Malcolm argues we should invest spending on the first three years of children's lives
Debate on Preventative Spending Malcolm Chisholm (Edinburgh North and Leith) (Lab):
I start by paying tribute to Andrew Welsh for chairing the Finance Committee in a model, non-partisan way for the past four years, and for the contribution that he has made to his constituents and in public life more generally for four decades.

This is an important report from the Finance Committee, and a significant development of our work. The Parliament knows a great deal about what we spend in fact, we on the Finance Committee know everything about what we spend - but we know very little about what we save. We need to become very good very quickly at the science of preventative economics and I hope that the Finance Committee report makes a small contribution towards that.


Preventative spending goes much wider than the early years and health and social care, but there are good reasons for concentrating on them in the report. Briefly, in relation to health and social care, we have talked about the issues with a growing elderly population for many years, and we have also talked about shifting the balance of care and, in particular, trying to cut escalating emergency admissions to hospital through preventative and continuous care in the community. Indeed, that was the central theme of the David Kerr report. However, the fact is that, despite great progress in health over the past decade, we have not got anywhere with that agenda.

It is important to flag up both that point and the various issues that are connected with it in the report. It is a big challenge for the next parliamentary session. I believe - if I can be slightly partisan for five seconds - that Labour’s proposal for a national care service will help on that agenda, but the issue is wider. We will need more than that to shift the balance of care and balance of spending.

The most important evidence and recommendations in the report are on the early years. That theme was repeated in a conference in this chamber on Friday morning. I recommend in particular the words and wisdom of Dr Suzanne Zeedyk and Detective Chief Superintendent John Carnochan. Their evidence was given on 26 October and 2 November 2010, and members can also read their speeches in the transcript of last Friday’s conference.

I will start with a brief quotation from John Carnochan to the committee:

“the most important four years of a child’s life are those up to age three.” - [Official Report, Finance Committee, 26 October 2010; c 2555.]

I wish that that was written up on the Canongate wall. We know that it is not just somebody’s opinion. Other members have quoted some of Dr Zeedyk’s evidence, and she explained the neuroscience behind the truth that we all know that

“Children’s brains develop more quickly between birth - really conception - and the age of three than they ever will again.”
- [Official Report, Finance Committee, 2 November 2010; c 2614.]

The brains are in place at age three, which is why we need to refocus on the years nought to three - or, we should rather say, conception to three. We were told that the quality of early interactions is particularly crucial.

People say that if we concentrate on the early years agenda we will get results only in the long term. We will get results in the long term - we know that investing in the early years, particularly nought to three, will have implications in improved mental health, reduced crime and so on - but we should also point out that there would be benefits in the short term, too. Suzanne Zeedyk was particularly strong on that point. I do not have time to read out the quotation that I planned to read from column 2614 of the Official Report of the meeting on 2 November, but she made that point. That is important for politicians. It is difficult for us to invest now for benefits in 20 years’ time but, as she points out, we will have benefits within a very short timeframe - within one year - if we invest in the agenda.

Another theme was the tension between universal and targeted services. Derek Brownlee mentioned that with reference to health visiting, but - to mention a third witness - I was struck by the evidence from Dr Philip Wilson, who answered the conundrum by saying that we need universal services for screening and identifying the families and children who have problems, whom we then target. That is the key insight into the tension between targeted and universal services.

Let us refocus on nought to three. Let us build consensus around that, starting with the committees of the Parliament. I want also to say - this is a bit more controversial - that we need concerted central direction. As has been said, a lot of the evidence pointed in that direction. Again, I was going to read a quotation from Detective Chief Superintendent Carnochan at column 2574 of the Official Report of the Finance committee meeting on 26 October, but I am in my last minute so I had better not. He said, controversially, that we may have to reconsider ring fencing money for the early years and ensuring that all local authorities prioritise that work. I realise that that suggestion is controversial and anathema to many people in the chamber.

What is not controversial is the fact that we need to lead on preventative spending. Whichever way we think that leadership should be given, the Parliament has to lead on the agenda. Recognising the strength of the evidence that we receive, we must shift investment as far as we can to nought to three. I say “as far as we can” as I recognise the financial difficulties of the time that we live in, but if we shift investment to the early years we will save in the short term as well as in the long term. If the next Government - whoever it is - will not lead on the agenda, I hope that the Finance Committee and the Parliament as a whole will do so.
March 9th 2011 (15.24-15.30) Submissions made to the committee referred to by Malcolm in his speech Dr Zeedyk:
I would like the budget to give a commitment to the evidence that now exists everywhere that investing early brings all sorts of savings. We do not need any more evidence; we need a decision on whether we believe it. That is because, if we believe it, to do anything else with our money would actually be wasting it. All the discourse has been about long-term savings, but the story is much more exciting and powerful than that. We do not have to wait for the long term to get the savings. Politicians try to make decisions about where money will go, but they might not be in office in 10 or 15 years. However, we do not have to wait that long to see the savings.

Lots of evidence shows that if we measure the right things, as Anne Houston talked about, we will achieve savings within months and certainly within a year's budget. We just do not measure those things. We are used to thinking about the cost of prisons, mental health services and lack of academic achievement. The long-term savings will be achieved, but the model is not invest now, save later - if we measure the right things, the model is invest now, save now and save later. If we measured things such as the decrease in doctor visits, the increase in parents being able to attend work and the decrease in police call-outs for domestic violence, I have no doubt that we would see that we are saving money now.

The reason why early years services work is that they influence children's brain development. The neuroscience is now undebatable. Children's brains develop more quickly between birth - really conception - and the age of three than they ever will again. So we need to get the money into services and get support to families because, after that age, those brains are in place. If we delay, all that happens is we continue to spend our money in ways that are, frankly, dumb. We are wasting our money if we do not get it into early years services. In other words, early years services are not a luxury; they are essential if we are to do the things for Scotland that we want to do.

In 2007, the United Nations Children's Fund - UNICEF - produced a ranking of all the western countries, in which the United Kingdom came out at the bottom, next to the USA and ex-Soviet states. The question is how we ended up there. I can tell you that the answer is to do with our early years services. We will never move out of that position until we change the support that we give to families. All that I want to see in the budget is evidence that we believe the empirical evidence that is out there. That does not take courage; it just takes understanding that politicians who put money into early years services are wise and prudent - they are not brave, they are just wise. They are spending our money well.

Detective Chief Superintendent Carnochan:
I nearly used the phrase "big government", but that would be wholly inappropriate. However, if the national Government thinks that far more should be done about early years, there might come a time when it needs to decide that X amount of expenditure must be ring fenced and that, instead of leaving it to 32 autonomous local authorities - as we did with the sure start money - it will have intrusive supervision of how that money is delivered. Sure start was a fabulous idea that received £65 million, but where is it now? Until the situation changes, the Government should take control of how it will be changed, which will mean asking difficult questions and, as I say, having intrusive supervision of how the money is spent in certain areas over the next few years.

Of course, some great work is going on and some local authorities, such as South Lanarkshire Council and West Lothian Council, are doing effective things and facing up to those challenges. However, we probably need leadership from the centre, with the Government saying, "We're going to control this money and spend it where it should be spent."