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§ Mr. Andrew Love (Edmonton)I am grateful for the opportunity to raise an issue that is of great importance to my constituency. Teenage pregnancy is not an easy issue for Members of Parliament or the Government to tackle. There are all kinds of sensitivities around teenage pregnancies, particularly for families and individuals with deeply held religious beliefs, so we must tackle the subject with great care. I welcome the work of the social exclusion unit and the Government's programmes to tackle teenage pregnancy. There is no simple solution to reducing teenage pregnancy rates, but we must find solutions, however difficult that may be.
Teenage pregnancy is both a symptom and a cause of social exclusion, and tackling it may be one of the keys to breaking the terrible cycle of poverty trickling down the generations, which I often see in the area that I represent. In my constituency, we have a problem with teenage pregnancy, and a more worrying problem of teenage pregnancy among asylum seekers from countries of conflict who have been raped.
Younger girls from poorer areas are more likely to become pregnant. In a deprived environment, extra support is required for teenage parents to break the cycle of teen pregnancy. Teenage years should be the time when people begin to fulfil their potential and graduate to adulthood. How is that possible if they have the responsibility of bringing up kids?
Responding to a written question in July, the Department told me that the most recent Government data for 2001 show a 10 per cent. reduction in the under-18 conception rate and an 11 per cent. reduction in the under-16 rate since 1998. I agree with the Government that the signs are encouraging, but we need to do more. We must ensure that proper information and education about sex and relationships are available to young people, and that more support is available, especially for particularly vulnerable groups such as refugee women who have been sexually abused and are pregnant when they arrive in Britain.
Enfield's teenage pregnancy co-ordinator, Debbie Young, with whom I have worked closely in preparing for this debate, informed me that in 1999 the under-18 and under-16 conception rates decreased, but that since 2000 both have increased. There was a 14 per cent. increase in the under-18 conception rate between 2000 and 2001, and a 39 per cent. increase in the under-16 rate between 1999 and 2000. In addition, the proportion of conceptions leading to abortion increased to 60 per cent. in 2000 from an average of 52 per cent. in the two preceding years.
There is a desperate need for a young people's sexual health and contraception service in my constituency, which has the highest teenage conception rates in the borough of Enfield, as well as the highest levels of gonorrhoea and chlamydia. At present, one of the two weekly young people's sexual health and contraception sessions in Enfield is funded with a teenage pregnancy grant, but the local primary care trust is unable to provide mainstream funding to enable teenage pregnancy finance to be directed to new and innovative pilot projects in my constituency. Sexual health is a priority for Enfield PCT, but there is no national service.
91WH framework for sexual health, and funding is not directed at such issues. The PCT argues that although non-recurrent extra funding has been provided, it is grossly inadequate and, because it is non-recurrent, it is impossible to establish new services to meet the demands and diverse needs of the community.
The strain is very obvious. The teenage parents support project in Enfield has had 204 referrals since it started in October 2002, but it has only one outreach caseworker, who works four days a week. Most of the young people seen are 15, 16 or 17 years old. That tells us that many children of school age are far from knowledgeable about sex and sexual health. The image often portrayed that teenagers are sexually active and well informed about the birds and the bees is far from the truth.
The editor of Exposure, a local magazine for young people, recently told me that the principal reason why young people do not access advice services is that they are not usually promoted in a way that is appealing to young people.
§ Dr. Rudi Vis (Finchley and Golders Green)I agree with my hon. Friend that education is extremely important. I am originally from the Netherlands. One thing that is different there, besides education, is that parents, families and so on frown on teenage pregnancy. That is an important reason for the rate of teenage pregnancy being so low in the Netherlands.
§ Mr. LoveI shall come to the European experience a little later, but my hon. Friend is absolutely correct in saying that the rate of teenage pregnancy in Europe, particularly the Netherlands, is much lower than in this country.
The editor of Exposure magazine told me:
Remember that young people have been born and brought up in the information age. Commercial organisations promoting products and services to young people use very sophisticated ways of getting their messages across through film, music, pop-videos and glossy magazines. To stand any chance of getting noticed by young people, government backed promotions on sexual health must compete for attention against commercial communications. What the Government produces must be of an extremely high calibre and equally sophisticated.He continued:The reason magazines like Exposure have any kind of impact on young people is that we are not talking down to them. It's young people themselves, encouraged and guided by adults that are given the freedom to write and produce the magazine to get important messages across to their peers.Siobhan Phillander, a 16-year-old reporter for the magazine, confirmed that when she said:Since coming to Exposure I've made friends, I've written articles about TV shows, crime and teenage pregnancy. I've learnt to write. Before I couldn't be bothered to even write a letter! I've seen young people come in and say what they want to say and how they want to say it instead of being on the streets making mischief.Responding to a written question in June, the Department confirmed that the teenage pregnancy strategy national campaign, which was launched in October last year, involved advertisements aimed at 13-year-old boys and girls in popular teenage magazines and on local independent radio stations. The Minister said that the early success of the campaign was 92WH recognised in the first annual report of the independent advisory group on teenage pregnancy and that since October the free telephone advice line had advised more than 8 million young people and that, importantly, half of them were boys.
The Minister will be aware of the work of the Royal College of General. Practitioners, which is working closely with the teenage pregnancy unit to provide training and resources to support GPs in making their practices more teenage friendly. I urge him to reinforce that important work by including and engaging young people in it.
Involving young people, including their ideas, creativity and personal experiences, in national media campaigns is critical. There is a wealth of initiative and innovative ideas among young people in my area, but their opportunities to have any input to national campaigns to make them more relevant to them are limited. That is particularly relevant locally, where a high proportion of young people come from black and ethnic minority communities, many of which are not represented in national campaign material. I strongly urge the Minister to look carefully at that important issue and would welcome his feedback.
Last year, a UNICEF report told us that the UK had not made enough progress in tackling teenage pregnancy and that the UK had the highest teenage pregnancy rate in the developed world. However, the House of Commons Library confirmed that the rate of teenage births has fallen over the past 30 years by almost 40 per cent. Does the Minister agree that we must find new ways to prevent teenage pregnancies and to help young mothers in teenage pregnancy blackspots? Furthermore, investment in new strategies must be directed specifically to tackle the unique issues in each area.
A local health visitor in my area told me about some cases in her current work load, which show her clients' diverse and complex histories:
C is 16 years old and from Uganda. She witnessed her family members killed. She was raped and fled to England. C attended local family planning se ^vices to request a termination but this was not possible as the pregnancy was too advanced. She remains ambivalent about the pregnancy and at times feels hostile towards the baby. C requires support for all areas of her life, to be given appropriate advice and information and enabled to make informative choices. She is indeed a child in need herself.Living in bed-and-breakfast accommodation can be extremely isolating for a teenager who has been raped and is an asylum seeker. She is often unable to access crucial advice services.Such young women have experienced incredibly traumatic situations and require specific services, which current arrangements do not provide. Will the Minister examine new measures to help and protect that vulnerable group and to meet its specific needs? English is not the first language of many such women, and they can expect only one visit from a caseworker once the baby is born.
Does the Minister agree that extra clarity is needed on where the funding and additional support services will come from? Asylum seekers in the UK who are victims of rape are also victims of torture and should be treated accordingly. There is one outreach caseworker in Enfield, who works for four days a week with 204 93WH pregnant teenagers. Does the Minister agree that that is not enough and that we must ensure that new money gets through to the cutting edge of service delivery to increase capacity in those crucial services?
One of the main concerns of the National Society for the Prevention of Cruelty to Children is that teenage parents should receive support and help, which will in turn help their children. Its 2001 report, "Improving Children's Health", found that much work on teenage pregnancy is focused on preventing pregnancies rather than supporting teenage parents. It believes that it is vital to support teenage parents to end the cycle of poverty and misery, which often occurs. It found that teenage mothers' babies are generally vulnerable and that the mothers are more likely to suffer post-natal depression. The NSPCC supports complementary services and a co-ordinated, cross-departmental approach, which the Minister might comment on today.
To sum up, the Government are clearly committed to tackling teenage pregnancy, which is reflected in the significant increase in expenditure from £5 million in 1999 to £21 million in 2002. I welcome their plans on educational advice and the approach adopted by the social exclusion unit, which is working across Departments. We have the worst teenage pregnancy rate in Europe and many such women in my constituency are confused, isolated and afraid. We should be doing more to reach them. Teenage pregnancy is prevalent among the poorest sections of the community. Other risk factors include being in care, being excluded from school, having mental health problems and having experienced sexual abuse. We must try to prevent young people from becoming pregnant, but if they have a baby we should support them. We also need to learn from our partners in Europe, who have much lower teenage pregnancy rates.
The Government's target of reducing teenage conceptions by 50 per cent. by 2010 is ambitious. I share that ambition. We must consider in particular the way in which we respond locally to the needs of individuals. I hope that the Minister will use this debate as the basis for further discussions on the issue. Behind the statistics are the lives of children in their teens whose children risk having children in their teens. It is crucial that we tackle the issue coherently to ensure that the vicious cycle is broken once and for all, and that people from all backgrounds are enabled to achieve their potential.
§ The Parliamentary Under-Secretary of State for Education and Skills (Mr. Stephen Twigg)I thank my hon. Friend the Member for Edmonton (Mr. Love) for having raised this important issue. I shall do my best to explain the Government's response to the challenges that he set out.
My hon. Friend asked us to consider new ways of tackling a massive issue that has many implications in terms of health, social exclusion and education. As both he and my hon. Friend the Member for Finchley and Golders Green (Dr. Vis) have said, it is vital that in doing so we learn from examples of good practice in this country and elsewhere. I agree that it is a key issue in respect of social inclusion: a great deal of the problem is 94WH associated with what my hon. Friend the Member for Edmonton described as the cycle of poverty. There are varied and complex reasons for the continued high rates of teenage conception. One is the limited aspirations of young people living in areas of high unemployment and deprivation, and another is ignorance. Education would certainly make a difference. A third, the nature of the message, was raised by the young people working on Exposure magazine, to which my hon. Friend referred. I shall return to that in a moment.
The Government's teenage pregnancy strategy was launched by the Prime Minister in 1999. It was the first ever attempt by Government to consider the issue on a cross-Government basis, to deal with the causes and to examine some solutions. As my hon. Friend said, we have had some success. Our latest data, from 2001, which he outlined, showed an encouraging 10 per cent. reduction in the under-18 conception rate since 1998 and a larger fall, of 11 per cent., in the under-16 rate. That is very welcome. It represents a fall from 47 per 1,000 in 1998 to 42 per 1,000 in 2001. However, it still a horrifying statistic: 42 in every 1,000 15 to 17-year-old girls become pregnant. That is the continuing challenge before us.
The fall has occurred in four out of five areas of the country. Enfield, as my hon. Friend said, is one of the exceptions. In that area, the under-18 conception rate has increased. The reasons should be examined carefully. The strategy on the ground is strong and has been widely praised. He described some of its features, not least the emphasis that Enfield has placed on the particular needs of asylum seekers and the partnership between agencies, including those concerned with health and housing. The Enfield example reminds us of the scale of the challenge.
I am interested in exploring whether the areas in which there has been no decline in recent years have any characteristics in common. There does not seem to be a single explanation. The Government are working with public health observatories in the Government office regions to try to identify factors that might explain the trends to get a clearer picture. We cannot be complacent.
There has been good progress in the past three years, but there is more to be done. Our commitment is reflected in the inclusion of the reduction target as a Government public service agreement target. It is also a PSA target for local government and one of the two cross-cutting indicators in the local government best value performance indicator set. We also recognise that prevention is critical, and some prevention targets are shared with Connexions. Its role in that regard is critical, and the Government have invested £98 million to support implementation of the strategy, by funding local work and the work led by the teenage pregnancy unit, including the national campaign.
My hon. Friend referred to the important work of the independent advisory group on teenage pregnancy. I pay tribute to the group, particularly in the light of the recent publication of its second annual report and its recommendations to the Government. We are considering those recommendations carefully, and will provide a response later in the year.
It is vital that we have effective, joined-up action, and that all the agencies work together. That requires effective work locally and nationally. We have recently 95WH seen a significant change in responsibility, with the strategy moving from the Department of Health to the Department for Education and Skills. That move was part of a wider change, and work in that area will be led by my hon. Friend the Minister for Children, with assistance from me and the Department for Education and Skills.
My hon. Friend the Member for Edmonton spoke of the excellent work being done in Haringey and Enfield by Exposure magazine. He made a number of powerful points about the need to get the message across in a language, and a tone and style, that are relevant to and can be understood by young people. We have also been running an advertising campaign through teenage magazines and local radio. Through that campaign, we seek to target 13 to 17-year-olds—both boys and girls—using a mixture of media to reach them.
We are advertising in teenage magazines and on local independent radio stations, with the aim of dispelling myths, raising awareness and giving accurate information. We want to use an approach that gets through, so humour is useful and the style is non-authoritarian. We have been assessing and evaluating how successful it has been.
The campaign has achieved high recognition: for example, more than 70 per cent. of young people know of it, which compares well with television advertising, which we have not been able to undertake. The campaign has a free helpline that provides advice and gives details of local services. That has helped a significant number of young people, half of them boys, who phoned as a result of the campaign. Our survey of callers showed a high level of satisfaction.
We are now looking into working with brand names and others associated with young people. We recently received the endorsement of a new girl band called Tommi, who played at a young people's sexual health conference last week. They are keen to support us by taking the message out to thousands of young people as they tour the country.
My hon. Friend raised the important issue of how we can get the message to all parts of the community, but we must recognise that in boroughs such as Enfield there are particular issues for some black and ethnic minority communities. We also have to deal with those from other parts of the world, such as asylum seekers, some of whose pregnancies are a direct consequence of rape and torture. We need to do more to help such people, and I shall ask for further research to be undertaken, as my hon. Friend requested.
We have much to learn from local examples, and some work done by Enfield and Haringey councils with their asylum-seeking communities could contribute to the development of our national thinking. I undertake to consider that, and come back to my hon. Friend with more information.
My hon. Friend the Member for Finchley and Golders Green raised the important example of the Netherlands. If we are to be really effective in our work, we need to engage with parents and the wider family. We need to consider how better to support parents in talking to their children about sex, relationships and the possible consequences. The research that I have seen shows that young people want their parents to be the main source of advice, but that talking about such 96WH things causes incredible embarrassment in the family. We are working with Parentline Plus on a "time to talk" campaign to promote better communication in the parents' media, using outlets such as Best, Bella and relevant magazine agony aunts. We are looking at a range of ways in which parents can be engaged more.
My direct responsibility is to do with improving sex and relationship education in schools, which is critical. We have done have a lot of work and listened to young people about how they think sex is talked about in schools, and we clearly have a lot of progress to make on that. What is done is still regarded as too little, too late, with still too much focus on the biology and not enough on relationships. Not enough teachers have the confidence to deliver really effective sex and relationships education.
The Department for Education and Skills issued guidance in 2000 that set out the programme needed to address issues of information and knowledge for boys and girls in schools. Ofsted has reported good progress in schools in implementing the guidance, but has pointed out that a great deal more still needs to be done. I shall work closely with Ofsted to ensure that the reporting arrangements for personal, social and health education are as effective as possible, so that we can monitor progress. In part, there is a need for more specialist teachers who have greater confidence and a wider knowledge base. We are seeking to encourage such teachers and have launched a national personal, social and health education teaching certification programme, which is aimed at developing specialist teachers. About 750 teachers have voluntarily participated this year. We are also considering a similar programme for community nurses, which is being piloted and will be available nationwide from 2004.
As part of that, want to raise awareness of sexually transmitted infections and consider how to reach boys. I have seen some good examples of schools in London and elsewhere that have made a special effort to reach boys as part of their sex and relationships education, which have not only had potentially positive results in preventing teenage pregnancies, but supported boys who become teenage fathers. We want to ensure access to advice in all its senses.
We need services that all young people who need them can trust. Since the launch of the strategy, we have seen an improvement in the number of services that are available to young people. There are all sorts of good examples of using leisure centres, one-stop-shops, mobile units and other facilities. My hon. Friend the Member for Edmonton will be aware of the Enfield and Haringey 4YP sexual health bus, which is an excellent model of the difference that those practices can make locally.
We must work more broadly with the sexual health and HIV strategy, because our concern about teenage pregnancy goes hand in hand with concern about the high rates of sexually transmitted infections among young people. Our work on teenage pregnancy will continue to be closely co-ordinated with work on sexual health and HIV, so that we can reduce waiting times for advice, screening and treatment, in both community clinics and general practice.
We want to ensure that we provide proper support for young parents, because, as my hon. Friend said, they are obviously more likely to live in poverty, be unemployed 97WH or be unable to access education, training and child care facilities. That is why in 35 areas with high rates of teenage pregnancy we have developed the sure start plus pilots, which include a personal adviser to help pregnant teenagers to make a decision about continuing with the pregnancy, having the child adopted or having a termination. The evaluation of those pilots will be available in 2004. We also want to tackle social isolation via supported housing.
Progress is being made, but as my hon. Friend said, we still have a great deal more to do. It is important that we engage with young people and learn from local and international examples. If we do that, we can continue the progress made in the first three years of the strategy. It is a reflection of the Government's commitment to bring down the rate of teenage pregnancy that we intend to focus on the issue right through the Government, with my hon. Friend the Minister for Children leading.
§ Sitting suspended until Two o'clock.