Outreach work is key to Sure Start

Ravi Chandiramani
Monday, January 18, 2010

It is becoming pretty clear that Sure Start will be a key election issue. For months, Labour has claimed that a Conservative government would decimate the service it has created, an accusation consistently denied by the Tories.

And so David Cameron last week set out plans on how his party would aim to improve Sure Start. Given Cameron has identified very few services as fundamental to Tory reforms, his intervention helped to underline the continued importance of Sure Start. The thrust of his argument was that it needed to demonstrate better value for money and focus much harder on its original purpose of reaching society's most vulnerable families.

There has been no shortage of sceptics about the value for money Sure Start brings. They range from the Taxpayers' Alliance's loopy and barely substantiated call for it to be axed last autumn, to the National Audit Office's recent assertion that there is "still scope for improving cost-effectiveness" in its submission to the select committee inquiry.

The Tories want to introduce a payment-by-results method to fund Sure Start children's centres. This reflects both a determination to get the best outcomes for children, and the tough economic times. School attendance and infant mortality rates have been mooted as possible measurements. But that alone would put centres located in deprived areas, with steeper social challenges, automatically at risk and undermine the party's stated intentions. We need much more detail on how payment-by-results would work.

The Tories' key method to reach the most vulnerable families is to redirect money councils receive for Sure Start outreach workers to fund 4,200 extra health visitors. This is misguided. They will gain satisfaction that the National Audit Office claimed to find only "a low level of outreach activity", but it is naive to think health visitors can simply replace outreach workers.

That we need more health visitors and that they should be located in children's centres is not up for debate. The crippling shortage of health visitors is well documented. But encouraging society's most marginalised, often troubled, families is not a soft leaflet-giving exercise. It requires the skills to go out into the community, form relationships with vulnerable people, gain their trust and bring in other agencies. Some health visitors will be capable of this, but it is not their core calling. Outreach work must retain its status for Sure Start to deliver on its original aims. And Sure Start must not become a political football.

Ravi Chandiramani, editor, Children & Young People Now

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