§ Mr. Andrew Love (Edmonton) (Lab/Co-op)
This debate follows a Westminster Hall debate on teenage pregnancy in July 2003, at which my hon. Friend the Minister was present. At that time I brought to the Minister's attention increasing levels of teenage pregnancy in areas such as my outer London constituency of Edmonton. It is a critical matter, as we are daily reminded of the terrible cycle of poverty trickling down the generations, and of the fact that many young women become pregnant between the ages of 14 and 18, often failing as a result, to reach their full potential.
There is a young girl in my constituency, aged 18, living on the 10th floor of a tower block with her baby daughter who has special needs and requires weekly treatment at Great Ormond Street hospital for sick children. She previously had a baby who died. She finds budgeting difficult and has often been in serious debt. She requires support with life skills and the care of her baby, and needs bereavement support to deal with her depression.
Another young woman is aged 17 and lives with her grandparents and extended family. Her mother has a long-standing history of drug and alcohol abuse. That young woman is expecting a child and is determined to provide for that child what her mother could not give her.
How do we persuade such teenagers to heed warnings about under-age sex and the dangers of unplanned pregnancy? It is not an easy issue to tackle, but we must find new and creative solutions, however difficult it may be. That is especially true where unplanned pregnancy is still increasing, as it is in many parts of London. The 1999 social exclusion unit report on teenage pregnancy, describing the scale of the problem, reported thatthere are nearly 90,000 conceptions a year to teenagers; around 7,700 to girls under 16 and 2,200 to girls 14 or under. Roughly three-fifths of conceptions—56,000—result in live births. Although more than two thirds of under 16s do not have sex and most teenage girls reach their twenties without getting pregnant, the UK has teenage birth rates which are twice as high as in Germany, three times as high as in France and six times as high as in the Netherlands.Although rates are higher in the USA and other comparable countries, the UK now stands out as having the highest rate of teenage births in Europe.
The social exclusion unit report also identified poverty as a contributory factor. It states thatthe risk of becoming a teenage mother is almost ten times higher for a girl whose family is in social class V…than those in social class I".In 2004, according to the Association of London Government, almost 40 per cent. of children in inner London schools are eligible for free school meals—that is a strong indicator of poverty—compared with about 16 per cent. nationally. More than 25 per cent. of London's children live in a household where no one works, compared with 18 per cent. in the UK as a whole.
A 2004 Institute for Social and Economic Research report on teenage childbearing found that teen birth significantly increases the probability that when a woman is 30 her partner—if she has one—will have no 296WH education beyond the age of 16, and will be unemployed. The report argues that having a teen birth substantially reduces the probability that the woman will be a home owner at the age of 30. Depressingly, the same report found that daughters of teen mothers are more likely to become teen mothers themselves. It grimly concluded i hat the children of teen mothers have reduced chances of success in education and employment.
The campaigns officer for the Young Women's Christian Association told me that teenage pregnancy is strongly associated with educational underachievement, with having been in local authority care and with not being in education, training or work at the age of 16. In London, teenage pregnancy has soared above the national average, with the 2000 and 2002 figures showing a 40 per cent. increase in outer London boroughs such as mine in Enfield. That is why I am here today. One Enfield doctor dealt with 85 more teenage pregnancies in 2003 than in 2001. Locally, those figures have sparked deep concern. This week, the House of Commons Library was able to tell me that the Enfield rate has increased from 42 per 1,000 of the female population aged between 15 and 17 in 1998, to 56 per 1,000 in 2002. As a result, Enfield has gone from being the 98th highest local authority to the 33rd highest in the 148 authorities in England tested during that period.
Other London boroughs have also seen an increase in their rates. However, it is important to note that the under-18 conceptions across England and Wales have fallen in recent years, and continued to fall in 2002. Sadly, those improvements are not shared in my part of London.
I recognise that reducing teenage pregnancy remains a Government priority, and I welcome early signs that Government efforts to reduce teenage pregnancy rates are working, including a 10 per cent. reduction in conception rates in under-18s and an 11 per cent. reduction in under-17s. I also welcome the Minister's commitment to reducing teen births, and, more importantly, the report "Every child matters", which provides a vision of how to help every child and young person fulfil their potential. That is critically important. The Government's commitment to halving child poverty by 2010 will do much, I hope, to reduce teen birth rates. For young women in my constituency desperate to escape an environment of low expectations and life chances, such commitments cannot come soon enough.
Enfield's young people desperately need more education on sex and relationship issues. I know that because I have met young people throughout Enfield and in Haringey next door. They told me how valuable creative, accessible and young people-friendly advice services on relationships and sex can be. When I visitedExposure magazine—written for and by young people—I was told:experts and statisticians never include in their charts, graphs and formulas that young people are not bound by sense, logic and reason. We can choose for ourselves something we know is harmful and stupid just because we can. Young women who know about sex and contraception, get pregnant because, fully aware of the possible consequences, they are prepared to take a risk.Jasneth, who is 18 and expecting her second child, said:
I know about sex and all them things but sometimes you use a condom and sometimes you don't. That's just the way it is.297WH It is a truism to say that young people are extremely hard to reach. They demand a much more sophisticated message on safe sex education—perhaps more so in London and inner-city areas than anywhere else. I would like to hear the Minister's comments on that.
Services such as the 4YP bus in Enfield reach out to find young people—mostly young men under 18, who are often the hardest to reach in a community—and work extremely hard to educate people with a safe sex message. Relationship education however is only one important element among many in reducing teenage pregnancy rates. London boroughs are crying out for a much more focused leadership from the primary care teams with local authority support to help drive the numbers down. Responding to a written parliamentary question in November last year, the Minister commented that much had beenachieved through targeted work in deprived localities with high numbers of conceptions by…the allocation of funding to teenage pregnancy partnerships".—[Official Report, 3 November 2003; Vol. 412, c. 453W.]I endorse that view. However, I draw the Minister's attention to a recent conversation I had with representatives from my local teenage pregnancy unit who told me that funding for the teen parents support programmes could run out in a few months and that a lower bid for neighbourhood renewal funding had been submitted. To put it mildly, the future is uncertain. Even if the attempt to secure funding is successful, that funding will only take the team through to 2006.
On behalf of Enfield's teenage pregnancy unit, I seek an assurance that its funding will be secure, and confirmation that it will be safeguarded beyond 2006. That would allow the team to develop longer-term solutions to Enfield's problems. Along with the primary care team and the local authority, it should be able to plan and think further ahead, instead of permanently living from hand to mouth and focusing on survival rather than strategy.
There is also a case to be made for boosting teenage pregnancy co-ordination in London, given that the record in the capital is so grim compared with other parts of the country. The Minister will be aware that although the Association of London Government is working closely with a research team from the straight talking project, who take virtual babies into schools, it does not have a full-time policy officer looking into the incidence of teen pregnancy in London, or indeed someone taking a pan-London approach. Nor does the Greater London authority, or the Mayor of London. Will the Minister consider developing the existing London co-ordinator role to provide, in particular, better help for those boroughs in which the incidence of teen pregnancy is especially high, so that local teams can seek improved guidance and support, and achieve best practice?
At a recent pan-London conference, the capital's teen pregnancy units suggested looking at improving IT systems and the collection of data generally, because at present accurate information cannot be guaranteed on a regular basis.
I have one more request: can we consider boosting best practice pilot projects so that kids can visit advice units regularly? That would be significant in helping to lock in young people's attention and focus when it 298WH comes to safe sex issues. More research is urgently needed to understand fully why rates are increasing in Enfield and other parts of London, and there is the particular issue of providing culturally appropriate sex and relationship education to young asylum seekers. Can the Department help to fund that sort of research?
Following my previous Westminster Hall debate, the Minister facilitated a London regional teenage pregnancy seminar in November at London university. The seminar provided an opportunity for all London co-ordinators to discuss the needs of pregnant asylum seekers and the service needs of the group. Debbie Young from Enfield produced a full report for the national teenage pregnancy unit, which highlighted issues and included recommendations from the conference. So far there has been no feedback and no details have been received on how the Department will take that agenda forward. Can the Minister indicate when feedback might be forthcoming and what the next steps will be in relation to meeting the needs of pregnant asylum seekers in London?
The Refugee Council told me this week that it is anxious for the experiences and needs of asylum seekers and refugees to be reflected in teenage pregnancy strategies. It said:There needs to be a greater understanding by policymakers and healthcare professionals of pregnant asylum seekers who may have been made pregnant following rape. The Government should actively consider what support could be provided for teenage asylum seeking mothers during labour and in particular consideration should be given to the provision of interpreters where the mother cannot speak English. Health workers also need to be trained to be aware of the needs of teenage asylum seekers".Will the Minister comment on that?
Appropriate sex education is more crucial than ever, particularly in areas such as London where teen pregnancy is above the national average. I accept that abstaining will be the right choice for some young people. However, I do not accept that US-style chastity tour groups, which invite our young people to take a pledge of abstinence until marriage, are always the most sensible or coherent way of educating our young people on sex. The acid test must be their effectiveness in reducing unwanted pregnancy. The Family Planning Association told me this week that the Health Development Agency in its 2003 review found no strong evidence for the effectiveness of abstinence-based interventions. One study even found evidence that abstinence-only approaches had the opposite effect.
I welcome the two-year experiment by 104 schools in the United Kingdom that have pioneered an education scheme called added power and understanding in sex education, which, despite much tabloid flak, is a fairly conservative programme aimed at combating stereotypes that may lead teenagers to believe that early sex is something they have to engage in. Recent press reports have indicated some success and I am interested to hear the Minister's reaction to the APAUSE programme, and the benefits of such a programme in areas such as Enfield or throughout London.
Tackling the issue coherently is crucial to ensure that the vicious cycle of teenage mothers having daughters who, in turn, become teenage mothers is broken once and for all. As the Institute for Social and Economic Research report already referred to commented:daughters of teen mothers are more likely to become teen mothers themselves and children born to young mothers are, on average, less successful than children of other mothers.299WH That is not acceptable in Enfield, or anywhere else in the UK, in the 21st century. We have to work harder, in a more coherent way to ensure that young people from all backgrounds have every opportunity to achieve their full potential.
§ Mr. Deputy Speaker (Mr. Frank Cook)
Very briefly, Angela Watkinson.
§ Angela Watkinson (Upminster) (Con)
I am grateful to the hon. Member for Edmonton (Mr. Love) for allowing me the time to make a brief contribution to the debate. Although I share his concern about teenage pregnancy, I believe that the style and content of advice on sexual health to minors is contributing to the rising numbers of unplanned teenage pregnancies and sexually transmitted diseases such as chlamydia. That was brought into the spotlight last week, when we learned of a 14-year-old child who had been advised and helped to have an abortion without the knowledge of her parents. Nowhere in the reporting did I see mention of the fact that sex with a 14-year-old is illegal. The decision was made by a young health adviser that this 14-year-old child could make a rational decision in frightening circumstances. How was the competence of the adviser assessed, bearing in mind that the adviser would not have to deal with the outcome of her own advice? It was disgraceful to exclude from that decision-making process the very person who has the most direct responsibility for a child's welfare, her mother, who is now helping that child to recover from that trauma and who knows what a long-term task that might be.
Children are being force-fed information on sex masquerading as education without being given the strategies and socially acceptable boundaries to cope with it. Some 400 girls under 16 have been given hormone implants that make them infertile for three years without their parents' knowledge, and a further 2,500 have had injections to make them infertile for three months. This drastic action might help to prevent unwanted pregnancy but the cost could be more diseases and promiscuity. This is condoning sex at that age rather than trying to prevent it.
The FPA recommends the provision of nonjudgmental information on sex to primary school pupils without any of the firm personal or social guidelines that have stood the test of time such as fidelity and commitment. I am happy to report that the head teachers, governors and parents in my schools are far too sensible to make use of the graphically illustrated FPA pamphlet designed for 9 to 11-year-olds. The organisation receives £420,000 of taxpayers' money every year to run a sexual health helpline. Such information overkill, together with the easy availability of contraception, has led to a rise of 30 per cent. in sexually transmitted diseases and the highest rate of teenage pregnancies in Europe.
School children by their very nature are emotionally and physically immature. They cannot be expected to cope with the endless value-free, morally neutral information in a sensible and mature way. In particular, teenage girls cannot cope with the end of their own 300WH childhood, suspended education, pregnancy, childbirth and the responsibility of caring for a baby 24 hours a day without a great deal of moral, practical and financial support. The recognition of the importance of marriage, which so often seems to be overlooked, should be contained in the Department for Education and Skills guidance, as should the discouragement of precocious sexual activity and warnings about the possible outcomes of ignoring this advice. Children deserve to be protected from making unwise decisions, and I recommend to hon. Members the Youth Enquiry Service leaflet "Sex: Yes, No or Maybe", which is full of unexpected, common-sense advice.
§ The Parliamentary Under-Secretary of State for Education and Skills (Mr. Stephen Twigg)
I shall take this opportunity to respond primarily to my hon. Friend the Member for Edmonton (Mr. Love), who is a fellow Enfield Member of Parliament. I shall also briefly respond to the contribution by the hon. Member for Upminster (Angela Watkinson). I shall not be tempted to go into some of the broader issues that she raised, although I shall touch on them in responding to my hon. Friend. I would certainly dispute the suggestion that what we are seeking to promote is value free and morally neutral.
What has been described as the Brunts case, after the school in Mansfield, is clearly very sensitive. None of us would have wanted to end up in the position that we ended with there. As I am sure that my hon. Friend is aware, there is guidance on confidentiality and the appropriate procedures to follow. Although it is hard for me to comment on the detail of the case—partly because I am not aware of the immediate implications—it is fair and, indeed, important to say that any health professional who is working in a school, including a school nurse, does so within the same legal framework as they would anywhere else. If a young person requests confidentiality, their request will be respected, unless there are serious child protection issues. Within that framework, there is no obligation to inform teachers or parents.
Of course, health professionals in cases involving a young teenage girl would always try to persuade her to discuss the pregnancy with her parents, and experience tells us that it is very unusual for a young person not to agree to do so. If, as appears to have happened in this instance, she does not agree and is adamant that she does not want her parents to be informed, the health professional must make a professional judgment about that young person's competence. That is a very difficult and sensitive judgment to make, but my understanding of the case is that that the professional made just such a judgment. I also understand that the police are questioning the father, and I could go into further detail, but I shall not. However, I wanted, to give the hon. Lady a response.
I want to update hon. Members on the progress that has been made since the previous debate, which my hon. Friend initiated in July 2003. As he said, our strategy on teenage pregnancy seeks to do several things. It seeks to provide information and advice so that young people have the knowledge and skills that they need to make informed choices. It also seeks to improve access to confidential advice services in young-people-centred 301WH locations and to support measures to remove the barriers that prevent teenage parents and their children from achieving their full potential.
The key lesson that we are learning is that there is no one-size-fits-all solution to the challenge that we face. I shall not repeat what my hon. Friend said about the context of poverty, but it appears overwhelming when we compare the chances of becoming pregnant among teenagers from poor families and richer ones.
My hon. Friend made an important point about educational achievement and access to education, and a significant part of our teenage pregnancy strategy addresses the reasons why young people, including young women, leave education and are not motivated by it at a very young age. School and college reform for 14 to 19-year-olds is important not only for educational and economic reasons but to address social challenges such as teenage pregnancy.
Our national awareness campaign and policies to strengthen sex and relationship education seek to tackle the issues of which my hon. Friend reminded us. Clearly, prevention is critical, which is why I agree with him about the central role that sex and relationship education must play in reducing conception rates. That is why we are committed to delivering the best possible sex and relationship education through personal, social and health education in our schools and why we recognise that a lot more needs to be done if teachers are to feel that they have the confidence and support to deliver. For example, we are looking at how we can train more teachers and community nurses so that they are properly qualified in this area. Last year, more than 600 additional teachers took part in the certification programme in personal, social and health education, and there is funding for up to 3,000 teachers this year. We are also launching a linked programme for community nurses, which was piloted last year. The evaluation of the pilot was positive and we are trying to build on that. We have asked the Qualifications and Curriculum Authority to develop materials that will clarify our expectations about the standards of teaching that we expect and the ways in which schools can better assess the knowledge and skills that young people gain through their sex and relationships education.
Evidence shows that young people are likely to have sex later and are more likely to use contraception if their parents talk openly with them about sex and relationships. Survey evidence shows that parents recognise the value of greater openness in such discussions with their children. An important element in the progression of the children's and young people's agenda will be addressing sex and relationships education. There are many programmes, including the time to talk initiative delivered through Parentline Plus, 302WH which gives information to parents who might be unsure about the best way to engage their children in discussion.
Sadly, experience shows that there will always be some young people who will become pregnant. That is why we need to focus on the support that we can give those young people, some of whom my hon. Friend powerfully described in the opening part of his speech. We must see what can be done through programmes such as the Sure Start Plus pilot, through the role of Connexions personal advisers and through the support that we can give to cover child care costs for teenage parents.
I finish by addressing the challenges that my hon. Friend put to me. If we compare 2002 with 1998, there has been a welcome 9.4 per cent. fall nationally. However, in certain parts of London, including the borough of Enfield, the trend is completely the opposite. We must look at why something works in some places but not in others. During the forthcoming months we will examine in more detail those areas in which the rates have gone up and down significantly to identify the particular factors that have led to those results and to use that information to inform the future direction of local strategies. It is critical to have a clear evaluation of what is working, what is not, and what factors lead to geographical differences in results.
With specific reference to my borough, I echo my hon. Friend's comments about the 4YP bus initiative and theExposure magazine in Haringey. He is right to highlight the crucial role of the primary care trust in providing a solution. I assure him that I will consider the various specific issues that he raised, especially those about future funding, because we want to ensure that programmes are sustainable. I am advised that the teenage pregnancy partnership board for Enfield is trying to tackle the issues, but I will come back to him with a response.
My hon. Friend also asked about developing the London co-ordinator role, and we will consider that in the broader context of what must be done in London. He mentioned the conference held in November as a consequence of his debate last July. I understand that a report has been commissioned and is due to be published later this year. I will write to him setting out exactly what the programme is for that and when and how we will publish the report.
This is Every child matters an important area of work. My hon. Friend talked about the Green Paper. If we are to ensure that every child matters and that we give the best possible start in life to children and young people from all backgrounds and communities, we must crack this problem. We have started to do that on a national level, but lessons must be learned from areas that have reduced teenage pregnancy for those where the rate is still increasing. The work is underway but there is a much more to learn to get things right for the future.