FABIAN POLICY REPORT

PEOPLE NOT PROBLEMS Politicians respond to five experiences of severe and multiple disadvantage

Edited by Ben Cooper and Olivia Bailey, with contributions from Labour and Conservative MPs legacies of different eras of political thinking. We have grown so used to their coexistence that we scarcely FOREWORD notice the incoherence they represent. This doesn’t mean that one worldview should determine the whole response. Messiness in systems is unavoidable, and a diversity of approaches is usually healthy. What lets people facing extreme disadvantage down is the lack of any attempt to make the whole add up to more than the Lankelly Chase is a charitable foundation with a sum of the parts. mission to change the systems that perpetuate ‘severe By Andy Cook and Andrew Harrop and multiple disadvantage’. By this, we mean the way At Lankelly Chase, we see many outstanding initiatives social harms cluster in the lives of some people and the focused on severe and multiple disadvantage pursued eople have potential to be developed, they are not means building on what they do have, not pointing out contribution various systems make to that. by gifted people. But there is rarely any dialogue Pproblems to be solved. what they don’t. between them on what an effective overall system As politicians, policy-makers and governments, we too William speaks emotionally of how his family supported We come to this work with urgency, hearing as we do might look like that isn’t based exclusively on their own often look at a person’s situation and come up with strategies him in his darkest days; Rebecca talks about how an acting every day about the reality of life (and death) for people ideas. We all, not least politicians, feel that we should to fix it. Too rarely do we listen - really listen - to their stories, part as a dancer in a play transformed her confidence; and facing severe and multiple disadvantage. A sense of be able to deliver clear and convincing answers to lives and experiences and form policy based on a true Lucy talks about her ambitions for her education and her urgency, however, is not the same as understanding complex problems. No one is free to admit that we don’t understanding of the complexity of disadvantage and the future. These are building blocks for better futures. what to do. These essays reveal a level of political have the whole solution, that each of us is capable of tools that people have to overcome it. It is these five stories that form the foundations for the 10 interest in severe and multiple disadvantage that is an believing quite inconsistent things about the same issue, That’s why this report starts with five stories: five people essays by politicians that follow, ensuring that their topics, encouraging basis for a renewed focus on the issue. and that perhaps the answers lie between our different talking us through what multiple disadvantage really looks like. ideas, and policy proposals draw on real lived experience. The challenge is that the various actions proposed, perspectives. As they do so, several things become immediately clear. We send our enormous thanks to the 10 MPs who have while they would undoubtedly make a difference, draw First, the problems of severe multiple disadvantage start contributed their thoughts to this publication. There are on worldviews that can be hard to reconcile. This is Lankelly Chase is increasingly convinced that the young and demand early intervention. Take Lucy, who was obvious differences in approaches, from different authors and not only attributable to the party political positions of outcomes we seek rely on the healthy functioning of placed with 19 foster families before she was eight years old; or from different parties, which you can read for yourself. But the authors, it also reflects longstanding tensions found systems rather than on the individual parts. No one is Keith who had left education and served his first prison sentence there are also areas of great agreement. across the political spectrum about what causes severe served well by people working in defensive silos, no by age 15; or William who grew up in an abusive household. In an age of increasingly polarised public debate it is and multiple disadvantage and how change happens. matter how perfectly evidenced the silo. Achieving better By the time we are looking at healthcare interventions, heartening not only that groups of Labour and Conservative outcomes in the future is going to require us all to get welfare support, and the criminal justice system we are MPs are happy to write together in the same report, but that Among these tensions are those between authors who better at attending to the health of the whole. As this already years too late. for all of the political disagreements they have, there are also place a central importance on place, communities publication demonstrates, this includes working with the Second, the stories highlight that governments may work areas around which they can all rally. and trusting relationships and others who highlight the inevitability of often conflicting ideas. in silos but people do not. Governments may deal with mental It is good to see consensus around early intervention, science underpinning,say, early years’ interventions. health, education, and disability through several different joined-up services and agile responses to complex problems. Between authors who advocate a strong national We may not think that all of the authors here have got departments. But they all factor into the single daily struggle We hope that you enjoy reading this report as much as focus and others who believe in ground-up responses. it right, but if we recognise that each one might hold a of children like Louise, growing up in difficult circumstances. we enjoyed collating it as a joint initiative between our two Between authors who see well-funded and joined-up small and necessary proportion of the truth that might When public services fail to work together, it’s not simply think tanks. But more than that, we hope that within its pages public services as the solution, others who want a new allow a more hopeful conversation to emerge. Where that people fall through the cracks, it is that the support agencies politicians, policy-makers and governments of any colour compact between state and citizen and others who that takes us to is the need for trusted spaces for dialogue provide cannot relate to real life. may find ideas that can truly support and empower those continue to believe in a greater role for the private and between very different actors, including those with lived And third, we see that everybody has assets - strengths most disadvantaged in society to reach their full potential. voluntary sector. And between authors who emphasise experience of severe and multiple disadvantage. Where you can build on. Too often our services do things to people, Andy Cook is chief executive of the Centre for Social Justice the role of strong families and others who emphasise people can identify their contribution to the whole, rather leaving them powerless in their own lives. Enabling people and Andrew Harrop is general secretary of the Fabian Society. structural economic factors. than trying to define it on their own terms. It also takes us to the skills and tools needed to work with complexity. In the UK, we have care and support systems made up In other words, it takes us towards a more 21st century of a patchwork of ideas, initiatives and policies that are approach to age-old problems. CONTENTS

4 Introduction 20 Roots, communities, and homes 30 The ladder of opportunity Michael Tomlinson MP Robert Halfon MP 7 In real life 23 People-centred services 33 Joining up support A Fabian Society report Like all publications of the Fabian Society, Jointly published with: 12 Every child matters General secretary Andrew Harrop this report represents not the collective Jim McMahon MP Thangam Debbonaire MP Olivia Bailey Lucy Powell MP Deputy general secretary views of the society, but only the views of 26 Results, not structures 36 Lifting the stigma Report editors Ben Cooper & Olivia Bailey the individual writers. The responsibility 16 The first 1,001 days Editorial director Kate Murray of the society is limited to approving its John Redwood MP Johnny Mercer MP Assistant editor Vanesha Singh publications as worthy of consideration Maria Caulfield MP within the labour movement. 28 Investing in work 39 Endnotes 18 In the right place Cover image © Shutterstock Stephen Timms MP First published in October 2019 Lisa Nandy MP

2 / Fabian Policy Report 3 / People not problems THE FIVE CHALLENGES TO POLICY MAKERS

Challenge one: Intervene early to give every child the best We asked politicians to consider how public services can start in life be reformed to ensure that individuals are treated well and Most of the people in our case studies set out on a path empowered by their interactions with the state. towards severe and multiple disadvantage at a very young Labour response: Jim McMahon MP argues we urgently age. All five had adverse experiences during childhood that need better integration of public services so that we can help contributed to the challenges they faced later in life. These the most vulnerable. Introduction range from abuse and trauma through to falling in with “a Conservative response: John Redwood MP writes that This report sets out the real-life challenges of bad group of friends”. Rebecca identifies her childhood as the public, private and third sector must work together to the “critical juncture” in her life. achieve results. those facing severe and multiple disadvantage We asked politicians to suggest how better childhood and asks policymakers to respond, as Olivia intervention can prevent future experiences of severe and Challenge four: Provide appropriate help to gain skills and get into work Bailey and Ben Cooper explain multiple disadvantage; with a focus on the importance of family and stability, the care system, and experience of Lucy’s ambition is to become an archaeologist. She wants to school and education. go to university, and to show that she can be trusted to have Labour response: Lucy Powell MP argues that we need a her daughter back. Rebecca’s dream once she leaves prison is new national mission to improve the life chances of our most to “make my family proud. Get a job. Have money”. People vulnerable children. experiencing severe and multiple disadvantage are ambitious his report is about the tens of thou- have grappled with the root causes of Conservative response: Maria Caulfield MP argues that for themselves, want to develop their skills and often want to Tsands of people who face multiple poverty and unemployment, violence THE CASE STUDIES government must focus on a child’s first 1001 days, believing work. But the challenge ahead of them looks insurmountable complex problems such as homeless- and trauma, family breakdown and in every child’s potential. and there is very little support available. Where this help is ness, drug and alcohol misuse, experi- neglect. While some interventions have Lucy: Fabian researchers met Lucy provided it can be transformative. We just have to look at ence of the criminal justice system, had success, the problem today is in near the sea where she is currently Challenge two: The importance of relationships and Keith’s example - Recycling Lives gave him a chance at a job, serious mental health problems, and many ways worse than it has ever been. living. She has experience of the community and he now has “the second chance he always wanted”. cycles of violence, abuse or trauma. Austerity has contributed to an increase care system, homelessness and The experiences of Lucy, Rebecca, Keith, Louise and William We asked politicians to consider what support is needed These problems and experiences coin- in child poverty, rough sleeping and mental health difficulties. show how critical relationships and community are for for people experiencing severe and multiple disadvantage cide with each other and complicate drug deaths. Stretched public services recovery. Lucy’s example – being forced to move numerous to access education and work, including possible reform to the ability of public services to provide are struggling to provide the necessary Rebecca: Fabian researchers met times and never given the chance to lay down roots – is a stark social security. support. Too many people fall through level of help, with charitable provision Rebecca in prison shortly before reminder of the importance of belonging. Keith’s example Labour response: Stephen Timms MP argues that to enable the gaps between different types of help failing to fill the gaps. she was due to be released. She shows the significance of the friendship and support offered people to work and learn, the state must invest, embrace volun- or have their problems exacerbated by This report centres on the experi- has experienced severe domestic by a charity at the prison gates in his journey to turning his tary provision and enable decisions to be taken at a local level. ill-suited support from ill-equipped ences of five people with experience violence, drug addiction and life around. Conservative response: Robert Halfon MP writes that eve- public services. of severe and multiple disadvantage: has served a number of prison We asked politicians to consider the importance of stabil- ryone in our society must be given the means to learn, grow Governments, service providers, Lucy, Rebecca, Keith, Louise, and sentences. ity in accommodation, the significance of community and and thrive. campaigners and charities have all William. Fabian Society and Centre for roots, and the role of personal support. adopted different phrases to describe Social Justice researchers spent time CSJ researchers met Keith Keith: Labour response: Lisa Nandy MP argues that places matter Challenge five: Support good mental health this challenge: ‘complex needs’, ‘mul- with each person and - while we’ve through the charity Recycling because they build the communities and relationships that Mental health is a key factor across the case studies, with tiple needs’, ‘deep, chronic or extreme changed key details to protect their Lives. Keith has spent much of are so important in times of crisis. frequent reference to long waiting lists and insufficient social exclusion’, or ‘severe and multiple anonymity - the opening essays in this his life in prison and with a drug Conservative response: Michael Tomlinson MP suggests gov- support. Experience of abuse and trauma is also disadvantage’. The latter is the term this report tell their stories. The clear theme addiction. He now has a job and ernment must support families, invigorate communities and commonplace, including harrowing instances of sustained report adopts. running throughout is the failure of his own home. give individuals greater security and control over their home. domestic violence and emotional neglect in childhood. Severe and multiple disadvantage is public services to provide effective and We asked politicians to consider how mental health inter- i defined by Lankelly Chase , a founda- appropriate support. Louise: CSJ researchers met Challenge three: Public services need to work better acts with domestic violence, substance abuse and the criminal tion that campaigns on these issues and The experiences of Lucy, Rebecca, Louise near her home. She has together and build trust justice system, as well as suggesting ways to improve access the funding partner for this report, as Keith, Louise and William are instructive experience of serious mental health Public services too often work in silos, unable to collaborate to mental health support. describing the ‘interlocking nature of for policymakers, and in the second half problems and alcohol addiction. or coordinate help effectively. Homelessness is dealt by Thangam Debbonaire MP focuses on do- ii Labour response: [severe] social harms’. The foundation of this report we give politicians a chance one service, substance abuse by another – and the different mestic violence, and argues that the interaction of problems says the term helps to avoid focusing on to respond. The Fabian Society and the William: CSJ researchers teams don’t do enough to join their services together. Public makes it harder for services to be effective – but we must specific needs and implying that the chal- Centre for Social Justice asked one La- met William through the Fife services also need to do more to build trust, with the case tackle these complex situations head-on. lenges people face originate from their bour and one Conservative MP to write Employment Access Trust. William studies showing that too many services overpromise, under Conservative response: Johnny Mercer MP writes that men- own personal characteristics rather than an essay in response to five public policy suffered childhood abuse which deliver and let people down. As Lucy explains, “loads tal health can exacerbate severe and multiple disadvantage, being caused by systemic disadvantage. challenges which emerged from the case ultimately resulted in a mental of people just don’t really listen at all [and are] just very and argues we must fight for better mental health services. The challenge of systematic and studies. The five challenges and the MPs’ health crisis. dismissive of what you have to say”. interlocking disadvantage is not new. responses are summarised in the box on Successive generations of policymakers the next page.

4 / Fabian Policy Report 5 / People not problems In real life For this report, we spoke to people facing severe life challenges about their experiences - and how they might best be supported

LUCY’S STORY one toilet, and one shared bath per floor. determined to prove that she is capable Lucy’s room was ‘tiny’ with broken of having her back. Fabian Society researchers met with Lucy in a windows and ‘pigeons [who] used to Lucy is very clear about the help she seaside location with her support worker from literally come in and wake me up in my needs. Explaining that she doesn’t ‘do Fulfilling Lives, a programme that works to room’. While pregnant, Lucy stayed in very well’ in shared environments, which ensure services are more tailored and more a hostel where ‘the woman in the unit can cause her to panic or become angry, helpful for people with complex needs. opposite me was selling and smoking Lucy would like anger management As a child, Lucy craved stability. smack and crack [heroin and cocaine]. classes or cognitive behavioural therapy. But her childhood was defined by the © flickr/David Jones Eventually, Lucy was forced to move 100 Lucy told us she’d never been taught opposite: she was placed with 19 foster miles away to live with her new baby in how to contain her anger: “If you haven’t The essays from Labour and Conserva- Second, there is agreement that public exclusions, arguing that intervention families before she was eight years old. an area she knew little about. She said shown people ways to control that tive MPs underline clear differences in services need to become more responsive to stop exclusions would help prevent It was ‘inhumane’, Lucy described it, ‘to there was ‘no support, no anything.’ anger, they’re not going to know.” But political approach. We already know that and agile in the way that they support instances of multiple disadvantage uproot somebody so many times’. Her accessing the support you know you Conservatives tend to focus on the role people with severe and multiple disad- later in life. Johnny Mercer calls for early childhood, in her own words, ‘was just want is difficult, Lucy argues, “when of charity and family, while Labour MPs vantage. Labour MPs point to the very intervention on mental health, pointing lots of moving, and lots of people’. ‘Social services you don’t know what you’re doing, and are more focused on the role of the state. real damage that austerity has inflicted out that early help and support could When she was eventually placed in a you don’t know any guidelines, and you Readers will no doubt disagree with some on public services. But they also believe stop multiple disadvantage developing children’s home, Lucy would climb out literally packed can’t contact the relevant people. It’s of the proposals and approaches. Some that reform, not just more money, is in the future. Jim McMahon argues that through the windows to spend time with my bags, gave me very tricky”. may think that the ideas proposed are necessary to improve the support they people shouldn’t have to wait to get the her friends. She was ‘really naughty’ at When asked how services could be insufficiently bold to address the scale of provide. Meanwhile John Redwood ac- help they need – and that earlier support school, she says now. She was excluded some food vouchers different, Lucy prioritised mental health the challenge. But the essays also give us cepts that public services are ‘letting too will also save the state money. from most schools and did not complete care. It is currently far too complicated, cause for optimism, revealing clear areas many people down’ and argues that the Too many people who are living with any GCSEs. and left me’ Lucy argued, to access support if you of consensus on which policy change can most vulnerable should be at the front of severe and multiple disadvantage are be- Lucy has struggled to access the help have a mental health problem, because be built. our mind when considering reform. ing let down. Public services are siloed, she needs. Although she was able to stay With a mental health problem and a “you need so many bloody referrals”. One significant area of agreement – and There is some agreement too on children aren’t getting a fair chance, and in care for longer than usual, leaving child, Lucy needed safety, security, and It is easier to access support if you are perhaps a surprising one – is the shared be- the role of voluntary provision. John people are being denied the opportunity at 21 rather than 18, Lucy left without help – ‘a lot of help, because I was doing overdosing than it is if you are struggling lief that the significant causes of severe and Redwood’s enthusiasm for an increased to lay down roots. Politicians from across the necessary support around her. As it all on my own’. She had no family to with your mental health, Lucy tells us. multiple disadvantage are structural and role for private, voluntary and charitable the divide are always going to have she describes it, social services ‘literally provide this, and her friends were facing Despite an unimaginably tough not a consequence of personal failure. MPs provision will be met with caution on the disagreements, but on this issue there is packed my bags, gave me some food challenges with drugs and alcohol. upbringing and ‘just a continuous cycle from across the divide write of ‘entrenched left. But Stephen Timms’ approach, which also a substantial degree of consensus. vouchers, and left me near the local Sounding frustrated, Lucy described of being let down by various services’, disadvantage’, ‘the cycle of deprivation’ combines a strong state with a willingness A policy agenda that prioritises early church with no help, nothing’. how social services treated her while Lucy tells us about her dream: to be an and the impact of trauma and hardship. to increase collaboration with voluntary intervention, improves the coordination In adulthood, Lucy found her she was pregnant. They offered ‘loads archaeologist and present a programme Stephen Timms notes the “resilience of the groups, might get a warmer hearing. of public services, supports the volun- childhood experiences repeating of help, help for my mental health, help like Time Team. Her desire to go to human spirit and the capacity of individu- There is also consensus on the im- tary sector and challenges the structural themselves. Since leaving care four years with housing, all sorts’, but none of it university is clear, and her plan to do als to overcome seemingly insuperable portance of early intervention. Robert injustices in our country has the potential ago Lucy told us she has stayed in eight ever materialised. ‘Loads of people just so is mapped out: she wants to do her odds”. It is welcome to see politicians ac- Halfon rails against the ‘social injustices’ to generate cooperation across a divided different hostels or homes and had three don’t really listen at all [and are] just very GCSEs next year and then study an cept that it is the root causes of disad- which leave disadvantaged children house. If politicians who have much they periods of homelessness. dismissive of what you say’. access course at university, ideally vantage that must be tackled, rather than behind their peers, and calls for greater can agree on can work together, we can The first hostel she moved to after Lucy’s daughter, who has recently Canterbury. She is determined not to let trying to point the finger of blame at those investment in early years. He also calls transform the lives of people like Lucy, leaving care was ‘a really, really, really turned one, has now been taken into her past decide her future and to get her who have complex needs. for action on the soaring rate of school Rebecca, Keith, Louise and William. badly run hostel’ with 20 to 30 people, care. Lucy has very limited contact but is daughter back.

6 / Fabian Policy Report 7 / People not problems REBECCA’S STORY some of the events that night: ‘he beat behavioural therapy has been extremely me …and the person who lived with us.’ helpful, Rebecca told us. An acting part Fabian Society researchers met with Rebecca After that night, and the horrific injuries as a dancer in a play, performed to in prison as she was preparing to complete she sustained, Rebecca took steps to ‘get paying attendees, has transformed her her sentence. This meeting was facilitated by away from him’, ensuring he was found confidence. Fulfilling Lives who were helping Rebecca guilty of grievous bodily harm with Looking back over her life, Rebecca prepare for life after prison. intent and sentenced to prison. identified her childhood as a critical Rebecca was only 13 when she met juncture. Better education on drugs a much older man. They met at a time When Rebecca’s would have helped and made a when Rebecca was largely avoiding difference to her life, Rebecca argued, school, getting into fights so she could baby boy was born, because she ‘had no real knowledge’ of ‘be excluded’. He introduced Rebecca to the dangers. Rebecca also felt let down heroin at a party, eventually encouraging in the maternity by social services, saying that she had her to shoplift to fund their drug habits. wing of prison, he lost trust in them. Explaining she said: She has been in a cycle of being arrested “You ask them something and it’s ‘oh and imprisoned ever since. was addicted yeah, I’ll do it’ but it doesn’t get done.” Rebecca managed to leave this first Rebecca was released from prison abusive relationship, but soon entered from birth just before Christmas 2018. After 17 another. Her next partner was also a years of sofa surfing, staying with drug drug user and, over a period of 16 years, Rebecca suffers from poor physical users in crack houses, and living on the subjected Rebecca to severe domestic and mental health, a consequence of streets, Rebecca will be living in her own violence. He was arrested a couple of years of drug use and abuse. She has accommodation. With her sister and times, but Rebecca never talked about suffered pneumonia twice, had nine auntie contributing to the rent, Rebecca it to the police. Early in the relationship, blood clots, leg ulcers, anxiety, paranoia, believes this offers the best chance of a aged 15, Rebecca fell pregnant. By the and depression. Rebecca found it hard to stable life. Her hopes for the future are © flickr/Gareth Judge time she had a baby girl, her partner was get help, especially for her mental health. simple: “Be drug free, sort my mental Louise from noticing the warning signs two weeks, a treatment centre in London. in prison and seemingly out of her life. To do an assessment, she had to be WILLIAM’S STORY health out, keep my accommodation … that something was wrong, eventually She agreed. It changed her life. With support from her nan, she was able clean and struggled to be. Failing to get see my children. Make my family proud. leading to a diagnosis of post-traumatic Centre for Social Justice researchers met to ‘get clean’, ‘get a flat’, and ‘be happy’. support, especially for the pain she was Get a job. Have money. Just be happy.” stress disorder (PTSD) and clinical William through Fife Employment Access But soon after his release, he entered in, resulted in more drug use: “I was just depression. She said, ‘the work keeps Eventually Trust, a charity based in Glenrothes. Rebecca’s life once again. In her words, in so much pain … that I was using more LOUISE’S STORY you pre-occupied … I didn’t notice’. William is in his forties, living happily ‘I knew that he was using [heroin] in thinking it was helping the pain go away Louise quickly descended into a darker Louise began in Fife with his wife and three children. the flat and I put up with it for a little but I was making it worse”. Centre for Social Justice researchers period of her life. Her marriage was He works for the Individual Placement and then it just made me start craving Rebecca’s latest sentence – of more met Louise through 1NE, a charity based to engage and unhappy with routinely hostile encounters. Support (IPS) service, in conjunction with again so I got back on the heroin’. Her than 12 months – is the longest she in London. Her drinking escalated. Her mental health the community Fife Employment Access Trust (FEAT), life became ‘chaotic again’. Rebecca’s has served. Shorter prison sentences, Three decades ago, Louise was at declined. Eventually, unable to cope and and very much enjoys his job. Life, at the daughter was frequently left in the care Rebecca claims, did not provide her school. An unusually tall, slight and in deep desperation, she stabbed herself in helped her moment, is good for William but things of Rebecca’s nan, until she had a stroke with the adequate opportunities for the rather timid teenager, she was bullied her leg, severing an artery. Losing custody have not always been that way. and couldn’t look after her any longer. training and education that might have relentlessly. But away from school, her live life both in of her children. Louise’s lost her desire William describes his early childhood Social services stepped in and Rebecca’s prevented her from reoffending. “When family life appeared to be everything to cope and drinking became her terrible as difficult. He regularly witnessed his daughter was taken in to care and you’re in here for a short amount of time one would hope for: “My dad always and out of the refuge. She explained: “I hated what I mother suffering physical and verbal subsequently adopted. nothing really gets done … You’ve got worked and the family would take had done and I hated the drink.” But she treatment abuse at the hands of his father. The These circumstances led Rebecca to to wait. You’ve got to do five days ‘lay holidays in the summer. There was no added: “I drank to black out the hurt I felt break-up of his parents led to him living have a breakdown, and she was sectioned down’ it’s called” – an ‘induction’ into abuse at home,” Louise said. about being drunk all the time.” centre with his mother for the remainder of his for four weeks. As a coping mechanism, prison life – before you are considered for However, her mother suffered from Louise’s parents encouraged her to childhood. Although this was a more she smoked crack cocaine. When her support or training.” For someone like depression and Louise felt only she seek help and she went to rehabilitation. For the first six weeks Louise said stable home life it was not a loving one baby boy was born, in the maternity wing Rebecca, who has multiple experiences of could provide the emotional support She left treatment after months of sobriety little, she understood little. Eventually, – he was very much made to feel like a of prison, he was addicted from birth. He prison life, this is effectively wasted time. her mother desperately needed. For but, with little in the way of after care, she began to engage and the community stepchild by his stepfather as opposed to was adopted by Rebecca’s sister, and she Rebecca argued that avoiding lengthy this reason, she felt unable to talk about she was drunk within two weeks. High helped her live life both in and out of the a loved member of the family. can only see him at her sister’s discretion. inductions for those in and out of prison what was happening to her at school. strength cider costing as little as £2.50 treatment centre. William did not only witness abuse as Rebecca continued to experience would help prisoners access support The stress built up. Louise developed and cheap wine blurred out the months Today, more than five years after a child. He suffered from it too. Through horrific domestic violence. It culminated quicker, encouraging rehabilitation. alopecia and started to self-harm. that followed. Looking back, Louise said her last drink and first day at 1NE, his childhood he was subjected to seri- one night. Still troubled by the extent of This longer sentence, however, was By Louise’s twenties, things she was “dead. I was just a body. I can’t Louise is sober and ambitious about ous and sustained abuse by his brother. the violence perpetuated, Rebecca said different for Rebecca. She was able to appeared to be easier. She worked in believe I was that person now”. her future. She has her kids back and His abuser died before any action could “what I witnessed that night and what I get a job in the kitchen, providing useful the City, with the boozy culture of Ready to give up completely, Louise’s she is helping children to understand be taken against him for the crimes he suffered … I can’t explain it, it was bad”. skills for after her release. A course after-work socials going unquestioned. local council offered to pay for her detox the need to talk about their mental committed, which provided no solace But she managed to briefly describe on anger management and cognitive However, work and socials prevented on one condition: that she attend 1NE for health and to disclose bullying. to him. Whilst he was relieved that the

8 / Fabian Policy Report 9 / People not problems abuse had stopped he was unable to get his ability to function well – significant of his wife and children throughout this sive about attending, the organisation’s and so eventually he started just copying spice. Keith didn’t understand how the closure he needed. short-term memory loss and an inability period. He fondly recalls how his wife in ‘Employ your mind’ course helped him them. He got a buzz from driving. dangerous this addiction was. He would Despite this, William achieved well at to perform even the most basic tasks and particular took on everything to ensure the think about the future for the first time in His group of mates would club be walking around the prison, thinking school and college and ended up work- a pronounced loss of confidence and family was able to keep things together. years. His outlook changed and he was together any money they had and buy he looked OK, unaware of how badly ing as a manager at a leading insurance self-esteem. With support, William turned his life able to be more optimistic about what the old bangers to drive around the block. spice had damaged his body. company. It was at work however, that around. Occupational therapists helped future could hold. Having been out of Back then, the police used to just give Aged 41, Keith realised it was time life changed for him, an innocent con- William regain his ability to do, as he work for five years, after just six months out tickets for driving offences. There to sort his life out. He could not keep versation with a colleague triggered off During puts it ‘basic things around the home’ with FEAT, and following a further refer- was not any real deterrent: you’d give in returning to prison, something had all that had happened to him as a child William’s such as cooking, and regain his confi- ral to IPS William was able to re-enter your documents, get a ticket, and move to change. It was at this point that he leading to a serious breakdown. Despite dence to re-engage with his community into employment. along. So, the first time that Keith was learned about Recycling Lives. Recycling having the right policies and procedures hardest – helping him to do things like visit the William’s journey, particularly over sentenced for driving whilst disqualified Lives is a total waste management in place his employer let him down: in shops for the first time in a long time. the five years from breakdown to recov- he ‘shit himself’. company, based in Preston. It provides place of support came a lack of under- times he was Accessing other services was not always ery, has highlighted many things that He was sentenced for six months at a multitude of rehabilitation projects standing and pressure – resulting in the as easy. Eye movement desensitisation he believes need to change. Crucially, Hindley young offenders’institution. for offenders, offering prisoners a real company terminating his employment hospitalised and reprocessing (EMDR) which is rec- he feels that there needs to be better and When he was released, he went back opportunity for employment. At present, through ill-health retirement. for over a year ognised as particularly useful to people faster access to services, and that funding home and his parents tried to lecture they operate academies in 11 prisons, Left unable to work, and eventually with PTSD was only available privately promised by government needs to reach him. His dad wanted to give him a ‘kick provide a rehabilitation project for ex- diagnosed with complex PTSD William and had to wait and art therapy, which proved incred- the frontline, often charitable services, up the arse’. His mum tried to ground offenders and homeless people, and run speaks of the void of not having work ibly useful to him, was taken away when that take a personalised approach to the him. It did not change much. a food redistribution centre to tackle food in his life. During his hardest times he over a year for a the only practitioner in Fife relocated to people they support to make a real differ- Things only got worse. At 16, Keith waste and poverty. was hospitalised for three months and referral for Glasgow. He also felt that the emphasis ence to their lives. had started to steal cars. There were two Up until this point, Keith hadn’t had had to wait over a year for a referral of the services he was accessing was too William remains positive about the lads on the estate who would sell them much support. When he was younger, for psychological support. Medication psychological focused on looking at the past and going future, and although he fears darker days on, it was an easy way of making decent the mentality in prison was very much that he was prescribed helped to numb over old ground. It helped to talk about may lie ahead, he has now built up the money. To get money, he’d either steal or one of keeping your head down and the pain he was feeling but left him dis- support it, but he wanted to move on with his life. resilience and the tools to deal with them. ask friends if they had any work going getting on with it. These days, Keith engaged and distant, unable to support An occupational therapist’s referral dealing drugs. thinks the system is getting better. There his family in any way. He speaks of the During these darkest of days William to FEAT helped significantly accelerate KEITH’S STORY The cycle continued to repeat itself. are more opportunities to get help if impact his poor mental health had on speaks of the immense love and support William’s recovery. Initially apprehen- Centre for Social Justice researchers met Keith would be sentenced, go to prison, you want it. Prison is far from perfect, Keith through the Recycling Lives company, bump into friends on the wings, be given but there seems to have been a gradual based in Preston. his discharge grant and return home realisation concerning the importance of Keith has been in and out of prison to start the whole process again. His rehabilitation. since age 15. He reckons that has been in sentences got lengthier after he started Keith put himself forward for a place at 12 different prisons and has committed a dealing drugs. One time he was convicted a Recycling Lives Academy whilst serving total of 152 driving offences. for dealing and sentenced for two years a sentence at HMP Lancaster Farm. Born and raised in Liverpool, Keith and eight months. After serving his time After working with Recycling Lives for has lived with his mum for most of his on the inside, he’d returned back to 11 months throughout his sentence, Keith life. Keith’s dad left home when he was Liverpool only to be sentenced again for was offered a place at their residential. just five years old. The two never really another drug offence three weeks after This time, upon release, Keith wasn’t had a good relationship, they were leaving the prison gates. just sent away with the bare minimum always fighting, but Keith has always funding for a train ticket. He was picked been close to his mum: “My mum means up by Barry, a Recycling Lives employee, the world to me.” Aged 41, who took him straight to his new home. When he was young, he fell in with a Keith realised This was his turning point. If there had bad group of friends. They all showed not been that support at the gate, Keith very little interest in school. By the time it was time to thinks it would have been all too easy to he was 15, Keith had left education. He slip back into old habits. But something didn’t have any qualifications to show. sort his life out. was different this time. He had people He admits that he didn’t really try hard. who could support him. Most days, he would go in, get the mark He could not Starting out in the canteen, Keith soon for attending, and leave with his friends. keep returning moved on to the food redistribution plant His teachers would try and chase him, and gradually worked his way up to but it did not change anything. to prison working on site at the recycling company. He just wanted to be like the older He finally has a permanent job where kids on his estate. They’d drive around He had smoked weed on the outside he gets to drive forklifts day in day out. the block with all of the younger kids but, after being locked up with an addict He has moved out of his mum’s home looking on in admiration. They were his in Walton, he began to use heroin. It was and finally has his own place. This is the role models. There wasn’t much else to do whilst at Kirkham that he discovered second chance he really wanted. © flickr/Justin Berman

10 / Fabian Policy Report 11 / People not problems EARLY INTERVENTION intervention funding – with devastating be rejuvenated ensuring that parents are impact is lifelong and deeply damaging. consequences for our future. The Treasury supported through pregnancy and the Exposure to the criminal justice system has wielded the austerity axe for almost a critical 1,001 days between conception for already vulnerable children can have decade with little regard for where it falls, and the age of two, supporting both further disastrous consequences for their Every child creating a false economy where universal parents to bond positively with their life chances. services and non-statutory support are cut children and each other to ensure a stable Doing the right thing for these back or dropped altogether. Innovative family life from the very beginning. children will ultimately save money. It local authority-funded programmes have is a staggering 63 times more expensive matters been early casualties of the slash and burn Life lessons: The care system and the per year to place a child in a residential approach towards early intervention challenge of social work trying to home than it is with foster parent which We need a new national mission to improve the life chances funding since 2010. change things in isolation in itself is much more costly than timely of our most vulnerable children, writes Lucy Powell Government departments that would Our children’s social care system is on successful interventions to prevent benefit the most from an ‘early help the verge of crisis. families breaking down in the first place. state’ don’t pay into the system at all. Unsustainable funding pressures, The Department for Work and Pensions, accompanied by increasing demand, the Home Office, and the Ministry of are stretching services and increasing strain We consistently Justice would all benefit hugely from a on social care leaders and social workers.iv fail children reduction in the number of adults unable At the same time, targeted or specialist to grasp opportunities, or steer clear of a services like mental health, drug and alcohol Lucy Powell is the Labour MP in care. A third life of crime. Yet high-cost interventions services and homelessness provision are all for Manchester Central later down the line are the norm. seeing their budgets reduced. of children in With the cost of a prison place for a When we look at the experiences of n the experiences of Lucy, Rebecca, can often be defined by your experience • The care system and the challenge of year for one inmate roughly the same as people like Lucy in this report, we see residential homes IKeith, Louise and William, we see of parenting and whether you end up in statutory social work trying to change the annual cost of the salary of a family a pattern of interventions focused on have had six or stories of difficult childhoods which are the care system. things in isolation support worker able to support multiple short-term crisis management leading punctuated by trauma, abuse, neglect. families, we need to make smarter choices to multiple placement moves and cycles more placements We see too a society unable to help these • The impact of school and education on early intervention to break the cycle. of cared-for children having their own young people to process their experiences Trauma at any or of its absence when a young person The government should reverse children taken into care. In the stories It is time we restate that every child and the resulting consequences of age can define is excluded. funding cuts to early intervention services, involving social work interventions, still matters. We need a new national criminality, substance misuse, poor with local areas allocated increased earlier experiences of trauma are mission to improve the life chances of mental health and potential wasted. life choices and Embedding an early help system funding and devolved powers to develop displayed through destructive our most vulnerable children through But what stands out in their for families and embed early intervention services in behaviour leading to social exclusion, increased resources for local authorities, experiences is not simply adversity and destroy life chances, Many families encounter challenges. their localities to tackle disadvantage. By criminalisation, homelessness and investment in the social care workforce trauma, but resilience and recovery too. Their ability to cope with these chal- creating an early intervention fund, we substance misuse. and more effective holistic support Stories like these show clearly that at but the impact on lenges depends on how stable and secure could start the process of shifting from The Children’s Commissioner for children in and around the edges every stage of people’s journeys, there a child’s development their lives are, with factors such as their crisis to early intervention and an ‘early estimates that around 2.1 million children of the care system, alongside more are chances to step in and provide income level, the nature of their accom- help state’ over time. are living in households with complex focused educational support. As well as tailored support to help. Where people is particularly modation and employment and their We know that supporting families needs including domestic abuse and improved early interventions services have engaged with consistent and skills level hugely important. works, with the latest Troubled Families mental health issues. Yet many receive and family support, we must ensure that appropriate support, they have been long-lasting and Our current welfare and social care Programme evaluation showing improved very little support until they reach crisis children have stability of placements, able to rebuild their lives despite their damaging system too often intervenes late to protect outcomes. But the £184m per year point through statutory intervention. reducing unnecessary moves, and personal challenges. Therefore, while we children from harm rather than stepping programme is due to end in 2020iii and little Relying on statutory children’s social putting the interests of children before know that trauma has lasting impacts in early to equip families with the tools is known about what might survive the work to support children and young any financial imperative. Early help for and that wider social determinants like This makes early intervention so they need to cope with challenges. We spending review process. We should learn people is not enough. young people and their families who family poverty are strongly related to life important. Early intervention simply need a system of social welfare and from the success of this programme and The inequality of outcomes have faced difficulties is vital if we are chances, we cannot accept fatalism. means providing the most appropriate early help – with supporting children create a family stability fund, supporting experienced by children in care is to minimise any long-term impact on Trauma at any age can define life support at the first opportunity working and families at its heart – running right families early to work on their issues and to stark and shaming. We consistently their lives. choices and destroy life chances, but with a family or young person rather than across the public sector from schools, help them provide stability. We could fund fail children in care, as Lucy’s story In order to care for children better the impact on a child’s development is waiting until statutory thresholds are nurseries, police and health through to this by ending the married couple’s tax shows so clearly. A third of children in we need to care for adults better too. particularly long-lasting and damaging met requiring costly statist interventions. the Department for Work and Pensions break. Family support services genuinely residential homes have had six or more Adults with experience of domestic as all the evidence from our education There are several themes that and the tax system. This requires early joined up at local level, with no barriers placements, with almost half having violence, addiction, criminality or and care systems shows. How well you particularly stand out from the intervention to be embedded as an between health, education and care should histories of abuse and neglect. Six in 10 unstable housing are likely to struggle do at school exams as a teen is dictated by experiences in this report: overarching principle, guiding every be embedded across the country. Access to children have mental health difficulties. to parent effectively. We need to work the level of your development before you budget, every policy decision and every targeted and specialist services should be Children living in children’s homes are with families to make lasting changes, walk through the school gates. Whether • The importance of relationships and a government announcement. available for families and children at any 13 times more likely to be criminalised rather than intervene in ways which you will end up incarcerated, or on the stable life The past 10 years have seen us go age and any stage. than other children according to the perpetuate cycles of trauma and edges of crime, of addiction or of abuse backwards when it comes to early Sure Start children’s centres should Howard League for Penal Reform. The disadvantage. Providing early help to

12 / Fabian Policy Report 13 / People not problems children, their parents, and the wider ties with a long-term, 10-year funding per cent on the poorest children.vi family network can help keep children strategy to improve both children’s social Sure Start has experienced a funding out of the care system when this is in care and the wider social welfare system cut of £1bn between 2010 and 2018, the best interests of the child. We must it exists within. A children’s social care with Sutton Trust research showing not forget that having a child removed workforce strategy should be developed hundreds of centres have closed and is itself a trauma and we should roll out to ensure all other frontline workers have services have been hollowed out. We programmes which work with mothers the skills and resources necessary to sup- urgently need to rejuvenate Sure Start who have had children removed from port families effectively. and we must also ensure that every their care to support them to make child, not just those of often better-off changes and reduce the chance of Life lessons: early years and education parents, is eligible for 30 funded hours further removals. Any mother whose The trajectory for our young people of early education and care. This can be children are taken into care should starts long before they arrive at funded through a reduction in the upper receive specialist one-to-one support school. The development gap between eligibility threshold as the education to tackle the causes of instability and disadvantaged children and their peers select committee has suggested.vii reduce future trauma. As we see with can be up to 18 months before they start Lucy and Rebecca, these mothers are school, and many do not catch up over not the problem, but people who need their educational life.v Our system of Schools are being compassion and support. early education and care is failing many forced to plug the gaps But we can’t do all this without sorting children, and changes risk entrenching the funding out. We need to ensure that disadvantage. The government’s caused by austerity local authorities can continue to fund new 30 hours of free childcare is a children’s social care system which only available to children of working and decimated demand necessitates. The fundamental parents. Analysis I conducted with the changes needed to move from crisis Social Market Foundation found that support services © unsplash/Markus Spiske intervention to early help will not be three-quarters of new money going possible if driven by the need to cut costs into childcare in this parliament is Our failure to give every child give enough people a second chance. Whilst school standards have been and processed, enabling people to turn in the short term. The government must being spent on families in the top half the best start in life is compounded Vulnerable children are falling through transformed by successive governments, their lives around. agree a new compact with local authori- of the income spectrum, with just 2.7 by an education system that fails to the net and too many are being ‘off- results for disadvantaged children The policies needed to shift the dial rolled’ - pushed out of mainstream remain stagnant and in some cases, they on tackling disadvantage are not rocket education. As the Education Policy are going backwards.ix Changes to the science. We do not need lots of whizzy Institute recently highlighted, one in accountability regime for schools have new initiatives. Instead it is the long three pupils in social care, one in seven meant that many vulnerable children hard road of working with families disadvantaged pupils, and one in eight are falling through the net and too many and children intensively, one to one, black pupils have left school rolls for poorer pupils are failing to reach their whenever and wherever they need it, unexplained reasons.viii We know that potential and achieve good results at and for as long as they need support, this has devastating consequences – every life stage.x that will make the real difference. with exclusions having a lasting impact The high-stakes, low-trust accountability By playing a greater, smarter role in on the life chances of young people and system means that school leaders are family life, the state can support and making them instantly more at risk increasingly forced to choose between what enable families to thrive, and helping of safeguarding concerns. But schools is best for individual children and what is them to pick up the pieces when cannot be left on their own to deal with best for the school. problems arise. the causes of challenging behaviour. The increasing scandal of children This requires consistent, joined-up Because of funding cuts to other public off-rolled, pushed out of mainstream policy making across the whole public services, schools are increasingly expected education, is a consequence of this. sector and a system which gives local to meet a variety of social and health needs areas the long-term funding, powers of children and their families, as well as Conclusion and responsibilities to deliver an early too often providing food and clothing for Many of the problems faced by Lucy, help guarantee for all families and families living below the poverty line. They Rebecca, Keith, Louise and William are children. We will need a new kind are being forced to plug the gaps caused by a result of entrenched disadvantage and of politics, one that builds consensus austerity and decimated support services at consequences of painful experiences in across the political divide, so that a a time when they too are facing significant childhood. No single policy response change in government does not take us funding pressures. Properly funded social could have saved any of these people back to square one. welfare built around the principles of early from the trauma they have faced or Getting all this right means we help would ease the pressures on schools helped them to rebuild their lives after can enhance the life chances of all, and allow proper long-term partnership their experiences. But their stories do tackle multiple disadvantage and limit work across the whole workforce working show that with the right support, trau- the intergenerational impact of trauma

© unsplash/Aaron Burden with children and families. matic experiences can be understood and hardship.

14 / Fabian Policy Report 15 / People not problems EARLY INTERVENTION similar schools, lived in similar housing life events similar to Lucy’s, their life with these issues not only improves the and had similarly low household in- chances are significantly impacted as if life chances of the mother but the child comes, those who avoided drugs, crime, they had. For me, a poverty of ambition she is expecting too. unemployment and prison had one thing in the first 1,001 days is as significant as Unsurprisingly, parenting is incred- in common: a stable home life. Those any of the other life events in determin- ibly important and a driver of social who experienced problems from early ing a child’s future. inequality in a child’s development on in school already had far too much ex- The importance of the first 1,001 days before school, as the education select The first perience at home of addiction, domestic of a person’s life and the negative con- committee found in its report Tackling violence or absent fathers or mothers. sequences of problems during this time Disadvantage in Early Years. The Sup- When I became a councillor in are clear. The key question is therefore porting Families manifesto, produced Brighton, I represented one of the most how we can mitigate any problems to by a group of Conservative MPs in 1,001 days deprived council estates in the south improve the life chances of those who 2017, identified the family as the most east with similar levels of deprivation don’t get the best start in life. Previous influential factor in a person’s life and Belief in a child’s potential must sit at the to Tower Hamlets in London and Moss governments have attempted to come underlined that a dysfunctional family heart of government early years policy, Side in Manchester. The patterns of up with solutions and failed. David environment was a predictor of poorer writes Maria Caulfield experience were very similar to those I Cameron’s life chances strategy was outcomes in life. A study by the Sut- had seen growing up and reflected the dropped in 2016 and the social justice ton Trust found that children without experiences faced in these case studies, green paper that was to replace it sub- secure parental bonds were more likely in particular those of William with his sequently turned into the current social to have behavioural and developmental experience of domestic violence as a mobility action plan, which critics have problems. A home learning environ- child and the experience of being a child said does not address the role played ment where reading and language with an absent father. The impact of by a person’s early years. The focus was practised by parents was crucial these life events so early on in life can in the social mobility action plan is on in improving life chances for children. lead to a form of social exclusion from improving chances once a child reaches This proved particularly difficult in Maria Caulfield is the mainstream society. school age but as we have seen much of those homes where parents themselves Conservative MP for Lewes In Brighton we found that a signifi- the damage has already been done by struggled with literacy. cant minority of 1,500 households had this stage. To help families, the Supporting people experiencing multiple disadvan- Many experts have made recom- Families manifesto recommended a person’s life chances can be deter- mental health problems, child services, educational achievements and her own tage, with 25 per cent of those people mendations about how life chances cross-governmental approach with a A mined by what happens to them homelessness, or physical or mental children being taken from her because concentrated in the most deprived 10 could be improved in the first 1,001 cabinet minister responsible for ensur- from the moment of conception until abuse, they will achieve less academi- she could not cope. per cent of neighbourhoods. Most of the days of a person’s life and these can ing families are supported by every they are two years old, according to cally, earn less, and will be less healthy, adults finding themselves in this situa- be grouped into two broad categories: department and that they are central to many academics and experts. according to the former chief medical tion, had themselves been born into this specialist support in the anti-, peri- and all government policies, whether that These first 1,001 days are the most officer Sally Davies. The all-party par- Those who environment. As Brighton and Hove post-natal stages; and strengthening be the government drugs strategy or critical period in shaping future liamentary group for conception to age experienced Council wrote in 2009: “Social exclusion families. Both of these have at their welfare reforms that keep supporting health and wellbeing. They are vital two produced a manifesto for the first was an extreme consequence of what heart the aspiration that someone’s families staying together. for a child’s personal development 1,001 days, estimating that 26 per cent problems in happens when someone does not get start in life should not determine their The experiences of individuals drawn as an infant’s brain and neurological of babies in the UK have been affected a fair deal throughout their lives often destination. For me, this belief in a together for this report and wider evi- pathways are set for life. International by at least one of these factors and that school had far because of the disadvantages they face person’s potential is what is missing in dence show that the first 1,001 days of a studies have shown that when a baby’s this exposure has long-term effects for at birth.” Through the work that was current government policy and without person’s life can be the most influential development falls behind in the first both the individual and their family. too much experience done to tackle pockets of deprivation in it the cycle of deprivation is perpetu- in determining not only their future but years of life, they are more likely to Tackling these issues must be a social at home of addiction, the city of Brighton, we found that the ated, and lives are written off before also their children’s. Tackling issues of fall even further behind in subsequent justice priority if we are to ensure every- cycle of exclusion was about more than they have even begun. addiction, abuse, family breakdown years. If problems are encountered one has the best possible start in life. As domestic violence or income or poverty. It was also about a Specialist support in the anti-, and mental health problems during during this stage of development, the Sally Davies argues: “We know too that combination of problems such as unem- peri- and post-natal stages of life is a pregnancy can transform life chances consequences can live with them for not intervening now will affect not just absent fathers ployment, poor housing, high crime and recommendation that can be found for those not yet born. Interventions the rest of their life affecting their intel- this generation of children and young or mothers family breakdown. in many reports including the APPG later in life are helpful but interventions lectual, social and emotional health and people but also the next.” Very few studies have looked at the 1,001 critical days report. The evidence in the first 1,001 days can make the wellbeing. In many cases, left unre- Studying Lucy’s experiences in impact of being born and growing up in suggests that specialist support for greatest difference. While many experts solved, the consequences can be passed the report, while we don’t know the While the experience of one example, an environment where there is no aspira- expectant mothers needs to include and think tanks have made recommen- on through the generations leading to exact dates, the fact that she was placed the pattern of events is frighteningly tion or where no one encourages you to tackling issues such as depression dur- dations about how this can be done, a cycle of deprivation that has tragic with 19 foster families before she was similar to my own experiences of hav- succeed, whether that be your parents, ing pregnancy, domestic violence and successive governments have failed to consequences as illustrated in the case eight, indicates that significant negative ing grown up in a tough part of south teachers, social workers or others. In my addiction. Any expectant mother expe- put anything into practice that realisti- studies in this report. experiences occurred in her first 1,001 London in the 1980s, where more of my experience, many children who are born riencing any of these events is likely to cally makes a difference. As a result, we If a child in their first 1,001 days days. These have clearly shaped the friends ended up going to prison rather into families with intergenerational so- see their child have poorer outcomes have generations of young people not experiences any domestic violence, rest of her life, leading to mental health than university. Although as children cial issues are written off at conception. throughout their life. Having access to fulfilling their true potential. We have drug or alcohol abuse, absent parent(s), problems, living in poor housing, low we all grew up in the same area, went to Even if they don’t experience any of the specialist professionals who can deal to do better.

16 / Fabian Policy Report 17 / People not problems RELATIONSHIPS AND COMMUNITY charity Centrepoint. I saw how a stable as is so often the case with children in gang violence should be spent. Working home, an income that provides dignity care, the system drives a coach and horses together helped empower the community and the freedom to make choices, and through the relationships that sustain who opened up their homes to give young most of all healthy relationships with people at the most difficult times in their people a safe space to go and cut violence other people are conditions without which lives and compounds the problems they rates significantly. In the right place change isn’t possible. Relationships and face. Like Lucy, children are moved Despite this, the lack of funding for vital Places matter because they build the communities the support they provide are central to frequently, often placed hundreds of miles services is a major problem. Without long- overcoming disadvantage. from home and have a high turnover of term funding, staff burnout in services like and relationships that are so important in times of crisis. The importance of relationships is social workers. Behind this is the reality adult and children’s services, homeless Lisa Nandy explains exemplified in Keith’s story. After serving for thousands of children in care that they and drug addiction charities, foster care multiple prison sentences, he found a job lose the relationships that matter most: the and the Job Centre leads to high turnover and a community with Recycling Lives, teacher, auntie, friend or social worker at and those crucial relationships are broken. a waste management initiative that gives the time they need them most. As Shaks Ghosh, former chief executive of a second chance to former prisoners. Services, and the decisions that fuel Crisis, put it, what use is a service without An employee called Barry greeted Keith them, are too centralised. In nearly two the knowledge “that there is someone on at the gates, and led him to his new decades of working with Whitehall and the other side who cares if you live or die”? accommodation, where he now rebuilds Westminster I have found they are quick Keith found a service that cared, and that Lisa Nandy is the his life. After previous sentences, Keith to see problems but slow to see potential. waited at the prison gates; but many – if Labour MP for Wigan had no one greet him at the gates and There is a desperate need for local solutions not most - others find, like Lucy, that they ended up in cycles of crime. for local disadvantage. This is achieved by are left to fend for themselves. Similarly, Louise, who suffered from dispersing not just service delivery but the Funding of services has to go hand ommunities and places matter. That increase in 45 to 64-year-olds and over a lifeline. In hard times, overcoming PTSD and depression, alcohol abuse and decision-making power that shapes those in hand with local services becoming Cis one of the major lessons from 65s between 1981 and 2011 took place in multiple disadvantages requires a losing the custody of her child, found services; by pushing power downwards, more accountable. Genuinely responsive the huge political and social upheaval smaller communities including villages broader community of support. People refuge when her local council paid for so that local services can be responsive to services are driven by those who need them. of recent years. Community forges and towns; conversely 80 per cent of the who are vulnerable in our society need detox if she attended a treatment centre. individuals and local circumstances. Innovative ways have been developed political and social identities that are increase in 25 to 44-year-olds happened in this support to turn their lives around The community at the treatment centre for how to ensure accountability in even essential to understanding the events large cities and larger towns. – and this support often comes from became her rock and the community the most challenging circumstances. that have defined the last half decade of This demographic change has their community, as Louise and Keith’s stayed with her even after treatment. Nurturing local For example, Children England has British politics. undermined once strong communities experiences highlighted in this report But in other cases, those crucial services are those that developed ideas for children’s trusts that Brexit revealed a profound that enabled young people to stay at home show. relationships were taken away. Like so allow children in care to hold their social geographical divide. Areas that have if they chose and the institutions that These cases show us that change is many children who enter the care system, are both well-funded workers and councillors, who are their seen growth were less dissatisfied with underpin that social fabric and provide driven by people themselves. Those who Lucy was placed under the care of 19 corporate parents, to account. But too the political system and more likely the beating heart of the community – face challenges in their own lives know foster families before she was eight years and driven by local often the experience for those who rely to vote remain while places that have high streets, libraries, pubs, and social better than anyone what the problem old; social services left her with nothing on a service is one which strips them of experienced relative decline, with falling clubs that make up the building blocks is, see more clearly what strengths and when she left the system at 21. With a new communities agency - a disempowerment that is often populations and a greater frustration with of a British town. The lack of response assets they have in their lives and have a baby, she was forced to move 100 miles felt, rightly, as a lack of care and respect. the political system were far more likely across the political system has confirmed deeper understanding of how they might away after having been moved between Achieving this is not easy. Locally Nurturing local services are those that to have voted leave. to many that they are right to reject the use them to make positive change. The hostels. With no support, she turned to and nationally, politicians, civil servants are both well-funded and driven by local The discontent was fuelled by the political settlement. What use is a politics role of the state is not to prescribe what drugs and alcohol. and service managers do not give power communities. Empowered, resourced visible decline of our high streets: shops, that shrugs its shoulders when people that change looks like, but to create the The correlative benefits of a place to away easily. But there are examples that communities are where people find the libraries, pubs and post offices close, bus lament the loss of these important spaces conditions so people can make change call home run like a thread through these demonstrate it is possible. In Wigan, the support they need to overcome the varied routes are cancelled and vital services lose that connect and root us and form part of happen. That includes a support base that stories, as they do through the stories council responded to some of the worst and multiple challenges in their lives. funding. The importance of these places our identities? provides stability and care. my constituents tell me in my weekly cuts in the country by establishing The Places matter because they foster and services is in the stability, continuity In times of crisis, this essential feeling This was very apparent in the time I surgeries in Wigan. Community and the Deal, a contract between the council and communities that in turn foster the strong and support they provide – offering an of rootedness and belonging becomes worked with homeless teenagers at the relationships it provides prevent relapse the people designed together. The council relationships that build strength, optimism anchor to families and neighbours in a and create the stability to grow and thrive. agreed to keep libraries open and protect and resilience. For too long we have failed world that increasingly feels it is spinning It is a tragedy that the system, and street cleaning and other valued public to recognise just how important this is and out of control. services, very rarely recognise the services in return for increased recycling, failed those facing the greatest challenges. Behind this deeply-felt sentiment centrality of strong relationships or more volunteering and rising rates of Putting people and their communities is a demographic shift over several provide stability. As these case studies fostering. Similarly, Lambeth Council’s at the centre requires moving power out decades. Research by Ian Warren for the show, local services are diffuse and uproot community youth trust was set up to of Westminster and Whitehall and back Centre for Towns found a migratory lives. In recent years the centralisation tackle gang violence after years of failure. to people themselves and the services phenomenon that has left towns with of services has left rape and domestic Both have relied on the understanding they rely on. As Abraham Lincoln put ageing populations as young people move violence victims, those with mental health that to empower some people, you have it in a time of similar social and political to urban areas for employment or higher problems and people battling addiction to take power away from others. Lambeth upheaval: “The dogmas of a quiet past education and find increasingly there is travelling miles to access services away Council gave power to social housing are inadequate to the stormy present.” It’s

little to return to. Three-quarters of the © flickr/Diamond Geezer from their support networks. At worst, tenants to decide how funding to tackle time for radical change.

18 / Fabian Policy Report 19 / People not problems RELATIONSHIPS AND COMMUNITY Roots, communities, and homes We must support families, invigorate communities and give individuals greater security and control over their home, writes Michael Tomlinson © flickr/John Howe

Again, this barely troubles the scorers provider of welfare. government is a replacement for a of Hansard. Under Tony Blair, the issue Parish and town councils could welfare state dealing with the big issues was considered as much of a taboo as be asked to focus the time of their of relieving poverty through services dismissing immigration. We were told councillors – and where they exist staff and provision of welfare. It is easy to Michael Tomlinson is the Conservative that talking about family structures – on community building activities. assert that the state is the only means to MP for Mid Dorset and North Poole and the impact of family breakdown on This could involve using the precept address poverty and the misery which it children growing up in poor households for small grants to support local groups brings. Conservatives know better. It is was moralising and not the business of or societies. It could involve organising not for conservative thinkers to propose eading the case studies compiled in the conversation in Westminster which longer living with both their parents by government. David Cameron blew away events to bring the whole community that we increase interference from the Rthis report, it is impossible not to barely utters the word ‘family’, as both the time they sit their GCSEs. However, many of these assumptions from the together in a single place. This isn’t state. Rather we should highlight that be struck by the complexity of poverty a potential contributor to poverty, in our poorest communities, the same New Labour years. He was positively about setting up rival groups with it is not the only tool within our grasp. and moved by the accounts of life on and a solution to it; and when it does, proportion of children have already seen enthusiastic about the role family could self-styled ‘community leaders’. Instead There must be a recognition that the way the breadline in modern Britain. It has apologetically, it is often dismissed and their parents split up by the time they play in improving lives – especially for it is about a civic body representing in which we interact with one another, become something of a mantra on the shouted down by those on the left. start primary school. those children who are already growing everybody who lives and works in and indeed look after one another, has a centre-right of British politics that an Children growing up in lone-parent up poor. a recognisable local area. Our sense direct impact on the state and what it is effective approach to tackling poverty families have almost double the risk of Politicians should not be afraid of of community built on shared space in turn required to provide in services. has to tackle ‘root causes’, rather than Children growing growing up in poverty than children this issue. Indeed it could be a popular is what will matter, not an issue or Whilst our sense of home is rooted fixating solely on spending money on up in lone-parent living with two parents, with 47 per narrative out there in the real world, a grievance. Many larger parish and in families and communities, where those in need. The real stories of lives cent of children in lone parent families where people actively value family. town councils already quite rightly take people actually live is important. So lived in poverty illustrate profoundly families have almost living below the official poverty line But we cannot rely on families alone, their role in organising a local sense of when considering our approach to that handouts from the state will not be compared to 24 per cent of children with when it is all too clear that often they community incredibly seriously. There poverty and disadvantage, we also sufficient in and of themselves to tackle double the risk of two parents. are so fragile. Conservativism has is probably very little that politicians in need to consider housing and housing these problems. A powerful new and extremely always championed the importance of Westminster can do to aid a true sense tenure for those on the lowest incomes. The title of this chapter directs us to growing up in poverty comprehensive study from the Centre communities, civic groups, charities of community. But beefing up our local Rebecca’s belief that living in her own consider the role of ‘roots, communities than children living for Social Justice finds that young people and sports teams, all playing their part parish and town councils to create the accommodation, for the first time in her and homes’ in addressing the who experience family breakdown under in building resilience among the most space for local community to flourish is life, offers her the ‘best chance of a stable complexities of the lived experiences in with two parents the age of 18 are more likely to experience vulnerable and disadvantaged people one thing we could encourage. In some life’ gives us all a powerful reminder this report. Reading these accounts, and homelessness, crime and imprisonment, in society. ‘Community’ is a word often areas of central London, where parish why getting housing policy right for stepping away from the Westminster Britain is a country where family educational underachievement, alcoholism, overused by political advocates to councils have long been abolished, the most vulnerable is critical in helping bubble, the word we miss and overlook, breakdown falls disproportionately on teenage pregnancy and mental health promote their cause. This distorts the people are now choosing to bring them people overcome disadvantage. The but which is in fact shouting from the poorer children. The experience and issues . Yet this is too little talked about in true meaning of community that finds its back. This is a sign of their value as a private rented sector is now the sector page, is family. When we talk about consequences of family breakdown do parliament. Despite the increased poverty value in human kindness and generosity. community convener. They are the containing the most people living in our roots, communities and homes, we not fall evenly, and this inequality should risks, it is estimated that the Treasury spends It is these virtues, in people with little political equivalent of the coffee shop relative low income. Recent analysis really mean our families. The collapse of be regarded as just as serious as any other a paltry £1 in prevention for every £6,000 political motivation but a strong sense of in the TV series Friends - a place where finds that the proportion of people in relationships and the break-up of families ‘injustice’ that politicians seek to address spent responding to the consequences of wanting to help others, which create real everybody knows your name. relative low income living in the private is vividly described within the five case in the policy process. family breakdown. The total cost to the communities. This kind of community None of this is to say that a rented sector grew from 15 per cent to 36 studies. This is in noticeable contrast to Almost half of all children are no taxpayer is estimated to be £51bn. is an important yet often overlooked community-focused layer of local per cent between 2000 and 2017. In the

20 / Fabian Policy Report 21 / People not problems PUBLIC SERVICES same period, the proportion of people in and 85 per cent currently do. multiple disadvantage. relative low income in the social rented New stresses have been placed on Moving to a new house, either in sector fell from 50 to 39 per cent, and families as they have experienced the the private or social rented sector, 34 to 24 per cent in the owner occupied relative instability and insecurity of the often means moving away from a sector. Households in the bottom third private rented sector in greater number. community and support structures. of incomes across all tenures make up As the charity Shelter has highlighted, This could involve moving schools, People-centred 38 per cent of the private rented sector. one in five of all families has moved GP surgeries, even away from a And the number of households claiming at least three times within the past friendly neighbour. It does not make housing benefit in the private rented five years. Analysis of government sense that Lucy was forced to move services sector now stands at 1.2 million. data also shows that moving is much a hundred miles away to live in an A survey of more than 2,000 adults in more common in the private rented area she hardly knew, and with no Public services need to be better integrated if we Great Britain, carried out in December sector than other tenures, with private pre-existing support networks. That 2018 by ComRes, finds that many people renters six times more likely than did not help Lucy, and it did not help are to help the most vulnerable in our society, value a sense of ownership over their homeowners to move. A network ensure Lucy’s new-born child had the argues Jim McMahon homes, even if that does not include full of 200 grassroots charities working best start in life. We have to focus on financial ownership. Large proportions of to address child poverty in London bringing real stability to our families adults living in the private rented sector surveyed its members on the impact and communities, which will help associate homeownership with being able of insecurity in the private rented people put down roots and invest in to control things like living space, home sector. It concluded that the ‘transient their local communities. decoration and when you move. Yet this and unstable nature of housing affects Helping every individual with sense of control has grown increasingly every aspect of family life’, as it experiences of severe and multiple Jim McMahon is the Labour MP out of reach for thousands of families as ‘undermines the health and wellbeing disadvantage cannot be solved with a for Oldham West and Royston becoming a homeowner becomes more of children and their parents’ . Four in single policy alone. There is no silver difficult. The survey found that while five of the voluntary and community bullet. However, supporting families, two-thirds (63 per cent) of private renters sector organisations it surveyed invigorating communities and agree that it is important for them to feel reported that insecurity was harmful giving individuals greater security to improve the way these services a ‘sense of ownership’ over their home, to families and our local communities. and control over their home will be interact with each other and help the only one in five (20 per cent) say they Those least able to deal with the vital steps in helping every person, most vulnerable in society like Lucy, currently do so. This compares to owner detrimental impacts of insecurity and especially those with experiences of Keith, Louise, William, and Rebecca occupiers, of whom 87 per cent say that instability in the private rented sector severe and multiple disadvantage, whose stories appear in this report. We feeling a sense of ownership is important are those already facing severe and overcome the challenges they face. must not allow the very real strain our public services are under to reduce our ambition, nor to stop us from focusing on how, even with swingeing cuts, the money which is left in the system can be used to better effect if we break free from institutional and historical shackles.

© flickr/Mikey Public services have, historically, operated in silos, failing to work in a ublic services are about people and by 2025. The Conservatives’ mantra joined-up way. They are often set up Pthe communities where they live. - ‘We’re all in this together’ - and their to help us with individual problems in When they are at their best, they act as claim that the end of austerity is upon us, isolation throughout our lives, whether the foundation of a decent society. But could not be further from the truth. that is being seen by a doctor, a support after nearly a decade of Conservative-led Anyone with even the slightest worker or the police. It is mine and the governments, it is easy to see that years knowledge of public services will tell you Labour party’s belief that we should of austerity and neglect have hit at the that no one service acts in isolation; they implement radical reform to eliminate very foundations of the essential public are a fragile ecosystem, interdependent silos in our public services. In this services our country needs to thrive. on each other. Preventative services way, people will have the power to act Analysis by the Institute of Fiscal which managed demand for other public collectively to create and implement Studies has found that by 2020, the services are now a shadow of what they successful strategies to help others in budget for public spending will have once were, which means demand is their lives. This could mean, for example, been slashed by up to 40 per cent. These increasing for already stretched services. allowing services in the social care cuts have hit our services severely and The result is clear to see: our NHS, industry to share information in order left many of them on the brink. The Local emergency services, social services and to create a plan of action for a struggling Government Association has stated that local authorities are at breaking point. parent or school student. local councils in England are facing a Reform is now necessary to protect Helping the most vulnerable in our £8bn funding gap across public services these services. But reform is also vital society requires allowing public services © flickr/House Buy Fast

22 / Fabian Policy Report 23 / People not problems to identify gaps in their knowledge move toward a ’people-centered public police. Reducing waiting times will act or experience would have saved her services’ with services built around to increase public trust and confidence years of trauma and abuse, as the how real lives are lived, with all of their in services. This is a key part of the correct place to intervene could have complexities and interrelationships. Labour party’s reform and one I wish been identified by social services. This Too many individuals who use to see implemented from day one of a would have benefited both Rebecca public services, have a lack of trust Labour government. and also the public purse, saving in them. People are continually let The Fabian Society has presented significant sums while still maintaining down by services no longer fit for us with a great opportunity by giving an empathic approach. purpose. Another of those featured this area the focus it needs. It speaks to A critical aspect of public services in the case studies is William, who the priority shown in Labour’s pledge we must reform is the organisational needed support from a psychiatrist to build a National Health and Social culture of each service. At present following a breakdown which stopped Care service with a shared commitment across our public services, there is a him from working. However, while to single commissioning, partnership tendency to treat people as a number, William had done well in education arrangements, pooled budgets and rather than a human being. Lucy’s and work despite some early traumatic joint working arrangements. The new experiences highlighted in this report events in his childhood, he was left to service will move quickly to establish a shows this clearly. A single mother wait three months for an appointment collaborative and joined-up service that who has struggled since childhood and with a psychiatrist. This led to William will be both appropriate and efficient has needed access to care to help look being let go by his employer through in the way it signposts those in need A post-it = a contact or intervention after herself and her daughter due to ill-health retirement, which left a void to the correct service, saving the user a mental health problem, Lucy found in his life that he was unable to fill. It distress and giving them access to care herself lost with care promised, but none is this waiting time that is a cause for quicker - all the while saving money for being provided. She said that “loads of great concern. the state. Police/ CAF Community Health Social Care Housing Community help was offered, help for mental health, We see time and again people unable We have to radically reform and Co-ordination Safety Outreach housing etc but none materialised”. She to access the care that they need, when invest in public services in order to felt that many she had to deal with did they need it. This is relevant right significantly reduce waiting times and not really listen to her concerns and that across our public services. Cancer can allow people like William, Lucy, and she was dismissed at every opportunity. be caught early, mental illness can be Rebecca to access help when they need This demonstrates a lack of empathy picked up and treated early and crimes it most. Only then can we ensure that Family Barnardos Attendance Housing within the organisational culture of the such as domestic violence can be our public services are at their best as Service Benefit Intervention Project care services. This has to change if we identified early and dealt with by the the foundation of a decent society.

to collaborate, allowing for successful preventing Rebecca from experiencing This all requires the single point of ways of dealing with an individual’s them. Rebecca herself believes that her contact approach that we believe will enable problem before they enter a crisis point. childhood was a critical point in her life. our public services to be ‘people-centred’, The urgent need for better integration Better intervention and education on putting efficiency and expertise alongside of services is best shown by Rebecca’s consent and drugs could have stopped saving costs for the state. experiences of abuse from childhood her from making the mistakes she did. Oldham’s Multi-Agency Safeguarding not being identified and dealt with early Social services, the education system and Hub has analysed cases of domestic on and being allowed to fester until it the police could have worked together violence to see where and when ruins a life. An abusive relationship to try and stop events spiraling out of interventions from a different service at 13 led to Rebecca being subjected control. Rebecca stands as an example of could have successfully averted the to domestic violence, drugs and an why we must reform our public services case from going on for as long as it early pregnancy alongside a plethora to work collaboratively. did. One case, between 2003 and 2012, of deadly and life-threatening diseases saw more than 100 different contacts or such as pneumonia. These factors led interventions from services including the to Rebecca becoming institutionalised, The single point police, social care, family intervention spending time in prison – with one of contact approach project and the charity Barnardo’s. The sentence being more than 12 months. conclusions drawn from this, and other A case like this clearly represents a will enable our cases, have been used to successfully failure of public services: they failed divert those in crisis into the correct care to identify the factors from early in her public services to be service if the current one is not helpful to life that would contribute to her later people-centred someone who is in crisis. challenges and they failed too by not For Rebecca, services attempting © unsplash/John Cameron

24 / Fabian Policy Report 25 / People not problems PUBLIC SERVICES However, there is also scope for a contractor, not the patient. Most patients service has the right to choose, they have middle or third way: private sector were content with this. some power over the body delivering the delivery of public services. This was The public sector, the private sector service and are able to demand higher something that New Labour accepted. and the third sector working together standards and a better performance. Results, not It used widespread contracting can bring significant benefits, both to No user feels trapped by bad service as out and encouraged a bigger third the state and to individuals. Take the there is a way out. For example, people sector of charities and not for profits example of Louise, who struggled with in many areas have a choice of school for working away at social problems and depression and drinking. After one their children to attend free of charge, structures public service. New Labour extended failed experience, her council offered or their child may also be able to win a contracting out in the NHS by buying to pay for detox on the condition she free place by scholarship at a fee-paying The public, private and third sectors should work in medical capacity for operations and attended 1NE. This charity has been school. There is some choice of GP and together to achieve the best results for those who treatments from the private sector, where successful in helping people tackle drug dentist within the NHS free provision. need them the most, writes John Redwood previous Conservative administrations and alcohol addiction, improving health Social care works best where individuals had confined the use of contractors to for participants and reducing the costs or their carers have choices over the type areas like meals and cleaning. We should of future treatment on the NHS. Another of care and the location of it to be offered. learn from this example and the idea that charity, Recycling Lives, shows how we Experiences like Lucy’s show how what matters is results, not the means of can successfully rehabilitate ex-offenders damaging a lack of choice is for people. achieving them. This is still relevant, and like Keith, giving them support to change She was placed in a series of unsuitable, more so for individuals with experiences their lives. As Keith said himself, without if not dangerous, homes before being John Redwood is the Conservative MP of severe and multiple disadvantage. the support of Recycling Lives “it would moved 100 miles away from her support for Wokingham Does it really matter who provides the have been all too easy to slip back into networks. Lucy was also disappointed numerous services they need as long as old habits”. The public sector should with how social services behaved they tackle the challenges they face and learn from this example, and work with towards her. She should have been able improve their lives? charities that can help vulnerable people to choose a better place to live and better Much of the public remains less get their lives back on track. The cost – support from social services. concerned about the ‘nationalise or both human and financial – of failing to privatise’ debate around public services do so is too high. than some politicians are. People are More widely, contracting out brings If the user of a more concerned about the big three advantages. It can allow access to a public service has areas of public services: providing a range of providers who compete to get good quality free education for children, the contract, bringing innovation and the right to choose providing free healthcare on demand new thinking to the provision of public when needed and assisting with social services. This can often mean a fall in cost they are able to care for the disabled, older people and and a rise in quality as the new bidder other vulnerable groups. Largely, the put their minds to higher quality and demand higher public do not know or worry if many higher efficiency in managing the task. standards of their services are maintained and Some providers can bring economies managed by a for-profit company, unless of scale as well as greater expertise

© flickr/Yisris they do it badly – and improvement or and experience because of the focus I support the public in their demand change are required. As I argued above, of their activities. Scale can also bring for better public services. Results, not e all come into contact with public to intervene, or intervening but doing so for shelter, warmth and entertainment. the public are concerned about results. in flexibility to manage staff better. structures, matter especially for the Wservices at some point in our lives. badly. When approaching public sector In the majority of cases, individuals They want high-quality public services Today it is difficult in some parts of the most vulnerable. This will come from But for many individuals facing severe reform, we have to be wary of radical use their own money to buy the goods which the state should lead and provide country to recruit enough GPs to meet both the public and private sectors and multiple disadvantage, that contact change that fails to work for the most or service they want from their chosen and which help the most vulnerable. The rising demand at surgeries. Companies working together to innovate, offer is critically important and near constant. vulnerable, including those facing severe private sector provider in a competitive state should play a role in coordinating can operate over a broader area and some choice and above all to provide From the NHS and emergency services and multiple disadvantage. marketplace. Individuals who do not as well as commissioning services and supply the right number of staff hours high standards. Support for the most to the police and social services, people But what defines a public service? In have a job or other source of a decent provision, whether that is public, private to provide the cover individual surgeries vulnerable, like Lucy, Keith, William, facing severe and multiple disadvantage 2002, I wrote a book entitled Third Way, income are provided with money by the or from the third sector. This approach need, whilst ensuring that GPs do not Louise and Rebecca, will be paid for are most affected by public sector Which Way? about public services – and state so they can also buy these things could be seen when the last Labour experience burnout. by the state one way or another. The reform. They rely on innovative, caring how we pay for it. The book sought to from the market. At the other end of the government said that patients could go Rather than asking the state to choose challenge is for the state to spend the and collaborative services, regardless of define what is a public service. The book spectrum is the provision of a monopoly to a private hospital to get their knee how public services are provided, money well to get enough care and how they are provided. What matters for argued that there were many different public service, like most healthcare or mended or their cataract removed. It sometimes it is easier to provide more better solutions. Quite often charities, these individuals is results – and, as the ways of paying for and delivering defence, where the service is provided expanded NHS capacity, allowed earlier money to those who need a particular energetic individuals and companies case studies show, our public services a public service. At one end of the free to the user or beneficiary by the delivery of the treatment people needed service and let them choose from a range will have some of the answers the are letting too many people down. spectrum are services for the public - state. It is paid for out of taxation, and the and maintained the essential promise of providers in the private sector. state needs to embrace to do a good Both Rebecca and Lucy show us the from supplying bread and water through service is delivered by state employees of the NHS that the care should be free Through this we can harness the power job for individuals facing severe and consequences of public services failing to providing many of our daily needs working for a state monopoly. to the user as the government paid the of customer choice. If the user of a public multiple disadvantage.

26 / Fabian Policy Report 27 / People not problems SKILLS AND WORK able to build relationships with needy families, as well as simply providing food, and so to provide at least some of the love and support which William found so invaluable. State employees are Investing in work rarely in a position to give that. I would like to see state agencies, and To enable people to work and learn, the state must invest, particularly local government, overcome embrace voluntary provision and enable decisions to be taken current reluctance to work with faith- © flickr/Andrew Writer at a local level, argues based groups, for fear (invariably Stephen Timms unfounded) that they will end up trying to guarantee that unemployed young employment and time-unlimited in-work to convert people. I chair the all-party people could find a job. An independent support for both the employee and the parliamentary group on faith and society evaluation published by Department for employer.” As this suggests, providing it which has drawn up a set of principles Work and Pensions in November 2012 is costly – and virtually impossible within for local authorities to sign up to, showed its effectiveness, concluding a government employment programme. together with the faith groups in their that it had delivered ‘a net cost to the The NHS does offer it, but availability has area wishing to work with them, with the Stephen Timms is the Labour MP Exchequer of £3,100 per participant; been patchy, depending on the priorities of aim of encouraging more collaboration. for East Ham and a net benefit to society of £7,750 per the mental health trust in each area. NHS participant’. England made a welcome announcement Tackling multiple disadvantage in the he case studies in this report show in institutions of manageable scale and government work programme’s failure In both case studies involving a in April 2019 of a major expansion in its welfare system Tvividly the severity of hurdles that a purpose. But as soon as we establish to provide effective support for people prison sentence, those of Rebecca and availability, but even then, in five years’ The case studies make hardly any significant number of our fellow citizens institutions to fulfil different purposes, claiming health-related employment Keith, the turning point came on getting time, it will still not be available in 20 per reference to the welfare system, but this have to deal with and the impact of the gaps between them become apparent, benefits. Working Well has brought a job. Recycling Lives, where Keith cent of England. Additional government article would not be complete without a hardship which selfish and evil people and the call arises for them to work together employment support, including works, sounds exactly like the kind investment in this programme would comment on universal credit. In principle, inflict on others. They illustrate as well how together. In supporting work and job centres and independent providers of organisation which thrived under be worth making, and its importance it should represent a step forward, making thinly stretched, after a decade of austerity, learning, there is an obvious need, for and education, with local colleges and the Future Jobs Fund. I greatly admire strengthens the case for collaboration the financial impact of moving from are the public services intended to help example, for employment, education and the NHS, including the mental health National Grid’s programme of training between employment support and mental unemployment into work, and from one people surmount these hurdles. But they health services to co-operate. trust, in an effective partnership focused offenders as gas pipeline engineers, health services in each area. job to another, much easier to work out. also underline the resilience of the human on helping people get jobs. It is very guaranteeing that, if they meet the In practice, however, the botched spirit and the capacity of individuals to difficult at national level, but achievable standard, they will be employed on Recognise fully the value of voluntary deployment of universal credit is making overcome seemingly insuperable odds. Having a job at a sub-regional level. release. The reoffending rate among sector, including faith-based, provision problems much worse. The five-week In responding to the case studies, I is key to overcoming It cannot be taken for granted that a people leaving prison is a statistic which William speaks of the ‘immense love delay between applying for benefit and would draw out three key lessons: model which has worked well in Greater shames our society, but it has proved far and support of his wife and children being entitled to the cash is the worst single multiple disadvantage Manchester will work well everywhere lower among those on the National Grid throughout this period’. For those who feature. It forces people who are just about • The city region is the best level to draw else. It is not at all clear what the scheme. We must do more to help those don’t have such family support, is there keeping their heads above water into debt together the support offered to enable equivalent of the Greater Manchester leaving prison find work and provide anything the state can do to make good to the DWP from which it is extremely people to participate in work and learning; In practice, getting the huge Whitehall level is in many parts of the UK, though greater assistance to those employers their absence? The cases of Keith, with a hard to escape. Technical problems often departments responsible for these establishing partnerships just at a local who wish to hire them. Recycling Lives Academy, and Louise, with make the delay in entitlement to benefit • Substantial investment by the state to things to work together effectively is authority level would not be efficient. But The contribution of employers is a 1NE, a voluntary sector treatment centre in even longer. The benefit of clarity in enable unemployed people to access very difficult. When I was employment marshalling resources at a sub-regional very important one. The case study of Woodford, North East London, illustrate the new system has been undermined employment pays off; minister, I met regularly with the level is most likely to minimise the risks William makes clear that the failure of his the value of voluntary sector support. by decisions in other departments – the minister for skills and we always reached of people falling between the gaps. employer – despite admirable policies – I was also struck by Lucy’s account Ministry of Housing, Communities and • Local and national government needs agreement. But ensuring that large to support him during a crisis led to five that ‘social services literally packed my Local Government’s insistence on keeping to recognise fully the value of voluntary nationwide bureaucracies, which were The state should invest to enable years of unemployment. bags, gave me some food vouchers, and council tax support outside universal sector provision, including faith-based accountable to each of us, worked together unemployed people to find work The case studies also highlight the left me near the local church with no credit, and the Department for Education’s provision, and enlightened business was much harder than merely reaching an Having a job is key to overcoming importance of accessing mental health help, nothing’. We regularly hear of the new eligibility rules for free school meals. support in enabling individuals to flourish. agreement between the two of us. multiple disadvantage. That is clear in support and difficulties in this area decline of religious faith in our society, This report is right to highlight Getting the local branches of these four of the five case studies in this study. feature in the cases of Lucy, Rebecca but it is a remarkable feature of the past the importance of tackling multiple Marshal support at the city region level bureaucracies to work together is much And I believe it is worth the state’s while and William. William’s story features decade that, as austerity has caused more disadvantage. Today – as recent publication It is very easy to point out that people more realistic. For example, Greater to invest more in supporting people into individual placement and support, an and more families to be unable to afford of the Department for Work and Pensions’ fall, all too often, between gaps in Manchester – taking advantage of an work than it has often been prepared to. effective approach to supporting people enough food, the churches – through the annual statistics on households below provision and that steps should be taken early devolution settlement – set up We can learn from the success of the with severe mental health difficulties Trussell Trust network of food banks – average income made clear – the problems to plug the gaps. It is much harder to its ‘Working Well’ project to support Future Jobs Fund, introduced in October into employment. The Centre for have been the one agency with not just are getting worse. It is vital that the next work out how to do it. into employment people who were 2009 to tackle youth unemployment in Mental Health explains that: “It involves the motivation but also the capacity to government makes progress in this area a Human effort to tackle the challenges out of work on health grounds. It the teeth of the global financial crisis. intensive, individual support, a rapid job help. And one of their strengths has priority and is willing to commit resources we, as a society, face has to be organised was established in response to the It provided wage subsidies in order search followed by placement in paid been their capacity to deploy volunteers to making it happen.

28 / Fabian Policy Report 29 / People not problems SKILLS AND WORK upper eligibility threshold for both 30 Creating more good quality one in five schools does not even meet hours of free childcare (3 to 4-year-olds) vocational options any of the eight Gatsby benchmarks - a and tax-free childcare is £100,000 per Once they have basic skills in place, series of international markers of sound parent. It is not justifiable to provide a children are far better equipped to get careers advice.xxiii We must transform The ladder of couple earning £200,000 with 30 hours on in life. But to do so, they must have careers advice into careers and skills of free childcare (and tax-free childcare a meaningful choice of options that suits advice. We must avoid duplication and on top) when disadvantaged children their natural talents, whether those are redirect the many millions of pounds opportunity need support. We should reduce the academic or vocational. The government that support careers advice into a one- current thresholds for 30 hours tax- is starting to address this; the introduction stop shop, with a UCAS-style system for Everyone in our society should have access to free childcare and redirect funding to of T-levels in 15 different clusters of skills further education and apprenticeships help disadvantaged parents with will bring standard currency to technical and a careers skills passport as designed opportunities to learn, grow and thrive, childcare support. qualifications in the labour market, by Lord Young. writes Robert Halfon As my colleagues on the education something we lack in the thousands of select committee have also rightly qualifications that exist today. Looking after our most vulnerable stressed, we must look after our But we can do much more. As the students, rather than excluding them maintained nursery schools. These education committee has pointed out, School exclusions have institutions perform exceptionally well we must urgently capitalise on the skyrocketed in recent years.xxiv And - 63 per cent are rated ‘outstanding’ by enormous potential of apprenticeships. it seems astonishing that we are Ofsted compared to 18 per cent of other Apprenticeships change lives - they allow disproportionately excluding pupils xxii Robert Halfon is the Conservative MP for Harlow provider types. They are also more people to grow their skills, increasing who are least equipped to deal with this: and chair of the education select committee likely to be found in disadvantaged employability and earning potential. pupils with special educational needs areas, and cater for children with But we need to be smarter about how are around six times more likely to be special educational needs, than we use the new apprenticeships levy. permanently excluded.xxv The prospects ocial justice has been my compass An enormous wave working aged adults in England have other providers. The government The government should introduce more for excluded children in alternative Ssince I entered politics. I want to low literacy and/or numeracy skills.xvi has provided transitional funding to flexibility in how it can be used, and it provision are dire - just 1.1 per cent of bring voice to those who have none; of lost opportunity An enormous wave of lost opportunity these schools until it moves to a new should provide discounted travel for pupils who complete their GCSEs in hope to those who are on the margins of is about to come is about to come crashing down on the funding regime in 2019-20, but there apprentices. Businesses, meanwhile, alternative provision achieve five good our collective vision; and the ladder of next generation of employees: quite are concerns that some will close soon should offer higher minimum wages. GCSE passes including English and opportunity to those who have fallen by crashing down on unbelievably, a third of England’s 16 after if this then tapers away. We must There is, however, no point in creating maths.xxvi the wayside. I believe the best way to do to 19-year-olds have low basic skills. continue to invest in what we know better vocational options unless people Given that we know pretty well the this is to give people the means to learn, the next generation xvii And all of this in an increasingly works, and should make sure these know about them. We also, therefore, kind of children that are likely to be grow and thrive. The means to inquire. uncertain labour market where 28 per prized assets continue to receive the need a world-class careers service. At excluded - those with special educational The means to build their own prosperity. of employees cent of jobs taken by 16 to 24-year- support they need. the moment, we do not have this: around needs and children in care, for example In other words, I believe that the chance olds could be at risk of automation by - it is clear that early intervention is the to develop good skills and social justice Despite the progress that has been the 2030s.xviii answer and will prevent experiences are naturally bound together. made, social injustice is still endemic of multiple disadvantage later on. But in every part of our education system. Getting the basics right to do this effectively, we need to make Education has improved Almost half of children eligible for free We must spark a skills revolution and sure our mainstream teachers have the There is no doubt that education has school meals are not ready for primary this starts with the basics. Literacy and skills to support children with special improved in recent years, and I have school.xii Disadvantaged children are, on numeracy are the bedrock of academic education needs - at the moment, only a great deal of admiration for the work average, four months behind at the end and vocational success. The government 46 per cent believe there is appropriate the government has done to improve of reception, 11 months behind at the end is right to focus on standards and to training to enable them to do this.xxvii standards since taking the reins in 2010. of primary school and 19 months behind do this early; its focus on phonics, for We must support and encourage Our children’s education now has more by the time they do their GCSEs.xiii Just example, has had a significant impact on mainstream teachers to spend time in rigour. We have a system that encourages 1.1 per cent of pupils who complete childhood literacy.xix alternative provision; the knowledge schools to innovate and raise their game. their GCSEs in alternative provision But we must go further. Almost and skills they would acquire would be We are stripping out qualifications that achieve five good GCSE passes including half of children eligible for free invaluable to mainstream schools, and hold no real currency with employers. English and maths.xiv And the most school meals are behind the expected would help them manage more complex Exams are more challenging, which is disadvantaged students are almost four level of development by the time needs. And schools should be asked raising our children’s skills levels so times less likely to go to university than they start primary school.xx Good to publish exclusions data on their they can get good jobs and compete in a the most advantaged students.xv quality childcare can help plug this websites. We must also make sure that global skills race. The highest proportion Our failure to build an infrastructure gap. However, 57 per cent of parents alternative provision is of high quality of 16 to 17-year-olds on record are in that works for all means we have in lower income groups are put off in all parts of the country, and that we education.xi And we have some of the ‘Nightmare on Skills Street’, which from working, or working more open up far more options post-16. finest universities in the world. stops people from building the skills hours, because of childcare costs.xxi However, social injustices are endemic they need to progress in life. More than Meanwhile, we are giving major Delivering a balanced higher

and we have a skills crisis. a quarter (around nine million) of all concessions to wealthier families. The © flickr/WorldSkills UK education offer

30 / Fabian Policy Report 31 / People not problems We have become obsessed with important that our system offers a way elements of the system we want to build. DOMESTIC VIOLENCE full academic degrees in this country back. Rebecca, Lucy and Keith all show The evidence suggests that children and and we need more balance in our us the importance of providing these students also need social capital. Our most higher-level offering so that there are opportunities. As the Open University’s disadvantaged pupils could develop this pathways into intermediate and higher model clearly demonstrates, flexible by attending our best private schools - if technical education. There is enormous learning can be a powerful vehicle for only they could get to these schools. As Joining up opportunity in this. There are skills social justice. Its students are not required Schools Week has highlighted, just 1 per shortages in several sector, and a need to have completed A-levels (or equivalent cent of the 522,000 pupils in Independent for intermediate skills. And there are qualifications), and so prior achievement is Schools Council-member private schools support millions of people who want to get on not a hindrance to personal development. receive full bursaries for their school fees in life - preferably without a lead weight It is able to reach some of the hardest niches (a proxy for the lowest income earners). The interaction of problems makes it harder of £57,000 of student debt dragging on within our system and is the primary xxix To retain charitable status (and all the their feet. FE colleges, which are ideally provider of higher education in UK prisons perks this brings), private schools must for services to be effective in helping those placed to offer flexible and local options and secure units. Its flexible online learning surely do more to reach out to the most experiencing domestic violence – but we must for those who need this, should be better model makes higher education possible for disadvantaged pupils. The government tackle these complex situations head-on, supported to deliver intermediate and those who live in areas where there is no should set up a levy to encourage wealthier higher technical courses. local university. private schools to bring in society’s most writes Thangam Debbonaire We can also be creative about blending We need to protect the continuing disadvantaged pupils, which might include technical and academic education. learning sector and we can start by students on free school meals, children in Degree apprenticeships are a remarkable reinstating the support that existed prior need or foster children. A levy is not a tax example of a vehicle that does just that and to the 2012 student finance reforms for the and schools would be able to reclaim their could be the crown jewel in a revamped most disadvantaged pupils. It is also vital investment if they in turn invested in the technical offering. Students earn as they that we create clear routes from further futures of our most disadvantaged pupils. learn, they do not incur mountains of education into higher education; these Thangam Debbonaire is the debt and they get good quality jobs at the could be supported through ‘Next Step’ Looking forward Labour MP for Bristol West end. The government should incentivise loans for individual higher education We know that, now more than ever, their growth. However, this is not just an modules. And we must prepare the people must have a good education to upporting people with multiple disad- from it according to our needs. For Across the case studies in this issue of supply. Few families are aware of most vulnerable people in our labour climb the ladder of opportunity. And, Svantage requires intense input from a frail, elderly woman who has been report, the state’s failure to fulfil its degree apprenticeships, especially from market for the inevitable disruption that as I have set out in this chapter, it is well a number of different organisations. It mugged for her handbag we would duty to protect individuals from harm, disadvantaged families where the returns will accompany the ‘Fourth Industrial within our collective ability to make sure is not always easy, but the benefits are expect police sympathy and assistance, especially if their parents cannot could be most profound.xxviii Both the Revolution’, which we can do by this happens. We must craft a more fluid significant, both for the individual and care from the NHS, as well as concern or will not, is clear and so are the existence of apprenticeships and their value introducing a lifelong learning allowance. and balanced system and we must build for society as a whole. Looking at the in- and probably outrage from the public consequences of a social contract that should be hard-wired into careers advice. excellence all along the way. dividual experiences in this report gives if her story reaches the news. But what fails to assist vulnerable people tackle Levelling the playing field when it I invite you to join me in driving this us insights into the challenges facing about someone who has perhaps never multiple disadvantage. More effective Making it easier to learn comes to social capital vital agenda forward. To root out social society in getting support right and the paid in? Who has, some would say, help could have been provided by throughout life Creating a continuum of learning would injustice in our education system. To give benefits secured when we do. ‘chosen’ her substance misuse or her public services. It is possible that public For those who are not able to build dramatically improve the life chances of advantage to the disadvantaged. Until all I want to focus particularly on abusive partner, who some would say services considered the individuals to high value skills the first time around, the most disadvantaged individuals in individuals, whatever their background, domestic violence and how it interacts has ‘failed to protect’ her child, do they be too difficult to work with, or that the or whose skills have been wiped out society. However, it would be a mistake can get the education, skills and training with other forms of disadvantage seem like a worthy ‘victim’ deserving of multiple problems they had were too by a fast-changing labour market, it is just to focus on the more tangible structural they deserve. including substance abuse. We need our support? difficult to deal with. to reassess how interventions work It cannot be right to abandon those to protect victims and tackle complex vulnerable people because they do not needs. We have to ensure that services Every person fit prior assumptions about who the helping domestic violence victims is worthy of social contract works for. A failure to collaborate better with, for example, assist those with multiple difficulties interventions on substance abuse and public investment has a strong chance of harming others, mental health. Simply dismissing especially children and other close victims as too difficult to help, which to tackle the family members. Instead of turning happens all too often, has very real our backs, we should respond by costs, and keeps them at risk. disadvantages expanding our understanding of they face, even the social contract. Every person is The social contract worthy of public investment to tackle Every experience of severe and if that person the disadvantages they face, even if multiple disadvantage poses challenging that person is difficult to work with. questions for us to answer. With our is difficult to What does this mean in particular for social contract, we have an expectation work with individuals who have experiences that we put into the collective pot of domestic violence, mental health

© flickr/WorldSkills UK 2 according to our means and draw out problems, and substance misuse?

32 / Fabian Policy Report 33 / People not problems Abusive partners and perpetrator Rebecca was effectively denied mental receiving abuse. programmes health help when she was unable to meet When a family in which there is Too often, domestic violence the requirement to be free from drugs. domestic abuse comes to the attention of interventions focus only on the victim. Her drug use is intertwined with her social services, the questions around fit Rebecca’s case study tells us a lot about experiences of abuse and of relationships parenting generally focus on the woman. her, but it doesn’t tell us much about and has consequences for how our public Professionals often ask whether she her abusive partners. These men were services provide help. is protecting her child or whether she not only responsible for their abuse Some organisations are developing exposing her child to the risk of witnessing of Rebecca but also substance misuse. joint work with domestic violence, abuse by remaining with her partner? Interventions with them could have substance misuse and mental health Is her parenting adequate? Is the child helped Rebecca and her children. interventions, which is welcome, but attending school and if not, why is the One approach that should be considered more is needed. Local government has a mother not achieving this? Rarely, in my in cases of domestic violence is a domestic role to play in encouraging these services experience of years of work in domestic violence perpetrator intervention to work together more effectively and violence (until I became an MP in 2015), is programme. This assesses and manages overcome barriers to do so. But there is the default professional setting to ask the the risk abusive men pose to victims, a need to fund these services properly if same questions about the perpetrator. especially any children or young people, we want them to work together for better Social care systems and societal and to others, providing an evidence-based outcomes that help women, especially assumptions about gender mean that behaviour change programme. those facing severe and multiple women are expected to take overall There are many questions, concerns disadvantage like Rebecca. responsibility for parenting and the and sometimes misconceptions protection from the impact of abuse. This about domestic violence perpetrator Gender expectations of social reinforces, to victims and to perpetrators, interventions. Some practitioners interventions and perpetrators the assumptions placed on the woman by and policy-makers worry that such In abusive situations, we often expect her abusive partner that she is responsible programmes are a soft option for the victim to take disproportionate for care-giving in the family, that she the perpetrator, or that they may responsibility for her situation, a position should be the perfect mother, no matter be ineffective or even increase risk. which is neither fair nor productive. what violence has happened to her. The However, there is now evidence that a This is based on assumptions around child protection system expects her to

well-run perpetrator programme, with gender, which are ignorant of the power keep the violence away from her children, Vigerova © unsplash/Milada linked support for victims and a clear differences in an abusive relationship. yet this is something which few victims aim of safety for women and children, In the case of Rebecca, we must factor can achieve as the perpetrator holds the Challenges and contradictions child protection system. For women Conclusion will assess and manage risk and provide in her use of drugs and how that is decision-making power about whether, in treating social problems in with experiences of domestic violence, The interaction of problems makes a route to the cessation of physical and associated with her experiences of when and in front of whom to use violence. chaotic families it keeps them in harm’s way and at it harder for services to be effective sexual violence. Some organisations are Domestic violence in and of itself further risk. in helping those with experiences of developing joint work with substance tends to have a detrimental impact Even when public services do try severe and multiple disadvantage. misuse and mental health interventions, on mental health, as does substance to tackle multiple problems, there can I have specifically focused on which is welcome, but more is needed. misuse. Anxiety, depression and self- be clashes of culture between different domestic violence and how public harm are all too common responses to interventions. Most perpetrator services need to better help women Alcohol and other drugs are living with someone who controls ever programmes focus on violence cessation with these experiences. But issues associated with violence, they are not more of your life every day. But that will as a prerequisite, which may not fit around gendered expectations, its cause. often make it much harder to have the with the harm reduction approach of clashes of culture between different We cannot expect a drug treatment strength to seek help for the violence, or a substance misuse programme. The interventions, and the willingness programme to solve a domestic violence for any drug or alcohol use. philosophical framework for such of some in public services to write problem. Nonetheless, if an abuser were People facing severe and multiple programmes is likely to include taking off those who are hardest to help still using drugs, it would likely be useless disadvantage require the help of personal responsibility for change, are relevant to a much wider range to offer him a perpetrator intervention, several organisations, but chances but this will not work for the victim of issues. no matter how well evidence-based and are none of them will find it easy to in relation to the domestic violence – The failure to rise to the soundly provided. Chaos and reduced meet her complex needs. They may, the perpetrator is responsible for this challenge of addressing multiple mental awareness impede effective understandably, refer her on to another and changing the woman’s behaviour is social problems does not make those participation in a perpetrator programme organisation or write her off when not going to stop him from choosing to problems go away and the stories which requires weekly attendance at a she fails to make appointments. But use violence. contained in this collection are not specific place and time. Participants need dismissing people with these problems A co-located or jointly run substance isolated outliers. We policy-makers to be able to focus, reflect and articulate as unworthy of assistance is costly, misuse, mental health and domestic must tackle these complex situations their thoughts, feelings and memories. especially if they are parents. If we do abuse service with separate but linked head-on. We owe it to the people Similarly, working with some not help, a lack of stable parenting has provision for victims/survivors and experiencing multiple problems as well individuals to increase their safety and real costs including to the emergency perpetrators would be really useful as their children, relatives, the people mental health can be tricky without services and social care, to the criminal to manage risk and offer realistic trying to help them and the taxpayer

sorting out drug use. We learn that © flickr/Sjoerd L os justice system, and to the childcare and opportunities for lasting change. funding emergency responses.

34 / Fabian Policy Report 35 / People not problems MENTAL HEALTH professionals, research bodies and people with experience of mental illness to give evidence. At a recent meeting I was the only man present and yet there is a huge issue surrounding mental health and Lifting the masculinity. Does it come as any surprise that despite encouraging recent statistics, suicide remains the biggest killer of men stigma under the age of 45? Veteran Care Poor mental health can exacerbate severe and Lastly, I have a specific concern for multiple disadvantage and we must fight for better the mental health of veterans, of whom I mental health services, writes Johnny Mercer am one. Care for those who have served in our armed forces is the second major reason I entered politics. In 2012, we reached a very unwelcome threshold when, tragically, more soldiers and veterans killed themselves than were

© unsplash/Kristina Tripkovic killed on operational service in defence of the realm. Johnny Mercer is the Conservative MP challenge. We have made progress here, there is simply a medical, pills-based There are some genuine heroes in our for Plymouth Moor View but it must become a higher priority still. solution to how they feel which is largely communities and charities up and down There are also some specific services I what people expect from their doctor. This this land who work tirelessly night and ur mental health and wellbeing started. It’s only 100 years ago that we had unacceptable treatment. Rather than would like to see put in place. When you fundamentally misunderstands the issues day to look after and assist those who Ois a big part of who we are and we soldiers with what we would today term supporting William, the company feel unwell, it feels very much like being around mental health. Yes, there is an have found returning to a peaceful life the shouldn’t be surprised to see it as a thread post-traumatic stress disorder - men who terminated his employment through in a cloud. You feel isolated and it can be aspect to it that you can address by taking biggest challenge of all. running through all the experiences in weren’t able to function for one reason or ill-health retirement. an incredibly vulnerable time for people. medication. However, we need to tackle But over the years governments of this report. They show how mental health another - being executed for cowardice. Mental health problems are just so Some of the most vulnerable moments the root causes of what is giving you that all colours have made a fundamental problems can exacerbate severe and mul- We come from a pretty dark place. And debilitating. They affect one in four of for people are between 1am and 5am. anxiety. What is stopping you sleeping? mistake in seeing veterans’ care as a tiple disadvantage, and how help is too I know that there are people of a certain us, yet we are still fighting to be heard. Most people are asleep. They don’t even What is causing your depression? third sector responsibility, in the belief difficult to secure. generation, even within my family, who Fighting the stigma is a tough battle. But recognise this world that exists for lots of We must be a lot more joined-up in that the great British public, in all their Mental health challenges have been a just don’t believe in mental health. It’s it is one worth fighting. people. But for others, it is their reality: how we think about mental health. We wonderful generosity, support our troops thread in my life too. My own struggles quite shocking that we have this situation night after night they struggle with these need to reconfigure how we look at well enough. Any new call for help is met with OCD completely dominated my life continuing in this day and age. Support things. I want more services to help wellbeing – it includes things like having with the response: “Well, there must be a for a while and it never fully goes away. The struggles of William, Rebecca people sleep. a job, good housing and social networks. charity for that.” That is fundamentally You learn your own coping mechanisms and Lucy in accessing help and support Talking therapies can be a game We try to tackle these problems in and unequivocally wrong. I am not a and there is lots of help out there but it’s a Mental health for their mental health problems are all changer. I have looked around to see isolation, but no one talks about how they charity case and neither were my men. tough illness to have. problems are too common across the country. William what works, not only in other parts of the affect mental health. When we celebrate We gave the best years of our lives in had to wait over a year for a referral to UK, but also in Europe and the US. One high employment, that is a mental health defending the privileges, traditions and Stigma so debilitating. psychological support, while Rebecca of the best models I have seen is a 24-hour gain. We must look beyond the NHS to freedoms that this country enjoys. It is the That’s why I fight to remove the stigma and Lucy talked about help that never open centre. Psychiatric care is integrated our welfare system and our education duty of the nation to look after veterans around mental health and why it was the They affect one materialised. with other services, but the fundamental system to address our mental wellbeing. and their families when they return to first thing I spoke about in my maiden Access to early intervention can be principle is that professionals are talking I have been struck by statistics about civilian life. speech in the House of Commons in in four of us, a game changer for many, but public to the most vulnerable at their most young people growing up in homes in 2015: “Often, those who struggle with yet we are still services often step in too late when it vulnerable time. It’s not meant to be my constituency in Plymouth where there Conclusion mental health problems cannot shout comes to mental health. We have to an all-singing, all-dancing solution to is no father figure. Their role models are We have made important strides for themselves and suffer in silence fighting to do better in reducing waiting times everything we do. But it is a place to go. only in the media or online. That is a big in ensuring everyone can access the because of the ridiculous stigma placed for mental health support. When we Sometimes for people that are struggling problem, because people only see the best support they need for their mental on mental health. That stigma ends in this be heard talk about a parity of esteem between with mental health problems, what side of people on a public platform. A lot health. But we have to go further and parliament. It is not good enough to have mental and physical health, it has to matters is simply knowing it is there, of our young people, men in particular, keep fighting for better services. The sympathy, empathy even, or simply to William’s story shows us how far we mean something and be more than just whenever you need it. are missing out on seeing that it is OK to case studies presented in this report – as understand these issues when they affect still have to go to make our country work a sentence. We need to stop paying it lip have a bad day, and to talk about how well as the way we treat veterans - show someone close to us. It is time to get this for those with mental health problems. service. Acknowledging it and talking A holistic view you’re feeling. how far away we remain from getting right and I look forward to starting this When William first experienced mental more about it is important, but we must I am also wary of the over- I am a member of the all-party things right. We must not be content crusade in Plymouth [my home].” health problems at work, he received also redress the funding imbalance. We medicalisation of mental health treatment. parliamentary group on mental health with anything less than parity between The reality is we are improving but it a lack of understanding and some can’t allow the strain on other parts of the We need to stop people thinking that, which regularly calls on government services, easily accessible services and is slow. You have to remember where we pressure from his employer. This is NHS to constantly undermine this crucial when they have a mental health problem, ministers, NHS organisations, health no stigma.

36 / Fabian Policy Report 37 / People not problems ENDNOTES

i About us. Lankelly Chase: www.lankellychase.org.uk/about-us/ xv End of cycle report 2017: Patterns by applicant characteristics. ii Severe and multiple disadvantage: A review of key texts, Mark UCAS, 2018. Ducansmith and Julian Corner. Lankelly Chase Foundation, 2012. xvi Building skills for all: a review of England. OECD, 2016. iii The troubled families programme (England), xvii Ibid. Alex Bate and Alexander Bellis.House of Commons Library, 2019. xviii PwC Young Workers Index, October 2017 iv Funding of local authorities’ children’s services. xix PIRLS 2016 International Results in Reading. TIMMS & PIRLS, House of Commons Education Select Committee, 2019. 2016. v Early language development and children’s primary school xx Early years foundation stage profile results: 2016 to 2017. attainment in English and maths: new research findings. Department for Education, 2017 Save the Children, n.d. xxi Parents’ experiences of services and information in the early vi Failure to invest in early years provision risks creating years, Becky Gulc and Kay Silversides Social Mobility and “lost generation” and hitting social mobility, warns senior Child Poverty Commission, 2016. Labour MP, Lucy Powell MP. Social Mobility Foundation, 2017. xxii The role and contribution of maintained nursery schools in the vii Tackling disadvantage in the early years. early years sector in England, Gillian Paull and Danail Popov. House of Commons Education Select Committee, 2017. Department for Education, 2019. viii Unexplained pupil exits from schools: A growing problem? xxiii State of the nation 2017: Careers and enterprise provision in Jo Hutchinson and Whiney Crenna-Jennings. England’s schools. The Careers & Enterprise Company Education Policy Institute, 2019. xxiv Forgotten children: alternative provision and the scandal of ix Early years foundation state profile (EYFSP) results by pupil ever-increasing exclusions. House of Commons Education characteristics: 2018. Department for Education Select Committee, 2018. x Education in England: Annual report 2018, Jo Hutchinson, xxv Permanent and fixed-period exclusions in England: 2016 to 2017, David Robinson, Daniel Carr, Whitney Crenna-Jennings, national tables. Department for Education, 2018. Emily Hunt, and Avinash Akhal. Educational Policy Institute. xxvi Revised GCSE and equivalent results in England: 2015 to 2016. xi Participation in Education, Training and Employment by 16- to Department for Education, 2017. 18-year-olds in England. Department for Education, 2017. xxvii DfE (2018). Teacher voice omnibus: March 2018 survey. xii Early years foundation stage profile results: 2016 to 2017: Department for Education, 2018. Department for Education, 2017. xxviii Wilton, P. (2017). If degree apprenticeships are to widen access, xiii Divergent pathways: the disadvantage gap, accountability and we need to raise awareness. The Guardian, 18th August 2017. the pupil premium. Education Policy Institute, 2016. xxix Private schools take 1% of pupils from very disadvantaged xiv Revised GCSE and equivalent results in England: 2015 to 2016. backgrounds. Schools Week,28th November 2017. Department for Education, 2017.

38 / Fabian Policy Report 39 / People not problems