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Jan 18, 2021
Early Intervention: Smart Investment, Massive Savings
The Second Independent Report to Her Majesty’s Government Graham Allen MP
3 Year old children
Costs to taxpayer
Early Intervention: Smart Investment, Massive Savings
The Second Independent Report to Her Majesty’s Government
Graham Allen MP
‘We have all recently conducted reviews for Her Majesty’s Government in this field and while we agree on so much, we would like to particularly underline that all five of us strongly support this Report’s emphasis on the cost-effectiveness of Early Intervention. We feel it is vital that the Government now begins the groundwork to enable our late reaction culture to be transcended by an Early Intervention one. Our collective view is that the moment for a serious, sustained programme of Early Intervention, which is promoted inside and outside government, has arrived.’
Dame Clare Tickell, Independent Report – The Early Years: Foundations for life, health and learning
Rt Hon Frank Field MP, Independent Review on Poverty and Life Chances – The Foundation Years: preventing poor children becoming poor adults
Graham Allen MP, Independent Review on Early Intervention Delivery – Early Intervention: The Next Steps and Early Intervention: Smart Investment, Massive Savings
Professor Eileen Munro, Independent Review of Child Protection – A Child-centred System
Joyce Moseley OBE, Chair – Resolving Multiple Disadvantage: leading local responses to local needs
Acknowledgement The images on the front cover illustrate the negative impact of neglect on the developing brain. The first CT scan is from a healthy 3-year-old child with an average head size (50th percentile). The image below is from a series of three 3-year-old children following severe sensory-deprivation neglect in early childhood. The child’s brain is significantly smaller than average and has abnormal development of cortex (cortical atrophy) and other abnormalities suggesting abnormal development of the brain.
From studies conducted by researchers from the Child Trauma Academy (www.childtrauma.org) led by Bruce D Perry, MD, PhD.
Perry BD (2002) Childhood experience and the expression of genetic potential: what childhood neglect tells us about nature and nurture. Brain and Mind, 3: 79–100.
Executive summary xxiii
What they say about what has to happen next on Early Intervention xxix
Letter to the Prime Minister ( July 2011) vii
Letter to the Prime Minister ( January 2011) ix
The core message on Early Intervention xi
Chapter 1 Creating a culture change 1
Chapter 2 Leadership and co-ordination to enable investment in Early Intervention 13
Chapter 3 A locally driven agenda 23
Chapter 4 Building an Early Intervention Foundation 33
Chapter 5 External finance through outcome-based Early Intervention contracts 43
Chapter 6 Early Intervention funds and bonds 55
Chapter 7 Creating the social investment market and tax incentives 67
Chapter 8 Moving forward 79
Annex A The 25 best Early Intervention programmes in the UK 83
Annex B What government departments are already doing for Early Intervention 84
Annex C Early Intervention in Northern Ireland, Scotland and Wales 87
Annex D Introducing a franchise function 91
Annex E Concept paper: The Early Intervention Foundation 93
Annex F Outcome-based contracts and Early Intervention 100
Annex G Case study: Private Equity Foundation proposal for a Social Investment Fund for 105 Disadvantaged Children
Annex H Funds and bonds 107
Annex I Individual Savings Accounts 113
Annex J Consultation 117
I would like to acknowledge my debt to the review team, who have continuously dedicated themselves to this work throughout. Their perseverance, skill and efforts have made this Report a much easier task to complete. In particular the team leader, Dr Angela Donkin, has co-ordinated the team to extremely high standards, as well as managed my expectations! Other members of the team that I would like to thank are my policy advisers from HM Treasury and other government departments, including Clive Senior, Laura Julve, Stuart Broom, Sam Tendeter, Lauren Kocan and Almudena Lara. I must also thank Nick Bodle for his essential administrative support and Matthew Woolston, who has linked my work in the House of Commons with this Report.
The review team and I have received incredible support from many external partners and individuals. I would like to thank, in particular: The Social Investment Business, Royal Bank of Canada; Coutts; Rothschild; Triodos Bank; Deloitte; Private Equity Foundation; BlackRock; PricewaterhouseCoopers; Impetus; Charity Bank; The Young Foundation; Royal Bank of Scotland; Birmingham City Council; Manchester City Council; Nottingham City Council; Oxfordshire County Council; East Sussex County Council; Hertfordshire County Council; Westminster City Council; Legal & General; Functional Family
Therapy; NESTA (National Endowment for Science, Technology and the Arts); Incredible Years; London Early Years Foundation; Family Nurse Partnership; Barclays Capital; McKinsey & Company; Number 10; NS&I (National Savings and Investments); Co-operative Bank; National Academy for Parenting Research; Greater London Authority; 4Children; and The Children’s Society.
Additionally, a number of individuals have been extremely supportive of the review, including: Ray Shostak; Matthew Pike; Richard Heller; Jim O’Neill, Goldman Sachs; David R Adair, Richard Collier-Keywood and Ian Oakley-Smith, PricewaterhouseCoopers; Richard Haseldine; Roberta d’Eustachio, Ambassador for Philanthropy; Stanley Fink; Professor Michael Little and Nick Axford, The Social Research Unit at Dartington; Christopher Egerton-Warburton; Charlie Green and Tom Attwood, Trustees for the Private Equity Foundation; Chris Robinson, Mayor’s Fund for London; Sir Howard Bernstein, Manchester City Council Chief Executive; Ian Charlesworth, The Social Investment Business; Ian McPherson, Metropolitan Police; Peter Wanless, Big Lottery Fund; and Stephen Hughes, Birmingham City Council Chief Executive.
I hope that those whom I have inadvertently omitted will forgive me.
Letter to the Prime Minister (July 2011)
Rt Hon David Cameron MP 10 Downing Street London SW1A 2AA
4 July 2011
Dear Prime Minister
I have completed my second Report, Early Intervention: Smart Investment, Massive Savings, in order to deliver it before the summer Parliamentary recess. As with my first Report, to implement the recommendations requires no legislative time and no net increase in public expenditure, but it does now need your political commitment to turn talk into action.
It proved hard to finance Early Intervention in our country even when public resources were abundant. Now that they are severely restrained, the task may seem impossible. However, Early Intervention turns this conventional wisdom on its head by reaping massive savings in public expenditure for the smallest of investments in better outcomes, and by avoiding expensive provision when things go wrong. By building out the immense costs of failure, it is in fact the best sustainable structural deficit reduction programme available.
My review, which has involved thousands of practitioners, service managers, policy makers and ministers, shows that there is an urgent case for greater investment in Early Intervention. There are no ‘magic bullets’ or instant cures – they do not exist. It has proved difficult; however, this Report outlines a serious programme of hard work to build a base from which to go further. People across the country have identified imaginative and creative ways to change our ‘late reaction’ culture. I know that ministers are persuaded, but my experience in compiling my reviews makes it clear that the whole official machine has to come to the party too, and my Report suggests how this can be done.
However, this is not a task for the public sector alone. This Report makes recommendations that will enable others – from neighbourhood charities to City financiers – to play a part in keeping with your approach to rebuilding civic society.
My first Report detailed the immense penalties to society and to the individual of failing to provide a strong foundation of social and emotional capabilities early in life. This second Report focuses more on addressing the vast financial and economic costs. It illustrates not just the price of failure to the taxpayer but the deadweight on the economy of carrying – across the generations – underachievement, low skills and poor educational attainment. Failure to address these will render us vulnerable to global competitors. Early Intervention must become a key priority for both our economic as well as our social renewal strategy.
viii Early Intervention: Smart Investment, Massive Savings
In this Report, I propose two complementary approaches to funding: one is to use current public funding more effectively; the other is to mobilise additional investment fro