The hardest lesson of all

Over the last two months we have witnessed an explosion of
headlines in the national press around the issues of underage sex,
teenage pregnancy and the availability of confidential sexual
health advice and treatment for children and young people.

May kicked off with reports of children as young as 10 being
prescribed the Pill by GPs and family planning clinics, and of a
mother planning to take her daughters’ school to court over its
decision to make the morning after pill available to underage girls
without parental consent.

The month ended with coverage of the now infamous Atkins
sisters, who have each had a child while still at school (see
picture) and whose mother blames their schools for failing to
provide adequate sex education early enough.

And in June, media interest moved on to concerns about the
explicit descriptions of oral and anal sex in the latest leaflet
for young people from sexual health charity fpa.

All of these examples demonstrate both the complexity of the
issue of educating children and young people about sex and
relationships, and the ongoing uncertainty about who is ultimately
responsible for delivering this education – not to mention how and
when.

Since the Social Exclusion Unit flagged up the UK’s position in
1999 as the teenage pregnancy capital of Western Europe, the issues
of sex education and teenage pregnancy have become top priorities
for the government.

Among other things, it has set itself a target of halving the
under-18 conception rate by 2010, launched a national teenage
pregnancy strategy setting out how to achieve this, and set up
independent advisory groups on teenage pregnancy and on sexual
health and HIV.

It has also issued updated guidance on sexual health services
and confidentiality for professionals working with children and
young people, backed various initiatives to help parents talk to
their children, and updated guidance on delivering sex and
relationship education (SRE) in schools.

However, contrary to advice from the advisory groups, the House
of Commons health select committee, professional bodies, and sexual
health charities, the government has repeatedly refused to make the
one move which many believe could make the biggest difference:
making personal, health and social education (PHSE) – including SRE
– compulsory under the national curriculum.

Under existing arrangements, the only elements of sex education
that are compulsory are the biological aspects of human growth and
reproduction covered under national curriculum science. At
secondary school level, schools must also offer education about HIV
and Aids, and other sexually transmitted diseases. In addition,
schools are required to contribute to the personal and social
development of their pupils.

Beyond that, headteachers and school governors are obliged to do
no more than “have regard” to government guidance when developing
their SRE policies, and make sure any sex education they do provide
is embedded in PSHE “to ensure that pupils consider the moral
aspects of sex education and are encouraged to develop loving and
caring relationships”.

But embedded or not, with PSHE remaining outside the national
curriculum, SRE is rarely going to top the average school’s agenda.
Indeed research published in January by the schools inspection body
Ofsted reveals that some schools still do not provide PHSE “in any
form”.

The introduction of citizenship as a national curriculum subject
in 2002 has also put PSHE programmes including SRE under serious
pressure in half of schools. “This has had an immediate and
negative impact on the provision of PSHE in these schools, which
have had to cut back on their core material,” Ofsted warns.

The report, based on evidence gathered from 160 schools across
the county, adds that the teaching of PSHE continues to be hindered
by the failure to recruit teachers with directly relevant subject
qualifications. As a result, although many schools have tried to
develop specialist teams of teachers through extra training, in
many others PSHE is still taught by inadequately trained form
tutors.

To try to address this problem, the government has developed a
certification programme for teachers of PSHE, including a
specialist module for SRE. It wants to see at least one teacher in
each secondary school complete the training – but has no deadlines
for this or plans to make the programme compulsory.

But sex and relationship education does not start and end at the
school gate. As children’s minister Beverley Hughes insisted
recently after Julie Atkins pointed the finger of blame at her
daughters’ schools, parents must do their bit too.

But many parents are not – or, at least, do not think they are –
up to the job. In 2002/3, over 4,000 parents called the charity
Parentline Plus with concerns about their children’s sexual
behaviour and relationships. Analysis of the calls reveals that
parents are desperate for support and help in how to talk to their
children and tackle this behaviour and its consequences. They also
have little understanding of what is being taught to their children
in SRE in school.

Helping parents talk to their children has been a key strand of
the teenage pregnancy strategy from the outset, as has encouraging
parental involvement in the development of schools’ SRE
policies.

The Teenage Pregnancy Unit continues to support Parentline Plus
to implement the Time to Talk initiative aimed at helping parents
develop confidence and skills in talking to their children about
sex and relationships. And the fpa’s Speakeasy community-based
education project has received funding from the Parenting Fund to
train children’s centre and Sure Start workers so they can deliver
the programme to local parents.

“Fundamentally, we know that not all parents feel able to talk
to their children – they also feel they do not know enough as they
didn’t get good sex education themselves,” explains Brook chief
executive Jan Barlow.

“Comprehensive sex and relationships education helps young
people delay having sex and makes them more likely to use
contraception when they do become sexually active. Leaving it just
to parents means you could have some children falling through the
net.

“If we were to make PHSE including SRE compulsory, we would at
least know there would be some consistency.”

More information from:
www.dfes.gov.uk/teenagepregnancy 
www.brook.org.uk 
www.fpa.org.uk 

The facts:

* In 1998, there were over 100,000 conceptions a year to
teenagers in England, of which 8,000 were to girls under 16.
* Under-18 conception rates fell by 9.8% between 1998 and 2003. The
government target is a 50% reduction by 2010.
* 2004 conception data is not expected before February 2006, but
the Department for Education and Skills predicts the figures will
not be sufficient to meet the interim target of reducing teenage
conception rates by 15% by 2004.
* 50% of under-18 conceptions occur in 20% of wards with the
highest rates. These neighbourhoods have now become the subject of
a new teenage pregnancy “hotspots” strategy.
* Under-16s accounted for 3967 legal abortions in England and Wales
2003.
* New episodes of chlamydia in under-16s rose from 787 in England,
Wales and Northern Ireland in 1999 to 1426 in 2003.
* A recent survey of 1,300 young people aged between 16 and 18
found that just over half thought chlamydia only affected women,
and almost a third thought STIs could be caught from a toilet
seat.
* Around 500 teachers completed the PHSE certificate when it was
rolled out nationally in 2003/4. In 2004/5, approximately 2,000
teachers embarked on the course, and funding for a similar number
is available this year.
* 325 nurses participated in the certification programme for nurses
working in schools in 2004/5. Funding is available for up to 800
nurses to participate in 2005/6.