§ 3.14 p.m.
§ Lord Northbourne asked Her Majesty's Government:
§ Whether they endorse the target set in The Health of the Nation (1992) to reduce the rate of conception among under 16 year-olds to 4.8 per 1,000 by the year 2000.
§ The Minister of State, Department of Health (Baroness Jay of Paddington)My Lords, the Government consider pregnancies among under-16s to be a matter of great concern. Noble Lords will know that progress on The Health of the Nation targets has so far been disappointing. We are currently reviewing those targets as part of the development of a public health strategy which will emphasise the role of social and economic factors in problems like pregnancy in young girls. We also want to ensure that all young people have access to effective and appropriate health and social education.
§ Lord NorthbourneMy Lords, I am most grateful to the noble Baroness for that encouraging reply. Do the Government accept that an important contribution towards solving this problem could be made through education for parenthood in schools both for girls and 887 for boys? In that context, is the noble Baroness aware of a report published yesterday by the Gulbenkian Foundation dealing with a study of 1,200 children in five schools who undertook for a year a programme of education for parenthood? The study shows both the popularity and effectiveness of the programme.
§ Baroness Jay of PaddingtonMy Lords, I am aware of that publication not least because the noble Lord, Lord Northbourne, was kind enough to send me an early copy of it. It is an enormously helpful piece of work and demonstrates the considerable benefits to pupils, teachers, parents and, potentially, society in general of good parenting education in secondary schools. The noble Lord may be aware that my honourable friend Ms Estelle Morris, one of the Ministers for Education, launched the report yesterday. We believe that schools have a part to play in teaching pupils about the responsibilities of parenthood. The Government are considering how best this can be done, including the recommendations of this very important report.
§ Baroness DavidMy Lords, does the Minister agree that school nurses also provide helpful advice and education? Is she aware that there have been cuts in that service in a great number of local authorities? Is she prepared to try to reverse that situation?
§ Baroness Jay of PaddingtonMy Lords, I am aware of the role school nurses have played in this important work. I am also aware of the way in which the service has been cut back in certain places. My noble friend will know that we are considering the whole issue of children's health and particularly the role of schools in the health of children. We shall want to look carefully at the role school nurses can and should play in that.
§ Baroness Carnegy of LourMy Lords, do the Government agree that it is important to help teachers to work in this area. It is a difficult and delicate task to perform. Are the Government contemplating extending the mainstream training of teachers so that this important area of helping young people understand the problems of young single parenthood can be developed?
§ Baroness Jay of PaddingtonMy Lords, the noble Baroness raises an important point. The whole issue of sex and health education in its wider context is not that it should simply be about practical advice; for example, on contraception. It is, as she said, a delicate and difficult issue. It is difficult for teachers and indeed for some parents to deal with. It is appropriate that teachers should be properly supported both in their training and in their in-service work in this way. I am sure that my honourable friend the Minister for public health, who is considering this matter as part of a public health strategy, will be conscious of those concerns.
§ Lord HyltonMy Lords, will the Government issue guidance stating that family planning advice should emphasise the benefits of lifelong stable unions between parents?
§ Baroness Jay of PaddingtonMy Lords, the noble Lord raises some of the same issues as those raised by the noble Baroness, Lady Carnegy. The whole issue of sex education, particularly for the very young, should be seen in the context of a broader social approach to growing up, to parenthood and to stable family relationships. It is inappropriate simply to offer them practical advice on contraception. We shall do everything we can to ensure that that is not the message which is being given.
§ Baroness YoungMy Lords, I welcome the Government's commitment to dealing with what I think we all agree is a very serious issue. Does the noble Baroness agree that one of the most important points to be made is the significance of marriage and stable family life, as they underpin everything that is required in this area?
§ Baroness Jay of PaddingtonMy Lords, the noble Baroness, Lady Young, has made some important contributions to other debates in your Lordships' House on this subject. I very much appreciate her point of view. When one is dealing with very young people—one could say children if one is talking about 13 and 14 year-olds—sometimes the concept of marriage seems very remote. What is important is to deal with these issues in a broad context of general support and counselling about relationships and hope that that will develop into stable marriages.
§ Earl RussellMy Lords, does the noble Baroness agree that the tendency of the evidence is to show that sex education reduces teenage pregnancies rather than increases them?
§ Baroness Jay of PaddingtonMy Lords, that is certainly the international evidence, particularly in Holland, where the programme of sex education in the broader context that we have been discussing is conducted from what we would regard as an early age. There has been a very substantial reduction in the number of teenage pregnancies.
§ Lord EltonMy Lords, the noble Baroness said that this would become a part of the policy on health. Does she accept that in fact it would not be taught unless it becomes part of the policy of the Department for Education and Employment? Can she take steps to ensure that it does become part of that department's policy?
§ Baroness Jay of PaddingtonMy Lords, I am grateful to the noble Lord for making that very important point about the structure of government relationships on this issue. Of course, the whole issue of public health and the broader aspects of healthy schools is being discussed already between my honourable friend the Minister for public health and colleagues in the Department for Education. This must be a broad approach. Frankly, it is my view that it is just as important to try to encourage liaison and co-operation at local levels as well as between departments in Whitehall.
§ Baroness CumberlegeMy Lords, bearing in mind the Minister's initial response to the noble Lord, Lord Northbourne, is my noble friend aware that the World Health Organisation cited The Health of the Nation Programme as a strategy which other countries should follow, which is not surprising since we have met the vast majority of targets and that only two out of 27 are causing problems? With that glowing endorsement, are the new Labour Government going to pursue the strategy in its entirety and, if so, how do they propose to monitor, measure and inform the public as to progress?
§ Baroness Jay of PaddingtonMy Lords, as I have already said, we are reviewing The Health of the Nation programme because we believe that in some areas—and I believe the question of teenage pregnancy is one—success has not been as glowing as the noble Baroness suggests. For example, perhaps I may quote the statistics. In 1994 there was a 0.3 per cent. increase in pregnancies among 13 to 15 year-olds and in 1995 a I per cent. increase in abortions. I do not believe that that is a satisfactory record and it is something that we want, in the broader context of a public health policy, to attack.
§ Lord McColl of DulwichMy Lords, we are very pleased that the Government have endorsed The Health of the Nation, but can the Minister explain why it is that when I received a letter from her the other week the inscription on the back of the envelope "Improving the Health of the Nation" had been deleted? When I telephoned the department the explanation was that it was no longer government policy. Can the Minister explain that?
§ Baroness Jay of PaddingtonMy Lords, I cannot account for decisions about stationery in the Department of Health. They were certainly not passed by me. I am surprised that both the noble Lord and the noble Baroness, Lady Cumberlege, have taken from my remarks a firm endorsement for The Health of the Nation policy. In response to two if not three noble Lords who have raised the matter, I said that we are reconsidering the whole strategy. It obviously has some important factors, but we do not believe that as an answer to public health it is the total and most satisfactory solution.