects.

Other European countries provide more than adequate family planning and sexual health services and take a refreshingly frank and objective approach to the issue. Rates of teenage pregnancy in the Netherlands and Denmark are a fraction of ours. Proper sex education and services are provided free of charge and advertised. People discuss matters more frankly.

In the United Kingdom, we are still bound by Victorian values such as, "Do as I say, not as I do" and, "These things must not be discussed with young people." We must educate ourselves to talk to children and encourage peer group speak-easy projects—a concept of which the Minister is aware—for children and for parents who find it difficult to talk to their children about such matters.

Today, I am calling on the Government to include several measures in their review, whenever it is published. First, there should be a compulsion on schools to deliver sex education from the beginning of primary school to school leaving age as part of the national curriculum. Sex education needs to be repeated. It is no good having a one-off lesson from the shy biology mistress or the local doctor; the message must be repeated and changed appropriately as children get older. It must be regularly assessed by the Department of Health or the Department for Education and Employment. That must be linked with proper provision of family planning, abortion and STD services for young people, via local family planning services and perhaps school nurses.

The irony is that when we need those services the most, they have been cut. Responsibility for them will lie with primary care groups. That is another concern. Who will ensure the provision of adequate family planning and youth counselling services if the primary care groups are to be so overstretched? In the absence of such services, trained pharmacists and the high street outlets that the hon. Member for Billericay (Mrs. Gorman) mentioned need to come into the equation.

To improve accessibility, we must deregulate some methods of contraception. Emergency contraception, which I spoke about in the House some months ago, must be made available when it is needed. It is needed in emergencies and should be as readily available as condoms. It should not be necessary to make an appointment to see a general practitioner to get emergency contraception.

Will the Minister assure us that she will support people such as Viv Crouch, the school nurse in Bath who has set up an advisory service in her school and directs young people to the right provision of services? The Minister should also support the Boots clinic in Glasgow. Those are examples of people and businesses taking the initiative. That must become more widespread. Such initiatives are needed in every city.

Young people need readily available, confidential, anonymous and non-judgmental advice from the time of their first sexual experiences. Let us stop pretending that young people do not or should not have sex. They do. As I have said, times have changed. I am sorry about that in many ways, but that is the way it is. People do not have to start so young, however. In the Netherlands, the average age at which young people start having sex is much older than in the United Kingdom and the provision of services there is much better. From 30 years' experience, I know that the more education—general and sexual—and the more advice and medical help teenagers can get, the more likely they are to delay their first sexual intercourse and the less likely they are to become pregnant.

Education is probably the main reason why the UK compares so badly with its European counterparts. We have a higher proportion of badly educated young people from unstable backgrounds. That situation is repeated from generation to generation. Putting teenage mothers into hostels and preaching at them will not help, but if we give them opportunities to return to education by providing creche facilities—incidentally, when are we going to get creche facilities for all the mothers in the House of Commons?—and proper support for their babies, we may prevent those babies from making the same mistakes when they grow up and stop them repeating the cycle.

Let us use the media to sell the messages that we want young people to hear. We see and hear about sex every day on our televisions, but when did any of us last see an advertisement on the box for emergency contraception, condoms or an abortion service? They never appear. It happens elsewhere in Europe; why not here?

Finally, will the Government tackle the anti lobby head-on, for the sake of our young people? Will they refuse to let uninformed media headlines and organisations such as the Society for the Protection of Unborn Children, and Life, preach, dictate and utter their hypocrisies? Will the Government spin for the benefit of young people?

Mrs. Maria Fyfe (Glasgow, Maryhill)

Is the hon. Lady aware that SPUC campaigns outside Boots in Glasgow every week, giving out grossly misleading leaflets that accuse Boots of breaking the law? That is true neither of Boots nor of the community and mental health service, which has been co-operating with it.

Dr. Tonge

I thank the hon. Lady for that intervention. I am well aware of what is happening at Boots in Glasgow. I hope to go there in April to see for myself. Organisations such as SPUC are disgraceful. They produce inaccurate and misleading information, and I have been the target of some of their campaigns.

The Government must tackle that lobby head-on and spin on behalf of our young people. Better, more honest sex education and contraception provision will bring down the teenage pregnancy rate, as it has in other European countries. While the Government have been thinking about the issue, tens of thousands of teenagers have had unwanted pregnancies. About 100,000 pregnancies have occurred, with perhaps 60,000 or 70,000 babies being born as a result. That represents a huge number of broken lives and an awful lot of misery, unhappiness and potential trouble for the future.

When will we have the review? Can the Minister assure us that it will contain the action for which so many agencies are calling? We have heard in recent months from the Family Planning Association, the Brooke Advisory Centre, the Health Education Authority and the Sex Education Forum. This morning, Childline produced a report that has aptly highlighted the issue for us. Those organisations have the experience. Have the Government listened? They know what must be done.

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

I congratulate the hon. Member for Richmond Park (Dr. Tonge) on securing the debate, on her speech and on her record as a campaigner for what is right on this issue.

We do not do well by our teenage parents. As the hon. Lady has said, our rates are four times higher than in France, twice as high as in Germany and seven times as high as in the Netherlands. More teenagers become pregnant in this country than anywhere else in western Europe. That is why the Prime Minister asked the social exclusion unit to report to him on ways to reduce teenage conceptions and support vulnerable teenage parents to break the cycle of exclusion that the situation almost inevitably brings for them and their babies.

I assure the hon. Lady that the report of the social exclusion unit will be submitted to the Prime Minister shortly and will be published within the next two months or so. The exercise has been exhaustive, involving wide consultation, with the clear purpose of seeking practical solutions and building a consensus for the action that the Government must lead. Action must be guided not by myth or prejudice, but by fact and the best available evidence of what works.

Let us look briefly at what happens to young women who become teenage mothers. Half the under-16s who become pregnant will have an abortion. Teenage mothers are more likely to suffer trouble with their pregnancy and birth and are much more likely to experience post-natal depression than older mothers. The infant mortality rate for babies of teenage mothers is more than 50 per cent. higher than the national average. The prospects in later life are poor, too. Teenage mothers and their children are more likely to live on benefits and to live on them for longer than their peers. As the hon. Lady made clear, there is no evidence beyond anecdote—which is easily deployed—that the benefit system acts as a direct incentive to any young woman to become pregnant.

The social exclusion unit's forthcoming report will look at the prevention of teenage pregnancy and the support necessary for teenage parents and their children. We already have a good idea of which young women are most at risk of becoming pregnant too early. Often, they have low educational attainment; their families have had financial problems; they have had emotional problems; their mothers were probably teenage mothers; and they wanted to be a young mother. Young women with those characteristics are 19 times more likely to become teenage mothers than young women with none of them.

Mr. Alan Johnson (Hull, West and Hessle)

My right hon. Friend will be aware that the city of Hull has the highest rate of pregnancies among 13 to 15-year-olds in the country, and one of the highest rates in western Europe. However, we managed to get a multi-agency approach to the problem only when we were allocated a health action zone. Will she ensure that the lessons learned in Hull are looked at closely and spread to other areas?

Ms Jowell

We will be delighted to learn from my hon. Friend's experience of tackling the problem in Hull. I hope that the implementing action following the social exclusion unit report will build on best practice and will make sure that that is spread as widely as possible.

Dr. Tonge

So far, the Minister has dealt with teenage mothers and their babies, and with what the Government plan to do in future. I respect that, but will she refer to the measures that are necessary to prevent teenagers from getting pregnant in the first place?

Ms Jowell

I will deal with those points in the short time remaining.

Social exclusion is not only associated with teenage parenthood for young women: like teenage mothers, teenage fathers are likely to share characteristics such as low educational achievement, lack of qualifications and a family background of financial problems. Teenage boys and girls who have been in trouble with the police are more likely than their peers to become teenage parents. It was recently estimated that 25 per cent. of young offenders were also fathers.

Teenage pregnancy is a problem simply because teenage parents have to look after a baby when they are little more than children themselves. They are expected to cope with one of the most difficult things that any adult is asked to do—to raise and nurture a child—without the emotional and financial stability that come as part of adulthood. In many cases, teenage mothers are also lone mothers. That puts extra pressure on them in terms of child care, returning to education and future employment prospects—all issues which I hope that the social exclusion unit report will address.

Mrs. Gorman

Is the Minister aware that the Childline report said that more than half of the 7,800 young girls who called over the past two years were worried and wanted emergency help? Is she aware that it is difficult for them to find that help, and that many accident and emergency units refuse to give emergency contraception? Does she agree that the Government should do more to examine the opportunities so that young, terrified girls can get a friendly helping hand and emergency contraception?

Ms Jowell

Clearly, in an ideal world, young girls who are little more than children would not be having sexual relations. They have sexual relations for some of the reasons that I have outlined. Given that about one in five girls under 16 are sexually active, it is important that they have access to advice and information. Where that does not come from their parents at home, it is important to have accessible agencies for young people to turn to for help—often in the kind of crisis identified by the Childline research.

Teenage pregnancy is both a cause and a consequence of social exclusion. Many teenage mothers are care leavers, or have been excluded from school. For them, life was never going to be easy, and having a child too young makes it all the more difficult.

To have a long-term answer to the problem—and long-term success in reducing our rates of teenage pregnancy—we have to understand why the rates are so high in the first place. The short answer is that too many teenagers are having sex too young, and too many are having sex that is unprotected. That is one of the key reasons for our much higher rate of teenage pregnancy, and that marks us out from many European countries where the rate is lower.

Contraception rates for young people here are half the rates in the United States or in a number of European countries. The Childline research may shed some light on precisely the kind of problems that we must address.

Mrs. Gorman

Will the Minister give way?

Ms Jowell

No, I will not. If I do, I will not have a chance to finish dealing with the points that have been raised.

We know that young people believe that they are immortal, and that is why there is such a clear link between the risks that young people take in terms of unprotected sex, smoking, alcohol, drugs and even dangerous driving. More than 90,000 teenagers become pregnant every year, and nearly 500,000 sexually transmitted infections in teenagers are diagnosed every year.

The bottom line for our approach to teenage sex must be to ensure that teenagers are more aware of the risks attached to sex too early, and that they have the tools necessary to wait until they are adult and ready. It is important that those who do have sex have access to reliable contraception and advice to prevent pregnancy and sexually transmitted infection.

The Childline survey clearly revealed the pitiful ignorance among young people. No young person ever got pregnant just by knowing about sex, but young people are calling for the opportunity to be told not just about the biology of sex, but about relationships, responsibility and feelings. Young people have sex because of peer-group pressure; because they cannot think of a reason not to; because the future seems irrelevant. These are the real reasons that young people give for having under-age sex, with pregnancy as a consequence.

That is why looking at personal, social and health education in schools is important. School nurses have an important part to play, and we have seen a substantial increase in school nursing over the past three years.

Mrs. Gorman

On a point of order, Mr. Deputy Speaker. Are not these debates designed so that Back Benchers can put their points of view across? Is it right for the Minister to take up so much time—

Mr. Deputy Speaker (Sir Alan Haselhurst)

Order. I understand the hon. Lady's point, but these are half-hour Adjournment debates, initiated by one hon. Member exclusively for the benefit of that Member to gain a ministerial reply. It is only by convention that anyone else can intervene in them. These debates are quite different from the one-and-a-half hour debates.

Ms Jowell

Thank you, Mr. Deputy Speaker.

I have sought to answer the points raised in the debate, and I am trying to convey some of the complexity of tackling the problem so as to reduce not only rates of teenage pregnancy but the accompanying social exclusion. We are determined to put in place a practical programme, based on the evidence of what works, to build a consensus of support. We will lead that support from the House, engaging parents, teachers and young people up and down the country. That is where the solution lies.