Children and Social Work Bill [HL] — House of Lords, 2016-10-18
Topic: Mixed Topics
Michael Goodall Watson (Labour, Centre-left): My Lords, I support the amendments in this group, particularly Amendment 4. I am pleased to support the remarks of the noble Lord, Lord Ramsbotham, who stressed the need for screening for the various neurodevelopmental disorders and neurodisability needs listed in the amendment. Many of those arguments were made in Committee with particular reference to communication disorders, and I hope the Minister will find them more persuasive on this occasion There are many problems related to getting children an assessment and/or a diagnosis. The social worker needs to be aware of neurodisabilities and the support and training to enable them to develop this understanding. The lack of time to build meaningful relationships with a child and really get to know them is also of concern. Again, I hope the Minister will have something to positive to say on that On Amendment 1, the Minister acknowledged the need for parity of esteem between physical and mental health, and of course that is welcome. That being the case, however, there is surely no reason why he should not accept that his amendment is logically extended by the wording of Amendment 8 in the name of the noble Baroness, Lady Tyler. Looked-after children are among the most vulnerable in our society, often entering care with a history of abuse and neglect. But it is the sad case that once they are in the care system—a system intended to protect them—many continue to be at risk of further abuse. The Children’s Commissioner estimated that between 20% and 35% of children who had been sexually exploited were in care at the time of that exploitation. I am afraid that, all too obviously, there have been several such cases in our newspapers recently Knowing and understanding what types of support would benefit children entering care should be a simple step. It should be a basic element of that support that they receive a mental health assessment alongside the physical health assessment that already happens. Not only would that identify children with diagnosable conditions that require clinical interventions, it would allow foster carers, social workers, teachers and other responsible professionals to develop an understanding of how they could foster therapeutic relationships with those children in their care. I echo the recent remarks by the noble Earl, Lord Listowel: in many cases children require mental health assessments prior to entering the formal education system because damage can often be done at that stage that it is very difficult to deal with later. Children cared for in institutional settings have often experienced a high number of foster placements which have subsequently broken down, which can often be a by-product of poor emotional well-being It is estimated that almost three-quarters of children in residential care have a clinically diagnosable mental health condition. If a concerted effort had been made to address the mental health needs of those children when they entered care, it is at least possible that they may never have needed to be placed in residential care, which is, after all, a much more expensive option than foster care. That is why a whole raft of professionals working with the mental health needs of looked-after children believe that this help should be offered as early as possible. There is no rational reason for delaying the introduction of these simple measures, which could prevent further trauma being inflicted on these children As many noble Lords present will know, we have raised this issue time and again. I was among several noble Lords making the case at each stage in the passage of the Children and Families Act 2014. It was repeated at Second Reading and in Committee on this Bill. I raised it again at the briefing session on the Bill for noble Lords which the Public Health Minister hosted in September. All this was to no avail. Nor has this House been the only source of such pleading. As the noble Baroness, Lady Tyler, said, in April, the Commons Education Select Committee published its report entitled Mental Health and Well-being of Looked-after Children. One of its recommendations was that, "all looked-after children should have a full mental health assessment by a qualified mental health professional. Where required this should be followed by regular assessment of mental health and well-being as part of existing looked-after children reviews" The Government considered the Committee’s report, rejected most of it, it must be said, and their response on that point was: "We do not accept the recommendation as it stands" The response went on to refer to the expert working group for looked-after children that the Government established in May as a possible means of filling this long-established gap in provision for looked-after children. Perhaps there is reason to be optimistic as to that group’s recommendations, since it will have as its co-chairs Alison O’Sullivan, the former president of the Association of Directors of Children’s Services, and Professor Peter Fonagy, a psychologist and medical researcher. By what I am sure is complete coincidence, both gave evidence to the Education Select Committee’s inquiry and both, I understand, indicated their support for children having a full mental health assessment when they enter care. The expert working group also included four people who gave evidence to the Select Committee, plus the person who acted as its adviser, so the crossover is considerable, which I very much hope is all to the good It would lack consistency for the Minister today to submit Amendment 1 but then dig in his heels and steadfastly refuse to go further with regard to a full mental health assessment. Simply pointing to the expert group is not satisfactory, because it is not due to report for at least 18 months, which means that the Government will effectively stonewall again when the Bill reaches another place. Even if the expert group recommends a mental health assessment for each child entering care, the Government would then need to accept the recommendation—which, on past practice, requires a leap of faith—and then we would need to await the next suitable Bill as a vehicle to introduce it. So if anything does change, it will be quite some way down the line The Minister, his advisers and officials at the DfE should ask themselves how many more children will have their mental health issues undiagnosed because of government foot-dragging on an issue that the professionals are quite clear on. Over the years ahead it will be many thousands and that is not a thought of which anyone associated with the Bill on the government side should be proud.