Consideration of amendments on Report resumed.
Clause 14 [Duty of local authority to ensure visits to looked after children and others]:
24: Clause 14, page 12, line 31, after “must” insert “—
The noble Baroness said: My Lords, in moving Amendment No. 24, I will speak also to Amendments Nos. 25 and 26. Since debating similar amendments in Committee, I have had a most helpful meeting with the Bill team, whose members assured me that the Minister is committed to dealing with these issues in guidance. Why then, noble Lords might ask, am I bringing this back to the House? The aim of the amendments is to clarify to social services departments that their visitor to a looked-after child should, except in exceptional circumstances, be a person known to the child.
We know that in going through the process of becoming a looked-after child, a child is very likely to have already been through at least three different workers for administrative reasons. The Minister said in our previous debate that the use of the term “exceptional circumstances” is too strong, and of course I understand why he took that view. Indeed, if we were dealing with less damaged children, I would be inclined to agree with him but, in the context of looked-after children, I ask him to consider most carefully whether in fact the wording is strong enough as it stands.
For example, if a social worker moves to a different team, I suggest that it should not be automatic that his entire caseload of children is immediately passed to a different social worker; but I understand that this happens routinely. One must think of this group of children, who have been let down by their parents and let down no doubt by a number of different people. Then they have gradually begun to make a relationship with a social worker and, just because of some administrative change, they are let down by yet another person. That is how they will see it; it does not matter what anyone says. That is really the essence of the amendment. We need to think of the child first and of our administrative considerations second. I am sure that the Minister will acknowledge the overwhelming importance to looked-after children of continuity of care, and I look forward to his response to the amendment.
Amendment No. 26 again focuses on the need for continuity but, in this case, the amendment requires that looked-after children who are remanded or sentenced to a period in custody should receive continued support from their social worker before, during and—ideally—after custody. I thank Barnardo’s and NCB for their very helpful briefing on the amendment, which is also supported by the Children’s Society, Rainer, Voice, Youth Access and NLCAS. I also thank Tim Kent of CAMHS in Tower Hamlets for his help on this and a number of other amendments.
We talked at length in Committee about the very high risk of children in care being taken into custody, and I certainly do not want to repeat those arguments. I welcome the assurances given by the Minister in Grand Committee which relate to looked-after children who enter custody. I could go through those but will not; it is late at night and people want me to keep this short. Despite those assurances I agreed to move the amendment because, along with Barnardo’s, the NCB and others, I believe that the requirement that the visitor be a local authority employee and have the necessary training and qualifications should be in the Bill. That requirement has particular importance for a looked-after child in custody. Also, the welfare and assessment visits cannot properly be carried out by the youth offending team worker, even if he or she is a social worker. That is the contention of the amendment.
The work done by the National Children’s Bureau in 2006 supports that view. The needs of children from care placed in custody are not met. Custodial establishments are often not aware of the child’s previous status or what services they might be entitled to on their release from custody. The youth offending team will have case responsibility for those children, but its main function is prevention of reoffending. There are essential functions for a qualified social worker from the local authority to perform while the child or young person is in custody—to assess the child’s needs while in custody, to plan how those needs will be met, and, even more particularly, to plan for the child leaving custody and work with the youth offending team to ensure that the child’s resettlement needs are met. The welfare of those vulnerable young people will be greatly improved if those good practice requirements are specified in regulations.
I therefore ask the Minister to give a number of assurances to the House in relation to regulations. First, which children in custody will be entitled to visits from a local authority representative under Clause 14? Secondly, will the regulations specify that within one week of entering custody a looked-after child or care leaver should be visited by his or her social worker, that there will be an assessment of the child’s needs, and that an interim care plan will be implemented to meet those needs? Will those procedures apply to children previously accommodated under Section 20 of the Children Act 1989? Thirdly, will the regulations specify arrangements to be made for the youth offending team and social worker to plan resettlement needs? Fourthly, can the Minister commit to revising the Children Act 1989 regulations and guidance, and the Framework for the Assessment of Children in Need and their Families, in line with those proposals?
I hope that the Minister will respond positively to our concerns. I beg to move.
My Lords, I gladly support the amendment. We all need to have it constantly in mind that children in the situations that we are describing and considering desperately seek some kind of secure, stable, ongoing relationships—some kind of continuity. To be impersonally buffeted around, however good the intentions of the people who in effect do the buffeting, can aggravate the situation. Therefore it is terribly important that, wherever possible, the person involved should be known to the child and be someone in whom the child has confidence.
The question we have to ask ourselves about those in prison is not only whether we are committed to the child, but whether we are committed to the whole process of rehabilitation; that word has come up again. If we are committed to rehabilitation, it is important to have some continuity in relationships outside the institution, not simply to make the child institutionally dependent. Goodness gracious, there is a good deal to be anxious about there; I shall come to that on my amendment later. The noble Lord, Lord Ramsbotham, knows more in his little finger about those issues than most of us put together.
Stable relationships—the continuity of relationships—are absolutely crucial to making a success of the operation. I therefore think that the amendment and the spirit in which it has been moved are designed to strengthen a Bill, which I think we all believe is good and which we welcome, and to help a Minister who is greatly respected on all sides of the House because of his commitment to the cause.
My Lords, I support these amendments and shall speak also to Amendment No. 28 in my name. I am glad that the noble Lord, Lord Judd, has spoken in the way that he has about the rehabilitation that is at the back of the proposals that I have put forward in my amendment, which I have amended slightly since Grand Committee to try to include the fact that, in order to have continuity, the same care worker should, if possible, be responsible for the same person in custody throughout the period that they are there.
All of us in this House have been enormously grateful to the Minister for the way that he has corresponded with us, kept us informed of what has been in his mind, and has listened to what we have to say. However, I have to say to him that I remain disappointed that one sentence of his that I referred to in Grand Committee has still not been replied to. My interest in that was heightened by the regulatory impact assessment published on 31 October last year about the Bill, which included statements that:
“Outcomes for children in care are strikingly poor … children in care are three times more likely to be subject to a final reprimand or warning or convicted of a crime than other children … 62% of children enter care because of abuse or neglect, which has a profound impact on a child’s development”.
On reading those statements, I felt, hooray, the people responsible for this Bill really understand that of all the young people in prison, those who gave me most concern had come from what purported to be care, but which, in terms of what they had gone through, certainly did not amount to care under the meaning of that word.
Therefore, I was concerned when, in his letter to us of 3 December, the Minister said:
“It is important to ensure that young people in custody are safeguarded and protected from harm”—
“but we do not accept that this requires them to be looked after and the state to assume a formal parenting role for them”.
I challenged the Minister in Grand Committee and I have not yet had a response to that challenge. The reason for my concern is exactly what my noble friend Lady Meacher mentioned—that, in custody, the youth offending team responsible for administering what goes on is not responsible for the formal parenting role. Unless someone is put in that role, those from care will not have someone acting for them in that role throughout the detention and training order. That was the purpose of my amendment.
On 19 December, the Minister wrote again to me about the amendment and said:
“It is intended that local authorities will be required by regulations to ensure that children who were voluntarily accommodated … are visited when they lose their looked after status because they cease to be so accommodated when detained in secure training centres, young offender institutions or prisons”.
In other words, regulations are intended to do what you want done. I am sorry, but the history of too many subjects brought up in the Bill, and my experience of looking at what was going on in the young offender estate, did not convince me that regulations were a strong enough requirement on people to do what they ought to be doing. This has come up time and time again.
While we are very happy with the tone and intention of the Bill, many of us have concerns that there are so many regulations and so many instructions that people simply cannot keep in touch with them. Some things need to be lifted out of the regulatory and instructing environment and put into the statutory environment so that someone can see that they happen. I can think of no one to whom this description applies more than young people in custody denied all the safeguards and parenting, about which we have had so much discussion. Now, unless something is put in place, these young people are likely to be denied the attention when they need it most, particularly, as the noble Lord, Lord Judd, said, when they are approaching rehabilitation. Someone must be responsible for seeing that the basics, such as accommodation and employment, are properly covered.
When I came to the House this morning, I was sorry to discover that, for the third time running, there would be a Statement which was likely to take one hour out of the time available to discuss the Bill. It meant that yet again, in realistic terms, I would be unable to test the opinion of the House on this matter. One thing that I find of considerable interest in the legislation that comes before this House is how much of one Bill is included in another. For that reason, I have tabled my amendment for discussion in the Criminal Justice and Immigration Bill, which applies to youth justice. The fact that unfortunate timing and a Statement have prevented me from testing the opinion of the House on this occasion will not stop me trying to do so when we reach the Report stage of the Criminal Justice and Immigration Bill. However, it is unfortunate that I should have to press this subject over and over again when I would hope that the Government, in the spirit of some of the things that they have said—although not in that unfortunate sentence of the letter of 3 December—would pick it up as a requirement that they should exercise themselves, and that is why I continue to press this amendment.
My Lords, it would be very difficult to argue with the noble Baroness, Lady Meacher, on these amendments. Detained children are particularly vulnerable, and it is very likely that their experience of life will have been marked by abandonment. Reinforcing familiar bonds can be invaluable, which is why having someone known to the child is particularly important. It is also important to have people who are professionally trained to assist at this time. They will obviously be best suited to addressing children’s fears and concerns and helping them to readjust to the outside world. These young people need some anchor points.
I turn to Amendment No. 28 in the name of the noble Lord, Lord Ramsbotham. I supported it in Grand Committee and was happy to put my name to it again today. Like the noble Lord, I feel that it is hugely frustrating when Statements interfere with the rhythm of a Bill. This is a very important issue which should be addressed to a full House. In order to stop the cycle of many children in care ending up in custody, it is essential that they do not feel abandoned and that their fears and concerns are addressed appropriately.
In Grand Committee, the Minister stressed that a child who is looked after because he is the subject of a care order does not lose that looked-after status if he enters custody. He argued that local authorities share parental responsibility for that group of children and, like any reasonable parent, should arrange to visit them. Unfortunately, the good practice of which the Minister spoke is often not to be seen, but putting it in statute would make it harder for local authorities to wash their hands of a detained child in need.
My Lords, from these Benches we add our support for all these amendments. We very much welcome the spirit of Clause 14. In Grand Committee, there was lengthy discussion about the value of visitors to looked-after children, and these amendments would ensure that the person responsible for visiting the child would be known to the child. Nothing is worse for a child who, as we have all been saying, often will have come from a very troubled and difficult background than being visited time after time by different people whom he does not know at all. This happens frequently. If the child is to build a relationship of trust with that person it has to be someone whom the child knows and therefore trusts. For those in custody, it is even more important for there to be trust and that the person understands their background and knows what they have gone through. No one could be but moved by the words of the noble Lord, Lord Ramsbotham.
Sadly, our discussion on this issue was curtailed in Grand Committee and we did not have a chance to talk about it as much as we might have done. It is obvious that society has frequently neglected its responsibilities to looked-after children—an unfortunate euphemism because very often they have not been looked after. Above all, when in custody they need to be looked after. We on these Benches have a great deal of sympathy with all that has been said and we support these amendments.
My Lords, I too support all these amendments. They are absolutely essential for the vulnerable people about whom we are talking. It is essential for the young person in prison to have someone to visit them, to have contact with them and to have a relationship with them, if there is to be any hope for them when they come out of prison. As my noble friend Lord Ramsbotham said, once they are in prison, thought must be given to accommodation for them when they come out and employment and training that will enable them to move into a more profitable way of life for them and for the country.
There are not many good things about the Criminal Justice and Immigration Bill—it has far too much in it—but if it allows my noble friend Lord Ramsbotham to have one more go at having this clause debated fully, with time for everyone to express their views, I shall think more highly of it than I do at the moment.
My Lords, I also support the amendment. It is one of the more important amendments we have before us. We have a common interest, which I know the Minister shares, to prevent the sad outcome of some looked-after children who are taken into custody and who slide into a way of life which is very bad for them and for society. The question is how best to minimise the risk. This is one element that can be important in that situation. The clause is very firm in imposing a duty on the local authority to ensure that a looked-after child taken into custody is visited by a representative of the authority and is given appropriate advice, support and assistance. I know that may happen now, but it would be good to have it in the Bill, as we are concerned with what may be a watershed in a young person’s life.
The local authority representative should know something about the child, his health, his mental health and other issues which could be relevant to the life of the child in custody and afterwards. It would be wise of us to insist on this approach by the local authority as a means of reducing the problems that we experience with looked-after children who leave custody and come out to very difficult circumstances.
My Lords, the intention of Clause 14 is to ensure that all looked-after children receive regular visits from a representative of their local authority and have access to advice and support when they need it between visits. Amendments Nos. 24 and 25 in the name of the noble Baroness, Lady Meacher, would require the local authority to ensure that the representative of the local authority who visits is known to the child in all but exceptional cases. The Government agree that in most cases it will be desirable that the representative is known to the child and I can reassure the noble Baroness that the guidance that we issue will reflect that. However, it is likely to be difficult in practice for local authorities to meet this requirement for all children when they first become looked after, and there will be times when the social worker who knows the child is simply not available to visit. Illness, holiday and maternity leave are just three examples of circumstances that are hardly exceptional. Equally, we need to recognise the practical realities: staff turnover is also unexceptional. However, I take the noble Baroness’s point about social workers who simply move teams within local authorities. I will reflect further on how we can meet that point in statutory guidance—to see that where reasonably practicable local authorities ensure that the representative is known to the child.
Furthermore, as I explained when I introduced our amendment to this clause, we will make it clear that a representative who visits a looked-after child in custody should be an employee of the local authority children’s services department and not, for example, a member of the youth offending team. Again, this is in general a desirable policy. However, in respect of whether or not that person should be a social worker, local authorities may at times wish, or indeed need, to choose a representative who is familiar to a child—for example, an experienced member of the children’s services team responsible for the child’s case who may not be a registered social worker.
Conversely, it may be necessary for registered social workers with particular experience, but who have not previously been involved in the child’s case, to visit the child, perhaps because the child has requested an urgent visit and the familiar representative is unavailable. In addition, the need may arise for someone with particular specialist skills or experience to visit the child at certain times—for example, in relation to the transition from one setting to another—who may not be known to the child.
For these reasons, we cannot go as far as the noble Baroness wishes in legislation but I hope that we can go most of the way to meeting her concerns in the guidance that will follow it. I certainly agree with the noble Baroness’s point that a transfer of responsibility between staff should not happen merely for administrative reasons or for the convenience of an area.
I appreciate that the intention behind Amendment No. 28 in the name of the noble Lord, Lord Ramsbotham, is to guarantee that local authorities provide proper support to children and young people in custody whom they have looked after or who remain in their care. We strongly support many aspects of this amendment; in fact, it duplicates much of the effect of Clause 14. I hope that I can resolve this misunderstanding between us, which I thought I had resolved in Grand Committee. I will have another go at explaining the issue at stake.
Clause 14 requires the local authority to ensure that visits and access to advice, support and assistance are provided for all children who are looked after. This new duty on local authorities will go beyond those children targeted specifically by the noble Lord’s amendment, which is focused solely on children in custody, and require local authorities to visit looked-after children wherever they may be living, whether it be in children’s homes, hospitals, residential schools including boarding schools, or custodial settings. I reiterate the commitment that I gave when this amendment was debated in Grand Committee: we will use the power to require the local authority to visit children who have been provided with voluntary accommodation by the authority but who then lose their formal looked-after status because they have been given a custodial sentence by the criminal courts and, as a result, are no longer accommodated by the authority. This will ensure that all the children within the scope of paragraphs (a) and (b) of proposed subsection (1) in the noble Lord’s amendment will receive visits, whether they are formally in the category of being looked after or not. We will use the regulation-making power in Clause 14, which is cast in exactly the same terms as subsections (4) and (5) in the noble Lord’s amendment, to prescribe the frequency of visits, the circumstances in which visits must take place and the functions of the person making the visit.
The noble Baroness, Lady Meacher, asked whether we shall through statutory guidance ensure that the authority works closely with the youth offending team in planning for a child’s resettlement when they leave custody. The policy intent underlying Clause 14 in relation to children in custody is to make sure that services for this vulnerable group of children are effectively co-ordinated so that the children have the necessary support to re-establish themselves in their home area, which will minimise the risk of their going on to commit further offences. The short answer to the noble Baroness’s question is: yes, we will seek to ensure that there is that necessary co-ordination. We also intend to revise the Children (Leaving Care) (England) Regulations 2001 to specify that one of the functions of a leaving care personal adviser is to visit the young person whom they support, wherever that young person is living. That will include visiting a care leaver who is in custody.
The combined effect of the commitment to revise the 2001 regulations, as well as Clause 14 and the regulation-making powers in that clause, will be to impose a duty on the local authority to visit and provide continuing support to all its looked-after children, wherever they may be, and to extend the benefits of that service to young people in custody who are care leavers or children who were looked after at the time they were taken into custody but who no longer have that legal status. I hope that that meets the essential points made by the noble Baroness and the noble Lord and that they do not feel the need to press this amendment.
My Lords, I thank the Minister for that sensitive and helpful response to my questions. I have a small point to raise. The Minister mentioned that sickness and leave are not exceptional circumstances. I suggest that in circumstances that are not exceptional the opinion of the child should be sought. Do you want to see yet another stranger or is it more important to you to wait a week or so for your social worker who is on leave or sick? That is what I am getting at: not just willy-nilly bringing in yet another new person. If there are exceptional circumstances, it may be necessary but, if at all possible, every attempt should be made to achieve that continuity because of the vital importance of trust. There can be trust only if there is continuity; trust is built over time. Nothing is more important to these children than that continuity in an attempt to rebuild trust that has been completely destroyed. I do not think that I explained myself adequately, but I hope that that gets the point across.
My Lords, like the noble Baroness, I thank the Minister for his response, but we come down to the word “formally”. Although “formally” no longer applies to the social services because the formal responsibility for those in custody has passed to someone else, the relationship between the social worker and the person who has gone into custody should surely not change. It should be adjusted to follow the formal responsibility. The state has not relinquished formal responsibility for that person. The state retains it, but in a slightly different form. I wonder whether this is the nub of the statement of 3 December, which I continue to question, which rather implies that, once someone has gone into custody, the state no longer has that responsibility. That is the burden of my contention.
My Lords, the state does not relinquish it. The state has many hats in these relations as it is in charge of the custody in the first place. In respect of the duty of the local authority, the point that I was making is that those who, because of the nature of their accommodation, were looked after but who lose that status because they go into custody will still be subject to a continuing requirement in respect of visits. That is a requirement on the social services department that is separate from those responsible for custody. I think that the difference between us is narrowing, but I do not know whether it has narrowed entirely. I shall look further at the noble Lord’s remarks and I promise to write to him further.
27: Clause 15, page 13, leave out line 8 and insert—
“(a) a young person becomes 25 or has been assessed as no longer likely to benefit from an independent visitor;”
The noble Baroness said: My Lords, the aim of the amendment is to enable an independent visitor to continue their work until the young person is aged 25 or until the young person has been assessed as no longer likely to benefit from an independent visitor. Clause 14 makes it clear that the independent visitor or the local authority may terminate the appointment at any time. I suggest no change to that. Without this amendment to the clause, however, the appointment would automatically be terminated in every case when the child ceases to be looked after by the local authority, if I have understood this correctly. This latter stipulation concerns me. Is it right that the support of an independent visitor is required by law to end at precisely the point when the young person ceases to be in care and when other supports are also likely to be withdrawn?
In east London, where I chair a mental health trust that includes a CAMH service, when the child leaves care or ceases to be looked after, he or she is automatically transferred to someone else; there is automatically a double whammy. I understand that this is normal practice in child protection work. At the same time, the young person is likely to move from a foster family or care home to an independent housing facility. I am aware of a young person who, as we speak, is in a psychiatric adult ward. I understand that the traumatic transition from looked-after status and the changes and transitions involved at that time have contributed substantially to his breakdown and admission to an adult ward. Anything that the Government can do to introduce some stability through the transition from looked-after status is surely terribly important. We debated a similar amendment in Committee. Since then, I have discussed the amendment with the Bill team and thank it for its helpful advice.
The other development since our earlier debate is the Government’s own amendment, which gives the Secretary of State a power to promote the well-being of care leavers and, by regulation, to extend the power to other groups of young people under the age of 25. All I propose in the amendment is to add a very small amount of flesh to the bones of the Government’s amendment. Independent visitors are paid only their expenses; the Bill team tells me that on average this amounts to some £2,000 a year. I seek the Minister’s agreement that, when a young person leaves their home and loses their social worker, if an assessment shows that continuation of the independent visitor’s work would be helpful to the young person and if the independent visitor is happy to continue working with the young person—they may not be—the local authority should be able to continue to pay the very small expenses of the independent visitor.
The whole point of an independent visitor, as I understand it, is to be an anchor for the young person through the traumas of transition and the ups and downs of young adult life. There is little doubt that one of the consequences of failing to provide sufficient anchors for young people who need them is that many turn to crime, with the vast expense involved.
In conclusion, I hope that the Minister will agree to amend the absolute requirement in Clause 14 that the appointment of an independent visitor must cease,
“when the child ceases to be looked after by the local authority”.
I know that the Minister wants to do his best to achieve the right outcome for looked-after children and young people; along with everyone else, I have huge respect for him and for the work that he has done on the Bill and in many other arenas of life. I beg to move.
My Lords, this is such a sensible amendment that I cannot think that the Minister will reject it. As the noble Baroness, Lady Meacher, has said, we know that the period of transition already creates problems for many of these young people and that some element of stability—someone whom they can rely on—is vital. They may have built up a relationship of trust with their visitor and, as we said earlier, it is important that there should be someone whom they can call on and whom they know to help them through these difficult days. The amendment is sensible and I very much hope that the Minister can give some hope that it will be incorporated either into regulations or into the Bill.
My Lords, this is another powerful amendment, on which I hope that my noble friend can again illustrate to the House that the gap is narrowing. Continuity is vital, relationships are vital and stability is vital. Offender rehabilitation or the severely disrupted lives of people who have not yet become offenders—for example, the dangers of vulnerability or the need to put a person on a positive course towards a stable and fulfilling future as a full member of society—must be given priority. For that reason, I applaud this amendment put forward by the noble Baroness, Lady Meacher, who speaks with a great deal of experience and practical knowledge, as well as with a lot of authority. I believe that it is time for our whole approach to be oriented towards the reality that we are dealing with human situations, not administrative situations. The necessary administration must underpin the human priorities, which are key to success.
My Lords, I spoke in support of this amendment in Grand Committee. The transition stage is crucial and, in a lifetime of uncertainty, help should not be abandoned when it is most needed. I was, however, reassured by the Minister’s answer that there is already provision under the Children (Leaving Care) Act 2000, which imposes a duty on local authorities to allocate a personal adviser and to keep in touch with all former relevant children until they are 21 years old, and in some cases 25 years old.
In Grand Committee, I asked the Minister for the number of people aged 18 to 25 who may be eligible under the amendment, but he was unable to give me an answer. I wonder whether he has managed to find that out. If he does not know today, I am more than happy for him to write to me.
While we are talking about independent visitors, perhaps I may also take this opportunity to ask about mentors. Does the Minister envisage mentoring schemes coming under this clause? I am a huge fan of mentoring because it brings the stability and continuity for which we are searching and it is a constant when other things, such as the professionals involved with a young person in care, change. As the noble Baroness, Lady Meacher, said, they are the anchors in the young person’s life.
Bolton Lads and Girls Club, with which I used to be very involved, was at the forefront of mentoring many years ago and it has had remarkable success. It is running a scheme training employees of Bolton Council to mentor looked-after children. Rainer is providing the finance and the club is delighted with the progress that is being made. The trouble is that, like all these things, funding is always on a short-term basis. It would be sad if, after establishing good relationships, the scheme had to stop. It would be especially cruel for those young people who, probably more than anyone, need those anchor points in their lives. Perhaps the Minister would comment on that.
My Lords, Young Minds, the mental health charity for children and young people, conducted research into mentoring and an overview of the literature. It found that the most effective mentoring was long term and not target focused. Shorter-term work, which focused on getting something done in a young person’s life, was not as effective as a longer-term relationship. The noble Lord, Lord Ramsbotham, reminded us that more than 60 per cent of young people coming into care do so as a result of neglect or abuse in the family. Many of those children need to learn to love again and they need long-term relationships into their 20s. After all, children on average leave home at the age of 24, so it is not too much to ask for this amendment to be agreed.
My Lords, I am well aware that all good things come from Bolton. I will study with care the mentoring scheme, referred to by the noble Baroness, Lady Morris. I cannot immediately tell her whether they come under the ambit of Clause 14, but I shall certainly let her know. The number of care leavers who might be eligible for an independent visitor, if it was in their interests, is 5,800. I am sorry that I was not able to have that figure earlier.
I understand entirely the points made by the noble Baroness, Lady Meacher, about transitions from care, and it is for the reasons she gave that we intend to pilot arrangements for young people to continue to stay with their foster carers up to the age of 21. It is one of a range of policies we have in place to see that there is a much more managed transition from care than was often the case in the past. We are also extending the duty to appoint a personal adviser and keep the pathway plan under regular review for young people who, before they are 25, seek support from their local authority to continue or resume their education or training. This builds on the existing requirements in Section 23C of the Children Act 1989 for local authorities to appoint a personal adviser at least up to the age of 21 for all care leavers. The personal adviser’s role is to help the young person make a successful transition to independent living.
In respect of the specific issue raised by the noble Baroness, there is no reason why a local authority cannot continue to meet the reasonable costs of an independent visitor as part of the pathway plan if the young person and the independent visitor want this. Given the potential role in supporting transition and the important stability that contact with an independent visitor may bring, we would expect a young person to discuss this with their personal adviser and appropriate provision to be made in the pathway plan. I can say to the noble Baroness that we will set out our expectation in revised statutory guidance that the local authority should continue to reimburse the reasonable expenses of the independent visitor where it would benefit the young person as part of the package of support they receive. I hope that the noble Baroness thinks that we are going some way to meet the concerns she has raised.
29: After Clause 17, insert the following new Clause—
“Provision of care for children and young persons convicted of criminal offence
(1) After section 42 of the Children Act 1989 insert—
“PART IVADetentionDetention orders42A Detention orders
(1) This section applies where a child or young person (aged up to 20 years) is convicted of a criminal offence and a court makes an order that that child or young person should be detained.
(2) A local authority must provide suitable premises in which that child or young person can be securely accommodated and appropriate care and support provided.
(3) The Secretary of State may by regulations make provision about the provision of suitable premises under subsection (2).”
(2) In section 27(1) of the Criminal Justice Act 1948 (c. 58) (remand of persons aged 17 to 20) omit the words—
(a) “, if the court has been notified by the Secretary of State that a remand centre is available for the reception from the court of persons of his class or description,”, and(b) “and, if it has not been so notified, it shall commit him to a prison.”(3) In section 43(2) of the Prisons Act 1952 (c. 52) (remand centres, detention centres and youth custody centres) omit paragraph (c).
(4) For section 106 of the Powers of Criminal Courts (Sentencing) Act 2000 (c. 6) substitute—
“106 Interaction with sentences of detention in a young offender institution
(1) Where a court passes a sentence of detention in a young offender institution in the case of an offender who is subject to a detention and training order, the sentence shall take effect as follows—
(a) if the offender has been released by virtue of subsection (2), (3), (4) or (5) of section 102 above, at the beginning of the day on which it is passed;(b) if not, either as mentioned in paragraph (a) above or, if the court so orders, at the time when the offender would otherwise be released by virtue of subsection (2), (3), (4) or (5) of section 102.(2) Where a court makes a detention and training order in the case of an offender who is subject to a sentence of detention in a young offender institution, the order shall take effect as follows—
(a) if the offender has been released under Part II of the Criminal Justice Act 1991 (early release of prisoners), at the beginning of the day on which it is made;(b) if not, either as mentioned in paragraph (a) above or, if the court so orders, at the time when the offender would otherwise be released under that Part.(3) Subsection (1)(a) above has effect subject to section 105(3)(a) above and subsection (2)(a) above has effect subject to section 116(6)(b) below.
(4) Subject to subsection (5) below, where at any time an offender is subject concurrently—
(a) to a detention and training order, and(b) to a sentence of detention in a young offender institution, he shall be treated for the purposes of sections 102 to 105 above and of section 98 above (place of detention), Chapter IV of this Part (return to detention) and Part II of the Criminal Justice Act 1991 (early release) as if he were subject only to the one of them that was imposed on the later occasion.(5) Nothing in subsection (4) above shall require the offender to be released in respect of either the order or the sentence unless and until he is required to be released in respect of each of them.
(6) Where, by virtue of any enactment giving a court power to deal with a person in a way in which a court on a previous occasion could have dealt with him, a detention and training order for any term is made in the case of a person who has attained the age of 18, the person shall be treated as if he had been sentenced to detention in a young offender institution for the same term.”
(5) Section 61 of the Criminal Justice and Court Services Act 2000 (c. 43) (abolition of sentences of detention in a young offender institution, custody for life, etc.) is repealed.”
The noble Lord said: My Lords, in one of those characteristic outbursts of well based indignation with which the noble Lord, Lord Ramsbotham, regaled us a few amendments ago—I always find those outbursts very challenging—he spoke of his increasing frustration at the relationships between each piece of legislation and how we have to approach each individually in the absence of anything to resolve the issue of an underlying theme that would govern all legislation in the respective areas. All I can say is that I could not agree with him more. In thanking all noble Lords who have added their names to my amendment, I should say that I shall be urging them to do the same in the Criminal Justice and Immigration Bill because I am going to do exactly the same there. I will be tabling this amendment again in the context of that Bill.
We are dealing here not with a theoretical issue but with real, pressing and acute situations and realities that affect the young and society as a whole. I hope I will be forgiven for drawing the attention of noble Lords to the horrific stories that have been coming from the island of Jersey recently. Jersey is not part of our immediate concern, but there are lessons to be learnt about what can go wrong and the vulnerability of young people.
However, it is not just Jersey. Let us look at ourselves. I picked up the newspaper only today and read that the Chief Inspector of Prisons is actually suggesting that Oakhill Secure Training Centre for young people should be temporarily closed because things have gone so badly wrong and because of what is happening to the young people held in that centre. I do not apologise for repeating what I said in Grand Committee and probably at Second Reading. Since 1990, some 30 children have died in custody, in the care of the state, the self-same state that has signed a convention which states that we have a responsibility for upholding and encouraging the well-being of young people. We have heard that 28 of these deaths were self-inflicted, one was a homicide and one was restraint related. Two of the most recent deaths were in privately-run secure training centres; all the others were in Prison Service accommodation in young offender institutions.
Relating back to the amendment we have just discussed, in the same period 201 young people aged 18 to 21 have died in custody, including 178 self-inflicted deaths and five homicides. I do not know how we can accept these figures; they are totally appalling in a country which regards itself as civilised. In this context, my amendment is designed to ensure that the young people are not destined to find themselves locked up in conditions which are not only counterproductive but dangerous for them.
I am, of course, the first to recognise that there is a need to protect the public—we all know this—and that there are some young people who simply have to be detained because they are a threat, a danger, a hazard to the public. But if we really want to look to the interests of the public, the challenge—and the greater the problem the greater the challenge—is to see how we can get down immediately to a programme which is designed to enable these young people to become positive and responsible members of society as distinct from negative, destructive members of society.
This, of course, ties up with the ongoing continuity of responsibility of the local authorities and the rest, and this is what my amendment is designed to achieve. I have said this before in Grand Committee—and I know that the argument can come back—but you cannot say “never”, because if you say “never” there will always be exceptions and what are you going to do about the exceptions? The problem is that, unless you say “never”, there will always be a tendency for the exception to become the rule; it will be the easy option to send people off to the wrong kind of detention. At some point you have to say this is simply not going to happen and we are going to ensure that it does not.
Other countries have done that. Why cannot we do what others have done? Are we helpless? In terms of penal policy and their responsibility for young people, other countries have found that it makes sense economically and socially to ensure that where young people have to be detained they are invariably detained in special accommodation designed for such young people. We know that in prison too often—not always, thank God—the prevailing ethos is not going to be one which is conducive to rehabilitation and to enabling the young to become responsible citizens.
I have been over these arguments in more detail in Committee and the rest. I hope my noble friend will be able to say today that the Government are set on a course which will make amendments of this kind unnecessary. I beg to move.
My Lords, I have added my name to the amendment and it is a great pleasure to follow the noble Lord, Lord Judd, and support it.
It has been eight years since the Youth Justice Board took over responsibility for the way in which we lock up 3,000 children in custody in England and Wales. In 2000, the then Chief Inspector of Prisons, now the noble Lord, Lord Ramsbotham, who is in his place, recommended removing responsibility for juveniles from the Prison Service altogether and setting up a juvenile secure agency. This at the time was a step too far for the Home Secretary and he chose instead to ask the Youth Justice Board to bring about improvements through a process of commissioning and purchasing secure places from a variety of providers. At that time, 85 per cent were held by the Prison Service in young offender institutions, and it is still the case that those institutions hold the overwhelming majority of children who are in custody. Some progress has been made in improving regimes and raising standards for children held in prison in relation to their health and education—I have seen some excellent examples of what can be done on that score—as well as child protection, but to some extent those improvements are superficial and we need to go further.
Young offender institutions are, first and foremost, prisons. That is not surprising; the Prison Service is an organisation designed for adults, who are 96 per cent of its clientele, and young offender institutions holding juveniles are managed by area managers with generic responsibility for all prisons. Similarly, Prison Service staff are generally recruited for work in any prison. Inevitably, there is a much stronger emphasis on security, control and the prevention of escape than on child welfare. In October 2007 the Prison Officers’ Association called for the use of batons to be available in children’s prisons, a stark illustration of the cultural gulf between Prison Service culture and a child-centred welfare-based approach, as advocated by the noble Lord, Lord Judd.
The physical conditions in young offender institutions leave much to be desired. They are designed in a similar way to adult prisons, with children housed in small spartan cells. Again, the design of the buildings themselves is dominated by the need for security and the prevention of escape rather than meeting welfare needs.
It is the inescapable conclusion of any analysis of this sort of provision that while the provision of the majority of places for children lies within that adult-dominated organisation in the shape of the Prison Service, the radical change that is really required is simply not going to be possible. The latest Home Office statistics show that 76 per cent of children leaving custody in the first quarter of 2005 reoffended within a year. That is a depressing statistic, and it is more or less the same as the figure for 2000—before the Youth Justice Board embarked on its reforming programme. It is clear to me, sadly, that custody, at least in the way it is currently provided, simply does not work in reducing reoffending, which of course is the Government’s primary objective. We are continuing to waste huge amounts of public money on locking up children. About £281 million a year, which is 70 per cent of the Youth Justice Board’s budget, is spent on custody. Unless radical reforms are implemented, there will be no change to this dismal state of affairs.
We have a new chair of the Youth Justice Board. Now that the Minister’s department shares responsibility for children in custody, as it has become the Department for Children, Schools and Families, he has an opportunity to change the situation. To what can we look forward in the review of youth justice promised by the recently published children’s plan? This is an opportunity not to be squandered.
My Lords, I have also put my name to the amendment, which in many ways, as the noble Lord, Lord Judd, has said, is complementary to mine. Like all noble Lords, I am grateful to the Minister for the way he listens to points and takes them away. He has worked with us on the Bill so far as he is able. Here, however, I understand that he has come up against the stops; he is not responsible for the justice part of the partnership that we are all talking about.
I always hesitate to go back to this, but one of the things that frustrated me most when inspecting young offender establishments and secure training centres was that in place after place I came across examples of good practice by good staff who were doing what needed to be done because they understood the young people. What is missing from all this is someone who is responsible and accountable for turning that good practice into common practice. We do not need massive, radical change; we need to ensure that good practice is turned into common practice and that the experience of those who have been looking after young people is used properly.
The Prison Service is not the place to do that. The Youth Justice Board started off with huge support, because people felt that here at last was an organisation focused on the needs of a particular group and therefore able to exercise them. Somewhere along the way, that initial hope has been dissipated. I hope that the Bill and all the other legislation that is going through, rather than introduce something new, will rejuvenate that Youth Justice Board and its responsibility for young people and re-empower it to do what is right for them, because—heavens above—all the evidence has been produced in amendment after amendment to this Bill and others, and all the experience is there. Surely to goodness, we can be sensible enough to pick it up and run with it, rather than let it and the young people go by default.
My Lords, I wish I could reply so briefly. I pay tribute to my noble friend Lord Judd and the noble Lord, Lord Ramsbotham, for their passionate commitment to improving the regime for those in custody, particularly young people. Underlying my noble friend’s concern is the long-term issue of the use of custody for children. I can best deal with it simply by reading to the House paragraph 6.69 of the recent children’s plan, which sets out our long-term ambitions in this area. It states that,
“we are taking a fundamental look at the way in which the criminal justice system overall is working for young people to ensure we learn from existing good practice and address current concerns. This includes examining what we know about why young people offend, what a more effective approach to prevention would look like, the options available for dealing with children who commit crimes, how we can use the time when young people are in contact with the criminal justice system to reduce re-offending and how best to tackle the most serious offenders. Detailed action on how we will jointly tackle these problems will be set out in next year’s Youth Crime Action Plan. We aim to significantly reduce by 2020 the number of young people receiving a conviction, reprimand or final warning for a recordable offence for the first time, with a goal to be set in the Youth Crime Action Plan”.
That plan will be published this summer. I hope that that gives some comfort to noble Lords who seek a statement from me that we have regard to long-term policy trends in this area.
However, I shall deal with the here and now in respect of custody. There was a major change when the Youth Justice Board assumed responsibility for commissioning and purchasing secure places in April 2000. That was accompanied by the creation of a discrete secure estate for boys and a national placement system to enable optimum use to be made of the secure places available at any time—most crucially, enabling the more vulnerable young people to be placed in establishments suited to their needs.
Perhaps the biggest single achievement is the progressive development of a discrete estate for girls. Following a commitment in 1999 by my right honourable friend the Secretary of State for Justice, in his then role of Home Secretary, all 15 and 16 year-old girls were moved out of Prison Service accommodation by the end of 2003. That was a major step, but we followed it by developing five new special units for 17 year-old girls within the Prison Service estate but entirely separate from adults and young adults. The opening of the last of these facilities, at Foston Hall, Derbyshire in January last year, marked the completion of the separate girls’ estate. Inspection reports have repeatedly praised the work of the new units. They are clearly an important step towards creating the secure estate that we want to see.
However, progress has not stopped. The Youth Justice Board is now concentrating on its next priority for the secure estate, which is getting better provision for 15 and 16 year-old boys who are more vulnerable. A new unit is being developed at Wetherby young offender institution, which is due to open in October. My noble friend Lord Judd rightly reminded us of the need for vision. I believe that we are applying ourselves to a vision for the medium-term future in this area. In respect of ensuring that the quality of the criminal justice estates is better suited to the needs of the young people who are placed in custody, I hope that he will accept that we are at least taking some sensible steps forward.
My Lords, will the Minister clarify a little point about the proposals for the children plan in the review? Will it look at all options, including the radical one that was not accepted in 2000, when the noble Lord, Lord Ramsbotham, suggested that children’s custody should be taken away from the Prison Service and given to a different organisation with a child-centred focus? Will it be that broad-minded?
My Lords, the point just made by the noble Baroness is very important. I am sure that my noble friend would have all possible support if he were to pursue it with those who carry mainstream responsibility. It is not an abstract theory, but follows the example of some countries that have successfully taken that road.
I thank the Minister for his reply, to which I listened carefully. I also thank all the noble Lords who have associated themselves with and spoken to my amendment tonight. I am aware that it was a Duke from the other side of the Pennines from where I live who marched his troops to the top of the hill and then marched them down again. I am always determined to demonstrate from our side of the Pennines that we are made of tougher stuff. It seems that my noble friend has left certain doors ajar if not open. We should be working on that. I hope that when we are discussing these matters at Report stage of the Criminal Justice and Immigration Bill we will get as positive and sensitive a response as we have had from my noble friend. That is terribly important.
I have a couple of observations to make. First, on the prison estate, we must consider carefully that if we had nothing and were starting from scratch with a purpose-built estate, we would produce what is needed at less cost and more effectively. The trouble is that we are using a lot of money in constantly trying to patch up a system that is not designed for the purpose. At some point we must wrest ourselves free of this treadmill and say that it is insane and that we must have a new strategic approach.
Secondly, when I served on the Joint Committee on Human Rights, and we were discussing deaths in custody, we encountered exactly the kind of highly professional, dedicated, imaginative, caring prison officers to whom the noble Lord, Lord Ramsbotham, referred. They would get angry with us parliamentarians and ask, “What are you trying to get us to do? You are trying to get us to do jobs for which we are not professionally trained or properly equipped in premises that are not right, and are making a bad situation worse. Instead of improving it, we are contributing to the deterioration, and we are very angry about that”. They are good people to whom we should listen.
I spent nine years as honorary president of the YMCA in England. Some of the work that I admired the most, done by a very fine crowd of people who were in the front line of social action, was that going on in prisons and detention centres. The stories that were told to friends in the YMCA, and which I was told when I made visits there, are a challenge to every Member of this House. Some of the experiences that the young people who became offenders had been through were horrific. In some cases it would have been an absolute miracle had they not shown delinquent behaviour of one form or another. That is a challenge to us all.
Sometimes it is said that it is soft or wet to talk about the social conditioning of these youngsters and their experiences, and that we should be tough with them and then things will come right. All the evidence is that the tough thing to do is to take those realities into account and to recognise that many of these youngsters have never been loved or cared for in their lives. We talked about that in more specific detail at earlier stages of the Bill.
I welcome my noble friend’s endeavour to leave the door ajar. It is right to say that the Minister probably sympathises 99.9 per cent with all we are saying but does not have the deciding influence in some of these key areas. We encourage him to speak in our name in the deliberations to which he is a party. We will work at opening the door that is ajar but at this stage, without, I hope, becoming the Duke of York, I consider that is appropriate to beg leave to withdraw the amendment.
Amendment, by leave, withdrawn.
[Amendment No. 30 not moved.]
31: After Clause 22, insert the following new Clause—
“Breaks from caring for disabled children
(1) Paragraph 6 of Schedule 2 to the 1989 Act (provision by local authorities for disabled children) is amended as follows.
(2) The existing provision becomes sub-paragraph (1) of that paragraph.
(3) In that sub-paragraph, after paragraph (b) insert “; and
(c) to assist individuals who provide care for such children to continue to do so, or to do so more effectively, by giving them breaks from caring.”(4) After that sub-paragraph insert—
“(2) The duty imposed by sub-paragraph (1)(c) shall be performed in accordance with regulations made by the appropriate national authority.””
The noble Lord said: My Lords, I wish to speak also to Amendments Nos. 54, 55, 57, 58, 60 and 64. These amendments deal with the provision of short breaks for disabled children and their families. They follow our debate on this issue in Grand Committee and are a further response by the Government to concerns expressed by noble Lords. I pay particular tribute to the noble Lord, Lord Rix, who has pressed the cause of disabled children and their families over many years in this House and who is deeply sorry that he is unable to be with us this evening.
Amendment No. 31 adds the provision of short breaks for parents and others caring for disabled children to the range of services that local authorities must provide for families and in doing so puts these services on an express statutory footing. The new duty will ensure that short break services lose their Cinderella status and become an essential local authority service, thereby reflecting the importance attached to them by the families of disabled children.
The new duty makes it clear that short breaks should not be provided just to those carers struggling to maintain their caring role but to those for whom a break would improve the quality of the care they can offer. Short breaks should not be used just as crisis intervention but should help carers to maintain and improve the quality of care they want to, and can, provide. However, I should make clear for the record that the new duty does not create an individually enforceable right to short breaks.
It is hard to overemphasise the importance of short breaks to the families of severely disabled children. Without these services many parents would go without any relief from constant caring responsibilities. I am in no doubt that without short break provision, the care population would grow considerably and with it the cost to the taxpayer. But we should also not forget the wider benefits of short break provision beyond relieving parents. Any parent will be able to testify that it is beneficial and healthy for their child to gain positive experiences away from their parents whether it is time spent with another trusted adult, or in leisure or youth work-based activities where disabled children and young people can mix with peers of their own age. Such activities are immensely worthwhile and provide an important means of social development. They reduce the isolation felt by many disabled children and young people and can play an important role in enabling disabled young people to make a successful transition to adulthood. This should be and is our ambition for short break provision.
The Government have put significant resource behind the provision of short breaks; £359 million will be provided to local authorities in England alongside further funding to healthcare bodies to enable a combined approach over the next three years. We estimate that by 2010-11, local government expenditure on short break provision in England will have doubled and in some areas will have increased by up to five times. This major investment would combine with the proposed new duty to create a significant force for change and would be coupled to high expectations for service transformation. We would use both statutory guidance and regulations to make clear our expectations and requirements. We would envisage laying the first formal requirements on local authorities under the powers in the amendments in 2011.
As the Minister with responsibility for disabled children, I see this as a decisive moment in improving services for this important group in our society. I commend the amendments to the House. I beg to move.
My Lords, I congratulate the Minister on being so positively responsive to the concerns expressed by the House. I also congratulate, in his absence, the noble Lord, Lord Rix, on his persistence and determination to achieve the desired outcome. What will be done to ensure that the short breaks that are offered will be of a sufficiently specific type and quality for the young person concerned? For example, for a child on the autism spectrum, will the short break that is offered be autism-specific? Will it have care from people with the right level of experience, so that the parent can be sure that the young person is in the right sort of care with the right level of understanding? That would give them complete peace of mind while they have a short break from their caring responsibilities.
My Lords, this is a very welcome amendment. As the Minister said, it is a tribute to the noble Lord, Lord Rix, who has campaigned for so long on this issue, and it is a tribute to the Minister for taking on board this very important issue. Like the noble Baroness, Lady Walmsley, I would like some assurance that the short breaks will be appropriate. A year or so ago, I met a group of parents with children across the range of the autism spectrum who were very wary of any sort of respite care. They had come back from it and their children had been so distressed that it almost was not worth having the care. They very much hoped that they might be able to club together to provide their own care, because they understand the children.
I hate to appear churlish, but the regulations will not be rolled out until 2011. What might happen in the mean time? As these short breaks are essential, surely some provision should be made for the interim. Why the delay? Would it not be worth putting in place a temporary system and adjusting it according to the lessons learnt from the AHDC programme, as the Minister said in his letter of 4 March?
My Lords, I am grateful for the welcome given to the new provisions by both noble Baronesses. The reason for specifying 2011 is that for the first two years of the investment that I set out, we are building up pathfinder programmes. We recently announced the 21 short break pathfinder areas, and based on the experience of those areas we will introduce national coverage in short break provision in the third year of the Comprehensive Spending Review, which is 2010-11. It is on the basis of the provision that we are able to make in that third year that the regulations will be framed. So there is a reason for 2011; we are not dragging our feet but until we have seen those pathfinders through, we will not be in a position to know what it is appropriate to specify in the regulations.
Those pathfinder authorities will pilot and seek to develop a range of different sorts of short break provision meeting the whole spectrum of the needs of parents with disabled children, including those groups mentioned by the noble Baroness, Lady Walmsley. We are mindful of the fact that there is a wide diversity of needs in the disabled children community, and we want to see how those needs can best be met before we either make the national rollout in 2010-11 or specify the regulations under which all local authorities will then be obliged to act.
On Question, amendment agreed to.
32: After Clause 29, insert the following new Clause—
“Health assessments and care
After section 90 of the 1989 Act insert—
“Health assessments and care“90A Health assessments and care
(1) Where a child is looked after by the local authority the Primary Care Trust (“PCT”) or, where there is no relevant PCT, the Health Authority, must co-operate with the local authority in the provision of physical, emotional and mental health assessments and care.
(2) The Secretary of State shall make regulations providing for physical, emotional and mental health assessments of a child looked after by the local authority.
(3) Regulations made under this section shall make provision about—
(a) the qualifications and experience of an individual undertaking a health assessment;(b) the length of time after a child starts to be looked after by a local authority by which a health assessment must take place; and(c) the inclusion of details in the care plan of the arrangements made jointly by the local authority and PCT, or, if there is no PCT, the Health Authority, for the area in which the child is living for the physical, emotional and mental health care of the child.””
The noble Baroness said: My Lords, I propose the insertion of two new clauses after Clause 29. I had it in mind to cut my speech down because it is very late, but a lot of people are relying on me to put some points here, so I hope that the House will bear with me. The amendments provide for health assessments and care for looked-after children and young people, and evidence-based therapeutic interventions. I shall focus first on health assessments in Amendment No. 32.
The purpose of the amendment is to strengthen arrangements between primary care trusts and local authorities to assess and meet the physical, emotional and mental health needs of children in care. The aims are to ensure the provision of those services, and that the practitioner conducting the health assessments has the required qualifications and experience. That is simply not the case at present, I am told. The amendment also aims to ensure that the health assessments take place within a reasonable period after the child enters care. I understand from the Bill team that we have no idea how many of the children have the assessments within a reasonable period. Finally, the amendment provides a clear expectation that appropriate support for children, young people and carers, including therapeutic support or mental health services, will be provided for children who have experienced abuse and neglect and have been assessed as needing that care.
The amendment is strongly supported by the NSPCC, the Who Cares? Trust, the LGA, the National Children's Bureau and others. They wanted me to emphasise that it reinforces the Care Matters White Paper and other significant government policies, as the Minister will be well aware. The Minister assured the Grand Committee that the Government would fulfil their commitment to place the relevant guidance on health assessments on a statutory footing. He also referred to the statutory authority for such assessments being in Sections 10 and 11 of the Children Act 2004. The Bill team explained to me that a raft of guidance would be produced on these issues.
The reason for bringing the amendment to the House is that I—along with the NSPCC, the Who Cares? Trust, the LGA, the NCB and others—believe that the current legislation, even with all those assurances, does not ensure that children and young people will receive timely health assessments, including mental health assessments. The amendment would fill the gaps in the legislative framework. The disproportionately poor health outcomes of looked-after children were well rehearsed in Committee and I want to make only one of the points now, which is that 45 per cent of looked-after children and young people aged 5 to 17—27,000 in all—have an emotional or mental health disorder. However, only about a third of those—9,500—receive any support from the child and adolescent mental health services. Ofsted found that only one local authority had a 100 per cent achievement of initial assessments. The poorest performing authority achieves only 48 per cent, but only if those assessments are undertaken can we know the demand for services. Only then will services be provided at a satisfactory level for those children. The amendment is the building block on which there may be some hope at some point of having the services available.
In relation to the amendment, I hope that the Minister will be willing to give a number of assurances to the House. First, the Staying Safe: Action Plan states that the Government will work,
“with the Healthcare Commission on measures to hold PCTs to account in providing services for children and young people”.
Will that include measures relating to the health of looked-after children, and could the Minister provide some details of that? Secondly, will issues around the physical, emotional and mental health and well-being of children in care be included in the Government's forthcoming children and young people's health strategy, referred to in the children's plan, and, again, could he provide details? Incidentally, I provided all this information to the Bill team, so I hope that the Minister may have some information available.
Thirdly, current regulations state only that the medical practitioner carrying out a health assessment must “have regard” to their mental and emotional health. Will the revised regulations under the 1989 Act specifically address the emotional and mental health needs of looked-after children who have been abused?
Fourthly, and finally, what plans does the Minister have to monitor the implementation of the revised statutory guidance and to assess its impact on the health of looked-after children?
I acknowledge that the Government are committed to placing guidance on the health of looked-after children, as I have made clear, and I very much welcome the Minister’s initiatives on all these issues. The fact remains, however, that the provisions will still be only guidance to which PCTs must have regard. That is my understanding. If that is the case, we know what will happen or, rather, we know what will not happen, from my experience. We believe, therefore, that this amendment would make a substantial difference in reducing the number of looked-after children with ongoing unresolved serious emotional and mental health problems, and would ultimately vastly cut the criminal justice bill.
I turn briefly to Amendment No. 33, which proposes that where a family court has recommended the provision of evidence-based therapeutic intervention, it should be the duty of the local authority to make such provision. The aim here is to try to ensure that, wherever possible, the appropriate intensive therapeutic work is undertaken at an early stage with the whole family of a child at risk of being taken into care, in order to try to avoid the need for that child to be taken into care.
Since our earlier debate on this issue, I have had a very helpful meeting with the Bill team, as happened regarding my other amendments. It pointed out that the Government are piloting a number of different therapeutic interventions including, for example, functional family therapy, multisystemic family therapy, multidimensional treatment in foster care—which was developed in Oregon, with very promising results—and several other approaches. In the light of that discussion, I have revised my Committee stage amendment to take full account of the likelihood that, over time, the evidence will clarify those interventions that are most effective in different situations or in relation to different family circumstances.
The important point, which I hope will persuade the Minister to take this amendment seriously, is that there is now good international evidence in support of therapeutic family interventions. I understand that there is good evidence within the UK of the success of such interventions with young people in the youth justice system. I trust that the Minister will not argue against this amendment on the grounds that we do not yet have the final results of all the evaluations of pilots, particularly bearing in mind, perhaps, the social work practices situation within this legislation. This amendment is carefully worded to take account of the need for flexibility and research findings.
I do not wish to repeat any of the arguments that I put during our earlier deliberations. I would remind the House only that I have personal experience of the remarkable results for children’s health, emotional and mental, of intensive family therapeutic interventions. But far more important than my experience is the international and national evidence of the cost-effectiveness of those interventions.
I hope that the Minister will respond favourably to both of my amendments. I beg to move.
My Lords, yet again, the noble Baroness has demonstrated how fortunate we are to have her in our midst. Her practical approach, reasonableness and experience are invaluable assets for us all.
Perhaps I may make a couple of observations. The first is that the noble Baroness referred to the organisations that have been making representations. All of them without exception said at the outset of our deliberations on the Bill how much they welcomed it. Therefore, they are not at all speaking from a position of hostility to the Bill. They are speaking with a commitment to it and a desire to see it made as effective as possible. I am sure that my noble friend would agree that that increases the responsibility of the Government seriously to consider what their position is.
Today, on my arrival in the House after the weekend, I saw a letter from the NSPCC, which emphasises some of the points that the noble Baroness made. Perhaps with the leave of the House I may quote from the letter. In doing so, I join the noble Baroness in expressing appreciation to all the officials and staff who have enabled us to complete our deliberations this evening. Whether they were consulted about enabling us to do so is another matter, but we are all very grateful to them. The letter states, as the noble Baroness said:
“45 per cent of looked after children and young people aged five to 17 are assessed as having an emotional or mental health disorder, compared to 10 per cent of the general child and young person population ... Looked after children and young people exhibit high rates of self-harm and high-risk behaviour, particularly in secure accommodation … and some studies have shown higher levels of substance misuse ... Two-thirds of all looked after children are reported to have at least one physical health complaint—most commonly eye and/or sight problems, speech and language problems, difficulty in coordination and asthma.
These figures demonstrate not only the significant physical, emotional and mental health needs of children in care, but also the extent of need that remains unmet”.
I shall quote just once more from the letter:
“Furthermore, 63 per cent … of children are taken into care for reasons of abuse or neglect. The negative consequences for their health and development, both in the short and the long term, are well documented. As the Royal College of Paediatrics and Child Health has clearly stated: ‘[T]aking into account the serious consequences abuse has on the child, the necessity of the intervention and psychotherapeutic treatment is obvious.
Undetected and untreated abuse and neglect yield devastating results for both the individual and the community … immediate reporting, intervention and treatment of abused and neglected children is an essential priority of public and social policy’”.
When those carrying front-line responsibility on behalf of society as a whole say these things to us, we must respond, and I am sure that my noble friend will do so when he comes to reply.
My Lords, I shall comment very briefly on the health assessment needs of children in care. I want to talk mainly about partnerships. I realise that there are a number of tools but the Minister commented on those in Committee, so I will not go into them.
Ofsted has identified the ongoing monitoring and assessment of the physical and mental health needs of vulnerable groups, including looked-after children, as a weakness within children’s services partnerships. There is enormous inconsistency. One local authority reports 100 per cent of children in care receiving an initial health assessment, while the poorest performing authority reports only 48 per cent. Multi-agency working between local authorities, healthcare bodies and others is essential in improving outcomes for children. In some PCTs, there seems to be little clarity about who has responsibility for the health needs of children in care. The Government have already proposed to make guidance statutory for PCTs and that is welcome, but will they guarantee co-operation between local authorities and PCTs, will assessments be carried out by suitably trained and qualified practitioners, and will regulations set out how joint arrangements will be made, recorded and reviewed?
The new NHS operating framework for England states that PCTs are expected to,
“ensure that children and young people’s health and well-being needs are assessed and that action to address these is included in PCT plans”.
This is most welcome, but what priority is given to emotional and mental health needs when we see as priorities obesity, smoking and teenage pregnancy? Those are all understandable and important but so is physical, emotional and mental health, particularly for vulnerable children and young people.
Some things need to be stated very precisely in legislation and guidance, and I think that this area of the health of looked-after children is one of those. I am grateful to the noble Baroness, Lady Meacher, for introducing the amendment. This matter cannot be dealt with satisfactorily unless there is good assessment of need in the first place. This particular group of children—not large—could be helped so much by having its exact needs assessed so that appropriate treatment and care can be provided, rather than that being done on assumptions or their needs being neglected. I look forward to the Minister’s response.
My Lords, there are 60,000 looked-after children in this country: 63 per cent of them were placed in care for reasons of abuse or neglect; an equivalent two-thirds had some kind of physical health problem; and, as the noble Baroness, Lady Meacher, pointed out, 45 per cent of them had mental health problems. Section 10 of the Children Act 2004 places a duty on local health bodies—the PCTs—to improve the health and well-being of these children. They are statutory partners within the children’s trusts with a responsibility to co-operate with local authorities. It is clear that that is not working and that the health needs of such children are not being met. Some local authorities have looked-after children nurses, but one gathers that some do not have looked-after children nurses at all and often those nurses cover two or three PCT areas. There is a desperate shortage of such nurses and a desperate need for more.
Not only are health needs not met for these children, but they are not even identified. The proposals put forward by the noble Baroness, Lady Meacher, in these amendments seek to strengthen the Children Act in this respect. When we talked about this in Grand Committee, the Minister promised that there would be revised guidance so that there would be a statutory duty for the health commissioning bodies as well as the local authorities to act in this way. Will that be strong enough? We know perfectly well that guidance is something that PCTs only have to have regard to. There is a very strong case for having a piece of legislation that says that they must co-operate.
I want to finish by quoting from a transcript of an interview with a consultant psychiatrist from the child and adolescent mental health services. It says:
“Provision is very patchy. One of the difficulties relates to the split in funding streams over the last couple of years—half to the health route and half to the social services route. This was based on the government’s idea of joint thinking which works well in theory but has been atrocious in practice. This has resulted in Health Services and Social Services not discussing the needs of young people and just setting up very ad hoc patchy services”.
In other words, each has taken their share of the money and not done what they are supposed to do.
My Lords, in supporting my noble friend Lady Meacher in her amendment, I declare an interest as an adviser to the Sainsbury Centre for Mental Health. At this moment the Sainsbury Centre is focusing on the mental health needs of those in custody. Emerging from that is the fact that the figures mentioned by the noble Baroness of those suffering from these problems while in care are far worse for those in custody. Therefore, I appeal to the Minister, in considering the very great importance of proper assessment and therapeutic treatment, to remember that custody offers not just an opportunity to do those things, but a requirement to carry on with whatever may have been achieved during custody. While acknowledging that forensic mental health services are not nearly as good as they could be, one should take the opportunity gained to assess someone during their time in custody, and it is essential that that is not lost when the person returns to the care from which they came.
My Lords, I support these amendments. We have heard all the facts and figures and they are all horrendous. As my noble friend Lord Ramsbotham has just said, they are far worse for those who end up in prison than for those in care. I am impressed by the range of bodies—the Local Government Association, the NSPCC, a whole range of children’s bodies and the associate directors of children’s services—that are all coming to the same conclusion. As the noble Baroness, Lady Sharp, has just said, the physical, mental and emotional needs of these children are not just not identified, they are not being met. It is clearly time that rather more attention was paid to this side of things. I congratulate my noble friend Lady Meacher on her amendments, and wholly support them.
My Lords, we fully support the spirit of Amendments Nos. 32 and 33. I was prevented from speaking to the earlier amendments of the noble Baroness, Lady Meacher, on this issue because of the ticking of the clock in Grand Committee and a fierce glare from the noble Baroness, Lady Crawley.
Healthcare assessments, though already obligated to occur every 12 months for children in continuous care, often do not. Information from the Chartered Institute of Public Finance and Accountancy, as the noble Baroness, Lady Massey of Darwen, said, shows that in Sandwell Metropolitan Borough Council, for example, only 48 per cent of children received a health assessment of some kind. Yet, at the other end of the scale, Trafford was able to provide assessments for all of the children in care in its area. The discrepancy goes to show that, although efforts have been made, not enough is being done. What these statistics do not reveal is what kind of assessment is being given. We agree that it is extremely important that assessments focus not only on the physical health of a child but also on their mental health. Thus we strongly support the intention of the amendment.
Amendment No. 33 fits with our position on early intervention: anything that can be done to prevent children going into long-term care is laudable. If a court has made the recommendation and there is obviously a need, it would be a cruel fate to have this denied because of lack of resources or provision of sufficient family therapy services. Though the training of sufficient workers to provide this therapy in sufficient numbers will be expensive, this is an investment to save the enormous amount of money—some £250,000 in some cases—incurred when a child enters the care system for the long term.
My Lords, we are all agreed that it is vital that we improve the health of looked-after children. We also agree that doing this requires us to improve both the proportion of looked-after children who receive health assessments—both initial and ongoing assessments—covering their physical, emotional and mental heath and the quality and timeliness of these assessments.
To reinforce the existing legislative framework, we will put revised guidance on promoting the health of looked-after children on a statutory footing for health bodies as well as local authorities, using the powers in Sections 10 and 11 of the Children Act 2004. The revised guidance will be statutory for primary care trusts, strategic health authorities, NHS trusts, NHS foundation trusts and local authorities.
I shall respond specifically to the questions posed by the noble Baroness, Lady Meacher, as to what this revised guidance will cover. It will cover health assessments for looked-after children, including their physical, mental and emotional health; health plans, including the implementation of these plans through the provision of appropriate health care; the involvement of qualified medical practitioners in health assessments and health reviews; the timescales in which the initial health assessment and reviews must be completed, a particular point that the noble Baroness raised; health promotion; the provision of targeted child and adolescent mental health services for looked-after children, which we know are important for improving their mental health; and the roles and responsibilities of health bodies and local authorities, including, to respond to the point of the noble Baroness, Lady Sharp, how they should work together to improve the health of looked-after children. I hope that that addresses the noble Baroness’s concerns relating to the timeliness of health assessments and reviews, the qualifications of those carrying out the reviews and the involvement of health services.
The noble Baroness also raised the issue of whether health bodies will have only to “have regard” to this guidance. I can assure her that this does not mean it is in any way optional. Health bodies, when exercising any discretion, and particularly when making decisions about delivery of services, will have to take proper account of the guidance and follow it unless they have good reasons not to do so. Failure to have proper regard to statutory guidance would be a ground for impugning a health body’s decision and challenging it thereafter. In the Court of Appeal case of the London Borough of Newham v Khatun and others, Lord Justice Laws said that,
“an authority is not entitled to depart from guidance given in a circular issued by central government, to which it is obliged by statute to have regard, merely because it disagrees with it”.
“what is conventional law, namely that respondents to such a circular must (a) take it into account and (b) if they decide to depart from it, give clear reasons for doing so”.
There are strong duties on health bodies in respect of the guidance that I have set out.
The revised guidance will be complemented by the new joint strategic needs assessment, the new NHS operating framework for 2008-09 and the national indicator set for local government. For the first time, the NHS operating framework includes keeping children well, improving overall health and reducing health inequalities as one of five priorities for the NHS. The JSNA forms the basis of local authority and PCT commissioning. Statutory guidance on the joint strategic needs assessment states explicitly that it should take particular account of the needs of vulnerable groups such as looked-after children. In addition, from April, the NIS forms will form the basis of all local area agreements and the new local government comprehensive area assessment. They will include indicators on the emotional health of looked-after children, placement stability and the timeliness of care reviews as well as indicators on the education of looked-after children, the proportion of care leavers in education, employment or training at 19 and adoption.
Improvements to the health of looked-after children will be monitored through our existing data collection systems, the new indicator on the emotional health of looked-after children and the Ofsted-led programme of inspection of services and outcomes for looked-after children. My officials are currently discussing this programme of inspection with Ofsted. I hope that that meets the concern of the noble Baroness in respect of monitoring.
Finally, on Amendment No. 33, the noble Baroness is right to raise the issue of ensuring that we use the most effective interventions in our work with the most vulnerable children and families. The Care Matters White Paper makes several references to the use of the term “evidence-based interventions” both for families where children are on the edge of care and for carers for looked-after children. The broad definition of such an intervention is that it has been the subject of reliable evaluation, preferably using a randomised control trial. As part of our wider parenting strategy, we are piloting nurse-family partnerships, which are aimed at vulnerable new mothers, and family intervention projects, which are comparing the use of Webster-Stratton and triple P programmes.
I particularly draw attention to the plans set out in Chapter 2—on page 37—for multisystemic therapy. MST has a strong evidence base in the US and my department is funding 10 pilot sites jointly with the Department of Health. In addition, the Department for Children, Schools and Families intends to support a single pilot of a new MST programme, which has a focus on child abuse and neglect rather than anti-social behaviour, as part of a wider international pilot. We take the noble Baroness’s points about evidence-based interventions very seriously in our work with vulnerable children and young people.
My Lords, I thank the Minister for that detailed reply. I got a bit lost in the middle and will look carefully tomorrow at what he said. For example, he referred to guidance making reference to the timeframe within which these assessments will take place. I am not sure what that means. I was hoping that there might be some specific time within which these assessments would be undertaken. I do not know whether he can provide any further detail on that between now and Third Reading. However, I am happy to beg leave to withdraw the amendment.
Amendment, by leave, withdrawn.
[Amendments Nos. 33 to 40 not moved.]
Clause 37 [Orders, regulations and guidance]:
41: Clause 37, page 27, line 16, leave out “ceases” and insert “and subsections (6) and (7) cease”
On Question, amendment agreed to.
Clause 40 [Extent]:
42: Clause 40, page 28, line 3, at beginning insert—
“(1) Subject to subsection (2),”
43: Clause 40, page 28, line 3, at end insert—
“(2) Paragraph 6A of Schedule 1 also extends to Scotland.”
On Question, amendments agreed to.
Clause 41 [Commencement]:
[Amendment No. 44 not moved.]
45: Clause 41, page 28, line 5, leave out “(except section 39 and Schedule 3)”
46: Clause 41, page 28, line 6, at end insert—
“( ) The reference in subsection (1) to this Part does not include—
(a) paragraph 4 of Schedule 2 (which comes into force in accordance with subsection (8)); and(b) section 39 and Schedule 3 (which come into force in accordance with subsections (2) and (3)).”
On Question, amendments agreed to.
Schedule 1 [Children looked after by local authorities: supplementary and consequential provisions]:
47: Schedule 1, page 29, line 5, at end insert—
“ In section 17(5)(a) of the 1989 Act (facilitation of provision by others of services local authority provide under provisions of Part 3 of that Act)—
(a) for “the authority have power” substitute “it is a function of the authority”; and(b) for “23” substitute “22A to 22C”.”
48: Schedule 1, page 29, line 5, at end insert—
“ (1) Section 59 of that Act (accommodation by voluntary organisations) is amended as follows.
(2) In subsection (1)(aa), for “an appropriate children’s home” substitute “a children’s home in respect of which a person is registered under Part 2 of the Care Standards Act 2000”.
(3) In subsection (1A) for “local authority” substitute “voluntary organisation”.
(4) In subsection (2) omit the words from “and” to the end.
(5) In subsection (3) omit the words from “and” to the end.
(6) After subsection (3) insert—
“(3A) Regulations under subsection (2) or (3) may in particular make provision which (with any necessary modifications) is similar to that which may be made under section 22C by virtue of any of paragraphs 12B, 12E and 12F of Schedule 2.”
(7) For subsection (5) substitute—
“(5A) Regulations under subsection (4) may, in particular—
(a) apply with modifications any provision of section 25A or 25B;(b) make provision which (with any necessary modifications) is similar to any provision which may be made under section 25A, 25B or 26.””
49: Schedule 1, page 29, line 6, leave out “the 1989 Act” and insert “that Act”
50: Schedule 1, page 29, line 33, leave out “22C(8)(d)” and insert “22C(6)(d)”
51: Schedule 1, page 29, line 35, leave out “22C(8)(d)” and insert “22C(6)(d)”
52: Schedule 1, page 32, line 36, at end insert—
“Children (Scotland) Act 1995 (c. 36)6A In section 26 of the Children (Scotland) Act 1995 (manner in which accommodation is to be provided) for subsection (2)(b)(i) substitute—
“(i) a local authority in England and Wales could place the child in a placement falling within section 22C(6)(c) of the Children Act 1989;”.”
On Question, amendments agreed to.
Schedule 2 [Minor and supplementary amendments to the 1989 Act]:
53: Schedule 2, page 36, line 22, at end insert—
“ (1) Section 59 is amended as follows.
(2) In subsection (1A)—
(a) for the words “the Secretary of State”, in the first place where they occur, substitute “an appropriate national authority”; and(b) for those words in the second place where they occur, substitute “that national authority”.(3) In subsection (2) for “Secretary of State” substitute “appropriate national authority”.
(4) In subsection (3) for “Secretary of State” substitute “appropriate national authority”.
(5) In subsection (4) for “Secretary of State” substitute “appropriate national authority”.
(6) After subsection (6) add—
“(7) In this Part “appropriate national authority” means—
(a) in relation to England, the Secretary of State; and(b) in relation to Wales, the Welsh Ministers.”In section 62(3) for “Secretary of State” substitute “appropriate national authority”.”
54: Schedule 2, page 36, line 24, leave out from “containing” to end of line 25 and insert “regulations which fall within subsection (3B) or (3C)”
55: Schedule 2, page 36, line 27, leave out sub-paragraphs (4) and (5) and insert—
“( ) For subsection (3) substitute—
“(3A) An order under section 4(1B) or 17(4) or regulations which fall within subsection (3B) or (3C) shall not be made by the Secretary of State unless a draft of the statutory instrument containing the order or regulations has been laid before, and approved by a resolution of, each House of Parliament.
(3B) Regulations fall within this subsection if they are the first regulations to be made by the Secretary of State in the exercise of the power conferred by section 23C(5B)(b).
(3C) Regulations fall within this subsection if they are the first regulations to be made by the Secretary of State in the exercise of the power conferred by paragraph 6(2) of Schedule 2.””
56: Schedule 2, page 37, line 3, after “Part 3” insert “, Part 7”
57: Schedule 2, page 37, line 7, leave out from “containing” to “, shall” in line 8 and insert “regulations which fall within subsection (4) or (5)”
58: Schedule 2, page 37, line 10, after “17(4)” insert “or regulations which fall within subsection (4) or (5)”
59: Schedule 2, page 37, line 11, leave out “it” and insert “the statutory instrument containing the order or regulations”
60: Schedule 2, page 37, leave out lines 13 to 17 and insert—
“(4) Regulations fall within this subsection if they are the first regulations to be made by the Welsh Ministers in the exercise of the power conferred by section 23C(5B)(b).
(5) Regulations fall within this subsection if they are the first regulations to be made by the Welsh Ministers in the exercise of the power conferred by paragraph 6(2) of Schedule 2.””
61: Schedule 2, page 37, line 19, leave out sub-paragraph (2)
62: Schedule 2, page 37, line 32, at end insert—
“In paragraph 7 of Schedule 5 for “Secretary of State” substitute “appropriate national authority”.”
On Question, amendments agreed to.
Schedule 3 [Repeals]:
63: Schedule 3, page 38, line 9, column 2, at end insert—
“In section 59— (a) in subsection (2) the words from “and” to the end; (b) in subsection (3) the words from “and” to the end.”
“In section 59—
(a) in subsection (2) the words from “and” to the end;
(b) in subsection (3) the words from “and” to the end.”
64: Schedule 3, page 38, line 19, column 2, leave out “, paragraph 17” and insert “—
(a) in paragraph 6(1), the word “and” immediately preceding paragraph (b); (b) paragraph 17.”
(a) in paragraph 6(1), the word “and” immediately preceding paragraph (b); (b) paragraph 17.”
On Question, amendments agreed to.
House adjourned at 10.36 pm.