"Our Nation's Future - Social Exclusion", York 2006
Tony Blair (Labour)
More than anything else, early intervention is crucial if we are to tackle social exclusion, Tony Blair has said.
Read the speech in full:
Our sovereign value: fairness
This lecture takes us to the wellsprings of progressive politics.
It is about our sovereign value: fairness. It is about potential never explored; talent torn-off unused, the inability to live a life free from the charity of others. The objective is timeless: we want to expand opportunities so that nobody whatever their background or circumstance should be left behind.
My thesis today is straightforward: some aspects of social exclusion are deeply intractable. The most socially excluded are very hard to reach. Their problems are multiple, entrenched and often passed down the generations.
Let me summarise my argument. I am not talking about "baby ASBOs", trying to make the state raise children, or interfering with normal family life. I am saying that where it is clear, as it very often is, at young age, that children are at risk of being brought up in a dysfunctional home where there are multiple problems, say of drug abuse or offending, then instead of waiting until the child goes off the rails, we should act early enough, with the right help, support and disciplined framework for the family, to prevent it. This is not stigmatising the child or the family. It may be the only way to save them and the wider community from the consequences of inaction.
The political and philosophical vision behind this is classic New Labour. The danger with this whole debate is that it divides into two camps that seem opposing. One says the answer is to improve the material poverty of such families. The other says that they themselves are the problem, a sort of social pathology argument. The reality is that of course material poverty for some families is indeed the root of their problem. That is why the child tax credit, the Working Family Tax Credit, the extra support for children are all absolutely crucial. But for a minority of families, their material poverty may be acute but is not necessarily linked to lack of work or income per se, but may well be the result of a multiplicity of lifestyle issues - drug or alcohol abuse, mental illness, or simply that no-one has ever bothered to offer them a way out. The answer for these families is that a rising tide of material prosperity will not necessarily raise all ships. A cash transfer, at least on its own, is not what is needed. What is needed, instead, is proper structured help, where a due sense of responsibility may be part of the mix, and at a stage early enough to make a difference.
And it is not as if there is no evidence base on which to draw. The truth is that around the world, in societies similar to our own, such social exclusion is common. There is now a wealth of empirical data to analyse. The purport of it is clear. You can detect and predict the children and families likely to go wrong. The vast majority offered help, take it. And early intervention is far more effective than the colossal expenditure of effort and resource once they have gone wrong. This is the lesson from Europe, the USA, New Zealand and many other countries.
To achieve this, we need a new approach, not one that alters all of what we have been doing up to now, but rather one that accepts the measures to tackle poverty have indeed in many, many cases, been successful; but accepts also that in some cases, with the "hardest to reach" families, with the most problems, these measures aren't enough.
It was to define the necessities of life that Seerbohm Rowntree undertook his famous survey here in York in 1899. Rowntree sought to estimate the income of all households and to compare them against a poverty line intended to capture the "minimum necessaries for the maintenance of merely physical efficiency".
Applying this severe criterion, Rowntree found that 9.9 per cent of the population of York were in primary poverty and that a further 3.2 per cent were near the line. The most immediate cause of poverty was that the chief wage-earner was 'in regular work, but at wages insufficient to maintain a moderate family in a state of physical efficiency'.
This exposed the idea of the idle poor as a fallacy. The poor were working, usually very hard, and it was inadequate wages that caused the poverty. This fact was emphasised again in the 1960s by Peter Townsend and Brian Abel-Smith's revelation that about two million people were in fact living below the National Assistance scale. For a quarter of them the problem was inadequate earnings. That is why this government, through the national minimum wage and in-work tax credits, has done more than any other to tackle this injustice.
The progress we have made is a proud part of our record. Between 1998/9 and 2004 we achieved a fall in child poverty of 23 per cent before housing costs. The number of individuals in absolute poverty has fallen since 1996/97 by 4.8 million. There are 2.4 million fewer people who live in relative poverty, after housing costs, now than there were when we came into government.
We are the fastest improving country in Europe for child poverty and are now close to the European average. The number of children in absolute poverty has halved. In this region there are 56,000 fewer children in poverty than there were in 1997 more than the total number of children in York. Nationally, families with children are on average, £1,400 a year better off and the poorest families are on average, £3,200 per year better off. Total spending on financial support for children will have gone up by over £10 billion in real terms since 1997, a rise of 72 per cent. Pensioner households are £1,500 a year better off in real terms. The poorest third of pensioner households are £2,000 a year in real terms better off.
2.5 million more people are now in work than they were in 1997. 1 million fewer people are receiving benefits. We have eradicated long-term youth unemployment. We have invested in regeneration through the national strategy for neighbourhood renewal in the 88 most deprived boroughs.
And we have acted to improve public services for the least well-off, especially early in their lives. Beveridge's stated ambition was care from cradle to grave. In fact the welfare state more or less disappeared after childbirth until it was time for primary school. We have begun the process of filling in the gap. We have made good the provision in the early years, which all the research evidence shows is the critical point in the life-course.
The Nobel economist James Heckman famously showed that the return on human capital was very high in the early years of life and diminished rapidly thereafter. And yet the emphasis in spending in British social policy had always been the opposite. Investment was negligible in the early years. It then began to grow at just about the age that diminishing returns were setting in. If policies had been devised expressly to defy the evidence they could hardly have been better. We have responded to the evidence and begun to correct the anomaly.
The Sure Start programme; the expansion of early years education, into which £17 billion has been invested during our time in government; free learning and childcare for 3 and 4 year-olds, which will be extended to an entitlement of 15 hours a week, for 38 weeks a year, by 2010; we are piloting extending this provision to 12,000 disadvantaged 2 year-olds at the moment; by 2010 there will be 3,500 Children's Centres offering education, health and parenting services all on the same site.
But it is precisely because of the success that we have had that the persistent exclusion of a small minority now stands out. About 2.5 per cent of every generation seem to be stuck in a life-time of disadvantage and amongst them are the excluded of the excluded, the deeply excluded.
Their poverty is, not just about poverty of income, but poverty of aspiration, of opportunity, of prospects of advancement. We must not in any way let up on the action we take to deal directly with child poverty. But at the same time, we have to recognise that for some families, their problems are more multiple, more deep and more pervasive than simply low income. The barriers to opportunity are about their social and human capital as much as financial. Universal services are not reaching them. And thus it follows that pre-fabricated services cannot answer to individual needs.
In social exclusion we are also talking about people who either may not want to engage with services or do not know how to. Our universal services are all predicated on the assumption that people want them and know how to get them. It is not always a safe assumption.
Agencies need incentives to co-operate. We need to liberate professionals to work ingeniously, strip away the rules, conventions and hierarchies that prevent them doing what is best in each individual case.
We need working across traditional silos of bureaucracy and government. And means of delivering that help and support which use the expertise and creativity of the voluntary sector, charities and social enterprise as much as the conventional system of the State.
This new approach involves complex and variegated decision-making. We shouldn't therefore introduce it in one go, across the board. We should test it in critical areas, where specific problems exist and build our own clear evidence base for future work.
Next week Hilary Armstrong will launch our Action Plan. We have defined four groups. They have all proved hard to reach. There has been some progress with each group - but not enough.
First, looked after children. There are approximately 61,000 children in care at any one time. They run very high risks of being unemployed, having mental health problems and becoming teenage parents. We need to be frank - we are not yet succeeding. 1 in 10 children in care get 5 good GCSEs compared to 6 out of 10 of other children. Only 6 per cent make it to higher education compared to 30 per cent of all children.
Second, families with complex problems - the Respect Task Force identified 7,500 such families. A child born into the most disadvantaged 5 per cent of families is 100 times more likely to have multiple problems at age 15 than a child from the 50 per cent best-off families. One of the biggest problems we face is parents who misuse alcohol. One in eleven children in the UK live with at least one such parent. These children have to take on more responsibility for running their family, they worry that the secret might be revealed, they often struggle at school and many start to use alcohol and drugs themselves.
Third, teenage pregnancies, of which there are 40,000 in the UK at any one time. Like looked-after children, teenage parents are more likely to end up unemployed, have mental health problems and themselves have children who have babies as teenagers. We have made some progress here - conception rates are at their lowest for 20 years.
And fourth, mental health patients. Between 125,000 and 600,000 people in Britain have a severe and enduring mental health problem. About 70,000 are on Incapacity Benefit and employment rates among the mentally ill have been falling, despite the fact that the majority are keen to work. The links with other problems are notable: half of those mis-using drug and alcohol have mental health problems.
The fact that we have yet to succeed with these groups is not for want of spending. The state spends £1.9bn acting in loco parentis for children in care. It costs about £110,000 a year to keep a child in residential care. And there is very little relationship between spending and outcomes. Families with complex problems cost between £50,000 and £250,000 each. Every teenage pregnancy costs an average of £57,900 in the first five years. A mental health bed costs £1,365 a week.
The problem is not that we are not trying, nor that the money is not being committed. It is that we need a radical revision of our methods. The Social Exclusion Plan will be guided by five principles: early intervention, systematically identifying what works, better co-ordination of the many separate agencies, personal rights and responsibilities and intolerance of poor performance.
More than anything else, early intervention is crucial. It is a commonplace that prevention is better than cure. But recent advances in our knowledge have offered the promise that we might be able to achieve it. There has been great progress in our ability to spot the risk factors associated with subsequent anti-social behaviour. We also know a lot more about how to protect people against these risks. The protective factors are not surprising - affectionate families, adequate attention from parents.
Of course prediction will never be perfect. But the combination of risk and protection means that we can now be reasonably confident that we can identify likely problems at a very early stage.
At any one time, children in care make up about 0.5 per cent of all children. But one quarter of the adult prison population has been in the children's care system at some point.
Around a third of looked-after children end up as NEETs (not in employment, education or training).
The daughter of a teenage mother is twice as likely to become a teenage mother compared with a daughter of an older mother.
Children from the 5 per cent of the most disadvantaged households are more than 100 times more likely to have multiple problems at age 15 than those from the 50 per cent of most advantaged households.
Boys with a convicted father are over three times more at risk of being convicted of a crime than those with a non-convicted father.
125,000 children have a parent in custody - and 65 per cent of children with parents in prison go on to offend.
People with no qualifications are seven times more likely to be unemployed and five times more likely to be low paid than people with higher education.
More than half of female drug users have dependent children.
41 per cent of problem drug-using parents had a child who had repeated a school year.
So we can predict. We can then, in the jargon, "intervene". Intervention can sound very sinister. Actually, in the great bulk of cases it means that extra help and support can be provided. It might mean that a more intense health-visitor programme is arranged. Or it might mean parenting classes are offered; or help with drug or alcohol abuse. Or placing families within projects like the Dundee project where the family is given help but within a proper, disciplined framework.
This is not about "blaming" anyone for what has happened. It is just about coupling social rights with social responsibilities. This distinction is as old as the debate about poverty itself. It is essentially a replay of the dispute between Helen Bosanquet and Beatrice Webb over the report of the Royal Commission on the Poor Laws in 1909. The Majority Report stressed individual agency: the Minority Report emphasised structural causes. Actually there was no need for two reports - both are true.
We then need to be clear about schemes that work and encourage the spread of good practice. We will provide a government hallmark for programmes that have proved to be effective. Commissioning of services will be strengthened. We will incentivise good practice.
We will improve Local Authority Area Agreements and look at how we can improve the sharing of information between relevant agencies. The barriers between agencies will be broken down and flexibility enhanced. Often this will require professional rivalries to be set aside and budgets to be pooled.
For example, we are pioneering this approach in relation to social care budgets. Imagine a woman who used to rely on social services to get her ready for the day but, because of shift patterns, the earliest they could get her ready for work was 11am. Now she can use her budget to get support around her working hours, enabling her to get back to work - greatly improving her self esteem and quality of life. This is made possible by a budget pooled from Council social care services; cash from the independent living fund; disabilities facilities grant and access to work grant.
We are now piloting the same approach for at-risk children. For example, Trafford are piloting a scheme where a young person's lead professional - in addition to directing the mainstream services around the child - has a budget of £200 per week per child. The funding is drawn from a budget pooled by the Local Council, PCT, Connexions and the Youth Offending team.
One 15 year old boy in Trafford had become disaffected, was truanting from school and drifting into offending. The lead practitioner used the budget to fund a tailored joint programme between a local college, employer and school. The programme combined basic skills training with work experience, engaging the boy's interest and getting him out of trouble.
Individual budgets allow people to customise the care to their own needs. We have a series of pilots to place the budget in the hands of a lead professional, acting on behalf of the citizen. These will be extended.
Again for example, midwives and health visitors already routinely screen and visit new born children - though at present the middle classes tend to ask for, and therefore get, more follow-up help.
Under the new arrangements, health visitors and midwives will seek to identify those most at risk, most simply by asking young parents or parents to be about difficulties they may be having, or about their own background. This can be supplemented by information from other public services, where we need to break down barriers to sharing data.
For those who are identified at risk, the health visitor or Children's Centre worker will engage in a more detailed assessment to clarify and confirm the level of need. For those identified as being most at risk (around 10-15 per cent of all first born), a two-year home visiting programme will be put in place.
Finally, we need a serious drive to root out poor performance. When we first came into government we acted quickly and decisively against unacceptable performance in literacy and numeracy. We need the same decisive, unsentimental focus on social exclusion.
These will be sent out in the Local Government White Paper later this year.
For at-risk children, we will also promote an expansion of budget-holding lead professionals for children in care. This will be the focus of the Green Paper this autumn.
We will focus efforts on teenage pregnancy on those areas where rates are rising against the overall downward trend with improved social and relationships education. We will begin an expanded media campaign and offer better access to contraceptives, where appropriate.
We will test different approaches to tackling mental health and conduct disorders in childhood, including intensive home-based policies and foster care. We will need to be a lot more ambitious, too, on parenting support and training.
For adults, we will test alternative approaches to improving outcomes for people with chaotic lives and multiple needs, and will implement a national individual placement and support approach for adults with moderate and severe mental health problems. Later this year we will publish the Leitch review that will address the poor prospects of those with few qualifications or skills.
This has been a poetic vision articulated in the most technical prose. The vocabulary of public service reform is not designed to lift the heart. But we should not lose sight of the vision we have, nor of the nature of the task we face. It applies directly to social exclusion but also goes wider than that.
The vision is opportunity and freedom for all.
Let me end where I started. There are people who will shout about the "nanny state", who will tell us it's none of "our business", who will say more reasonably that if you try to predict, you stigmatise. But today's society doesn't work like this. Yes, there are areas in which the State, or the community, no longer has a role or, if it does have one, it is a role that is completely different. It is not for the State to tell people that they cannot choose a different lifestyle, for example in issues to do with sexuality. All that has changed and rightly. But where children are involved and are in danger of harm or where people are a risk to themselves or others, it is our duty not to stand aside. Their fate is our business.
The alternative is that these children, these adults, these families are left behind, abandoned, when they need to be helped.
Yesterday, meeting children who are or were in care, two things struck me forcibly. The first was how varied their problems were and thus how individualised the response needs to be. But the second thing was their ability, their talent, the confidence they had been given through being helped, which was allowing them to develop into the type of human beings they have the potential to be. This is the ultimate point. Without help, they would have continued to suffer. With it, they can be fulfilled. Bringing them with us or leaving them behind: that is the choice and in the end, there is only one way for those of us who believe in progress. That's the way we will take.