19/03/15 – Q&A with the President of the British Medical Association

Speaker: Sir Al Aynsley-Green: President Elect of the British Medical Association

Wednesday 18 March 2015

Chair: Baroness Benjamin


‘Our UK children are fantastic but do we celebrate that sufficiently? I recently visited a town where 3 children had been killed on the Great North railway lines, they had been drunk; the area had   no sports facilities, youth clubs had closed and the children’s friends asked me to go and see the reality of many children’s lives today. The obstacles that such children face are diverse and horrendous. How can we, one of the fifth richest nations in the world have allowed ourselves to get into this position?

Education is a minefield; 37% of Olympic athletes attended fee paying schools. Medicine, acting, the arts and the law are dominated by those who have enjoyed the privilege of an independent education.  Why are we not giving those opportunities to other children?

In terms of youth justice, 80% of young offenders in prison re-offend. Comparing UK institutions and Spanish equivalent (they are not called prisons, they are called centres for re-education) they are not staffed by prison guards, but educators (trained in psychological management) and the focus is on re-education and re-integration. Why do we prioritise a   punitive attitude here? The starkest example of that is that in the UK, children, like their adult counterparts, are transported to prison in sweat boxes.

According to the Chief Medical Officer, more children die unnecessarily because of poor services (from common conditions like epilepsy, asthma and cystic fibrosis) than in our neighbour countries. One child in ten has a diagnosable mental health problem but only 25% have access to restorative services. That is the scale of the problem. I welcome the launch of the task force and Nick Clegg’s announcement of increased funding for child mental health services.

Who cares and where is the outrage now?  Victorians such as Charles Dickens were appalled and outraged by what they saw in society.

I visited  Finland recently  and asked what it was like to be part  of a family and young in Finland;  the country with the best outcomes, for childhood, in the world. From this trip my first ‘action point’ developed. Do we listen enough to  parents and  children?

I visited a community nursery, which was passionately supported by the local community. The staff were largely  graduates (most in child health or child psychology); their jobs were well paid as befits a  widely respected and desirable profession.

I also visited a school, which did well on the ‘smile’ index. The country has a truly comprehensive education system where every child is valued. The school’s philosophy was child-centred; there were no league tables, no Ofsted and the teachers were trusted by parents and politicians alike. The children were assessed against their own achievements.

The key words which make Finland the best country for a child are ‘attitude’, ‘trust’ and ‘common sense’. The attitude towards each child is positive with the importance of a good education as beneficial to the entire family at a premium.  Parents and politicians trust teachers. The policies pursued are grounded in common sense and based on what is best for the nation.

In Canada I saw that localities map the lives of their children by post code; all knowledge about the life of a child is mapped. Where were the crèches for example, or the after school clubs? That information was then used to deploy and target resources.

What is the purpose of education and what is the role of health in schools? Why should health inform schools? These are the points that we should perhaps start with in our discussions.’

Baroness Benjamin: ‘Before opening the floor to broader questions, the question I would like to ask is, when did we tear up the roadmap on what childhood should be about, and who created the new one? After working with children for the last 40 years, I have repeatedly heard derogatory phrases such as ‘it’s only children.’ Somewhere along the line politicians have forfeited the trust of teachers and professionals. We need to create a roadmap for everybody to start following. How do we create the new map? Perhaps Groups like ours will be able to help. We have not fully understood that childhood and its effects, lasts a lifetime.’

Comments and questions

The Criminal Justice system appears to write-off children who encounter it, with ex-offenders having to declare their records. What can we do about that?’

Sir Al Aynsley-Green:   ‘In Canada, 10 years ago, the Youth Criminal Justice Bill was passed. With a carefully orchestrated PR campaign, the government closed half of its secure estate; moving to restorative justice, flexibility (in terms of the police response to a variety of situations), re-education and integration. This was coupled with effective community sentencing. The Canadians also put emphasis on the fact that alcohol before birth was a  contributory factor in  learning disability (a high number of young offenders had been affected in this way). The antecedents of crime start before birth.’

From the floor

‘The dominance of children of independent schools in the professions is very well documented. Are we contributing to this divide with the growth of academies? Should there be a focus on small educational establishments with more of a community feel?’

Sir Al Aynsley-Green: ‘This is part of a fierce debate about the philosophy of education. It is morally wrong for a child’s opportunities to be based on their parent’s ability to pay.’

Baroness Benjamin:  ‘My daughter is a teacher who believes that it is important to stay with children and invest in them. The parents of children in independent schools have invested in them to learn. Families need to understand that ‘education is your passport to life” as my mother was accustomed to say. We need to educate parents, although it is initially easier to educate children about this. I would like every school to be like an independent school with that commitment towards investment in each child.

What is missing in the UK education system is a sense of democracy. Is it to do with teachers’ professionalism? Teachers have certainly been undermined in the last few decades.  When it works, the pedagogic relationship between teachers and children is great. Changes and regulations in recent years have been oppressive and have disrupted the relationship between the child and teacher. The situation as a consequence is  that education professionals are feeling undermined and children forgotten.’

Sir Al Aynsley-Green: ‘Underpinning the entire debate is a  simple question: “What is the purpose of education?”

From the floor

‘It is nurture, by any other name, to help individuals reach their potential and also to learn how to make a difference in the wider world. The big attitudinal stumbling block is that of not seeing the country’s ultimate future as the fate of our children in the here and now. How do we get parents to reassess their attitude to education?’

Sir Al Aynsley-Green: ‘Discussion with a group of Head teachers concluded that the purpose of education was to help support every child (and their family) to achieve their full potential and secondly to become healthy, creative, confident children now and therefore healthy, creative, confident adults in years to come. ‘Healthy and confident adults’ are those who are properly equipped with the skills to cope with life.  League tables are not part of the picture!’

Baroness Benjamin:  ‘We have been lobbying to get all of that into the delivery of  PSHE in schools, it is very important. There is often a fear of developing authentic relationships with young people displayed by  those who work in public services ( typically  mental health, social services and education).  It is essential that such relationships are developed. One of the most helpful things in the lives of many young people I have spoken to is that at some time they can say ‘someone listened to me’.

Sir Al Aynsley-Green: ‘’The UNICEF Rights Respecting schools agenda (Respect for each other, responsibility for each other and understanding their rights) was adopted by schools in Poole and Andover. The local authority then decided to become a Rights Respecting Local Authority. The beneficent influence from the school then infused into the local community.’

Sir Al Aynsley-Green:  ‘It is worth considering what health issues  the education sector should be involved in.’

From the floor

‘There should be additional investment in educators, especially within primary schools and prioritising the developmental needs of the child within on-going professional training modules.

Respect for teachers has been lost. It is now “easy” to become a good teacher in that it is a competency-based system making it easy to teach and access courses. We have teachers acting without knowledge of philosophy of education or child psychology because we have a competency-based system. The idea that league tables raise education standards is a myth.   Education is for educating people to see how they can make a difference in the world.

The Government response to the letter written by 128 experts in the field seeking to re consider the idea that ‘play’ could not be learning (including the instance  that children in Finland do not start full time education until age 7, supported by well trained, highly educated staff) was to dismiss the signatories as those who are responsible for the devaluation of exams and a culture of low expectations for state schools.’

From the floor

‘Finland clearly has a very integrated strategy. What was the impetus for that? How do we affect that cultural change here?’

Sir Al Aynsley-Green: ‘At the end of WW2, there was a general recognition in Finland that of the need for  a focus on children. ‘

From the floor

‘In the UK there is separation between policies (our systems grew up as different organisations) in health and education.  The Department of Education is responsible for the whole child but only deals with academic learning issues. .  Child health should be incorporated into teacher training because certain skills are needed for the education staff to ensure that children are healthy and thus  able to benefit from education. We need a system change, early intervention, and methods of working with  families in a positive way to support parents in their  understanding of  the importance of nurture and learning. We should   learn from the children on the margins of society, those in care, who (despite the money spent by the state) are still failing.  A system change is required combined with early intervention. The language and building blocks with  which to work and support parents and families  must  be in place from conception to age 2.’

From the floor

‘We need cross-departmental accountability; there are bunkers between the departments, there should  be a louder call for a Minister for Children and more joined-up thinking.’

Baroness Benjamin: ‘Children’s issues are not political. It took 20 years to get a Minister for Children in place; in 2003 there was an entire Department. Unfortunately that was not seen to be working and the role has now been relegated to add-on status.’

From the floor

‘How do we support and encourage breast feeding? Breastfeeding is essential in the first six weeks of a baby’s life; people do not know where and how they can get help for this.’

Baroness Benjamin: ‘It is part of understanding and nurturing and the whole relationship (the baby hears the mother’s heart beat 10 times a day). It meets many needs; for instance, mothers who breast feed are less likely to be depressed. Inspired by the previous APPG report (and her own personal experience in Parliament) Jo Swinson MP is carrying out a review in this area.’

From the floor

Joining the dots – theme common to health and education is “learning for love”.  Education feels like it happens to you whereas learning feels more personal and empowering. Is there a need for a change of language?

Play is learning, in a meeting with DFEE there was no one to speak to about play as learning (despite it being 1/5 of the school day).

Sir Al Aynsley-Green:  ‘There has been a systematic dismantling of Every Child Matters, which has had consequentially   catastrophic effects for children. This ground-breaking document attempted   to break down the barriers caused by Sovereign Departments of State as opposed to a holistic, inter departmental approach.’

The work of the APPG

Sir Al Aynsley-Green asked what the Group would  do to help achieve the required improvements and changes? Baroness Benjamin pointed out that this was a very busy and active Group which had achieved a lot in a year. Furthermore, the Group would contribute towards a checklist, which could then be held against the Early Years Report to create a scorecard that the Group could use to hold government policy to account, by “Ofsted-ing” the government.

Baroness Benjamin concluded  that the meeting had been positive, challenging and thought provoking.

The meeting closed.