George Hosking, WAVE Trust Primary Prevention – cheaper than cure, better outcomes for children Church House, Westminster, 21 st March 2013 The Case for Primary Prevention

Without dramatic change, within 20 years Council unable to provide any services except adult social care and children’s services Irrespective of savings planned demographic change – more children, more elderly – will soak up every available penny Barnet Graph of Doom

The Barnet Graph of Doom

Continue on current path or Paradigm shift: Invest in primary prevention Fundamental choice

Continue on current path? Out of 12 million children under 16 in UK: Severely maltreated 1 to 1.6 million Physical neglect over 1 million Alcoholic in household 1 million Witnessing domestic violence ¾ million

40% of all spending on public services accounted for by interventions that could have been avoided by prioritising preventative approach Must prioritise expenditure which prevents negative outcomes arising Scotland: Christie Commission on Future Delivery of Public Services

Annual waste from adverse early years over £200 billion, nationally Includes cost of welfare benefits, crime, mental health, alcohol and drug abuse, violence, family breakdown, domestic violence, NEETS, prison service, looked after children, young offenders, special education doesn’t include... Lost tax revenue and costs of poor physical health Costs of continuing on current path

National and local strategies of primary prevention, rather than reaction Transformation of the quality of parenting – Respect for children’s right not to be abused or neglected Adoption of early years’ interventions that work A new paradigm

At birth: 10 trillion synapses trillion by age 3 Emotional brain largely created by experience in first 18 months; acutely vulnerable to trauma ‘ The child’s first relationship, the one with the mother, acts as a template … permanently moulds the individual’s capacity to enter into all later emotional relationships’ Key: understand the infant brain

Attunement between mother and infant develops empathy –lack of attunement means empathy does not develop Low maternal responsiveness at months predicted: – at 1.5 years: aggression, non-compliance, temper tantrums – at 2 years : lower compliance, attention getting, hitting – at 3 years : problems with other children – at 3.5 years: higher coercive behaviour – at 6 years : fighting, stealing Key factor: Attunement and Empathy

Primary Prevention does work

Successful Primary Prevention

Need for Primary Prevention ?

A National Strategy of Prevention SwedenUK % Live Births to teen mothers Infant Mortality (per 1,000 live) Smoking (% per day aged 15+) 1625 Alcohol (litres per person p.a.) 711 Adult Obesity (% of population) 1123 Smoking Related Deaths (per 100,000 popn) Chronic Liver Disease Deaths, < 65 yrs (per 100,000) 49 Cancer Deaths, < 65 yrs (per 100,000) 5667 Circulatory Disease Deaths, Under A National Strategy of Prevention