PHT June 2011_Jan 10 - UK Faculty of Public Health

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INTERVIEW Graham Allen, Labour MP for Nottingham North, delivered his review Early Intervention: the Next Steps in January, and his follow-up report on financing the approach is just out. Here he talks to Public Health Today about what he sees as the main opportunities and challenges ‘Smoke alarms, Intervene early and save billions, says Allen What inspired you to take up the early intervention ‘banner’ in the first place? My own history in my own constituency, which has the highest teenage pregnancy rate in Western Europe, the fewest kids going on to university in the UK, and myself being born and bred in that constituency. It’s a white, working-class area with a lot of problems – but there’s nothing inherent in the kids to stop them achieving great things. The fundamental problem is an intergenerational cycle of dysfunction. I knew we could break into that by having an effective programme to give every baby, child and young person the social and emotional bedrock that most of us take for granted but which so often is not there because the transmission of good parenting skills has, for whatever reason, broken down. So how did you go about doing something about it? In 2005 I was asked to chair the local strategic partnership in Nottingham – and my vision was to create an ‘early-intervention city.’ We came up with a cycle of policies for ages 0-18 – some available to every baby, child or young person, and some specifically targeted. The general ones were things like family nurse partnerships (our ambition is to apply this to every child born in Nottingham and we’re well on the way); a SEAL [social and emotional aspects of learning] programme for every primary school child; and a life-skills programme – SRE [sex and relationships education], PSHE [personal social and health education], civic and financial awareness, etc – for secondary schoolchildren. Our specific interventions included a mentoring programme for eightyear-olds and help for children of persistent and prolific offenders. And the review? On the strength of our experience in Nottingham I co-wrote a little book with Iain Duncan Smith, published in 2008, and in July 2010 David Cameron asked me to lead a review on early intervention. What has your review identified as the main challenges? The big one is that it takes time. You need persistence, consistency, sustainability. You need political commitment nationally and locally, which means an all-party approach. I’m not going to let the current dispute about cuts stop me from doing all I can for early intervention. I see our initiative as a poppy in the battlefield – and to be fair we’re getting a lot of political mileage across the political spectrum. Where do you see the ‘Big Society’ fitting into this? I’ve always been a strong advocate of civic society, but it’s underdeveloped. We need to maximise the ability of local people to come up with their own answers. And we need to develop effective partnerships between civic society and a much more independent local government to achieve the sort of social consensus to make things happen. And do you think that the business world has a part to play? Yes, an important part locally and nationally. Locally, through partnerships engaging with businesses to invest in the future of the entire community. Nationally, we’ve floated the idea of an Early Intervention Foundation. Although government will always be the main funder of programmes, there’s room for a small but significant non-government arm which would pull together the Big Society Bank, the Big Lottery and various foundations to provide some start-up funding and act as a conduit for investment from the private sector. If the Government creates the right mood music we could get some solid private investment. More private sector organisations are seeing that social investment can be as profitable as investing in coffee futures or the gold market. Let’s face it, the City could do with a bit of positive PR right now. 4 PUBLIC HEALTH TODAY
INTERVIEW not fire engines’ The big bogies are institutional anxiety and territorialism, at Whitehall and local level, both of which get worse ‘when budgets are tight ‘ What about the short-termism of public sector managers? Any quick wins? We need as a society to change that philosophy. Looking back over the past 30 years, can we say that short-termism (what I call late intervention) has been successful? Clearly the answer is no. I think our party leaders need to have the courage to say that this isn’t the way to run public services. We need to think prevention – more smoke alarms rather than fire engines – to show how children with social and emotional capability can save on all the things that are the cost of failure: drink and drug abuse, literacy problems, antisocial behaviour, magistrates courts, lifetimes on welfare – billions of pounds. And the trick is to monetise the savings and to use that to repay investors. Many of our readers will soon be moving into new public health structures with broader responsibilities for health and wellbeing. What would you say to them? The whole early-intervention strategy is in essence a public health strategy. We see it in Scandinavia and in Scotland. There’s no reason we can’t see it in England. While good people can make almost any structure work, they can do even better if backed up by the philosophy of early intervention. There’s tremendous potential in the proposed new structures providing we can theme them to take on the philosophy of investing in early years. This is not to neglect teenagers and older people, but to see ages 0-8 as absolutely key to the future, so that kids can be self-starters and we don’t wait until problems become deeply rooted. With all this in mind, what keeps you awake at night? The big bogies are institutional anxiety and territorialism, at Whitehall and local level, both of which get worse when budgets are tight, often at the expense of a longer-term approach. Changing from a culture of late intervention to early intervention takes real political will, and I think a public health view is a strong driver for this. Finally what gives you hope – what keeps you going? In Nottingham and around the country I’ve seen what can be done with the right drive. We can make a difference. The challenge now is to learn from best practice and take it to scale. We’ve got 27 local authorities saying they want to become Early Intervention Places. If we can encourage and support this movement with an Early Intervention Foundation we can roll it out across the country. As ever it’s about partnership, investment and political will. A lot depends on whether the Government listens to my report and is able to drive it through Whitehall and the Treasury. But I’m confident that the case is so self-evident we will see real progress. Graham Allen was talking to Alan Maryon-Davis To download a copy of Early Intervention: the Next Steps, go to www.dwp.gov.uk. For a hard copy, email matthew.woolston@parliament.uk JUNE 2011 5
Page 1 and 2: In this issue > Interview with Grah
Page 3: UP FRONT Public Health in a Changin
Page 7 and 8: Predicting need in the early years
Page 9 and 10: SPECIAL FEATURE: EARLY INTERVENTION
Page 11 and 12: SPECIAL FEATURE: EARLY INTERVENTION
Page 13 and 14: Weighing the evidence - what actual
Page 15 and 16: How work can meet our core human ne
Page 17 and 18: ENDNOTES From the CEO WE ARE at thi
Page 19 and 20: Welcome to new FPH members We would

PHT June 2011_Jan 10 - UK Faculty of Public Health

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