The Committee has invited evidence from a range of organisations to contribute to its consideration of the extent to which Welsh Government policies and programmes support the early parent role, before birth and during the first 2 years of a child’s life, and crucially how effective these are in supporting children’s emotional and social capabilities and development

The contacts that all parents have with services before and after the birth of their child, provides a unique opportunity to work with them at a stage which is so vitally important to the development of the child.  For example, Midwives and Health Visitors who meet with parents on a regular basis during pregnancy play a pivotal role in the early identification of those ‘at risk’ or ‘suffering’ with mental health problems,  facilitating access to expert advice where required to both prevent problems from occurring or being exacerbated. 

Health professionals promote the concept of resilience, and advocate for the ‘normalisation’ of perinatal mental health problems, whilst addressing both the physical and emotional aspects of parenthood which impact upon the baby’s well-being and healthy social and emotional development. Welsh Government programmes need to play a key role in advocating that all relevant Health Professionals have an awareness of the Intergenerational transmission of poverty  model and its impact i.e. productivity losses, losses of quality-adjusted life-years (QALYs), development of emotional and conduct problems in children potentially leading to young people leaving school without qualifications.

Childminders, Nurseries and Childcare settings caring for under 2’s must also play their part in focusing on the attachment needs of babies and infants; OFSTED/ESTYN  should be asked to provide specific guidance on how this can be measured effectively.

The evidence base regarding the importance of the environment within which a child develops, from conception through the early years, is continually being developed and enhanced. There is a growing understanding and appreciation of the impact of Adverse Childhood Experiences (ACEs), and evidence from evaluations of specific programmes such as Flying Start, Families First and others provides a rationale to inform the investment and development of prevention and early intervention services.  

While targeted interventions delivered as part of Welsh Government programmes e.g. Flying Start are an essential component in supporting children and families with specified risk / need during the first 1,000 days, it is also important to consider the needs of the wider population.  There are children and families, who either live outside of geographically targeted areas, as well as those who fall below the criteria set for accessing targeted services, who still have needs which would not be addressed through targeted programmes.  The ability to address this “unmet need” is currently dependent on the availability of alternative universal services.

The opportunity to affect change in terms of health behaviours and general well-being exists before pregnancy occurs, i.e. when children are developing into young people (and the parents of the future). Therefore there is an opportunity to invest in education and targeted support for this group in order to encourage behaviour change in the pre-conception phase. The role of school nurses is absolutely crucial in terms of helping to build the resilience, skills and understanding of young people so that they feel prepared for adulthood and its responsibilities.  However, the focus on immunisation and other targeted interventions, whilst of course necessary and expected of school nursing services, often means that there is limited or no capacity to undertake wider public health focused education and early intervention support.  The benefits of a fully enabled school nursing service, designed and predicated on the needs of the school aged population is essential as there is a need to undertake the preventative work, acknowledging the need to invest in the wellbeing of future generations.

Policies and programmes which support children with disabilities or congenital abnormalities are also crucial.  The level of support available to children with disabilities and their families, especially in the first 1,000 days is worthy of exploration, along with the workforce development and planning requirements to meet need. Access to robust medical and nursing care within local and tertiary centres, as well as the community and primary care level, are an essential element of supporting positive outcomes for the child and their families.

A number of policy initiatives have clearly set out the expectation of society in terms of protecting and promoting our children’s health and wellbeing. It is essential that all agencies work together, with our communities, to address factors that adversely affect a child’s overall wellbeing.