Today, 15,000 Scottish children are in the care of social services and one child in four is assessed as ‘vulnerable’ when they arrive at primary school. Alan Sinclair, founder and former chief executive of the Wise Group, has spent 10 years studying where we are going wrong. He has set out his analysis and a long-term plan to put Scotland on a better path in a new book, Right from the Start: Investing in Parents and Babies. In this exclusive extract he summarises his case.
“There can be no keener revelation of a society’s soul,” said Nelson Mandela, “than the way in which it treats its children.” First Minister Nicola Sturgeon brought the message closer to home when she said: “We want Scotland to be the best place in the world to bring up children.”
But mind the gap. UNICEF, the United Nations Children’s Emergency Fund, has carried out the most robust study available on child wellbeing across 29 of the world’s advanced economies. Scotland and the rest of the UK came in at a lowly 16th position – below the Czech Republic, Slovenia and Ireland. At the top of the table are Holland, Norway, Iceland and Finland. We scored particularly badly in early childhood education and the number of young people not in work, training or education.
Returning from a visit to Utrecht and Amsterdam to see how they achieved this, I spoke to a Dutch woman who had spent the first half of her life in Holland and the second half in Scotland. Her view was straightforward: ‘In Holland we love children. In Scotland you tolerate children.’
Surely not. Yet it is a fact that more than one Scottish child in four arrives at primary school ‘vulnerable’. Vulnerable is defined as poor in one or more of social competence, emotional maturity, language and cognitive ability or physical health and wellbeing. About half of the vulnerable children come from households with the lowest income.
Some consequences are visible; disruptive children in school and poor attainment. Others like poor physical and mental health, offending, alcohol abuse and youth unemployment are delayed. But timing should not blind us to the source of the problem.
Today there are 15,000 Scots children in various forms of social care. Glasgow Health and Social Care Partnership spends over half its budget for children’s services on looking after nearly 1,350 children and young people. The annual cost is over £95m. Of that nearly £42m is spent on 239 children and young people in care – at an average cost of £175,700. Per year, per child.
Many of these children have complex needs and are traumatised by their early lives. What does this say about us as adults and as a society?
In this book I use many examples from Scotland because that is where I have lived and worked most of my life. But what I identify as the requirements for babies’ and children’s healthy life experiences are relevant globally.
All of us are ex-children, still have our childish moments and may have our own children. Yet when it comes to understanding what happens in this early period of life we are away with the fairies. As a society we don’t appreciate the benefits, or the damage, that parenting can bring upon our youngest citizens, even before they are born. We have barely started to understand the personal burdens and economic costs of unplanned pregnancies and childhood neglect and trauma. Our personal views and the views embedded in our institutions are child blind. This has a cumulative effect on each of us and on the fabric and feel of our communities.
Scientific evidence shows that the womb is by no means the safe place for babies that we traditionally imagined. The first days and months after being born have the biggest lifetime effects. Major discoveries in biological, neurological and genetic science have shown that physical, cognitive and emotional development has its foundations very, very early in life. At conception a rapidly expanding collection of cells needs a safe and nurturing home. In the womb and after birth, growth of the brain, body and behaviour is sequential with one step being the foundation for the next stage. Skipping a stage is damaging. This critical foundation stage stretches from before conception through pregnancy till about two years of age.
My book is largely about these transformative first 1,000 days. Days that are overlooked and misunderstood yet make the biggest difference. Following on from these 1,000 days comes the second most important period in each of our lives. This stretches from two until about five years of age: the second 1,000 days.
Being a parent can be a rich joy that enhances the whole of life. Or it can be a shouting sterile battlefield. Like a house, babies need foundations and if those foundations are not right life is wobbly. Building a house and then trying to build or correct the foundations is a distressing and expensive mistake. You may not succeed.
Better parenting will tackle Scotland’s seemingly intractable problems such as violence, poor mental health, alcoholism, obesity, low productivity and inadequate school attainment. These are not different problems but the same problem expressed in different ways.
Scottish parenting is not universally awful: if we were we would not be almost halfway up the global table of child wellbeing. Much of what we individually and collectively do as parents is good, producing happy, well-adjusted children who go on to build rewarding lives and careers. But as individuals and as a society we fall well short in appreciating and acting on the benefits and significance of the first 1,000 days.
In Scotland we have some uncomfortable truths to confront but building a nation of better parents and happier children is not an impossible task. There is so much we can do to influence positive change. It is not by luck that Dutch children are the happiest and have the greatest wellbeing in the world. It is liberating to know that improving parenting is not about tilting at windmills. There are serious practical steps that we can take both as people and as a society. On our doorstep we have fantastic models and case studies of successful child-rearing support to emulate.
Being a decent parent is not that complicated. In the era before washing machines, central heating and i-this and i-that, and when money was scarce, lots of people did a good job with their children. But many children were (and are) victims of serious inter-generational problems. In turn children from such homes frequently repeat the practices of their own parents.
Improving parenting by better preparing and supporting mothers and fathers and carers is in itself the right thing to do. It also makes financial sense for the state and for us as taxpayers. Long-term analysis of data on children whom researchers have followed into adulthood in different countries shows that investing in the first and the second 1,000 days produces the best rate of return on public spend.
The financial benefits flow from reduced crime and punishment, improved health, fewer people on welfare and more people working and paying tax.
Currently Scottish public expenditure is not directed to prevention and early days. It does not therefore gain the rewards. In education, we spend most money per head at around 20 years of age on the most able people who go to university. We spend the least money on the first and second 1,000 days on babies and their most important teacher – their parents. In health we spend most money on people’s final days before death, and least on looking after new parents before, during and after conception. Our priorities and spending are topsy-turvy.
Each week 1,000 children are born in Scotland, mostly in hospitals, unlike in Holland where 90% of babies are born at home. Let’s go into the maternity ward to meet four of them. Smell the toast, dodge the helium balloons, walk round each cot and take time to observe the visiting parents, family and friends.
This first little poppet will be cared for and cherished and introduced to babycinos. Engaged friends and family surround her.
Next door is a lad who is equally loved but there are evident domestic strains. Household cash is spent before it comes in. But the mother does a good job of looking out for him and being warm and attentive.
On the surface all seems to be in order for the third baby in the ward. She comes from a good home and her elder two siblings are doing well. But this is a new life and some babies, in a seemingly unfathomable way, do not do what you expect them to do as they grow up.
May I speak now on behalf of this little chap over here, the fourth baby in the ward; born earlier and lighter in weight than the others? He may surprise us, children often do. But more likely in time he will be defiant at primary school and hard to control. At secondary school he will be a poor achiever and graduate to a record of offending and the dole. The mother loves her baby but has spent her own young life being ignored and flung about. As for the father, he is rarely at home, and when he is he can fly off the handle, drink too much and use the mother for sex. The mother’s trauma will be visited on the child. This baby boy only has one visitor.
If you could advise each of these four when they were about to be conceived, your message would be: choose your mother and father with the utmost care. If tiny babies were prudent and had enough pocket (nappy?) money they would be well advised to take out insurance against being dealt a faulty parent.
With the knowledge we have today, it is entirely possible to foresee the most likely outcomes for these wee mites. At three years of age it can be predicted with even more conviction how content each will be with their life as an adult. We can also say with some certainty where each child will end up in the competition for careers. For most children fostering, adoption, kinship care, day care and primary school come too late to improve their life chances. These interventions fail to tackle the core issue: the early relationship between the mother, father or carer and the child. Parenting needs to be right first time.
No one who becomes a parent starts off with a desire to harm his or her baby. But having a child makes you no more a decent parent than having a chess set makes you a decent chess player.
Scotland is a community of intelligent citizens who want the place they live in to be better than it is. They want all children in that ward to have a fair crack at life. What would it take, in practice, to give each baby an equal opportunity to thrive? How do other nations meet this challenge much more fully than we do? And what would it take to really make Scotland one of the best countries in which to grow up?
Cultural, institutional and economic factors rob children of the appropriate attention they need and the respect they deserve. In a shared house the dirty dishes tend to gather in the sink because it is no one’s responsibility to wash them. Universities, secondary and primary schools are only responsible for improving the young people once they come through their door. They are not charged with improving the behaviour or intellectual capacity of our community as a whole. The NHS is orientated to sorting technical health problems and steers away from the human and preventable.
Like the flatmates with dirty crockery, no single institution, local or central government has the responsibility to prepare and support parents, and so the collective benefits are squandered. ‘It is not my job.’
Some voices have advocated a shift of national resources to parenthood and early days of life, but they are outmanoeuvred and drowned out by louder voices. As yet there is no public or political clamour to prioritise child well-being in more than a rhetorical way. Priority is given to where money has been spent before, the loudest voices, and the best connected. We are not going to see a bunch of babies and toddlers demanding better parenting or meaningful support for struggling parents.
Tolerating children and running public services the way we have up till now is not going to make Scotland the best place to bring up children. It will take the next 10,20 or 30 years to change deep intergenerational patterns.
But I am confident that we can shift attitudes, behaviour and priorities. Scotland can climb that telling UNICEF league table. We shall have to wait and see whether we could ever reach the top: it’s a challenging target, to say the least.
Right from the Start: Investing in Parents and Babies, is the latest in the Postcards from Scotland series published by Carol Craig of the Glasgow-based Centre for Confidence and Well-Being. Copies are available from www.postcardsfromscotland.co.uk for £10 inc p&p.