Breaking The Cycle Of Social Exclusion

Gordon Brown’s endorsement of nurse-family partnerships could help boost the life chances of some of the most socially excluded children in society, writes Pat McFadden.

A line in Gordon Brown’s speech saying he wanted to “expand the help of nurse-family partnerships” was little noticed by his audience yet holds out real hope for some of the poorest parents and children in Britain .

This programme, aimed at boosting life chances for some of the most socially excluded children in society, was established some 30 years ago in the United States. Last year the government set up 10 pilot projects to road test the idea in England.

In the poorest families there is often a cycle of deprivation, from generation to generation, and that even by the age of a few years old, the life chances of young children are shaped.

If we can break the pattern, we can change the life chances, and it is impossible to start too early because we know that the early months and years of a child’s life have a huge impact on the child’s development throughout the rest of their lives.

So the nurse-family partnership is based on the idea of personal support for the poorest young first time mothers as early as possible in pregnancy right up until the child is aged two.

Trained nurses visit the mothers on an average of a fortnightly basis from pre-birth offering help and support on everything from diet and prenatal care through to play, early learning and a range of issues which contribute to children’s well being.

When I met nurses in Britain taking part in one of the pilot projects they said the work was “their hearts’ desire” and spoke about the huge difference they could make by spending time with the mothers and building up a much stronger relationship than is often possible for hard-pressed health visitors dealing with caseloads of maybe 400 families.

With the nurse-family partnership, the caseload is around 25, allowing that relationship of trust and support to really take root. In the US the programme has been found to result in fewer accidents at home, a better start at school and even less contact with the criminal justice system in the teenage years for those children who have benefited from inclusion.

Of course it remains to be seen how a programme developed in the United States will translate into the different context of the UK, where we have a universal health service.

But the idea of extra help and support for those who need it most, at a time when it can have the most impact on children’s lives, is certainly worth trying.

Some have attacked the programme as too great an interference of the state in family life, or even a branding of the children involved as troublesome before they are born.

But if we know that help and support in the early months and years can make a greater difference than later in life, and we believe that through such support we can break the cycle of intergenerational social exclusion, what is progressive about sitting back and doing nothing?

The prime minister’s backing for the idea in his speech yesterday is good news for those keen to battle deep-seated social exclusion and keen to break the cycle that often diminishes life chances when those lives have barely begun.

· Pat McFadden, minister of state in the Department for Business, Enterprise & Regulatory Reform, was responsible for introducing the nurse-family partnership policy