Our new Prime Minister says he believes in early intervention. As Leader of the Opposition, in a speech to the Local Government Association in 2007, David Cameron said, '... ask a primary school teacher with a class of five-year-olds which ones are likely to be in trouble with the law in five or ten years' time - the chances are, the teacher will be able to tell you with total accuracy. So, given this, why do we wait until kids are ten or 15 before we try to intervene?'
If this statement translates into action under the new coalition Government, evidence suggests there could be an enormous long-term benefit to society - and a greatly reduced deficit, as opposed to an ever-growing one - in the years to come.
The Government has now laid out its full Coalition Agreement and pledged to 'take Sure Start back to its original purpose of early intervention, increase its focus on the neediest families, and better involve organisations with a track record of supporting families.'
While supporters of Sure Start as a universal service see this as an indication that it will be diminished, could this pledge indicate an intention to move from treating the symptoms of dysfunction in society, to addressing the causes?
Early intervention works on the basis that the care a child receives in their first three years largely determines their future outcomes. If a parent has grown up without appropriate care and support, it is far more likely they will be unable to offer this to their own child, leading to symptoms of dysfunction such as violent crime, anti-social behaviour, teenage pregnancy and drug addiction.
CROSS-PARTY AIMS
Iain Duncan Smith, the new Conservative Secretary of State for Work and Pensions, has been championing early intervention for many years, particularly as chairman of the Centre for Social Justice (CSJ), an independent think-tank seeking effective solutions to poverty, which he established in 2004. Together with Graham Allen, Labour MP for Nottingham North, he co-authored the pamphlet Good Parents, Great Kids, Better Citizens in 2008.
Their efforts to bridge the cross-party divide denote their wider ambitions to ensure the success 
of any major early intervention strategy. They say there must be stability over many Parliaments, sustained over a generation.
The Coalition Agreement states that deficit reduction is 'the most urgent issue facing Britain' and that 'the credibility of a plan on deficit reduction depends on its long-term deliverability'.
Graham Allen told Nursery World that investment in early intervention 'fits in with deficit reduction very neatly. This initial investment is miniscule compared to what we are doing now, which is constantly funding the repair of the damage that is being done because we are not tackling the problem now.'
As an example in the Good Parents report illustrates, 'Suppose that we help a young mother and a toddler with £1,000 of worth of health visiting at a time when she and her baby need it most: that makes more sense than waiting 16 years in order to pay £230,000 to incarcerate that baby in a young offenders' secure unit for a year when he has gone astray.'
Action for Children's report Backing the Future, published jointly with NEF (the new economics foundation) in September last year, said that a move to a comprehensive investment programme in preventive services would bring returns to the UK economy of £486 billion over 20 years. The report also showed that every £1 the charity invests in its services brings a return between £4 and £10.
FAMILY INTERVENTION
The tremendous social benefits are also apparent in many fledgling and established programmes around the country.
Dr Inge-Martine Pretorius is a child and adolescent psychotherapist for West London NHS. On the invitation of the head teacher she became an on-site psychotherapist at Randolph Beresford Early Years Centre, in the deprived area of White City, London.
Dr Pretorius says, 'Psychotherapists have a particular role to play in early intervention because we are specialists at working with complex emotional issues. We're very aware of the impact of the early environment on the child's development, as well as the transmission of behavioural patterns and how to work with families to alter them.
'If it's a small issue caught early, then often we can see the parent and child once a week for a few weeks and it can be resolved. If it's an entrenched problem, for example the parent has a mental health diagnosis, then I may see them once a week for a year or more. It's about consistency and reliability rather than a short-term intensive programme.'
Breakthrough Britain: The next generation, another CSJ report, highlights the effect of care on a young child's brain development. It says, 'Freud was entirely right when he said we come into the world "not quite finished" and in the early years, the brain is still forming. Due to this period of rapid brain development, adult-infant interaction can affect the architecture and long-term chemical balance in a child's brain, for better or worse. Key stress response systems, and foundational systems for emotional regulation, kindness, empathy and concern, are very immature at birth. How they will unfold is dramatically affected by the infant's relational experiences.'
The new Government has also promised to increase the number of health visitors by 4,200. Early intervention campaigners believe that health visitors, who are in a unique position for outreach because of their non-stigmatising approach, must be trained to safeguard children's cognitive and emotional as well as physical and nutritional health.
The Good Parents, Great Kids, Better Citizens pamphlet says, 'It is as simple - and as difficult - as making sure that very young children 0-3 receive nurture, warmth and attention from parents, which might also require that parents themselves were helped by appropriate packages of intervention as they grew up from 0-18.'
GOVERNMENT'S ROLE
'The seven-point plan at the end of our pamphlet is a plan of action for the new Government,' says Mr Allen. 'Iain Duncan Smith wrote this and re-endorsed it very close to the election. He would put this plan into action if given the right responsibility. I think it would require restructuring the existing Government departments, perhaps putting early years into the DWP as part of a continuum on this issue. We need someone who has a cross-departmental remit. But Iain could do it from the DWP if given the clarity of purpose and support from David Cameron and Nick Clegg.'
Central to a new scheme must be effective, multi-agency data-tracking. All early intervention supporters recommend that the Government commissions a long-term UK study using cohorts of children with and without early intervention to inform policy.
Kate Mulley, head of policy and research at the charity Action for Children, says, 'You need to invest in those interventions that make a difference, which is why we significantly invest in our research and evaluation programme - does our service make a difference in this child's life? It's the type of issue being discussed in Government, called paid-for by results, and it is trying to ensure that the money goes where it will make a difference.'
Local evolution of services is also essential, and the cross-party authors advise Government to let localities take the lead. This has been the case in Nottingham, where the Local Strategic Partnership of police, health, children's services, council, business and voluntary services has redirected their thinking and local budgets into a series of long-term policies, helping to tackle the causes rather than the symptoms of underachievement in the city.
Now this LSP is known as One Nottingham and it has developed cross-agency policy to create an 'Early Intervention City'.
From this work Mr Allen sees a holistic approach as absolutely essential. 'For me, children's centres are one of about 15 to 20 policy initiatives that contribute to the whole picture of early intervention,' he says. 'One part of the jigsaw can never be the magic answer to the problem. They are all essential ingredients to making this holistic approach from 0-18 work.'
FUNDING ISSUES
Mr Allen says, 'I think all Governments have grappled with this, but what's different now is that the possibility of a Secretary of State having grown up with this issue and being really committed to it is very high.
'This needs to be administered centrally and then it will catch on and become standard like the NHS. That's where we want to get to. But this needs the right departmental structure, rather than the department barons who just want to spend more and more on remedialism.'
But, as the new Government tries to make £6 billion in spending cuts, where will this funding come from? Both Action for Children and the cross-party authors believe the answer could lie in the money markets, because early intervention could bring a massive return on private investment.
Backing the Future refers to a £486 billion predicted return in 20 years. It says, 'To make the investment, there is a strong case for raising the funds needed through a series of annual bonds with ten-year maturities. The necessary finance could be raised through general taxation. However, given the scale of investment needed up front to reconfigure our services, we propose that the investment needs to be frontloaded through a bond issuance. There is a clear rationale for raising the money through bonds when it is used for investments where "returns" exceed the cost of paying off the loan.'
In conjunction with a new report, Deprivation and risk: the case for early intervention, Action for Children has seen 109 MPs sign its pledge to support early intervention - a sign that there is an awakening across Government and all political parties. Many practitioners, charities and families will be waiting and hoping this support bears fruit.
PLAN OF ACTION
Foundational elements of a potential EI strategy for those aged 0-18 aimed at interrupting the intergenerational cycle of disadvantage.
1. A pre-natal package
2. Postnatal (Family/Nurse Partnership)
3. Sure Start Children's Centres
4. Primary school follow-up programmes, including parenting support, language, numeracy and literacy, and development of children's social competencies
5. Anti-drug and alcohol programmes
6. Secondary school pre-parenting (ie. pre-conception) skilling
Source: Good Parents, Great Kids, Better Citizens.
Further information
- Early Intervention: Good Parents, Great Kids, Better Citizens and Breakthrough Britain: The next generation, available from www.centreforsocialjustice.org.uk
- Backing the Future: why investing in children is good for us all and Deprivation and risk: the case for early intervention, available from http://www.actionforchildren.org.uk/content/561/Backing-the-future
