SURE START WINS PRAISE-BUT DO WE KNOW WHETHER IT IS COST EFFECTIVE?

IN PRAISE OF SURE START

But questions remain over how to measure its cost effectiveness

Comment

‘Providing a Sure Start’, by Naomi Eisenstadt, tells the story of Sure Start, one of the flagship programmes of the last government. It tells how Sure Start was set up, the numerous changes it went through, and how it has changed the landscape of services for all young children in England.  It offers insight into the key debates on services for young children, as well as how decisions are made in a highly political context. Eisenstadt is a senior research fellow at the University of Oxford who ran the Sure Start Unit for its first seven years. She has extensive experience, both working directly with children and families and at the most senior levels in Government. Her last post before retirement was Director of the Social Exclusion Task Force in the Cabinet Office. Though clearly a fan of Sure Start she acknowledged that some mistakes have been made. She writes ‘The biggest mistake was not understanding the complexities of running a Sure Start local programme. Joining up local services across health, education and social welfare, commissioning a major capital project, working collaboratively with local parents, understanding the critical nature of data about the local population were all critically important factors in running a successful programme. However, often the individuals who had these skills knew little about young children and came from other career backgrounds. The early years workforce was then low skill, low paid and low status. People worked incredibly hard but we did not build a professional development programme to support this new workforce.  The second big mistake, aligned to the first, was that we vastly underestimated how long it would take to establish the services. Most of the programmes spent huge amounts of time in the first year just commissioning construction work. It took about 3 years to get a programme up and running while there was an expectation of improved outcomes within months. It is now clear that some of the disappointing results of the first outcome study were because very little was actually happening.  The disappointments were about the failure to deliver any real cognitive gains for children. Yet the social and economic gains for parents were substantial, and in time these improvements for parents may deliver the longer-term improvements in the life courses for children.’ Eisenstadt believes that, overall, the substantial success of the Sure Start scheme has been that the argument about the role government should play between birth and school is now won.  She writes ‘We never did a randomised control trial to prove that children benefited from school. We no longer need to deliver more evidence that the pre-school years are vital to children’s development, and that provision of services for young children and families is critically important.’ The debate on what those services should be, delivered by whom, aimed at parents or children, and at what age group care should start will run and run. However, she claims, the acceptance that there should be provision for such services, and that government has a role in regulating and at least partly funding this, is now firmly in place. However what she  largely fails to  address, head on, is  the accountability issues and value for money provided by the programme. The National Audit Office, in 2010, pointed out that given the diversity in how local Sure Start Services are delivered it is extremely difficult to work out whether or not they are cost –effective and they were not able to determine whether one particular delivery model was more efficient than another . The NAO stated ‘though the potential benefits of benchmarking  are widely recognised  our survey of children’s centres confirmed that only limited information was available’ Given the amount of public money invested in this scheme over many years (billions) this is surely  unacceptable .