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Let's all talk about sex

Teenage pregnancy is not just teachers' problem. LEAs must bring together the whole community to deal with it, reports Martin Whittaker

Torbay in Devon is known for its pleasant climate and golden beaches. The last thing you would associate it with is a high rate of teenage pregnancy.

And yet while many local authorities have seen their rates of under-18 conceptions fall over the past six years, the area - dubbed the English Riviera -has seen its rate increase by 13 per cent.

The Government is getting tough with authorities which fail to make progress on reducing teenage pregnancy. A recent announcement by Beverley Hughes, the children's minister, proposes a package of measures, including improvement in the quality of personal, social and health education (PSHE) in schools.

For secondary schools like Paignton community and sports college in Torbay it has not been for want of trying. Despite the borough's poor performance on the issue, Ofsted cited the support the school gives pupils in sex education as an example of good practice. As well as providing strong PSHE, the school has a TIC-TAC centre - an integrated health advice centre where pupils pop in at lunchtime to talk confidentially to trained health professionals.

"It can be daunting to ask a question in front of your class," says headteacher Jane English. "But to be able to speak to someone who is not a teacher, in confidence, is much more comfortable."

She is more acquainted than most heads with the complexity of the teenage pregnancy issue - she sits on the Government's teenage pregnancy unit's independent advisory group.

"Torbay does have specific problems, and the excellent PSHE at our school, which is one of eight in the area, will not alone bring down the teenage pregnancy rates," she says. "We need to work as part of a joined-up team in the area to tackle issues on all fronts."

Torbay Care Trust insists that it is working closely with organisations to address the issue. "We see schools as having a vital role to play in local efforts to tackle teenage pregnancy," said a spokesman.

Statistics show that nationally teenage pregnancy is falling, though by not as much as it should. In the six years since the Government's strategy to tackle it began, the rate has fallen by 11.1 per cent - there were 1,544 fewer under-18 conceptions in England in 2004 than in 1998. But this is somewhat short of the target. Its aim is to halve pregnancies among 15 to 17-year-olds by 2010. It has already missed its midway goal of 15 per cent by 2004.

One huge headache for the Government is the variation in performance in reducing teenage pregnancy rates between local authority areas. So what are the good ones doing right?

Kensington and Chelsea in west London, has seen the highest fall in teenage pregnancy rates among top-tier local authorities in England - in 1998 nearly 42 girls per 1,000 aged 15-17 became pregnant. This had fallen to 24 per 1,000 by 2004 - a drop of more than 42 per cent.

The borough says the key to its success has been a multi-agency approach to target vulnerable groups in deprived corners of an otherwise very affluent area. Its approach has included training GPs, nurses, teachers and youth workers in sex and relationship issues, as well as outreach work in schools and youth centres.

Neighbouring Hammersmith and Fulham has seen a reduction of 36.4 per cent in teenage conception rates since 1998. It cites an effective sex education programme in schools, including a growing number of primaries, as well as provision of accessible, young-people-friendly sexual health services.

In contrast, north London's Barnet has seen under-18 pregnancy rates increase by 42.7 per cent. A spokeswoman for the primary care trust admitted there had been care gaps caused by changes to combine the youth service and Connexions, and to front-line school nursing and health visiting. She said some schools in high-risk areas are not offering sex and relationship modules.

The Department for Education and Skills' teenage pregnancy unit has studied this variationin performance between authorities. Key features of all the high-performing areas in the study were: a strong focus on achieving healthy schools status; strong delivery of PSHE in primary schools; and training and support for schools, including programmes for governors.

Crucial measures also included providing a sexual health and contraceptive advice service that is credible, highly visible and young-people friendly.

The independent advisory group on teenage pregnancy has called for PSHE to become statutory at all key stages in the national curriculum.

Jane English says PSHE has become outdated. She wants to see a new compulsory programme with a new name.

Leadership and heads' commitment is critical to good sex education, she says, but ever-increasing targets are putting heads under pressure. There is a need, she believes, for well-trained and confident teachers to deliver sex education.

She said schools cannot do it alone - there needs to be a collaborative approach. It requires clear local-authority leadership to bring together all the relevant partners, good sex education delivered by trained, competent and confident staff, and involvement of parents and carers.

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