Features: May 28th, 2004

Sure Start: What Do We Mean By ‘Mainstreaming’

By Naomi Eisenstadt

Reproduced by permission of the Public Management and Policy Association.

How do we ensure that every child gets services designed around their individual needs within a structure of mainstream services that reach all children, but are often not differentiated to particular families and children?

Over a year ago the main government programmes on early years and childcare were brought together under the Sure Start banner. The now not so new Unit is responsible for the delivery of local Sure Start programmes, the national childcare strategy, and nursery education. More recently, the Government launched the children’s green paper ‘Every Child Matters’ and established the Children, Young People and Families Directorate within the DfES. This new directorate includes Sure Start, and brings together children’s services from the Home Office, the Department of Health and the Department of Constitutional Affairs.

So what is Sure Start? It is a programme which aims to achieve better outcomes for children, families and communities. Sure Start is working towards increasing the availability of childcare for all children and improving the health, education and emotional development of young children. This means we are also supporting parents as parents, and in their aspirations towards employment.

The Green Paper reflects some of the early lessons from Sure Start about bringing services together, and also seeks to solve some of our more intractable problems around information sharing and workforce issues. Both the departmental reorganisation and the Green Paper also address some of the mainstreaming issues looked at in this article.

What would success look like?

The Sure Start Unit is jointly accountable to the Department for Education and Skills, and the Department for Work and Pensions. The overall Sure Start programme is an integral part of the Government’s strategy to eliminate child poverty; this can only be done by a substantial increase in childcare available for working parents. But our research shows that high quality pre-school experience benefits children whether their parents work or not. Furthermore, it shows that children do best when provision is integrated – where services for children and parents as far as possible are all in one place. Therefore, in the long term, success will be the availability of high quality integrated care and education for all children alongside more support for parents, including employment advice, adult literacy, advice on child health and nutrition, and on child language and behaviour.

The main strategy for achieving this success is the development of ‘children’s centres’. These centres combine high quality childcare and nursery education with parenting support, health advice and employment advice. The intention is to develop a core set of recognisable services under one banner, rather than the myriad of different services that have developed over the years from different strands: Sure Start local programmes, neighbourhood nurseries, early excellence centres. Children’s centres will build on what is already available in existing provision, and add the extras needed to ensure a core set of services is available.

In the first instance, we are establishing these centres in the 20% poorest wards, where there is the highest concentration of child poverty. But the activities in the centres will not be confined to the poorest children. Indeed, both the sustainability of the day care, and the quality of care and education experienced by children are enhanced by mixing children from different backgrounds. However, a key difference between children’s centres and conventional childcare is the requirement to do outreach work. These centres will not reach full day care numbers and then stop recruiting. The wider services will be available to working and non-working parents and efforts will be made to reach those who often do not make use of family support.

Sure Start is working on a range of issues that are significant for all children, and a range of activities that are targeted at disadvantaged areas. We want to build an infrastructure for all areas which encourages the growth of sustainable childcare alongside the free early education offer for all three and four year olds. We are doing this through reform of regulation, simplifying funding mechanisms, and reducing the planning requirements on local authorities. Through Sure Start children’s centres we are trying to ensure that new cash resources are concentrated where there is most need. So, what does this mean for mainstreaming? What lessons have been learned from working in disadvantaged areas that apply to poor children living elsewhere, and what lessons apply to all children?

Mainstreaming: reaching all poor children

Even with the extensive resources going into poor areas, it is possible to miss significant numbers of children. Nearly half of poor children do not live in the poorest 20% wards. Moreover, it is harder to be poor in areas of affluence, and it is harder to be poor in rural areas. Parents living in poverty have challenges that more affluent parents do not. Providing a good diet, a safe place to play, a quiet place to do homework, and adequate learning resources are all much harder without money.

Area based initiatives have the benefit of avoiding stigma because they usually have the critical mass of families with similar difficulties to sensitively provide services tailored to local needs. Such sensitivity is often lacking in professionals used to dealing with families where poverty is not an issue. Trying to reach all poor children requires front line staff in all areas to develop the sensitive practice usually found in professionals working in disadvantaged areas. It requires greater flexibility in the way mainstream services for all children are delivered, allowing much greater discretion at the front line for deployment of additional resources. The health professional may interpret a failure to attend as parental fecklessness, when sometimes it is failure of public transport. Real flexibility is money for the taxi to get to the speech therapist.

Mainstreaming: reaching all children

While Sure Start has been concentrating significant resources in disadvantaged areas, aiming to reach as many children in poverty as possible, the consideration of children not living in poverty, but experiencing difficulties is also important. The population paradox leaves us with some important public policy lessons. While the children of the poor are more likely to be in some form of difficulty, the actual numbers of children in difficulty will be greater for the general population than for those living in poverty. A big percentage of a small number can be less than a small percentage of a much bigger number. By concentrating on poverty as an overarching risk the danger is that families in poverty are further stigmatised, with the assumption that they are virtually all in difficulty, while middle class families feel less able to share their problems. For example, professionals can easily miss signs of domestic violence or alcohol abuse in middle class families. Both of these are prevalent across class boundaries, and are high risk for children. Reaching all children means a significant change in assumptions and prejudices on the part of professionals. It means training the front line workers who are in contact with all children to be more sensitive to the signs of difficulties. This has big implications for early years settings, schools and primary health care.

Mainstreaming: inherent tensions; key challenges

Mainstreaming presents some real challenges. Services for all tend to miss those most in need; targeted services can be stigmatising or simply not good enough. Public sector delivery of services tends to push towards a one size fits all model. It tends to be risk averse and sometimes obsessed with recording process rather than measuring outcomes. The best in the public sector do good by stealth. The voluntary sector can be brilliant, but its brilliance is patchy. It is not available to everyone, and sometimes what is available is less than brilliant.

The most difficult challenge is money. Even with the seemingly huge amounts of money going into disadvantaged areas, it is still dwarfed by the size of resources in mainstream services. Additional money, even quite modest amounts, helps to bring key partners around the table, but the real change will only be accomplished by the reshaping and redeployment of mainstream budgets: health, education and social services. Early childhood care and education has suffered from significant under investment; there is much to do to catch up. Building on the universal offer for three and four year olds is a good starting point, but it needs to be delivered with more flexibility and choice, particularly for working parents. A child spending two and a half hours a day at an early education place doesn’t allow a parent to work outside the home, unless it can be teamed with childcare arrangements.

The second most difficult challenge, and not unrelated to it, is workforce issues. Across the whole of social care and childcare, there are serious shortages of staff, as well as under investment in staff development and training. To deliver flexible front line services that are responsive to individual, family, and community diversity, there is a need to equip all the key professionals who come into contact with young children and families with a broader range of skills and knowledge. Basic advice on parenting, child health, and child learning should be consistently available for a range of front line workers; health visitors, nursery staff, teachers. And there is a need for job design that encourages flexibility and creativity at the front line. This would greatly increase job satisfaction, as well as deliver more appropriate accessible services.

Local Sure Start programmes are expert in delivering services in the most disadvantages areas of England to families experiencing real poverty. These services seem to be having some impact., but the real benefits will show up in years to come; reduced youth crime, reduced teen pregnancy, better educational outcomes. Mainstreaming what we have learned from working in new ways is not about having Sure Start programmes everywhere. It is about the existing services already widely available redesigning and reshaping what they can offer families and children.

Naomi Eisenstadt is the Director of the Sure Start Unit in the Department for Education and Skills.