Grand Committee
Children and Families Bill
(11 years, 1 month ago)
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The Deputy Chairman of Committees (Lord Bichard) (CB)
Welcome. If there is a Division in the Chamber while we are sitting, the Committee will adjourn as soon as the Division Bells are rung and resume after 10 minutes.
Amendment 26
The Earl of Listowel
“Looked after children: duty to provide information about support on returning home to care of parents or others with parental responsibility
(1) Except in circumstances prescribed by regulations, a local authority must provide the information specified in subsection (2) to—
(a) any person who has contacted the authority to request information about “return home support services” for a looked after child returning home to the care of P; and(b) any P within the authority’s area, to whose care a looked after child has returned, who has contacted the authority to request any of the information specified in subsection (2).(2) The information is—
(a) information about the return home support services available to people in the authority’s area;(b) information about the authority’s duties under section 22(3A) of the Children Act 1989 (“return home support services”: personal budgets) and regulations made under it;(c) any other information prescribed by regulations.”
The Earl of Listowel (CB)
Amendment 26 is in my name and that of the noble Baroness, Lady Massey of Darwen. Our two amendments relate to support for children returning home from care. Perhaps the best way to illustrate quickly what this is about is to give a couple of illustrations. Here is a quotation from a female caller to ChildLine:
“I’ve been in and out of care from a very young age due to my mum hitting me, neglecting me and taking drugs. Social services would come and take me away and I would spend some time in care, then mum would promise to change and I would go back home for the whole situation to start again. I don’t understand why social services keep giving me back to mum if they are going to end up taking me away again”.
Recently, I met a group of young care leavers, who shared with me their experiences. A 15 year-old girl—a lovely, lively young girl—had been promised that she was returning to a well equipped home. She found that there was no cooker and no microwave, and that she was sharing a pull-out sofa-bed with four other members of the family. There was no support. She had been doing well educationally in care, but when she went home her results plummeted. Another young woman did not want to return home. Her social worker offered to take her to McDonald’s; lo and behold, she was taken back to the family home and told that she had to stay there. I am sure there is good practice, but there is clearly a lot of work to be done.
I turn to the detail of my two amendments, which are supported by the NSPCC, the Family Rights Group, the Who Cares? Trust, the College of Social Work and TACT, the largest independent fostering and adoption agency. Returning home to a parent or relative is the most common outcome for children who have been placed in care. However, approximately half the children who come into care because of abuse or neglect suffer further abuse when they return home. Social workers often feel unsupported and lack the time and resources to support the children whom they return. In over one-third of cases, children returned home without an assessment. Parents’ problems often remain unresolved. Practice is highly variable in different local authorities. The Bill should be amended to require local authorities to assess, prepare, support and monitor a child’s welfare when they return home, and to ensure that parents know what support they are entitled to, just as has been developed in changes to adoption. It is vital that we improve support for all looked-after children if we are to protect our most vulnerable children from harm, and thus extend the entitlement in Clause 4 to support for children who return home.
Further research has shown that two-thirds of children who returned home remained with a suspected abuser even after concerns had been identified. Over one-third of children return home from care without an assessment, and a further 8% return after only an initial assessment. Research highlights children returning to households with a high recurrence of drug and alcohol misuse: 42% with drug misuse and 51% with alcohol misuse. Recent statistics published by the Department for Education show that almost half of children who return home re-enter care. In total, two-thirds of children who returned home experienced one failed return and one-third had oscillated in and out of care twice or more. A report published by the Department for Education concluded that appropriate services and support in place for a child and parents from the beginning of the care episode, throughout care placement and after the return home could significantly reduce the cost to the local authority. It costs around £2,650 per placement in care but it only costs £193 per month to look after a child in need. It therefore makes good financial sense to ensure that children and families get the support they need.
In a new Department for Education consultation on permanence, there have been welcome proposals in this area but they apply only to voluntarily accommodated children and, although it is more likely for such children to return home, it is important that support is also provided for all children returning home from care. Most importantly, the Government’s current proposals do not ensure effective assessment or that children returning home—and their parents—receive the support needed to increase the likelihood of a successful return.
I mentioned a recent meeting with some young people. In summary, they all found that they had not been given enough information about why they were returning home and their views were disregarded. One of them said that she had been promised regular monitoring for months after her return home, gradually reducing over time. She received two brief monitoring visits. None of them had received any substantial support to integrate back into the home and rebuild relationships, nor had their parents’ problems improved enough for them to stay at home safely. They all agreed that there needed to be more support for children and their families when they returned home and for this to happen over a longer period of time.
This amendment aims to increase the chances of successful return home from care for all looked-after children by requiring local authorities to adequately assess, prepare, support and monitor the welfare of the children when they return home from care, in line with support that is proposed, in Clauses 4 and 5, for children who are adopted. I look forward to the Minister’s response and beg to move.
Baroness Massey of Darwen (Lab)
My Lords, I support Amendments 26 and 29, in my name and that of the noble Earl, Lord Listowel. I will briefly state the arguments for my Amendments 30 and 31, which refer to improved support for special guardianships.
I want to reflect on some of the things which came up in Committee last week about children wanting to know; children having experiences and having a voice. We know, from children’s own stories, that support for them is not always there when they return home from care. Returning home to a parent or parents is the most likely outcome for children who have been in care and this can be the best result, but NSPCC research shows that about half the children who go into care because of abuse and neglect suffer the same when they return.
I will illustrate this with something I heard at the weekend, at the opening of a centre in Brighton which supports young people whose parents are addicted to drugs or alcohol. Children may be placed in care because one or more parents are addicted. The parent or parents go into treatment and are rehabilitated: they get clean. The children return and family stress may mean that the parent turns again to drugs or alcohol. The parents need support and the child needs support. I know from my experience as chair of the National Treatment Agency for Substance Misuse that some local authorities and drug or alcohol agencies provide excellent information and support for parents, but others do not. So often in services, we end up with a vicious circle of rehabilitation and relapse—be it drugs or prison, abuse or neglect—with children in the middle. A recent report from the Centre for Social Justice talked of children falling between the cracks, and so they do. We have in the Bill an opportunity to strengthen local authorities’ responsibilities towards children returning home from care and increase the chances of it being a successful return. If that return is not successful, not only does it cause more stress for children and families but it is expensive, as the noble Earl, Lord Listowel, said. Improving things is not likely to cause extra expense to the LA; it is likely to save money.
One key is assessments of the needs of the family and the child. It is worth asking families and children what they need rather than making assumptions about it, assuming that everyone is the same or that they simply need information. As Amendment 26 suggests, information is important, but it is not everything. Information about support services should also be in place. More than one-third of children return home without an assessment taking place, and assessment is not necessarily ongoing. Assessment should not be a one-off. Needs can change. I know that successful treatment for an addiction means revisiting the initial assessment regularly. The Department for Education produced a useful data pack entitled Improving Permanence for Looked After Children in September this year. It has messages and questions for local authorities, such as: what are all the assessment and decision-making processes for return to home from care? What services are available for returning children to their family? How do services link across children adult and specialist services—for example, can access to parenting programmes and drug or alcohol programmes be part of a “return to home” plan? What action are you currently taking to improve return on practice?
All those questions are important, but perhaps the most important is the linking of services. So often, services are parcelled out into child, adult, mental health, drug and alcohol, but often there are significant overlaps which are not recognised or responded to. Following a child’s return home from care, neither they nor their parents have a right to any support, and children often end up, as we have heard, back in the same situation—as I said, a vicious circle. Children have said, “I was left to it. I have been in care because my dad assaulted me. Since I have been home, he has been threatening me, pushing me around. I have been cutting myself and I feel like I want to die”.
We all know that behaviour change is difficult. It is perhaps especially difficult for troubled families. The needs of such families—of all families and their children—must be addressed before a child returns home. Engaging with families has been identified as an opportunity to enable the return home to be successful. Personal budgets are important and Clause 4 suggests that they should be available to parents of an adopted child. It is vital that that is extended to children returning home. I hope that the Minister will respond sympathetically to the amendments.
I shall say a quick word about my Amendments 30 and 31, which refer to special guardianship support services and personal budgets. I shall not go into detail on the amendments; they are self-explanatory. Their aim is simply to ensure that improved support for adopters in the Bill in the form of personal budgets and better information about support is extended to special guardians who, like adopters, are providing a permanent home for a child as an alternative to them being in the care system.
I am aware that this issue will come up again but, meanwhile, I hope that the Minister will respond favourably.
Baroness Howarth of Breckland (CB)
My Lords, I shall speak only briefly to the amendment because I presume that the Minister’s response will be that this should not be necessary because it should be provided by local authorities through good practice. I support the amendment simply because the postcode lottery in local authorities means that some will get good services, good information and steady support but a large number will not. The Government, in setting a framework, have a responsibility to ensure that there are consistent services right across the piece.
Many years ago, when I was dealing with children in care, I had to deal with what we called yo-yo children—those children who came in and out of care. When you identified a child who was not consistently either in care or at home, you settled down and set a proper assessment and programme for that child and made sure that there was a good way forward. I hope the Minister will have an answer to the kind of practice that is happening, otherwise, at a later stage, I will need to support the amendment.
As to special guardianship, when we were sitting in the adoption committee it became clear that there was very little difference between some children who were adopted and many children who were in special guardianship placements. The one difference was that those in special guardianships were struggling even more than those in adoption placements because, although the support is poor for post-adoption, it is even less for post-guardianship. Any services that are extended to adoptive parents must be looked at in relation to special guardianships, because these very often are the same children but have the benefit of being placed with those who know them and who loved them even before they were placed with them. I believe that is what the Government have been trying to do.
Baroness Hamwee (LD)
My Lords, I support what the noble Baroness has just said about special guardianship. It is a paradox that there were obstacles to special guardianship when it was a desirable outcome in particular cases.
I thank the noble Earl for arranging the meeting with the group of young people 10 days or so ago. I found it encouraging and disturbing at the same time. They were a remarkable group of young people. I do not think I could have been nearly as resilient as most of them seem to have been in the conditions they described. In support of the amendment, I shall read from a few of my notes: “There was no checking on the conditions I’d be going back to”, and the noble Earl has referred to the capacity of the mother and the physical conditions; “it depends on the child to tell or to ask for help”, which is a very salutary thing to have heard; “I went home once a month but no one checked up or even asked how the weekend went”, and the picture that I got was of variable circumstances and variable support depending, frankly, on where the child was. One—I hesitate to call him a child—young person said, “I should not have been allowed to go home”.
Baroness Howe of Idlicote (CB)
My Lords, sadly, I was not able to go to the gathering of young people. However, what one has seen and read is appalling. The most appalling aspect of it is that the children’s voices are not automatically heard in situations such as these on every occasion when they are of an age where their voices could be heard. Their rights should be protected, and if they do not wish to go home there is no question that they should be sent home under those circumstances. We have seen and read so much evidence from so many organisations that I hope the Minister will be able to give us a great deal of reassurance about the changes that are clearly needed.
Baroness Walmsley (LD)
My Lords, I make the point that if you want to know what a child needs, you should ask the child. If you want to know what the child’s parents need, it is also often quite a good idea to ask the child. People who are addicted are not always totally candid with the social workers, but if a child goes home for visits or is sent home—apparently permanently but that turns not to be permanently—he or she knows exactly what is going on in that home and can help the services in assisting the parents so as to ensure that the child can eventually go home if the parent is genuinely rehabilitated.
I also add my support to what the noble Baroness, Lady Massey, said about special guardians. They perform an invaluable public service at very little cost. Some of them break down because of lack of support and help, and we ought to do something about that.
Baroness Hamwee
My Lords, this is Committee: I was rather carried away by reading the notes and I meant to ask the noble Earl a question on his drafting in Amendment 26. In proposed new subsection (1)(a), he provides for,
“any person who has contacted the authority to request information”.
I suspect that he does not quite mean “any person”. I can imagine circumstances where it would be entirely wrong for information to be given out. Perhaps he can give the Committee some assurances about that, particularly if he is going to come back with this at a later stage.
The Earl of Listowel
I thank the noble Baroness. She makes a very good point and I shall look at that. We are trying to ensure that anybody caring for these young people gets the support they need to do an excellent job. We do not want people who might wish to misuse any information about them to get information.
Baroness Armstrong of Hill Top (Lab)
My Lords, I want to intervene briefly. We know that many children want to maintain contact with their natural family, even if they know that that family is chaotic. I absolutely support the amendments but my concern is that they do not push hard enough for support when the child initially goes into care. This builds on something that I was trying to say last week. Our responsibility ought to be to ensure that, while the child is in care, work none the less goes on with the natural parents so that an assessment can be made of whether they are capable of change and willing for change to take place. Our problem is that too often children who themselves have improved are then sent back home and no work is done with the parents before that happens. That is often why the placement breaks down again, and that is expensive—not just in monetary terms in trying to deal with that when the child comes back into care, but precisely because it adds to the damage that has already been done.
I chair an organisation in the north-east which does quite a lot of work with people who have addictions. We have a programme where we take mothers who are addicted into residential accommodation with their children. It is largely paid for by the National Health Service but we put a bit of our own money into it and we try to get some money from local authorities too. During the residential period, intensive parenting takes place and what happens to the children in that situation is also monitored extremely carefully. In that way, you really can make an assessment as to whether it is going to be feasible for the mother and her children to make it outside the care system.
One problem that was re-emphasised to us while we were on the adoption Select Committee is that very often parents who are encouraged or are made to put their children up for adoption because they are not capable of looking after them simply go and have other children. Our intervention with the Cyrenians in Newcastle is really trying to stop that by saying, “If you’re going to have another child then you’ve got to take the steps necessary to make sure that that child actually stands a chance”, so that there is not a wheel continually going round where they are saying, “If I can’t have that child then I’m going to have another child”, without any exit.
The Government really need to look at how we work with natural parents once the child has gone into care. If we can get better at that work, we may indeed be able to return children much more successfully and the support package being talked about in the amendments will then really bear fruit.
Baroness Hughes of Stretford (Lab)
My Lords, briefly, I particularly support the points made by the noble Baroness, Lady Howarth, in relation to Amendments 26 and 27. These amendments are important because, as she said, the statistics show us that the system is not working well for children who return home. While going home is the most common outcome for children in care, around half of them have to go back into care—sometimes more than once in this revolving-door pattern that can emerge—simply because there is not the good social work practice in relation to children returning home that we associate with other forms of childcare.
As the amendments address, there is not good assessment, good identification of need or provision of the necessary support services. There is also, very often, no continued monitoring of how that child is faring when they go home. That is the first point which the Government need to address: the statistics show us that it is not working when half the children who go home have to come back into care. That obviously not only damages them; as the research has shown, the costs of the consequence of coming back into care escalate because as children return from successive attempted reunifications, they are more damaged. The cost of caring for them in other placements then becomes that much greater. As the University of Loughborough has shown, as well as the social and moral imperative to try to reduce these failed reunifications there is, potentially, a financial benefit. If you can prevent the escalating cost of failed reunification, it makes financial sense as well and may in fact reduce costs to the local authority.
These amendments are about preventing further breakdown and damage to children. They are really about the good social work practice that should be going on but which we actually know is not, because reunification practice varies so widely across local authorities. The amendments would at least set a standard as to what should be required.
Viscount Eccles (Con)
I wonder whether the noble Baroness, Lady Hughes, will tackle the question that she has just referred to. Is there anything in existing legislation—I do not know how many Acts there are but there are those of 1989, 2002 and 2004, and probably quite a few more—which prevents the favourable outcomes described so well by herself and by other Members of the Committee?
Baroness Hughes of Stretford
My Lords, no doubt the Minister will enlighten us but what I am saying is that where local authorities have discretion around the quality of the social work practice that they will deliver to different groups of children, as they do, it means that some of those groups lose out. Demonstrably, by the statistics, it appears that children who are sent home from care are sometimes sent too early or without thorough assessment, do not necessarily get the ongoing support and are not monitored sufficiently. Those kinds of things happen with other cases—with child abuse cases, perhaps. However, it seems as if in many local authorities a decision is made that the child can go home but the focus of attention does not continue on to that child, which is more likely to result in breakdown.
Baroness Massey of Darwen
I shall comment briefly on what the noble Viscount said. One of the main issues is that the children and parents have no right in law to support—support is discretionary.
Baroness Northover (LD)
My Lords, noble Lords have highlighted some key areas on support of children, particularly those who may be returning from care. I assure the noble Baroness, Lady Howarth, and others, that we take these issues seriously. I hope, too, that I can be heard.
Lord Northbourne (CB)
I confess to being one of those who finds it difficult.
Baroness Northover
Okay, I shall shout loudly.
I shall speak first to Amendments 26 and 29 on the issue of assessment and support for children returning home from care to their families. As the noble Earl, Lord Listowel, pointed out, and as research has shown, almost half the children who return home later re-enter care, and almost one-third of those children have very poor experiences of that return. This is clearly unacceptable, and we recognise that. The noble Earl gave a very compelling instance of this, which was echoed by my noble friend Lady Hamwee.
This area is a priority for the department, which is why we established an expert group over a year ago to help us to understand and drive forward the improvements that we recognise are needed. The group includes academics, local authority representatives and sector organisations such as the Family Rights Group, the Who Cares? Trust and the NSPCC. We thank them for their work in this area. We are particularly pleased that the NSPCC is undertaking research in this area to understand how decision-making and support can be improved for these families. This will and must include ensuring that the voice of the child is at the heart of all decision-making, and I hope that that will reassure the noble Baroness, Lady Howe, my noble friend Lady Walmsley, and others. The working group has focused on how data can be used effectively to support local authority practice improvements, identify the areas where the statutory framework needs strengthening, and help us understand how we can support changes in practice that are effective and sustainable.
The current statutory framework clearly sets out requirements to return a child to their parents and to provide information about the support services available for these families. It is important to acknowledge that the statutory framework is different for those children who are subject to a care order and return home and those children who have been voluntarily accommodated and then return. The current statutory framework clearly sets out the requirements for placing a child with their parents—that is, when a child will remain subject to a care order after returning home. For example, a robust assessment of the parents’ suitability to care for their child must be undertaken; a nominated officer must be satisfied that the decision to return a child to the care of their parents will safeguard and promote the child’s welfare; and the local authority must continue to review the child’s case, setting out the services and supports in the child’s care plan and reviewing this regularly. However, the statutory framework for voluntarily accommodated children is not as strong—and noble Lords are clearly aware of that. That is why we are consulting on changes that might be made to this.
The Improving Permanence for Looked After Children consultation launched on 30 September includes a number of proposals to address the issues faced by voluntarily accommodated children in returning home. We want to strengthen the statutory framework to ensure that the decision to return voluntarily accommodated children is taken by a nominated officer, that the plan for support following the return home is clearly set out and reviewed, and that these children and their families are offered continuing visits and support from the local authority following the return. Those are some of the issues that noble Lords have just raised and which the noble Baroness, Lady Armstrong, highlighted. Also, the department’s evidence-based intervention programmes announced in February 2013 include interventions forsome of the children who often return home, such as teenagers. There is, for example, a focus on developing multisystemic therapy and family integrated transitions; this intervention supports children and young people returning home from care or custody.
We also propose to place a duty on local authorities to review a child’s case within a specified framework where the return home is unplanned. The consultation on these changes will close at the end of November, and we expect to publish our response in the spring, with the changes coming into force in the summer of 2014. I hope very much that noble Lords will take advantage of this consultation and feed in their experience, expertise and ideas effectively by the end of November.
I now turn to Amendments 30 and 31, which refer to information and support available to special guardians. Special guardians do a very important job, which we heard from both the noble Baroness, Lady Massey, and my noble friend Lady Walmsley. We agree that we need to look at whether they are being given sufficient support. The department therefore commissioned the University of York in March 2012 to carry out a two-year research project to investigate how special guardianship was working in practice, and the rates and reasons for any breakdowns. The final report is expected in autumn 2014. This is a major piece of research which will help us to understand how well special guardianship is supporting children and families.
We are planning to pilot personal budgets, as noble Lords know, as part of the adoption support fund prototypes over the next 18 months, to see how they work in practice and whether they deliver the benefits that we expect. These pilots, alongside the richer understanding that we will have by then of the way in which special guardianship is working, will allow us to reach an informed view about the potential for personal budgets for special guardians. If there is a need to change the statutory framework we will consider what secondary legislation and statutory guidance needs to be brought forward and will consult on these before implementation. I hope, again, that noble Lords are reassured by the work going on. I hope, therefore, that I have given noble Lords sufficient reassurance that the Government recognise and are committed to working towards supporting birth parents and special guardians, and that the noble Earl will withdraw his amendment.
The Earl of Listowel
My Lords, I thank the Minister for her very careful reply. It is very welcome that the expert group was set up a year ago, and it may be too early to ask what progress has been made. We have heard the rather depressing statistics about children returning from care. How much difference does the Minister expect to be making in the next three years, year by year? What is the timescale for changing the outcomes for these young people? Perhaps the Minister would write to me.
Baroness Northover
I am happy to write to the noble Earl, and to copy it to other noble Lords who have contributed to the debate, spelling it out in some more detail.
The Earl of Listowel
My Lords, I thank the Minister and I also thank my noble friend Lady Massey of Darwen for her eloquent support, and for all her experience with the issue of substance misuse. Clearly, it is concerning that people who are addicted to alcohol or other substances will lapse from time to time, and if children are placed with them such families need to be monitored, with additional support put in as necessary.
I am very grateful to all noble Lords who have spoken in support of the amendment, and I particularly thank the noble Baroness, Lady Hamwee, for her communication on the voice of the children at our recent meeting. I was very glad that she was able to make the time to be present. I hope that those young people and others will feel that we have done justice to their concerns today. I will consider what the Minister has said and beg leave to withdraw the amendment.
The Earl of Listowel
“Local authority investigation: advocacy
In section 47 of the 1989 Act (local authority duty to investigate) after subsection (5A) insert—“(5AA) In meeting its duty under subsection (5A), a local authority shall give consideration to making arrangements for the provision of independent advocacy for the child in relation to any decision making meeting in the course of section 47 enquiries unless the child states that he or she does not wish to receive the services of an independent advocate.
(5AB) For the purposes of this subsection—
(a) “advocacy” means the provision of independent and confidential information, advice, representation and support to a child;(b) “independent” means where the person appointed is not connected with the local authority by virtue of being—(i) a member of the local authority or any of their committees or sub-committees, whether elected or co-opted;(ii) an officer of the local authority employed by the Children’s Services Department of that authority; or(iii) a spouse or civil partner of any such person.””
The Earl of Listowel
My Lords, I shall speak also to Amendment 28 standing in my name. Both amendments relate to advocacy and, again, it may be helpful if I begin with an illustration of why advocacy is important.
Advocacy is a means of ensuring that the wishes and feelings of children, particularly children in care, are heard. A typical issue might be whether they have the right to have contact with siblings or to continue to remain in the same placement. Another concern might be a child whom it is convenient for the local authority to move to a new placement, or the local authority may consider that it is in the child’s best interests to do so, but the child very much feels that where they are is where they wish to continue to be.
The first amendment looks at advocacy in relation to child protection conferences. This is a probing amendment and its purpose is to debate the merits of the introduction of a statutory presumption that local authorities should give consideration to ensuring that children and young people are supported by an independent advocate in initial and review child protection conferences unless they choose to opt out.
The purpose of the two amendments is to elicit a debate on advocacy and to get an assurance from the Government on two things. First, will the Government produce an advocacy handbook to replace the 2004 Get It Sorted guidance, which is now nearly 10 years out of date, to reflect current policy and practice? Secondly, will the Government collect more data on how advocacy is used in child protection conferences and care reviews so that we know better what happens and how good access to advocacy is for children in care in those two situations?
Evidence has consistently shown that the child’s voice is often not heard and effectively represented in child protection cases. Both professionals and children think that meaningful engagement of children in the decision-making process would lead to improved outcomes. Recent high-profile cases have once again put child protection services under close scrutiny. The exposure of systematic safeguarding failures in Oxford, Rochdale and Edlington have raised questions about the extent to which services are putting children’s experiences and voices at the heart of the child protection process. The 2012 Monro Review of Child Protection states:
“Children and young people are a key source of information about their lives and the impact any problems are having on them in the specific culture and values of their family. It is therefore puzzling that the evidence shows that children are not being adequately included in child protection work”.
Child protection conferences are a key part of the child protection process, although I shall not describe them in detail. Until recently, the framework for ascertaining a child’s wishes during the child protection process was provided by the Working Together to Safeguard Children guidance, published in 2010. From April 2013, a revised version of this guidance has been in place with the aim of reducing the level of prescription and bureaucracy involved within safeguarding procedures. Although the revised guidance recommends obtaining and understanding the wishes and needs of children within a child-centred system, it gives far less prominence to the involvement of children during assessment and within the child protection process than the previous version. In particular, there is no longer a presumption that a child, subject to age and understanding, should be invited to attend their conference with an advocate if they wish to do so. So there is less prescriptive guidance alongside no clear statutory right to advocacy. This risks reducing the opportunity for people to participate in the child protection process.
Baroness Stedman-Scott (Con)
Amendment 65A seeks to appeal restrictions to Section 8 orders for children in local authority care. At present, legislation which aims to ensure the welfare of looked-after children is not being consistently implemented at local authority level. For instance, Section 9 of the Children and Young Persons Act 2008, states that:
“As far as is reasonably practicable”,
and when “consistent with their welfare”, a local authority must provide accommodation for a child that is “in the authority’s area”, yet in reality one-third of children in care are placed outside their local authority’s area. In the case of residential care, almost half of children are placed outside their area.
Similarly, Section 8 of the Children and Young Persons Act 2008 states that suitable accommodation should ensure that,
“if C has a sibling for whom the local authority are also providing accommodation, it enables C and the siblings to live together”,
yet in a survey by the Children’s Rights Director in 2011, almost three-quarters of children in care reported being separated from their siblings. Young people in children’s homes are most affected with, I am advised, 96% being separated from a sibling. Noble Lords will agree that the current situation is unacceptable, yet there is little recourse at present for looked-after children to enforce their rights.
Independent reviewing officers are supposed to intervene if a child's views and welfare are not being taken into account in care planning, and have the power to report cases to CAFCASS, which reports to the family courts. However, this rarely happens in reality. Between 2004 and 2011, independent reviewing officers reported only eight cases to CAFCASS. Independent reviewing officers seem to lack the time, independence and legal expertise to properly ensure children’s rights are not breached.
Similarly, the complaints procedures available to looked-after children are both too lengthy and insufficiently robust to make a difference in serious cases. A survey by the Children’s Rights Director in 2012 found that over one-third of the looked-after young people surveyed said that making a complaint made no difference at all to their situation and over one-fifth said it had made it worse.
Finally, children in care already have access to legal action through judicial reviews for very serious cases. However, while judicial reviews are superior to complaints procedures and IROs as they are truly impartial, robust and fast enough to make a real difference, there are also limits to their effectiveness. First, they can question only the way a local authority has made a decision, not the decision itself. Secondly, judicial reviews are an extremely expensive way of enforcing rights, costing upwards of £30,000. Given the economic climate we are in, it is increasingly unlikely that judicial reviews will continue to be an option for looked-after children. Thirdly, they happen after the event and usually after significant harm has been sustained.
However, there is an important legal right that looked-after children are denied, which could provide them with a means to prevent local authorities acting against their interests. As I am sure noble Lords are aware, Section 8 orders such as contact, prohibited steps and specific issue orders enable children to prevent their parents taking actions that are against their best interests. If a parent attempts to prevent a child seeing a family member or tries to move the child away from their home, the child may, through their solicitor and if that legal representative considers there to be sufficient grounds, ask a court to make a Section 8 order. Though rarely exercised or indeed necessary, the right to do this is a crucial protection for children in difficult situations.
However, at present, Section 9(1) of the Children Act 1989 states:
“No court shall make any section 8 order, other than residence order, with respect to a child who is in the care of a local authority”.
This is a gross inequality for looked-after children, denying them the same rights available to all other young people. Opening up Section 8 orders to looked-after children would give them a clear and direct means of redress if a local authority is acting against their interests and welfare. For instance, a child threatened with an unnecessary move far away from home could ask a court to make a prohibited steps order. The threat of legal action would also provide a clear incentive for local authorities to implement existing policy concerning looked-after children and act in their best interests. The paramountcy principle is enshrined in the Children Act 1989; importantly, this will be driven not by government but by the people whose lives are most affected.
It is not envisaged that large numbers of looked-after children will approach courts to make Section 8 orders against local authorities. However, for those in very serious situations where such legal action is appropriate, this will be an enabling right which could make all the difference. The potential gains of opening up Section 8 orders are very great. By allowing young people to seek help from a court to prevent local authorities acting against their interests we could prevent many disruptive placement moves, which have such a harmful effect on the outcomes of children in care. Opening up Section 8 orders would enable prevention of harm rather than simply redress after the event. It is a vital early intervention measure and this proposal will be an historic step forward for the rights of children in care. I look forward to hearing the Government’s response.
The Parliamentary Under-Secretary of State for Schools (Lord Nash) (Con)
My Lords, in responding to Amendments 27 and 28, I pay tribute to the long-running commitment of the noble Earl, Lord Listowel, to improving the lives of our most vulnerable young people by ensuring that their voices are heard. As my noble friend Lady Walmsley said earlier, it is only if we listen to children in the child protection system and those who come into care that we will ensure that they are being effectively supported and safeguarded. In particular, children in care need to be able to challenge and influence strategic planning as well as day-to-day decisions taken about their lives.
For those in the child protection system, the revised government guidance Working Together to Safeguard Children makes it clear that the child’s needs are paramount and that children need advocacy as part of an effective child protection system. The Department for Education has also worked with the office of the Children’s Rights Director on the publication in August this year of the Young Person’s Guide to Working Together to Safeguard Children. This highlights that in child protection conferences and the child protection process children should be listened to and supported, including by being able to ask for an advocate to help them put their views across. To quote from it, social workers,
“should ask your views so that you can have your say on what should or should not be in the child protection plan. Remember, you can ask for an advocate to help you do this, if you want”.
I believe that the guidance strikes the right balance of clarity over statutory responsibilities, while allowing local authorities and professionals to develop professional practice in the best interests of children. I feel that guidance rather than primary legislation is the most appropriate vehicle for promoting advocacy support for children.
While advocacy can help and benefit some children, sadly one of the concerns highlighted in recent, tragic cases is that the social worker and other front-line professionals have sometimes not done enough to seek the views of children at the assessment or the child protection inquiry stage. I would not want at this stage to detract from the important responsibility of professionals to listen to the child by introducing in legislation an additional person with this responsibility.
I turn to advocacy for looked-after children. The Children and Families Minister meets regularly with groups of children in care and separately with care leavers. We recognise that many of them say that they do not have access to advocacy services and that, as the noble Earl said, provision is patchy. That is why the Government, as part of our commitment to improving advocacy services, have doubled the funding to them from £150,000 to £300,000. This year, we are supporting both the National Youth Advocacy Service and Voice to provide an advocacy service for looked-after children and care leavers. The services will include information and advice via telephone, enabling young people to access and obtain advice when they want it, and the allocation of an independent advocate to support and represent young people when they want it.
We do not think that further legislation in regard to the role of advocacy in children’s reviews of their care plans is necessary. The Government have already strengthened the role of the independent reviewing officer to give due consideration to the wishes and feelings of the child when making decisions with respect to the child. It includes a specific duty to ensure that a child understands how an advocate could help to support them at their care plan review meeting. We recognise that even more needs to be done, and that is why we are working closely with the advocacy sector and Children in Care Councils to enable all children to know their rights to have an advocate.
The Countess of Mar (CB)
My Lords, I listened to the noble Lord very carefully. I note that the amendment of my noble friend Lord Listowel refers to,
“independent advocacy for the child in relation to any decision making meeting in the course of section 47 enquiries”.
I have a lot to do with young people who have ME. In many cases, not even the parents are invited to the decision-making meeting, and the children are never consulted. Can the noble Lord reassure me that this will not occur in the future? One particular charity, the Times Trust, has dealt with 90 such cases in the past 12 months, and each time the parents and the children are ignored—the decisions are made over their heads.
Baroness Stedman-Scott
I thank the Minister for his response to my amendment and I am delighted that he acknowledges the spirit behind it. I believe this to be worthy of more discussion, and I know that his officials have already promised that. On that basis, I shall not be pressing the amendment.
The Earl of Listowel
I also thank the Minister for his response. It seemed to me very sympathetic and reflected the very positive attitude of this Government towards the idea of advocacy and hearing the voice of the child. I saw that reflected in the practice of Edward Timpson MP when he was chair of the all-party parliamentary group on young people. I believe that he still regularly meets groups of young people in care—groups of younger and older people—as well as care leavers. I think that this sort of approach will make a huge difference to policy. If good advocacy can make a difference for one child through having contact with his siblings and the principle is proved that children should have such access, that raises the game for everybody and creates opportunities for other children with similar difficulties.
I was grateful to be reminded of the doubling of funding for advocacy by the Government from £150,000 to £300,000, and I am grateful for the Minister’s consideration of the idea of a handbook. I beg leave to withdraw the amendment.
“(2A) In subsection (1), after paragraph (d) insert—
“(e) his siblings (whether of the whole or half blood).””
Baroness Hughes of Stretford
My Lords, I am sure that Members of the Committee will recall that last week we debated the importance of kinship care and, unless there are reasons why this should not happen, the importance of children in care keeping in touch with members of their biological family one way or another. This amendment rehearses some of those arguments. Indeed, the importance of family contact and strengthening the potential for family contact for children in care will be a theme that I will return to a number of times as we go through the Bill.
The effect of Clause 7 is to clarify the existing law that any decision by a local authority about allowing a child in care—under a care or emergency protection order—contact with the parents or some other family member is subject to the local authority considering whether such contact would place the child at risk of harm. Obviously that is essential and, although the law probably currently provides for that, we have no objection to it being clarified here in Clause 7.
However, we think that if the Government are serious about the importance of continued family contact, they should go further and require local authorities to give specific consideration to enabling children in care to remain in contact with their siblings. That is the purpose of Amendment 32. We know that sibling contact has not always been a priority for agencies—certainly not the priority that it seems to be for the children themselves. We think that there is a need for the Government to enshrine sibling contact as a priority in the legislation.
There are two main reasons why we think that. First, 63% of children in care whose siblings are also in the care system are separated from them, so the vast majority of children in care who have siblings in care as well are not together. Those living in children’s homes are much more likely to be separated from their siblings than those in foster care, yet the sibling relationship is often the longest relationship in a child’s life, potentially offering the stability that is often absent from other aspects of the life of a child in care. The second reason is understandable: it is that young people in care themselves feel strongly that they generally have too little contact with their siblings. Some 85% of children in care thought it important to keep siblings together, and over three-quarters thought that councils should help children and young people to keep in touch with their brothers and sisters.
This amendment would make that sibling contact a priority in social work practice. I think we can all understand why continued contact with your brothers and sisters when you are in care is fundamental, yet it seems now that in many cases—the majority—siblings are separated and risk losing that contact, stability and link to their biological heritage. I hope that the Minister will accept the amendment. I beg to move.
Baroness Butler-Sloss (CB)
My Lords, I strongly support the amendment. As I think I said at our previous sitting, when I chaired the adoption committee we had two meetings with children, one with looked-after children and the other with children who were or were about to be adopted. Each group made it absolutely clear, particularly younger children—the seven, eight, 10 or 12 year-old children—how important their siblings were. They said to us that siblings were more important to them than parents. Some of them would have liked to have seen their parents; they all wanted to see their siblings. It was so sad; one little boy said, “I’m so worried about my brother. I don’t know what’s happening to him. Nobody will tell me and I’m not allowed to see him. I wake up at night wondering how he’s getting on”. That is not acceptable for children. The amendment would alert everybody to the importance of siblings, which is why I support it.
Baroness Hamwee
My Lords, I very much agree with all that has been said. I remember being struck by the strength of feeling expressed by the young people. At our previous sitting we talked about the importance of identity; contact with one’s siblings and understanding that family dynamic is another aspect of identity. I have been impressed by somebody outside the group of people whom the noble and learned Baroness saw, whose feeling of responsibility for her younger sibling was important to her to express and fulfil. By separating her from her younger sister—by being deprived of caring for her—she was being deprived of the expression of her own personality. That was of huge significance to her.
The Earl of Listowel
My Lords, I would also like briefly to support the amendment and give an example of how passionately young people in care feel about being separated from their siblings. Delma Hughes, who was separated from her five siblings, I believe, later went on to become an art therapist and work with young and vulnerable people. She felt so passionately about correcting the wrong that had been done to her that she set up a charity called Siblings Together. It has run for several years, organising holiday camps in the countryside and events at the Young Vic theatre, so that young siblings who may never see each other apart from on such occasions can spend a week or so together. That woman is a real example of how terrible it feels to young people when they are separated from their siblings, and how at least one of them has become a champion in the area and made a huge difference to many other young people who have gone through that experience.
Baroness Perry of Southwark (Con)
My Lords, I ask the Minister: why is this not already happening? It seems crystal clear that at least keeping siblings in contact with each other is common sense, is vital and makes emotional sense. I do not understand why there is a problem here. Why are children being separated when they go into care or adoption proceedings?
Baroness Walmsley
My Lords, I very much agree. As we have talked about the last three groups of amendments, it has occurred to me that we appear to be living in a parallel universe. Ministers stand up and, quite correctly, read out the situation as it should, theoretically, be. Although Ministers tell us in good faith what the situation is in theory, it is not happening.
The noble Baroness, Lady Hughes of Stretford, made a point which struck me as a little odd. She said that 60% of those siblings who are both in care and who are not together or seeing each other are in children’s homes. I understand that it might be quite difficult to get foster carers to take pairs of siblings because they might be prepared to take only one child, but it should not be that difficult to put sets of children together in children’s homes where there are multiple places. Might the Government consider doing some research to find out why that is? I would have thought that was the very place where you could keep groups of siblings. Could that be looked into?
Baroness Howarth of Breckland
My Lords, I support this very strongly. We should not have reached the position we have, but I have some understanding of how we have reached it.
I have talked to many young people over the years, and particularly remember two groups I saw, with the Children’s Rights Director, who talked about the way conflict in their families was relieved by the fact that they had siblings to share their sojourn and be a comfort when things were really grim. They were the people who were their in-group when all this was going on, so were even more important to them than their parents, who were often the enemy and doing the destructive things, while siblings were their protection. That is not always so: there are siblings who are damaging to each other. Professional decisions to separate siblings may be quite right, but they must be made properly, not by accident. I fear we have reached the position where it is by accident because of the way we arrange placements and the shortage of good ones. We have young people in adolescent groups because they are easier to manage with staff who can manage them and small units with small children, but many fewer family group homes than there were, so you do not have the mix of youngsters together. Managing a unit of very difficult young people is about training, and confidence.
I sincerely regret this, because I have heard heartfelt pleas, similar to the ones outlined by the noble and learned Baroness, Lady Butler-Sloss, from young people—particularly in court—saying, “Whatever happens do not separate me from my siblings”. It is the siblings, not the parents, who mean everything to them.
It is a serious practice issue. I am not sure how legislation would make it right, but this amendment might be a step towards it. I hope the Minister will assure us that Ofsted might look at this when they look at the organisation of residential care in various authorities and how families are planned for. I am a social worker so I know how easy it is, under pressure, to delude yourself that it is the best answer for the child when it is actually the best solution for you.
Baroness Benjamin (LD)
My Lords, I support this amendment because as a child I was separated from my siblings for a while, which was quite customary. It happened in the Caribbean, but it is the same experience no matter in which part of the world we are. I know how important it is to feel that we can speak to our siblings if we are going through some trauma in our lives. Children from diverse backgrounds who live here in Britain go through hell almost every day. I always say that their life is like a marathon. To have siblings there to help with bonding and to give confidence to face the world is terribly important. I am here to passionately support this amendment because of personal experience.
Lord May of Oxford (CB)
I turned up explicitly to support the amendment and am reassured that I need not have done. I hope that people will take heed of those remarks and recognise that, in addition to the amendment, somebody should be looking at the idiots who are doing what they are doing.
Baroness Eaton (Con)
My Lords, at the moment considerable consultation is taking place with local authorities on children’s homes, particularly in the area of safeguarding and bringing in new and helpful ways of running them. Is it possible, within that consultation, to consider the relationships of the children in the home, and why siblings are separated? Could that be part of the appraisal of the effectiveness of running children’s homes?
Lord Nash
My Lords, I thank the noble Baronesses, Lady Hughes and Lady Jones, for raising this extremely important issue. The amendment gives me the opportunity to say that I have published draft regulations for your Lordships’ consideration. I completely agree that contact between siblings can be of great importance and extremely beneficial—this is not in dispute. However, I hear what the noble and learned Baroness, Lady Butler-Sloss, my noble friends Lady Hamwee, Lady Walmsley and Lady Benjamin, the noble Earl, Lord Listowel, and the noble Lord, Lord May, have said. I am afraid that we do not agree that amending Section 34 is the right thing to do. The Family Justice Review recommended that the Government should consult on whether Section 34 should be amended, along the same lines as proposed in this amendment. We did just that. Drawing on the experience and knowledge of a number of experts, we agreed that amending the law was not the right thing to do, and that more work needed to be done to improve practice and facilitate positive contact between siblings.
When the child’s local authority is considering what contact there should be—whether with the child’s parents or siblings—the authority must ensure that it is consistent with safeguarding and promoting the child’s welfare. In doing so, the draft regulations require local authorities to have regard to the child’s care plan. We consider that that is the right approach. Current regulations already require local authorities to consider and review contact arrangements with siblings. Local authorities are under a duty to include in a child’s care plan details of how they will meet the child’s needs in relation to all family relationships. This includes arrangements for promoting and maintaining contact with siblings.
Baroness Hughes of Stretford
I wonder whether the Minister could develop his argument and try to convince us. First, what was the reason given by the respondents in that consultation as to why changing the law was not the best course of action? Secondly, picking up on the point made earlier by the noble Baroness, Lady Walmsley, why does the Minister think the current requirements on local authorities in the regulations, to which he is referring, are patently not working, as so many children in care are losing contact or are not placed with their siblings?
Lord Nash
I am grateful for the noble Baroness’s further question. We consulted a number of experts, including Dr Beth Neil, Fran Fonseca, Jack Smith, Linda Jones, Roger Morgan, Julie Selwyn and Alan Rushton. They felt that this was a matter of practice and that more work needed to be done to improve practice. I agree, and I share the noble Baroness’s concern about this. In the light of the feelings expressed today, it is a matter that we need to look at again, but our current thinking is that it is a matter of practice and not a question of changing the law.
When siblings are looked after but are not placed together, their individual care plan must set out the arrangements made to promote contact between them. The care plan must be reviewed regularly, which allows for the arrangements to be revised as the child’s circumstances change. Sibling contact is already provided for in the Children Act 1989, and the court must consider contact arrangements before making a care order. The looked-after siblings can apply to court for contact. We have specifically ensured that the court continues to consider contact arrangements through Clause 15.
As for the question about children in care homes, which was raised by my noble friend Lady Walmsley and the noble Baroness, Lady Howarth, I can give the commitment that we currently have a programme of work to look at how to improve the quality and support of practice in children’s homes. I shall ask my officials to look specifically at the issue of siblings being placed together as part of this work. It is true that Ofsted should look at how siblings are placed in children’s homes.
Baroness Howe of Idlicote
I wonder whether I could pursue something that has been said. On the question of whether the children’s officers throughout the UK are in support of this system—and I am thinking particularly of the requirement that the English Children’s Commissioner is clearly going to have much more independence than she currently has—is this an area that needs looking at? Could the Minister clarify that?
Lord Nash
It is something that we can ask the Children’s Commissioner to look at. We will talk to her about this. As my noble friend Lady Walmsley said, perhaps this is an area where we should do further research. I shall ask my officials to consider this. I think that the noble Earl raised that point as well. I have noted the strength of feeling on this point today, and we will take it away for further consideration. Nevertheless, I ask the noble Baroness to withdraw the amendment.
The Earl of Listowel
Before the noble Baroness does so, it occurs to me that the matter of staying put might be helpful in this arena. If there are two siblings, one of 16 and one of 17, in the same foster care household and then one turns 18, enabling the foster carer and the young person to stay together past the age of 18 might enable that sibling relationship to endure further. I do not know what the experience is there, so if the Minister can help with any information with regard to whether there is a significant factor in helping young people to stay put—if that helps in the issue of keeping siblings together—I would be grateful to him. Perhaps the voluntary agencies know of examples in that area; again, I would be grateful to hear about that.
Baroness Hughes of Stretford
First, I thank all colleagues who have contributed to this debate, because their contributions added considerable weight to my introduction. There was obvious support across the Committee for this amendment and the issue. The noble and learned Baroness, Lady Butler-Sloss, and the noble Baroness, Lady Hamwee, were able to give us some direct testimony of children, and the noble Baroness, Lady Howarth, as ever, gave us her insight into what is going wrong with the system and why things are as they are.
I am pleased that the Minister said that he has heard the strength of feeling on this issue. He made two points in response. The first was that a number of experts had said that because this was a matter of practice, changing the law was not the right way to try to improve contact between siblings in those care cases. There is a dynamic relationship between the law and practice, is there not? We frequently set out what professionals ought to do in legislation. Yes, we may flesh it out further in regulation, but practice is often defined in legislation. His second point was that we already have regulations that require that. Clearly, they are not working when so many children in care—by accident, as the noble Baroness, Lady Howe, said; it is not intended—are by default losing contact with their brothers and sisters.
Baroness Young of Hornsey
“Care leavers’ access to personal information
(1) It shall be the duty of every local authority and voluntary organisation that looks after or provides accommodation for a child or young person to maintain such records as prescribed by regulations.
(2) Regulations under subsection (1) may provide for the transfer of records held by a voluntary organisation comprehensive information from the records relating to their personal history, family background and time in care.
(3) A care leaver has the right, at his request, to receive from the local authority or voluntary organisation comprehensive information from the records relating to their personal history, family background and time in care while they were a looked after child or young person, and such information will include personal sensitive data and also identifying information about other family members, acquaintances and significant others.
(4) Subsections (1) and (3) do not apply to a request for information in circumstances where the local authority or voluntary organisation is authorised by regulations to withhold the information or any part of it.
(5) Local authorities and voluntary organisations have a duty to provide appropriate and reasonable support on request, including information and advice, along with explanations of the process of redaction, the offer of appropriate counselling and access to intermediary services to care leavers having received their care records.
(6) The regulations may provide for the circumstances in which the local authority or voluntary organisation holding the records may arrange for another local authority or voluntary organisation near the care leaver’s home to provide access to the records and support.
(7) In this section, “care leaver” refers to a person aged 16 and over who, while they were a child or young person, was in the care of or looked after or accommodated by a local authority or voluntary organisation.
(8) It shall be a defence to any allegation of unlawful disclosure of data under the Data Protection Act by the data controller, if it can be shown that the data controller has made a reasonable examination of the data and has satisfied himself as to the need to disclose data and identities of individuals whose consent has not been obtained under section 7(4) of the Act having regard to the needs of the care leaver as set out elsewhere in this Act.”
Baroness Young of Hornsey (CB)
My Lords, I start by declaring an interest as someone who has had direct experience of the childcare system and of accessing social services care records.
This amendment is informed by the experience of care leavers and by professionals in the Access to Records campaign group, which comprises, among others, the Care Leavers’ Association, the British Association for Adoption and Fostering, the Association of Child Abuse Lawyers, the Childcare History Network, the Post Care Forum and Barnardo’s and is also supported by the charity TACT.
Whether they have spent all or part of their childhood and/or adolescence in the care system, for too many the current system simply is not working in a consistent, helpful way. At the moment, care leavers apply under the Data Protection Act for access to personal information held in care records, but unfortunately the DPA is often misinterpreted by local authorities, with some organisations severely restricting the information made available. There are too many examples of care leavers receiving such incomplete and heavily redacted records that their case histories are rendered virtually meaningless. Furthermore, the service given by local authorities is erratic and inconsistent: some are enabling and supportive while others are bureaucratic and obstructive. Some seem so concerned about negligence claims and media headlines that their position is defensive from the very beginning.
The relationship between practice and legislation was brought up in discussion on the previous amendment, and it is key here, too. Our argument is that, although there are regulations and guidelines in place, they are not working sufficiently well. Before I go into the detail of the amendment, I want to say something about the rationale behind it.
Many of the points made by the noble Baroness, Lady Hamwee, last week in relation to Amendment 25 resonated with me, because very similar issues concerning identity, belonging and knowledge of family history are relevant to this amendment. The question, “Who am I?”, is fundamental; it is a question necessary for us to recognise our sense of self and our status as a distinctive and unique human being. We understand that responses to that question are highly complex: we are the sum of our experiences and memories, and of what other people tell us and how they respond to us. Some experiences are indelible and remain with us through memory; some experiences, even though they are an essential part of our experience of the world, may none the less be forgotten, especially if they have produced trauma of one kind or another.
If you have been brought up in care, you come to think about what kind of person you are and where you have come from, asking, “Who am I?”. However, these questions may be unanswerable. Who is there to tell you at what age you accomplished something or about a specific difficulty you had, or the circumstances of your early life? How is it possible to accumulate the kind of knowledge about yourself that people brought up in conventionally caring situations take for granted? It may be your story and your journey but it seems to belong to the state in the form of records, whether they are hand-written, type-written or whatever.
Several thousand people ask to see their records and many of these requests come from people in their middle or later years. The lifelong needs of adult care leavers are at least as pressing as those of adults who have been adopted, although this is rarely recognised in respect of access to care records and the aftermath. The DPA enables care leavers to see personal information about them on their care files. The problem is that when asking a local authority to see these files, care leavers’ experiences range from a response which is at best enabling and supportive and at worst bureaucratic, restrictive and inconsistent with the corporate parenting role. There are some examples of good practice but we want the Government to ensure that local authorities work with the Information Commissioner’s Office to enable care leavers to have all the personal information they are entitled to, and to exercise their discretion regarding third-party information in a less restrictive way.
As I have suggested, despite the requirements already in place, we think that the standard and quality of case-record keeping is not consistent across the children’s services sector. Organisations need to be mindful of keeping older records safely and under secure conditions, whether they are paper, scanned or microfilmed. We have heard too many instances where organisations with poor archival records and retrieval systems respond to the care leaver’s request for personal information with a statement that the files or records cannot be found, without any sense of the profound impact that that can have on the post-care adult. Without support, the persistence necessary to obtain care files places a substantial psychological and emotional burden on the individual, who may already be very isolated. Even if they are not isolated, the impact of disturbing revelations can have repercussions on current relationships and families.
We also need to make sure that we can track where records have moved to: for example, a children’s home might have been closed or a voluntary organisation wound up or absorbed into another organisation. Not being able to find records on that basis is also frustrating and works against care leavers. Regulations could provide a framework for the coherent transfer of care records systems across childcare service providers.
Our evidence suggests that the response from the authorities is often not focused on the rights and needs of the individual care leaver. Again, this echoes other points that have been made in respect of children. Although we are clearly talking here about adults, they still have rights and needs as care leavers that are not being respected by the rather defensive attitudes often displayed by local authorities, which seem to be worried about potential criticism or fearful of litigation.
Similarly, when it comes to sensitive personal data, care leavers can find that many data controllers interpret existing provisions narrowly and that the information withheld significantly reduces clarity about the information they want to access. There are circumstances where organisations can withhold information, and there are plenty of guidelines on that. However, again we come to this point: they are not being implemented consistently or necessarily in the best interests of the adult care leaver who is seeking to find out more about their past, particularly when it comes to relatives. Even if somebody gets hold of their care records, there is then the issue of whether they understand how and why the data controller has made decisions about what information is provided and about what has been withheld, redacted or left out. In relation to that, there is also the need for adult care leavers to at least be offered the opportunity to have some kind of support in going through what is often a difficult situation to navigate.
We understand that some data controllers feel nervous about making disclosures of a sensitive nature that particularly affect other people’s personal backgrounds—for example, a mother or father or other relative—and we want to make sure that data controllers have adequate protection in such circumstances, hence the latter part of the amendment. To summarise, care leavers seek information about their past for all kinds of reasons. It may be that they are starting a new relationship or becoming a family, or perhaps they have been bereaved.
I should like to give a flavour of the experiences of some adult care leavers who have been in touch with, particularly, the Care Leavers’ Association. In one instance, a care leaver—let us call him Arthur—wanted to connect with his records because he was coming to a new phase in his life. He was told that he had come into care because his mother was admitted to hospital but he was not told why. It was considered that the reason for her admission was private and that he had no right to know. It turned out that his mother had suffered from a long-term, severe mental illness.
A second example is of a social worker who took a boxful of records, unsorted, and handed them over to someone on their doorstep and went away again. So there was no support or help through that difficult situation at all.
Another care leaver said:
“I am now at the stage in my search of having applied to Council X three times, Council Y once … Council Z and Council Q as well as making numerous Freedom of Information requests about the children’s homes and other institutions I was kept in as a child”.
Again, the implication of this is that if your own family and children ask you, “What was it like? Where are the photographs of you? What was your family like?”, and you do not have that information, having to persistently knock on the door can be very debilitating.
The Care Leavers’ Association says:
“Care Leavers above a certain age are … a largely invisible group whose rights and needs to access basic information about their family background and childhoods are continually being denied. This discrimination needs to be addressed to ensure that they can access crucial information that may profoundly affect the decisions they make in life. Care leavers’ fundamental human right to access their social care files should be recognised in legislation and fully supported so that they can make sense of their past and go forward into the future”.
I beg to move.
Baroness Massey of Darwen
My Lords, I strongly support the amendment of the noble Baroness, Lady Young. This is a very important issue. I applaud her efforts in challenging the current problems for care leavers in accessing their records and I respect her poignant experiences and her descriptions of the loss of identity, the “Who am I?” and the journey.
The treatment of care leavers can be about blatant discrimination and defensive responses. I have been told by two people how much distress and frustration this has caused them. As the noble Baroness said—I want to underline some of these matters—there are many forms of such discrimination. Those that I have heard of relate to organisations which have poor information, or have a reluctance to seek out information and respond that the records cannot be found—that they have lost the records. In one case, I heard that records had been moved. As the noble Baroness said, children’s homes close and organisations merge. Where do these records go? How does the care leaver find them? What help is there for them to find them?
Some local authorities or voluntary organisations become defensive or evasive, despite the fact that a care leaver has the right to access personal information. The request for information may also involve another person who has to give permission, although it may be deemed possible to give the information without permission, but some organisations which control those data may interpret the rules very narrowly. I know of one person who is still trying to access information after a year of trying. Redaction of records may occur, as the noble Baroness said. In this case, surely local authorities and voluntary organisations should provide explanations and offer counselling and support to those who receive their care records.
There needs to be flexibility about who can provide the information. People change residence. It should be possible for another local authority or voluntary organisation near where the care leaver lives to provide information and support the care leaver. People who have been in care may be desperate to access information about their life—just as those who have been adopted may wish to access records. To remove part of someone’s life history is surely cruel and unnecessary. I look forward to the Minister’s response.
The Earl of Listowel
I strongly support the amendment moved by the noble Baroness and speak to my Amendment 41. I support the amendment because of the importance of human curiosity. In recent child case reviews commentators have criticised professionals because they simply were not curious. They did not ask, “Why was this child bruised? Why did somebody not ask why the child kept coming back?”. They complained about the lack of curiosity among professionals. When Anna Freud, back in the 1930s, spoke to teachers about how to be a good teacher, she said that the most important quality was curiosity. She said, “We need you to be curious about the child, think about where he is, where he is going, and how to get the child to go there”.
Curiosity is so important and is reflected in our culture. Stories from Genesis or of Michelangelo’s most celebrated works of art are about where we come from. Another example is Haydn’s “Creation”. We are fascinated about our origins. The noble Lord, Lord May, is absent now, but he knows that we spend billions on finding out about the origin of the universe. How did we come into being? I am concerned that to deny young people the opportunity to find out where they come from is a way of undermining and frustrating their curiosity. It is a way of stifling their wishes and interest in the world if you say, “No, you can’t know where you come from; no, we will not help you with that”. This weekend I was looking at some photographs of my father from the 1950s which I had never seen before. I found them inspiring. I very much identify with the concerns of the noble Baroness and it was a privilege to hear her talking about her own experiences in this area. I hope that the Minister will give a sympathetic reply to her amendment.
My amendment deals with support for young people leaving the care system and allowing all young people to have access to personal advisers up to the age of 25. Currently, past the age of 21 it is restricted to young people in training and education. I give the example of a young man, Ashley Williamson, who is a care leaver of 21 or 22. He left care at the age of 16. I have met him on a number of occasions recently. He has chaired the All-Party Parliamentary Group for Children and Young People in Care; he has provided advice on matters around sexual exploitation of children in children’s homes; and he left care himself at the age of 16 and wanted nothing more to do with the system. He washed his hands and went on with his life. However, at the age of 20 he connected with his local authority again and asked for help. He found a fantastic personal adviser who was very supportive and helped him to get a fantastic home for himself. Now, in his early twenties, he has a good, solid base. He has been very helpful to me and I am sure he will be helpful to other young people in care because he is articulate, intelligent and thoughtful and has had that experience.
For so many young people, early trauma means it takes them longer to do what many of our own children might do. Give them the time to make mistakes and then to realise they need to come back and ask for help. If I remember the story correctly, a young man who was a foster child of a social worker, Kate Cairns, was, as the age of 19 or 20, in prison and addicted to very nasty substances. He was a very difficult person to deal with and yet, 10 years later, at the age of 30 he had his own family, was employed and was providing for his children. Given time, he changed.
Let me give more detail on this amendment. Most people continue to receive love, advice and, perhaps, financial assistance from their parents into their adult lives and the average age for a young person leaving home is 26. However, young people in the care system are often thrust into instant adulthood at just 16 and, like most 16 year-olds, they tend not to have the life skills to be able to cope independently at this age. Of course, they often find adult life especially hard due to the traumatic childhoods they have endured. So young people leaving the care system are disproportionately more likely to end up getting involved in crime and drug abuse and very often struggle to achieve good qualifications. Our failure to help this group of people, for whom we have a clear responsibility, leads not only to personal tragedy but to great cost to society.
At present, young people leaving the care system are designated personal advisers and have pathway plans drawn up for them. These help to smooth their journey to adulthood but, at present, are only available until they are 21 unless they are in education or training. Young people who are not in training or education also need support. I recommend that personal advisers be made available to young people up to the age of 25, whether or not they are in education or training. These young people need that kind of support even more. This would ensure that vulnerable young people leaving the care system receive the ongoing support and advice that other young people receive from their parents and take for granted. I look forward to the Minister’s response.
Lord Northbourne
My Lords, I am not going to make a speech but I strongly support the noble Baroness, Lady Young. The more I learn about and think about disadvantaged young people, the more I realise that the question they are always asking themselves is, “Who am I?”. Their second question is “Am I a person who could succeed?”. Some of your Lordships may remember the two Ofsted reports about schools which were outstandingly successful although the children were from very disadvantaged backgrounds. The three principal things those schools had in common were: outstanding leadership, very committed staff and, thirdly, every child believing that they could succeed.
Baroness Stedman-Scott
My Lords, I beg to move Amendment 45, which has three parts.
The Countess of Mar
My Lords, I am sorry to interrupt the noble Baroness, but may I suggest that she does not move it at this stage but speaks to it and that she does not move her amendment when it is called? She does not withdraw it at this stage either?
Baroness Stedman-Scott
Thank you. This is the first time I have done this. Forgive me, I will start again.
I will speak to Amendment 45, which has three parts. It seeks to ensure that children leaving care have the best possible support into adulthood. I strongly support the points made by the noble Earl, Lord Listowel. If every young person had a personal adviser to take them on their journey from youth to adulthood, our hearts would sing. Indeed, as I said to the Minister on a visit last week, we would think we had died and gone to heaven because of the difference we could make to their lives.
I strongly support Amendment 38, tabled by the noble Earl, Lord Listowel, to allow young people to remain in foster care until the age of 21. This amendment is vital as it gives looked-after young people stability into adulthood and allows them to keep the relationship they have built up with their foster carer over many years. The more support they have, the better the outcome and the more hope for their future.
However, I also worry that this measure cannot provide an answer for all looked-after children, particularly the most vulnerable. For this reason, I have tabled three supplementary amendments. These are probing amendments intended to question inconsistencies in our current policy towards children leaving care.
I declare an interest as the chief executive of Tomorrow’s People. Day after day, young people who have not made that transition come to us. We have to try to rebuild their lives, put them back together and get them on the right path. The cost of this is extensive, whereas if we spent the money earlier it would be better for them and for the country.
I shall speak, first, to Amendment 45A. This would guarantee to young people who make an early exit from care at 16 or 17 the ability to return to a foster or residential care placement if their return home or move into independent living breaks down. At present, the door closes behind care leavers when they exit care early, allowing no recognition that this may be a mistake. It is crucial that we give young care leavers the safety net that all other young people enjoy.
I am aware that under the Children Act 1989 local authorities must already accommodate any 16 or 17 year-old who is homeless. However, at present the law does not require that the accommodation has a supported element. This means that if a young person leaves care at 16, returns to their birth family and the placement breaks down, as an estimated 50% of returns home do, there will be no entitlement to return to foster or residential care. Similarly, if a young person decides to move into independent living and struggles to live alone and manage a tenancy, he or she is likely to be given a place in a hostel or a new flat when what is really needed is a more supported option.
Young people who leave care at 16 and 17 are extremely vulnerable. They are the most likely to have incomplete education, be unemployed, have unstable housing and experience drug and alcohol misuse. I know that the law has previously recognised this fact as the Children and Young Persons Act 2008 states that children should not leave care before 18 unless they are deemed ready by an independent reviewing officer. The logic of this is that if a child is under 18 and not ready to live independently we must continue to support them. For children who have left care and shown that they are not ready to live independently, the same logic must apply. It is not unreasonable that we should try to guarantee these very vulnerable young care leavers the chance to return to a supportive environment.
The second amendment I shall speak to is Amendment 45B. This aims to question how we treat children leaving residential care. Amendment 38, tabled by the noble Earl, Lord Listowel, would extend foster care to 21. While this has received national funding for pilots, had explicit backing from the Children’s Minister and is already in some stage of implementation at local authority level, there has been no mention of what happens to the roughly 2,500 children who exit residential care every year. This is a very vulnerable group of young people with challenging needs. For example, 62% of young people in children’s homes have “clinically significant” mental health difficulties, and 74% of young people in children’s homes have been reported to be violent or aggressive in the past six months. These young people are the most likely to struggle to sustain a tenancy and live independently yet they are also the most likely to make an early move to independent living. Currently, more than half—56%—of children in residential care leave care at 16 or 17 and the remainder will leave on their 18th birthday.
On moving to independent living, they lose both the supported environment and the relationships that they have built up with their carers. It is crucial that we offer children in residential care the same opportunities that children in foster care have to remain supported until 21.
Baroness Hamwee
Perhaps I may briefly put on record my support for the amendments, in particular for that of the noble Baroness, Lady Young. It struck me, listening to those who spoke in support of it, that we are talking about not casual interest but real need on the part of the children and young people concerned. It is important to understand that.
Baroness Howarth of Breckland
Perhaps I may say something briefly, going back to the amendment of the noble Baroness, Lady Young of Hornsey. What has happened to good recording? In the distant past when the Data Protection Act came into being, I was involved in writing some of the guidance—it is such a long time ago that I do not think I have a copy of it or any reference to it—about how data should be made available and where we should redact the information that should be kept separate. Good recording demanded that there were separate parts to the record which were absolutely clear and identified, so that if there was an appeal, someone could look at the separate parts of the record.
What has happened, I ask the Minister and local authorities, to personal story books? What has happened to the need to keep packs of photographs, which used to happen when I was in children’s departments and, early on, in social services? What has happened to those good social workers who shared their recording? I shared my recording with those people I was working with, so they had a copy—unless there was a child protection issue which could not be shared. Therefore you asked other people involved for their permission at the time to share information.
Some of those principles of recording have been lost over time. Perhaps Ofsted could look at the principles of recording these days. I am not saying that it is a simple issue. It is not; I understand how complex it is; but I think that some of the basic principles have been lost. If we returned to some of those, the issue would not be a forward issue. Clearly we have an issue going back for those people who find themselves unable to access records. I have seen records which are so redacted that they are unintelligible. I have had to go through them as an information officer. I felt so strongly about the professional issue that I wanted to intervene briefly.
Baroness Howe of Idlicote
My Lords, I congratulate the noble Baroness, Lady Young, on her brilliant exposition of her amendment and the reasons behind it. Others have said better than I can how impressed they were with it.
However, I also want to congratulate the noble Baroness, Lady Stedman-Scott, because her amendments are all very important. I hope, too, that if they are put to the vote they will receive the support that the amendment of the noble Baroness, Lady Young, obviously will get. I hope very much that they are supported.
The Earl of Listowel
My Lords, I omitted to comment on the amendments of the noble Baroness, Lady Stedman-Scott. I support her welcome amendments. Of course, children in residential care are among the most vulnerable. Unfortunately, the way it works is that there tends to be a placement in foster care and, if that does not work out, then it is in residential care several broken placements down the line. So the ones with the most complex needs are often in residential care and they need the most support.
I welcome what the noble Baroness has said. There is an issue about price and other issues around it. One solution offered by Jonathan Stanley, a former chief executive of the National Centre for Excellence in Residential Child Care, is to pair up young people in residential care with foster carers so that—one can do a staying-put—one can ensure that there is a seamless move from a residential setting to a foster setting for at least some of these young people to the age of 21.
Norfolk is a very good exemplar of break-home practice. There they have supported housing right by the children’s home so that there is little movement for the children and they can feel in touch with the staff in their old setting. The noble Baroness has made some extremely important points and I look forward to hearing the Minister’s reply to her concerns.
Baroness Benjamin
My Lords, I support the amendment of the noble Baroness, Lady Young. I would like to draw the Committee’s attention to the case of a young man I know who was brought up in care for many years. For the first 49 years of his life he kept wondering who he was and where he came from. This affected his relationship with his children—when he eventually had children—and with his wife, who had to deal with his depression. He had a loss of confidence, did not believe in himself and did not feel worthy. After much searching he eventually found out who he was and it completely changed his outlook on life. It changed his mental well-being. He got a better understanding of who he was and started to accept his situation in life. That is why I believe that it is an abuse if we deny any young person information which can help them come to terms with their identity, culture and background if they wish to do so.
Baroness Jones of Whitchurch (Lab)
My Lords, we have had a good debate and I do not intend to talk at any length. However, I wish to make a few quick points.
First, obviously, I welcome and endorse the points made by the noble Baroness, Lady Young. She made an eloquent speech last week about the importance of identity and she has raised the issue in a helpful way today in a different but complementary context. It is no doubt important for children as they are growing up and becoming fully rounded adults to know about their history. It is their history and it is their right to have access to it. We all accept that point.
The second point to make is that we have talked about children and young people leaving care but very often adults can be well into middle age before they really begin to question their identity and want to search for that information. That provides a particular challenge for the people who keep the data because we are talking about keeping it for a very long time. Nevertheless, it is still people’s right to have access to it.
To pick up on a point made last week by the noble Baroness, Lady Hamwee, about people in care who had been bereaved, having lost their parents, one would have hoped that somehow or other we could have lined up all these rights to information and brought them together. We are talking here about the same sorts of issues coming up in a number of different contexts. I would have hoped that somewhere in the midst of all that would be a universal right to that information and that we could address it in that way rather than in a piecemeal way.
Thirdly, I was alarmed to hear noble Lords today talking about data being lost, or indeed being dumped on a doorstep. There is a real issue here concerning the security of the information. It is rather alarming, and I absolutely agree with the noble Baroness, Lady Howarth. What has happened to all those accurate expectations of privacy and security and of records being kept properly? You cannot help but wonder whether there is going to be a scandal at some point with all this stuff coming to light, having been left on a rubbish dump somewhere. I do not think that anybody here has a sense of reassurance that this information is being kept securely in a proper place. Perhaps the noble Lord could address that and say what the requirements are for keeping the information secure.
I should just like to add my support for the amendment. The noble Baroness has raised a very important point, as have the noble Earl, Lord Listowel, and the noble Baroness, Lady Stedman-Scott. In particular, I hope that we will get a chance to debate the whole question of staying in foster care until the age of 21. I know that my noble friend Lady Hughes will respond in more detail on that but I want to pick up one point which the noble Baroness touched on concerning the distinction between foster care and residential care. Clearly, there is a distinction and we have to be careful not just to lump the two issues together. There is a difference for young people leaving residential care, which is, after all, still formally an institutional provision. What those young people really need is a phased transition to independence, rather than just the requirement to stay on until they are 21. They need help over a period of time to find their feet and to find independence. Therefore, while the noble Baroness raised absolutely valid points, I think that we need to separate them out and make slightly separate provision for them. I know that we will debate this in more detail when we come to Amendment 38. Apart from that, we have had a very good debate and I thank noble Lords.
Lord Nash
My Lords, so far as concerns accessing information for looked-after children and care leavers, I share the convictions of the noble Baronesses, Lady Young, Lady Massey and Lady Jones, the noble Earl, Lord Listowel, the noble Lord, Lord Northbourne, and my noble friends Lady Hamwee and Lady Benjamin that all young people should be able to access their records. However, we believe that this is a matter of practice rather than legislation. As the Committee will hear, our regulations on this are clear.
Regulations require the local authority to open a case record in respect of each looked-after child. So, for example, a child seeking information referring to them that is held within a foster carer’s records could make a subject access request to see that information. Care leavers are entitled to access their records, regardless of whether they were in foster care or a children’s home.
Our transitions guidance states that local authorities must assure themselves that agencies which contribute to the young person’s pathway plan understand their responsibility to make arrangements for secure storage of documents containing personal information about care leavers. Local authorities have a duty to retain records for 75 years from the birth of a child. Under the Data Protection Act 1998, people who were looked after have a right of access to personal information held by their responsible local authority, fostering service et cetera.
The Deputy Chairman of Committees (Lord Faulkner of Worcester) (Lab)
My Lords, I apologise to the Minister but a Division has been called in the Chamber, so the Committee will adjourn for 10 minutes and resume not before 5.58 pm.
Lord Nash
My Lords, I am pleased to inform noble Lords that the department is also funding Catch22 to deliver a project on improving support to care leavers from children’s homes, including looking at how providers can offer an environment in which young people from children’s homes can benefit from staying put-type arrangements.
On the question of 16 and 17 year-old care leavers returning to care, the statutory framework states:
“Local authorities should use joint protocols to ensure that: there is flexibility to enable young people to return to more supported accommodation if they are not coping with independent living … Provision and partnerships should be developed in such a way as to permit young people to move to other accommodation in a crisis, including returning to more supportive accommodation if appropriate”.
We are also planning to change the law so that directors of children’s services sign off decisions for 16 and 17 year-olds leaving care. We think that such a move will ensure that young people leave care when they are fully ready. We believe, therefore, that we do not need to impose new duties on local authorities, but need to ensure that all local authorities use good practice. Again, the new Ofsted inspection framework will lead to support for care leavers being given more scrutiny. I hope that the course of action that I have outlined will reassure the noble Baronesses, Lady Young and Lady Massey, the noble Earl, Lord Listowel, and my noble friend Lady Stedman-Scott. I urge that the amendment be withdrawn.
Lord Northbourne
My Lords, the noble Lord has said many times that local authorities should do this, that and the other, but we all know that some local authorities are under tremendous pressure and have difficulty in finding adequate social workers as they do not have enough money. Some of us were wondering whether the Government have sanctions to ensure that local authorities do it. What provisions are there for ensuring that it happens? I believe that Ofsted has to report on it but I am not sure.
Baroness Young of Hornsey
My Lords, I start by thanking the Minister for his response and for his offer for me to meet with officials to discuss this issue further. There is still a case to answer here. In the brief life of this Committee, we have heard time and time again that there is a huge amount of inconsistency across different local authorities and that there is a disconnect between practice and what already exists, so we are not getting the impact. My noble friend Lady Howarth talked about initiatives in record-keeping but that is not happening in a consistent way and this still needs to be addressed.
We have a whole suite of amendments relating to looked-after children. Like my noble friend Lord Listowel, I am very pleased that the Government are taking seriously the need to address the needs of this particularly vulnerable group. However, those needs do not stop the moment you leave care. Although the noble Lord referred on a number of occasions in his summing up to children, we are actually talking about post-care adults who still have needs, vulnerabilities and difficulties and who still have to come to terms with their difficult experiences.
I thank my noble friend Lord Listowel and the noble Baroness, Lady Massey, for their support. I can clarify for the noble Baroness, Lady Jones of Whitchurch, a point about the doorstep incident. I was not very clear because I was desperately trying to summarise what I wanted to say. What actually happened was that the social worker brought the box around and handed it over to the person, who was hoping for her notes and records but who just got this box with a load of papers in it in no particular order. There was no understanding that this was a difficult situation to handle: the social worker was off again in her car straight away. It was not just a box of papers dumped on the doorstep but, having said that, the whole issue of redaction is one that I would like to explore with the Minister and officials. Having said all that, I beg leave to withdraw.
Baroness Hamwee
“( ) the benefit to the child of an order under subsection (2),”
Baroness Hamwee
My Lords, Clause 8 is also about contact: contact post-adoption. Subsection (5) sets out the points which a court must consider when there is an application for an order for contact by any person who has obtained the court’s leave to make that application. The court must consider: any risk of the application disrupting the child’s life to the extent that he or she would be harmed; the applicant’s connection with the child; and representations made to the court by the child or any person who has applied for, or been granted, an adoption order. I am quite prepared to be told I have misread this, because the amendment comes out of my own head: it has not been raised by anyone else with me. If I have got it completely wrong, I apologise to my noble friend who has put her name to it.
There must be a place for considering the welfare of the child. Section 1 of the 1989 Act states that when the court determines any question with respect to a child’s upbringing, the child’s welfare is the paramount consideration. Is that the answer in the sense that it would apply in any event? If so, why do we have the new subsection (5)(a) about the risk of disruption to the child’s life, because welfare of the child would clearly cover that? It seems to me that the balance of the clause as drafted, the presumption, is that if the risk of disruption to the child’s life is slim, you should not take account of it. I am curious—to use a term used earlier in a different context—about what has and what has not gone into the clause. I beg to move.
Baroness Walmsley
My Lords, I am happy to support my noble friend Lady Hamwee’s amendment, because it is never a bad thing to draw attention to the paramountcy principle in the 1989 Act and the fact that the welfare of the child must be pre-eminent. What she is suggesting is really nice, because it is positive. What we have in Clause 8(5)(a) is negative: that you should not do it if there is any risk. My noble friend is saying that you should do it if it is to the benefit of the child. I am a very positive person and I should like it that way round.
Baroness Northover
My Lords, I hope that I can reassure my noble friends Lady Hamwee and Lady Walmsley on this point. We are very concerned to ensure that when the child has contact, it benefits the child. There is both the positive side, when contact benefits the child; and the negative side, to protect the child where such contact is not regarded as being in their interest. It is striking that research has shown that the proportion of children suffering negative consequences from contact after adoption is twice the proportion for those for whom contact had a positive effect. In the light of that, this must obviously be weighed up extremely carefully.
My noble friends are clearly well aware that the paramount consideration of the court must be the welfare of the child throughout his or her life. Section 1(2) of the Adoption and Children Act 2002 states that the paramount consideration of the court when coming to a decision relating to the adoption of a child must be the welfare of the child throughout his life. I hope that that gives the reassurance that my noble friend is looking for. If it does not, I am more than happy to write to clarify, but I hope that she can be reassured that the balance is right and that the protections that she wants are indeed here in both directions, as it were.
Baroness Hamwee
My Lords, I am grateful to my noble friend. I agree that contact is important and frequently beneficial. I of course accept what she says about the Government’s intent. I am much less persuaded about the wording, because it seems to me that if the paramountcy principle applies, as it must, there must be a question why one is spelling out risk of disruption but only to the extent described. I do not quite understand the drafting, so I shall take up her offer of considering it further, but I beg leave to withdraw the amendment
Baroness Massey of Darwen
Baroness Massey of Darwen
My Lords, I shall speak also to Amendment 37 in my name. Amendment 35 is about the effectiveness of local authorities with respect to care leavers. At its core is the need for monitoring and evaluation of their effectiveness.
In a debate on a previous amendment, I spoke about the Department for Education’s data pack on improving the performance of local authorities with regard to looked-after children. This data pack contains checklists and recommendations. I will not repeat the advice given there, but simply say that monitoring and evaluating effectiveness is good not only for clients—in this case, care leavers—but for the local authority. The duties on care leavers are set out in the Children Act 1989 and are clear. We all know that local authorities have many duties, and perhaps not much money, but surely evaluating practice is an important one. There is also good practice to share. After all, if local authorities do not monitor and evaluate practice, how do they know what is going on and how it might be improved? I was intrigued by the intervention of the noble Lord, Lord Northbourne, which seemed to be about the difference between “should” and “must”. Guidance is presumably the “should” bit, but guidance is not always respected. Does that therefore give rise to the need for a “must”?
Lord Touhig (Lab)
My Lords, I support my noble friend Lady Massey’s Amendments 35 and 37. I will also speak to Amendment 36 in my name. Amendment 36 would grant control of the pupil premium to the virtual school head. It would ensure that virtual school heads are responsible for allocating the pupil premium to looked-after children.
Clause 9 is one of the few parts of the Bill that provides extra support for children in the care system. It amends Section 22 of the Children Act 1989 by introducing a duty upon every local authority to appoint an officer whose role will be to ensure the promotion of the educational achievement of looked-after children. The role is usually referred to as a “virtual school head teacher” or “virtual head”. The idea of the virtual head is not new. My noble friend Lady Massey referred to pilots; pilot schemes have been trialled in 11 local authority areas and have been shown to be extremely successful.
Why is this amendment necessary? Well, the most recent figures we have show that in 2011-12, just 14% of children looked after for at least one year achieved A* to C in GCSEs, including English and Maths. That compares with 58% of all children, so there is no doubt that children who have entered the care system, and who are likely to have experienced abuse or neglect before entry into care, need additional educational support. Once in care, the disruption that can be caused by a placement breakdown or move can also severely impact upon educational achievement.
As parents and grandparents, I am sure we all know that young people approaching their GCSEs have enough to contend with without needing to worry about whether they will be living in the same house when they take the exams. For many young people in care, this is a common reality. It is little wonder that their success rates in exams lag behind the norm. The original proposal to require local authorities to provide a virtual head was contained in the report of the All-Party Parliamentary Group for Looked after Children and Care Leavers, Education Matters in Care. At that time, the chairman of the all-party group was Edward Timpson MP, who is now the Children and Families Minister.
The all-party group went further. It also recommended that:
“Virtual School Heads should control the Pupil Premium”.
The pupil premium allows for a level of financial support for eligible children, which is currently about £600 per annum, to be used by their school. The all-party group report also noted that virtual heads have little control over how the pupil premium is spent and recommended that the system would be more effective if they were given control of this resource. As the present Children’s Minister recommended that these changes were necessary when he chaired the all-party group, I am sure that I am not alone in being a little disappointed that they are not included in the Bill.
The arguments in favour of their introduction remain and I hope that when we consider the Bill on Report, we will ensure that these provisions are properly made. The case for allowing the pupil premium to be controlled by the virtual school head seems to be supported by recent comments made by Ofsted’s chief inspector Sir Michael Wilshaw. He expressed concern that a significant minority of schools are struggling to show how their use of the premium is having any significant impact upon the attainment of those pupils it was intended to assist, so clearly there is an issue that Ofsted recognises. I hope that the Minister will see the wisdom of this amendment, and I look forward to his reply.
Baroness Morris of Yardley (Lab)
My Lords, I support the amendments in this group—in particular my noble friend Lord Touhig’s amendment—but I very much support the point made by my noble friend Lady Massey about the need to evaluate. That is a theme throughout the considerations of this Committee. It is not that nobody has thought of doing the right thing but that we have not been good enough in implementation and monitoring, and in amending what we do in the light of the evidence. That is why that amendment is important and is one that we should pursue.
My comments will be in particular about the pupil premium. It is a brilliant little idea. I admit that when I first looked at the Bill and when we were discussing it at Second Reading, I could not be against the notion of the virtual school head but it did not quite ring right with me. I was not against it but I was just not sure that it would have any impact. Perhaps those local authorities that have voluntarily carried it out and feel they own it will make a success of it. My worry was that once you made it statutory throughout the nation, it would become just a job to be done and a box to be ticked. It needed some sort of bite beneath it that would give it teeth and make sure that something happened. I did not raise this at Second Reading because I could not think of anything at the time, but I think that the pupil premium might be one of those things that means that schools and other places in the education system have to sit up and listen because there is a control of resource in someone else’s hands. That might just give the edge to this post, new as it is, as it starts its contribution to education.
There are perhaps one or two other reasons. My noble friend Lord Touhig was right to say that the evidence at the moment is that some schools are not spending the money to greatest effect. Many are, and there are now lots of things that will help them spend the pupil premium to great effect, such as the toolkit. A lot of good work is being done by Ofsted and a lot of people. My worry is that this could be one of the cases where the group of people on whom it is spent least effectively are those children who are looked after. They seem to miss out on every bit of the system. This gives us a chance to make sure that in this we actually give them a head start.
I envisage that those people who are virtual heads could build up a body of expertise and experience about how best to spend the pupil premium. In that way, they could be champions of spending quite a significant amount of money. I am sure that teachers throughout schools in all local authorities might then look to them for advice. I trust that they will do it carefully. I would sooner the amendment said “in partnership with schools” because I do not think it will work unless it is in partnership with schools. Perhaps after consideration here, if it were to be brought back on Report, my noble friend Lord Touhig and others might wish to reflect on that. However, it is a really good addition to what is basically a good idea—the virtual school head. Until this amendment, they ran the risk of not having any teeth to do their work.
Lord Nash
My Lords, I am delighted by the cross-party support which Clause 9 has attracted. In spite of the modest progress in recent years in the attainment of looked-after children, progress is nowhere near what it needs to be. That is why we have decided to make the role of the virtual school head statutory, so that all local authorities are required to appoint a dedicated officer to discharge its duty to promote the educational achievement of the children it looks after.
Natasha Finlayson, of the Who Cares? Trust has said:
“Virtual school heads have been shown to have a positive effect on the attainment of young people in care”.
Ofsted’s thematic inspection of the role of virtual school heads published last year found that, where the role works well, it has a positive—some might go as far as to say transformative—effect. One of Ofsted’s key findings in that report referred to the very effective support virtual school heads provide. That support not only made a difference to children’s educational progress but often enhanced the stability of their placements and had a positive impact on their emotional well-being. Every inspection report of local authorities will in future, from November, include how virtual school heads are improving outcomes for looked-after children
On the aim of Amendment 36, I am sympathetic to the motivation of the noble Lord, Lord Touhig, and the noble Baroness, Lady Morris. If we want to maximise the benefits of pupil premium funding it is right to expect the virtual school head to have a role. As looked-after children will attract a pupil premium plus of £1,900 in 2014-15, dialogue between schools and virtual school heads will be vital.
We have therefore signalled our plans to extend the role of the virtual school head to work with schools to manage the pupil premium plus and ensure that the money is spent on securing the best educational support for children in care. Discussions between the school and local authority on the content of a child’s personal education plan and how the pupil premium will be used to support meeting the needs set out in that plan are crucial. That is a message that we intend strongly to emphasise in guidance.
I am grateful for the opportunity to discuss the role of the virtual school head in relation to care leavers. We know that their educational outcomes are not good enough compared to their peers and I recognise entirely how important it is that someone is there to support care leavers who are in, or who wish to return to, education. I can see therefore why there are calls to extend the role of the virtual school head to cover care leavers. In a number of local authorities, the virtual school head’s remit includes some overlap with care leaver services.
Although I share the objective of the noble Baroness, Lady Massey, in the amendment, I believe that addressing the educational needs of care leavers will not necessarily be met by adding a new duty to Section 23B. Extending in statute the role of the virtual school head to care leavers too widely risks undermining the very reason we are making the role statutory: to redouble our efforts to narrow the intractable attainment gap between what looked-after children achieve compared to their peers. If we extend the role of the virtual school head, it would add significant burdens to the local authority and the person undertaking that role and would dilute the impact of the role. We do not wish to do that.
I do not wish to appear complacent on this point. Supporting care leavers to stay in education and training is vital. That is why we have extended local authority responsibilities to care leavers up to the age of 25, where they are in education and training.
Under its new inspection framework, Ofsted will be looking at the quality of care leavers’ services and whether they have access to appropriate education and employment opportunities, including work experience and apprenticeships. They are encouraged and supported to continue their education and training, including those aged 21 to 24. Care leavers are progressing well and achieving their full potential through life choices, either in their attainment in further and higher education or in their chosen career or occupation.
If we are changing legislation, we have to be really sure that the changes are for the better and we have to have evidence of impact. We know that the virtual school head has had an impact on looked-after children nationally, and we cannot risk diluting that. There are other ways to ensure that the support that care leavers get to continue their education and training takes place.
I hope that I have provided reassurances to the noble Baroness, Lady Massey, and the noble Lord, Lord Touhig, of our commitment to improving outcomes for all looked-after children and care leavers, and that they will join me in welcoming our recent announcement on the pupil premium plus and withdraw their amendment.
Baroness Massey of Darwen
My Lords, I thank all noble Lords who have contributed to this short debate, and the Minister for his clarification. I am particularly pleased that the issue of monitoring and evaluation of practice is coming up quite consistently; it is terribly important. I also look forward to seeing how the Department for Education guidance, which I have quoted already, is played out in practice and implemented. I shall be interested to see how local authorities use that guidance to improve practice.
My noble friend Lady Morris emphasised how looked-after children miss out, and talked about champions of spending. I am pleased that the Minister could confirm that the virtual school head will be made statutory. Again, I look forward to hearing how exactly that role will now be defined. Will it include the pupil premium, which is a very interesting and important issue—perhaps, as my noble friend Lady Morris said, in conjunction with schools? In the mean time, I beg leave to withdraw the amendment.
The Earl of Listowel
“Young people resident with foster parents to remain with them until the age of 21 when they choose to do so
(1) Section 23C of the Children Act 1989 (continuing functions in respect of former relevant children) is amended as follows.
(2) After subsection (4) insert—
“(4AA) The assistance given under subsection (4)(c) shall include the continuation of accommodation with the former local authority foster parent, unless—
(a) the former relevant child states that he or she does not wish to continue residing in such accommodation,(b) the former local authority foster parent does not wish to continue to provide accommodation, or(c) it is not reasonably practicable to arrange such accommodation.”(3) At the end insert—
“(11) In this section “former local authority foster parent” means a local authority foster parent within the meaning of section 22C(12) with whom the former relevant child, as a looked after child, was placed under section 22C(6)(a) or (b).””
The Earl of Listowel
My Lords, this amendment would allow young people in care to remain with their foster carers until the age of 21 where they and their foster carers agreed to do so. I hope that it might be helpful if I give a couple of examples of practice in this area already. Before I do so, I would like to correct an omission that I made earlier. The Minister was kind enough to say some good words about my work in this area, and I omitted to thank him for them. I appreciated what he said.
I recall a couple of relevant episodes while on the All-Party Parliamentary Group for Looked After Children and Care Leavers. One young man described his experience of being set up in independent accommodation. Pretty soon the local drug dealer had decided that he wanted to join this young man, and soon afterwards he lost his accommodation. I think that he also ran up a big back rent. A foster carer talked to me about a young girl who had been excited by the prospect of moving into independent accommodation at 17 or whatever, and his comment was, “Well, she was doing so well at school while she was with me, but now that she’s independent she obviously has other priorities”. We should try to normalise the experience so that it is what we would want for our own children: we want them to keep in touch with us and we do not want them disappearing goodness knows where, getting mixed up with goodness knows whom.
If I may make just one more comment, there has been a lot of concern about the experience of young women in care in recent years—the past 18 months, I suppose. One has to remember that many of these girls and women leaving care have had poor experience of men in their lives, and unfortunately many of them may turn to men who will not treat them well. For them this has been the norm and their experience. It has been striking for me, in recently meeting young women who have been allowed to stay with their foster carers past the age of 18, that they have a good continuing relationship with their male foster carer—and one can hope that they have a better model of how a man can relate to a woman than many of those who move out earlier.
Young people are living at home longer than ever, with an average of leaving home now at well over 24, yet many children in foster care, who are arguably among the most vulnerable in society, are still required to leave their foster home at the age of just 17. Those who get to stay past their 18th birthday are either the lucky few, funded by their local authority, or fortunate enough to have foster carers who can afford to offer them a home for free and support them out of their own pockets. Research shows that the longer a young person can stay with a foster family, the more successful they are later on. In 2011-12, only 320 young people remained with their foster carers past the age of 18, which is only 5% of care leavers; in the most recent year, only 10 more young people stayed put. It has been put to me that, in the current rate of progress, to reach the Government’s aspirations of 25% of young people staying put would take about 140 years.
Care leavers are more likely to be unemployed, young single parents, mental service users, homeless or in prison than those who grew up in their own families. This amendment to the Children Act 1989 is really important, in that it would allow young people to remain with their foster carers up to the age of 21. Staying Put has been piloted already in 10 local authorities across England, with great success. Young people who stayed with foster carers were twice as likely to be in full-time education at 19, compared to those who did not. Those staying put gave young people more control over their lives and their transition from care. Studies have shown that allowing young people to remain in care until 21 is associated with increased, post-secondary educational attainment, delayed pregnancy and higher earners.
The benefits to care leavers and to society of extending care have been found to outweigh the cost to government by a factor of at least 2:1, so staying put represents value for money. The department’s evaluation of the pilot found that to implement the policy nationally would require £2.7 million per year. This modest funding could be found partly through a smarter use of existing expenditure but, given all the burdens being placed on local authorities, it is only reasonable, especially as central government will be the greatest beneficiary in the long term, that a sum is set aside to enable local authorities to make the transition to this new arrangement, with many more—we hope that soon it will reach 25%—staying put.
To point out the saving to state-funded services, I turn first to housing. For every young person staying put with their former foster carer instead of independent living before they are ready, a one-bedroom flat is freed up locally, so this saves on local authorities paying rent on such properties in the private sector at high expense. Many care leavers who are forced to live independently before they are ready build up huge rent arrears, and that money is rarely recouped. Staying put is successful also in tackling the benefits cycle that young people are often at risk of entering. The one-to-one support and guidance offered by foster carers to young people in their transition to adulthood is crucial to ensuring that they can be helped on the road to becoming net contributors to society as adults, rather than a drain on resources. Those who stay put are more likely to be working full-time or part-time, or studying, and hence claim less housing benefit and income support.
The Children’s Minister strongly shares our belief that more young people should be allowed to stay with their foster carers for longer, and I am grateful to the Minister for taking a couple of occasions over the summer to talk to me about this issue. I recognise that the Government really want to see this happen, but they are in favour of a voluntary approach. As I have said, over the past year, only 10 more young people have taken up the Staying Put offer, so overall there has been a 0% increase because the number of young people coming into care has increased over the period.
What is happening is that, even in the current situation, many young people and foster carers have had to fight with their local authorities to allow and support Staying Put placements. We need an end to this postcode lottery. It is unacceptable that at a time when young people should be focusing on their education and training, as the noble Lord, Lord Touhig, said, they face doubt and anxiety over their future. Interviews with former pilots show that half had scaled back the provision, either by reducing the maximum age from 21 to 19 or by excluding NEETS, who are the people most in need of support and guidance. While I welcome the Government’s current interest in care leavers and the many important measures that they are bringing forward, I believe that without legislation, too few fostered young people will have a realistic chance of staying with their foster carers beyond the age of 18. This is a rare opportunity to change the law and ensure that the next generation of care leavers is given a better start in adult life. My parents would not have wished there to be any uncertainty that I would not get the support I needed to go through my education and go to university. I am sure that noble Lords as parents would also want to be certain that they could support their daughters and sons through whatever they chose to do during their transition to adult life. So far, I have not heard anything from the Government to reassure me that we will see this happen soon. If we introduce this provision in the legislation, within a short time we would see hundreds of young people on a better course as they left care. I look forward to the Minister’s response and I beg to move.
Baroness Young of Hornsey
My Lords, I strongly support this amendment. As I said earlier, it is part of a suite of amendments aimed at making the lives of young people in care more palatable. The idea of being told at the age of 16, 17 or 18 that you are going to be independent and that you will live in a flat, with minimal training in handling a budget and coping with the unwanted visitor referred to by my noble friend Lord Listowel who will derail your attempts to study or work, is unthinkable in relation to our own children. There is a concept that we should think of children in care or looked-after children as being our children, so we should do everything we can to ensure that they do not experience even more disadvantage.
I am not going to repeat all the statistics, research and evidence put before the Committee by my noble friend; suffice it to say that the Staying Put scheme was piloted in 11 local authorities. As he has said, the outcomes for the young people who stayed with their foster carers were significantly and substantially better than for those who were not able to do so. It gave them an opportunity to take more control over their lives and to make more successful transitions from care towards independent adulthood. The Fostering Network found that none of the pilot authorities reported significant problems with foster carer provision as a result of offering the Staying Put scheme, which I know is a concern that has been expressed by some people. While a minority did say that staying put would mean that in theory a former foster bed would no longer be available, it is often the case that foster carers plan to retire after the placement ends and would have been retiring at whatever age the young person left, whether or not it was beyond the age of 18. In addition, foster carer recruitment strategies have simply been amended to suit the new needs of the service.
I shall quote a leaving care manager who participated in the Staying Put pilot scheme. He said:
“Nowadays we do not even recruit foster carers who would not want to offer Staying Put. Indeed, because many of them now want to provide a Staying Put placement, we are keeping them happy and ensuring their future commitment to our service by allowing them to keep young people living with them. They see it as the natural and obvious thing for a professional fostering service to do and they want to play a part in that”.
Lord Storey (LD)
My Lords, I support what the noble Earl, Lord Listowel, has said. I remember him stalking in the Corridor in July; he was very excited and asked whether I would support this. I did not indicate but walked away and reflected on what he had said. I remember my professional circumstances, where foster parents at my school came to talk to me about this issue and how upset they were. It was quite traumatic for them as foster carers to lose children at 18 when they had so much more to offer in those important years. I thought about my own children. At 18 my daughter has just gone to university. It has been a very difficult time for her and she has needed the support of her parents, her family and friends.
We talk about cost but the cost is minimal: there is a saving. Never mind the savings we have heard about in terms of compassion as a society but the savings, as research has shown, in terms of those young people being more likely to be successful in their lives. If they are more successful in their lives, there will be fewer problems that we might have to pay for later on.
Baroness Butler-Sloss
My Lords, I, too, support the amendment. It is so obviously a good idea. I have a suspicion that if it is not part of the legislation a voluntary system will work in a few places and will be disregarded right across the country. It is for that reason that it needs to be made part of the legislation.
Baroness Hamwee
My Lords, the meeting arranged by the noble Earl brought a number of comments about Staying Put. It was clear that there is a shortage of accessible information—particularly because not all authorities are operating the system—and that there are real complications when there are cross-boundary considerations. That follows on from the point made by the noble and learned Baroness.
Some things were mentioned which really took me aback. When a young person becomes 18, if he or she does stay with the foster parents a tenancy agreement has to be signed. As a couple of the young people we met said, “This does not reflect our relationship. They are our foster parents; they are not our landlords”. It is necessary, I understand, to have a tenancy agreement in order to qualify for housing benefit and income support. I asked how the total income compared to fostering allowances and I was told by the foster carer we met that the total income had reduced by about 50%. He was very enthusiastic about his foster daughter remaining with him. That foster daughter also said—she was part of a sibling group—that she had to be CRB checked in order to stay with her sisters. Something has gone wrong with the system.
Baroness Walmsley
My Lords, I, too, have my name on the amendment and support it wholeheartedly. The noble Earl, in his introduction, used the word “normalising”. We are trying to normalise the relationship between the young people and their foster carers because, as my noble friend Lord Storey pointed out, most young people who grow up in their birth family do not leave home at 18. They stay on.
I was interested in what the noble Baroness, Lady Young, said about the pilots. It did not have an adverse effect on the recruitment of foster carers; indeed, it had a beneficial effect. It occurs to me that the Government might be a little concerned that if we make it a right for young people, if they and their foster carers wish it, to stay on until 21, it will take away foster parenting places for other children coming into the system. Frankly, I think that we should be putting more effort into turning the tap off and giving more support to families so that children can safely stay with their birth parents, but that is an argument for another day. That might be the case, but I have a suggestion that might fulfil some of the need without the problem of taking away a foster-caring place for some other child. I have promoted this idea to successive Children’s Ministers over the past few years, who all say, “That sounds like a good idea”, but nothing ever gets done.
Many children go off to university or college, or to work somewhere else when they are 18, but they maintain a close and supportive relationship with their birth families. Why not allow foster parents, if they so wish, and the young person wishes, to have a sort of little stipend or retainer to act as a supporter and adviser to the care leaver for the next few years when they have left the bedroom in the house? That bedroom would then be freed up. A lot of young people who get on very well with their foster parents go back and visit them and ask for advice anyway. But many of them, knowing that the parents may have taken on another foster child and will be busy, would be hesitant to go back to the foster parent and ask for help and advice when things go pear-shaped, such as their accommodation or education plans going wrong, or they have trouble with their employment. Whatever it is, they would have somebody officially who was being paid a little bit by the state to help them and stop new arrangements breaking down. It is when they break down that the state has a great deal more cost liability to try to put things right. There is an existing relationship of trust, understanding, knowledge and emotion. If the Government cannot accept the noble Earl’s amendment—I very much hope that they will—perhaps the Minister will consider my suggestion of a sort of halfway house. The parent could retain that relationship formally and, one hopes, the care leaver would have no hesitation in going back to that person for advice if things went wrong.
Baroness Massey of Darwen
My Lords, I strongly support this amendment. I have heard the noble Baroness, Lady Walmsley, talk about this halfway house before. It is not a bad idea, but I hope that we can go the full way, for two reasons. First, there is the cost-effectiveness, which one or two people have mentioned. We sometimes forget that early intervention can actually save money in the long run; we should not forget that. Early intervention is not just about babies or children but older people. This example applies and it can be effective in this case. Cost-effectiveness was the first thing that I wanted to mention.
The second thing is the incredible importance of education, which has also been mentioned. Young people in education tend not to get pregnant when they are 15 or 16, they tend not to misuse drugs or alcohol, and they tend to do better if they are encouraged in that education. Like the noble Lord, Lord Storey, I was very impressed by the young woman at the meeting we had last week, who talked about the importance of education to her. As we know, education is such a key thing for all children, but particularly for these children. Therefore for me, cost effects on education swing this towards the Minister accepting this amendment.
Baroness Howarth of Breckland
My Lords, I will not repeat all the arguments that have been made, but of course, I want to support this. However, I will take it from a slightly different angle. I am quite sure that the Government do not want to take away from the determination that the local authority has to do its work. I know that devolution is important, and that the independence of the local authorities, such as it is, is valuable. Therefore I can understand that that might well be a government point of view. I can understand that the Local Government Association may have some concerns about additional responsibilities being added in statute, and I can understand some of the arguments, such as that if we have older young people in placements, they may block placements when we are short of foster-parents.
I have looked at those issues. It is quite clear that unless there is something absolutely straightforward, either legislation or regulation, in this area, local authorities will not be consistent in their care of over-18s. I have numerous case studies, which I will not read out now, but they have made me think that I need to speak about this in this way, rather than supporting the independence of local authorities, as I usually do as a vice-president of the LGA. Time and again, we read of young people—and I have met them alone, and with the noble Earl, Lord Listowel—who tell heartbreaking stories of their education and of how their success in other areas is being stymied because they have to leave their family in which they have all their relationships. We are failing significantly to understand that emotional context.
Noble Lords have talked on numerous occasions about their own children. Sometimes you do not get rid of them until they are 30. They do a lot of things in between, and you still take them back. I have not had children of my own but I have brought up more than most, and I know about that trauma. Secondly, I understand that fostering, and numbers, are now improving, and that we have to look at that in a different way. It was explained to me—and this is not an area in which I have recent expertise—that foster parents who take adolescents often retire, as has been said, but also tend not to take small children when they need a placement. You need a different set of skills and you are looking for different foster parents. The idea that these young people are blocking a foster place is not a real one.
I can understand that the voluntary way forward is preferred by the Government. It will not work in present circumstances in local authorities, pressed as they are, unless there is some very strong legislation or statutory guidance.
Lord Ponsonby of Shulbrede (Lab)
My Lords, I support this important amendment, which I knew was coming up today. I was sitting as an adult magistrate in Westminster Magistrates’ Court earlier today, in a general remand court, and I took a note of the type of cases we heard. I had 26 defendants in front of me today, five of whom were in the age range of 18 to 21: a perfectly typical illustration of the age range that we see. Although it is not always obvious in court what someone’s background is, I would make an educated guess, based on their previous criminal history, that four of those five had been in some sort of care: that was not a surprise. The fifth defendant was a foreign national who was only 20 years old and was living rough in London.
This is totally typical of the type of defendants whom I see in my adult work in central London, and that is why I support so strongly the amendment moved by the noble Earl. I would see a similar distribution in my youth work, and this one amendment could make more difference than any other single amendment we are talking about this evening.
Baroness Morgan of Drefelin (CB)
My Lords, the noble Baroness, Lady Young, made a point about the age of 21. Noble Lords are sharing their experiences of parenting today, and the thought that my 21 year-old could be launched out into the world now fills me with anxiety. I feel that she is on a bit of elastic, will be coming back every so often and we will be there for her as things go on. I understand the evidence put very eloquently by the noble Earl, Lord Listowel, for this proposition, which I support. However, this is such an unusual opportunity that I wonder whether we should be saying 21 or 25. It might be pushing it slightly to say 25, but 21 seems so young. This is about making evidence-based policy, so I would be interested to know what the evidence is for the age of 21.
Baroness Hughes of Stretford
My Lords, I do not want to delay the Committee but I want to make a few quick comments in support of this amendment. It is very dear to my heart, as I was Minister of State for Children when we instituted the pilots to which several noble Lords have referred. One reason we did that was because, in the White Paper we wrote at that time, I felt strongly that one of our guiding principles in going forward and trying to improve the situation for children in care—a view shared by members of the Committee—was that we should provide them, as far as possible, with the same opportunities that we would want for our own children. As so many noble Lords have said, we have seen a social change over the last 20 years in that our young adult children do not leave home at 16, 17 or 18. Even if they go to university, their bedroom is still there and they come back. They often come back after they have done their studies and they now do not leave home until, on average, their mid-twenties. When the state is the parent, we have to aspire to the same opportunity for those children for whom we are collectively responsible. This is one of the most compelling reasons why we should extend these pilots and make them national.
The benefits to the young people in the pilots have already been well expressed and I will not rehearse them. There is, of course, a cost. The Department for Education has estimated, on the basis of the pilots, that the cost of instituting Staying Put nationally would be £2.7 million. I know that it does not work out as an average because some local authorities have more children in care than others, but, on average, that is £18,000 per annum, per local authority—not per child or per placement: per local authority. So the costs, relative to the benefits, are very small and, as we have heard, there are additional savings to the state from some of the state-funded benefits and support that would have been reduced in the pilots.
The Minister in reply to the previous debate said that helping care leavers to stay in education and training was vital. He also said that when the legislation is being changed, we need evidence of impact. I put it to the Minister that this particular proposal satisfies both of those criteria. If we were in government, and if we are in government again, this is something we would definitely be looking at to see if we could fund because the costs relative to the benefits are also small. I hope the Minister will consider this favourably.
Lord Nash
My Lords, I welcome the opportunity to debate the important subject of how local authorities support care leavers. I fully understand concerns raised by noble Lords, including the noble Earl, Lord Listowel, the noble and learned Baroness, Lady Butler-Sloss, the noble Baronesses, Lady Young, Lady Massey, Lady Morgan and Lady Howarth, the noble Lord, Lord Ponsonby, and my noble friends Lord Storey, Lady Howe and Lady Walmsley, and many external parties about the ongoing support for care leavers. As the noble Earl has said, we have had the opportunity of discussing this matter privately on a couple of occasions recently. I look forward to further discussions with him on this matter as he knows I also feel strongly on this subject.
We have emphasised the importance of staying put in revised statutory guidance, because we recognise that for many young people the ability to stay on with their former foster carers, particularly when they are in further and higher education, is the right decision. The Minister for Children and Families wrote to all directors of children’s services last October, encouraging them to prioritise their staying put arrangements, so that all young people who wanted to could benefit from this provision. I accept there is more to do. Naturally we are disappointed that the 2013 statistical returns from local authorities show only a marginal increase in young people in staying put provision. However, we should recognise that these figures collected by local authorities are a snapshot at 19 and they run only until March 2013, so there is not much time to see the impact of the actions we have taken since 2012. Moreover, they do not tell us about the number of young people who might be benefiting from this provision from the age of 18, and who will leave this arrangement before they turn 19. From next year the department will be collecting data at age 18, 20 and 21, and will be able to see from 2014 how many young people are benefiting from this provision before and after the age of 19.
Our approach is and has been to improve practice. We are continuing to look for ways to promote and encourage this. We have already worked with Her Majesty’s Revenue and Customs and the Department for Work and Pensions to issue practical guidance on staying put to help carers and local authorities around tax and benefit issues. As I have already said, the revised Ofsted inspection framework that comes into practice in November has a specific focus on the quality of leaving care services. A focus on the care leaver assessment will be on accommodation, and inspectors will consider staying put opportunities. Being able to stay in placements beyond 18 is mentioned within one of the grade descriptors of the care leavers’ judgement. We will monitor closely the reports on these inspections and feedback from care leavers, and expect to see significant improvements in 2014 and 2015 in the number of young people staying put. In addition, through our work with the National Care Advisory Service, my department will encourage local authorities to share effective practice where they are making good progress in this respect. While doing everything that we can to promote staying put, we must recognise that this sort of provision will not be appropriate for all young people. Care leavers, like their peers, have different needs, and attitudes regarding their transition to adulthood. The crucial point is that young people should be offered a range of placements that are safe and suitable, and meet their individual needs. I want to reassure noble Lords that the Government want to encourage all looked-after children to stay in care until they are 18 and beyond, where this is the right choice for them. We want to do everything we can for all care leavers.
I recognise the strength of feeling expressed today, and wish to take the issue away to consider further what more we can do to increase the numbers of young people in staying-put arrangements. I understand that noble Lords feel there is a case that all we are doing is not enough. I have asked my officials to work further with the Fostering Network and others on this issue. The noble Baroness, Lady Hughes, mentioned a figure of £2.5 million, which is no longer our view of the figure, although it is a figure that the Fostering Network has recently come up with. We believe the figure is considerably higher, but we will be working with the Fostering Network to see if we can pin this figure down further. I would be pleased to discuss this issue further with the noble Earl over the coming weeks.
I hope that what I have said reassures noble Lords of our commitment to this issue and I therefore urge the noble Earl, Lord Listowel, the noble Baroness, Lady Young, and my noble friends Lady Sharp and Lady Walmsley not to press their amendment.
The Earl of Listowel
I thank the Minister for his reply. Before thanking colleagues, perhaps I may put a few questions on the detail to the Minister. With regard to the timescale, he was good enough in his comments just now to say that he expected a significant increase in the next two years in the number of young people staying put. Perhaps he would like to write to me with a clearer timescale. My concern is that unless we move quickly on this in the next one, two, three or four years, hundreds of young people will miss out on a pathway which we know would do them a lot of good and mean that they would have much better outcomes. If the Minister wishes to take a different approach, the voluntary approach, I should be grateful if he could make it clear when he hopes to achieve the target of 25%, which I think is the government target. It would also be helpful to know what steps the Government will take if that target is not reached or if good progress is not made in that direction. Those are just a couple of questions. He may prefer to write to me rather than answer them now.
The Earl of Listowel
I thank the Minister. I thank all colleagues for their support for the amendment. It is heartening for me to hear that depth of support from across the Committee. If I may say so, it was most interesting to hear from the noble Lord, Lord Ponsonby, about his experience today in an adult court. It was not at all surprising.
I should have made clear a couple of things in my opening remarks. First, 11 local authorities took part in the pilots to begin with. Then two of them merged, so it became 10. That is the reason for the disparity between the comments made by my noble friend Lady Young and me about the number of local authorities in the pilot evaluation. I also omitted to say that some of the local authorities taking part in the evaluation were selecting young people who work in education or training, so that does not give us as clear a picture about the successful outcome as one might like. I think that it is still very clear, but I want your Lordships to be aware that there was a difficulty there in terms of the group used in the pilots.
I welcome what the Minister has said. Of course, the measures that he is proposing are untried. We have seen only a marginal improvement in the past year. My concern is that in the years to come—the next one, two, three or four years—if the movement is too slow, hundreds of children will miss out on an education, a training or employment and go down much worse pathways if we do not grab the nettle and act now. I look forward to studying what the Minister said and to further conversations before Report.
I reiterate once more how grateful I am to noble Lords across the Committee for their support and I beg leave to withdraw the amendment.
Baroness Butler-Sloss
“Provision of accommodation for children
In section 20 of the Children Act 1989 (provision of accommodation for children: general) after subsection (1) insert—“(1A) Where a local authority provides accommodation for a child identified as a victim of human trafficking who has been trafficked into England or Wales, that local authority shall have parental responsibility for that child during the period that child remains in the accommodation of the local authority or until the arrangements for the child have been completed, or both.
(1B) Where another local authority provides accommodation for that child, that local authority shall have parental responsibility for the child during the period that child remains in the accommodation of that local authority or until the arrangements for the child have been completed, or both.””
Baroness Butler-Sloss
This amendment deals with a totally different subject. There are three amendments in this group but I do not propose to speak to Amendments 43 or 234 because I understand that those who tabled them will in due course ask to degroup them. Therefore, I shall speak exclusively to Amendment 39.
This amendment relates to the most disadvantaged group of children who come into this country. Very often, they are children brought here against their will, or certainly without any knowledge of what is going to hit them when they get here. They may be sexually exploited or they may be victims of domestic service or forced labour, such as the Vietnamese boys who run the cannabis farms in rented accommodation. Among them are boys who are trained, Fagin style, to steal, and there are other children who go through appalling sorts of slavery. When they escape, or if they are fortunate enough to be picked up at the border control, they are not as well looked after as adults.
This is an area where adult victims of human trafficking—modern slaves—are quite well cared for in this country in many ways. It is much to the Government’s credit that they have signed the European directive on human trafficking and, indeed, are in the process of implementing it. However, we fall far short of what should be done with the children. They are placed in the care of a local authority, not under care proceedings, which we discussed earlier today, but under Section 17 of the Children Act 1989, which requires local authorities to look after a child in their area. They are placed with the nearest local authority by whoever has identified them as trafficked, and the local authority has an obligation to look after them under Section 20 of the Children Act. I repeat: it is an obligation to accommodate.
We know that very worrying numbers of children go missing from local authority care. Local authorities do not even know why or how some of these children have come into care because it takes anything up to 48 hours to register a child into care, and these children often go missing within 48 hours. In another place, Peter Bone MP sent a message to all local authorities asking how many children who go missing are trafficked children. No local authority responded with any figures at all, and only about eight out of all the local authorities responded at all but they had not identified the children who were missing as trafficked children.
If the children have a mobile phone, as they usually do, they are given a number and are told to ring the trafficker. The trafficker waits outside the care home, or very often the home of the short-term foster parents who have not had time to get organised with this child who is suddenly dumped on them: the child gets the telephone call, goes out of the front door and is never heard of again. Those children are trafficked or retrafficked. Something like 300-odd children have been identified as being trafficked, and that, I suspect, is the tip of the iceberg.
The reasons for asking for a local authority to have parental responsibility are twofold. One is that these foreign children do not have anyone in this country with any responsibility for them until they get to the local authority—perhaps with the exception of those who are trafficking them, who may be relatives. Secondly, the local authority does not have parental responsibility, as defined in the Children Act, for these accommodated children; it simply has a requirement to accommodate them. It is right to say that there is a requirement to look after them but if they do not have parental responsibility—and local authority social services know exactly what parental responsibility means—that is what they receive after they get a care order. Even an interim care order gives them a joint parental responsibility with the family. However, for these foreign children there is nobody with parental responsibility.
Parental responsibility may not be the best way of dealing with this; there are two views on it. I have tabled this amendment because I am concerned that, currently, local authorities are not treating these children with the seriousness that they should. Local authorities are overworked and very often under-resourced. These children are dumped on them at very short notice, identified as having been trafficked and are not given the same degree of care as a child who goes through the care process in this country. It seems that there are two ways forward here. Either the local authority makes a care application, which costs money—and it is getting more and more expensive for local authorities to make care applications—or, as I suggest, there should be an automatic parental responsibility. It would not cost a penny but it would flag up to local authorities the actual responsibility they have for these children who are dumped on them. They cannot just accommodate them and not really take that extra step of being a joint parent.
I am extremely concerned about the standards for the children we have been talking about last Wednesday and today. They are only a small number of children but, my goodness me, we are failing them. It is a blot on the England and Wales system, under which we are failing to deal with them. I do not know whether I really need to declare again an interest as a trustee of the Human Trafficking Foundation or as co-chairman of the All-Party Group on Human Trafficking and Modern Day Slavery, but this is a truly serious matter for a small group of children. One way of dealing with it is to give local authorities parental responsibility. It would hit them with the fact that they have to do something practical about these children.
Barnardo’s was given some money—I believe by the Government—to trial having specialist foster parents to look after trafficked children. I was told by one of the representatives of Barnardo’s that it was not taken up. I think that 15 specialised foster parents were trained and that local authorities were told they could have this for nothing. They were not being asked to pay a penny and they did not take it up. I think there were two or three places where local authorities did not do it, which is an indication of the degree of concern that I understand the overworked social services have for this group of children. Something absolutely has to be done. I beg to move.
Lord Northbourne
My Lords, I rise to reinforce, in a way, what the noble and learned Baroness, Lady Butler-Sloss, has said but also to ask some questions. I should perhaps declare an interest as a council tax payer in the district of Dover. As I see it, the amendment, as tabled, would require the local authority to bear the financial responsibilities of looking after these trafficked children, far more of whom probably come in through Dover than through any other point of access to the United Kingdom.
It so happens that a year or two ago, my wife chaired the Kent Community Housing Trust, which is for old people. During that time they received a panicked telephone call from the county council saying, “We simply can’t cope with this flow of people. Can you help us?”. Luckily, an old people’s home was able to be diverted for that purpose. As the noble Baroness said, it is not easy. In one case a child arrived at the children’s home absolutely white with fear and said that he had just seen a murder and the murderer. The child knew that the murderer had seen him, so he feared for his life. He was kept in the home for 16 days and at the end of that period he slipped down to the village to buy some fags and was never seen again. We are talking about quite a tough world.
What are the financial implications for local authorities which receive an enormous number of young people? My noble friend was being rather critical of the local authorities but they were presented with a very difficult problem at very short notice.
Baroness Butler-Sloss
The local authority has the obligation under the 1989 Act to accommodate children, so there are no financial implications that I understand. The only financial implications would be if the local authority were involved in care proceedings, when it would have to pay for the applications.
Baroness Butler-Sloss
They do it already. There is no difference. They have a requirement under the Act to accommodate. They have had that since 1989, or since 1990 when the Act came into force. I am talking about giving them a parental responsibility order, which is a wake-up call and has nothing to do with finances at all.
Baroness Howarth of Breckland
I am asking that Amendment 43 be decoupled from this amendment because it deals with a quite different issue. I wish to speak briefly to the amendment moved by the noble and learned Baroness, Lady Butler-Sloss, if the noble Earl, Lord Listowel, will allow me. It is extraordinary that there are children in this country, from wherever they have come, for whom the local authority fails to take some sort of action. I do not often say this but, in my day, children would be seen as having no parental cover whatever and there would be no doubt that the local authority would have had a care order. There is no doubt that that would have happened in the past. The noble Baroness, Lady Howe, agrees.
I understand why we want fewer court proceedings. Having been the chair of CAFCASS, I absolutely understand that. They are expensive and are often not helpful to the child’s experience, never mind that of the local authority. Under the 1948 Act we had a way of ensuring that children were placed under the equivalent of a care order by a process in the local authority. In the days of Sections 1 and 2 of the Children Act 1948, one lot of children went to court and the others went through a process in the local authority. We should ask the officials to look at this. Without a doubt we have a national responsibility to protect this small cohort of children. I have come into contact with them because I deal with serious sexual abuse issues. The girls who are trafficked are seriously sexually abused. It is not just prostitution; it is abhorrent prostitution. Unless we find ways of protecting these youngsters they will just slip away and disappear, not of their own choice. I support the noble and learned Baroness in her attempt to find a way that is not expensive but which secures these children’s futures.
Baroness Massey of Darwen
My Lords, an issue that is not directly relevant to this amendment, but which is akin to it, is that of parental responsibility and the accommodation that these children go into. I know that these highly vulnerable children are put into shocking accommodation. They are followed by traffickers, drug dealers and criminal gangs. They are abducted and disappear or something even more terrible might happen to them. I want to emphasise that parental responsibility must include decent accommodation for these children.
The Earl of Listowel
My Lords, I advise the Committee that I wish to decouple my Amendment 234 from this grouping. I apologise; I did not watch carefully enough the information from the Whips’ Office this morning.
Baroness Hamwee
My Lords, I have put my name to the amendment. I think that I could sum it up by saying that it would turn accommodation into care, and it is care that is needed. It is not surprising that children in this situation go missing, because the only people whom they know are those who have trafficked them. If they are given the means of staying in touch, as so often they seem to be, they will respond to a contact or make contact themselves. It seems that very often the first thing that happens is that they are given a mobile phone and instructed: “You keep in touch with us”. Whether this is the right way of going about it I do not know, but I have heard those around me who have much more recent or, indeed, current local authority experience muttering, “But the local authority has to do this”. Well, let us find a way of making sure that the local authority does more than what fulfils cold letters on paper and actually produces the service.
Lord Storey
My Lords, I would like to explore this in a bit more detail. Perhaps the Minister, if he is not able to give the information in his reply, could write to us. My experience in local government and as a head teacher is that, of course, children are trafficked, but some are trafficked because their parents in another part of the world want a better life for them, so they pay someone to put them on a plane and the poor child then arrives in the UK. As I understand it, there are regional centres where the children are received. There is one in Dover. Liverpool was and is another regional centre. The children come to Liverpool and Liverpool tries as best it can within the resources to cater for them and to look after them. I know that for two reasons. One is that, four or five years ago, our director of social services wrote a report saying, “Look, my budget can’t cope with the number coming in. We want to help, but it seems unfair financially that Liverpool should carry this burden”. Secondly, I also know as a head teacher that some of these children have been put into foster care. I gave the example at a meeting of a Mongolian street child, whose grandparents had paid a trafficker to bring him to the UK. He landed in London but was sent to a regional centre, which happened to be Liverpool, where he was fostered with a wonderful family in Halewood. He came to my school and he was well looked after. For me, the issue is not the reluctance of local authorities to deal with this but the sheer size of the problem and the support that they get. I hope that that makes sense.
The Earl of Listowel
I am reminded of the report by my noble friend Lord Laming on the death of Victoria Climbié. One of the comments made by the social workers in Haringey who were interviewed was that they were overwhelmed at the time, particularly by unaccompanied asylum-seeking children and young people. This can put a heavy burden on local authorities. I have another, related experience of visiting a children’s home some years ago. I spoke to the manager, who was very experienced—in many ways, she was a remarkable manager—but when it came to working with unaccompanied asylum-seeking children, she felt that these were not their children. She had enough to do looking after the children with whom she had to deal, rather than having to deal with these other children, if you like. There is a difficulty and perhaps the amendment is a helpful way of tackling it. Some people will just say, “Look, we have enough on our plate. We don’t want to think about these extra children and we’ll find ways not to do so”. I am not sure whether that is exactly the issue in hand, but my experience is that, understandably, given the strains on social services and the immense emotional burden that caring for children with complex needs brings with it, some people can find ways to rationalise not giving proper care to vulnerable children because those children come from a very different background from theirs.
Baroness Jones of Whitchurch
My Lords, I am extremely grateful to the noble and learned Baroness for tabling this amendment. We all share her abhorrence at what is currently happening out there in the way that the care system is routinely failing trafficked children. I was interested to hear what the noble Lord, Lord Storey, said. One aspect of it might be that children whose parents want a better future for them come here voluntarily. However, the people that the noble and learned Baroness is talking about are duped into coming here on completely false pretences. They are told they are coming for waitressing jobs or otherwise to earn money. They certainly do not expect to come in the mode of being owned by a gang member, which is where they find themselves. The noble Lord is right that there is some good local authority practice but that is where people want help and support genuinely to make a better future here: these are not the same people.
This all goes to show that the problem for local authorities is much bigger, in the round, than we are looking at. There are people who come in on the noble Lord’s terms and those who come in on the noble and learned Baroness’s terms. There are some excellent charities working in this sector, as well as the local authorities who are providing a safe haven and proper care and advice for these young people. However, they need to do more and they are very much the exception. All too often, everyone feels powerless to prevent those children who are rescued disappearing. It is not just that they are being traded and sold into slavery and sexual abuse. Very often, the children go along with the gang members because they are spooked by some form of black magic which is endemic in their original societies or they feel that their families will be threatened by violence back at home if they do not go along with it. In no sense are they involved voluntarily: this is under absolute fear, duress and panic. It is a scandal that we are allowing this to happen on our territory and are unable to prevent it.
I was pleased to hear the proposals of the noble and learned Baroness. I do not know well enough what difference it would make but it would be fair to say that if it did make a big difference it would have a cost implication. If it were not going to make much difference, it would not. We have to own up to the fact that there may be a cost implication to what is being proposed. It is only right that, if a child is under 18, the local authority should have the same duty of care to look after them as it would to any other young people under its jurisdiction. It also seems only right that, when they go missing, it takes the same level of care as it would for any other young children under its jurisdiction, including making sure that it escalates the details of those young people beyond the local missing persons’ procedures.
We have touched on what is going wrong with local authorities. It is partly about resources but they also think that it is just too complicated to deal with on their own, particularly when they are dealing with young children and traffickers who are constantly moving and crossing local authority borders and other boundaries. It is all too easy for local authorities to feel that it is, in a sense, someone else’s problem and that the problem has moved off their estate and into the hands of someone else. That is not justifiable and we want to work with the Government to find some way to deal with this problem. It seems an absolute affront to our civilisation that children can be bought and sold and exploited in our own sight, and that we seem to be powerless to stop it.
The real solution probably lies with having the political will to make this issue a priority, which I do not think that it has been up to now. At the same time, a lot could be done if all the agencies involved worked more closely together to share information and act decisively. Whether that needs to be put in legislation is another matter, but a bit more joined-up action and joined-up government could go some way to addressing it. I very much appreciate the noble and learned Baroness raising this issue, and I hope that the Minister will explain how she is going to solve this problem.
Baroness Northover
My Lords, first, I thank the noble and learned Baroness, Lady Butler-Sloss, for her tribute to the Government in relation to adults who have been trafficked. We appreciate her comments. But we share her concerns, and those expressed by other noble Lords, on the welfare of children who have been trafficked into this country. These are often extremely vulnerable children, who may have suffered tremendously at the hands of their traffickers. As recent work by the Refugee Council and the Children’s Society shows, these children can fail to gain the support that local authorities should provide. They should get the same support as other looked-after children; the legal duties to support them are the same. The noble Baroness, Lady Jones, pointed towards that. Local authorities already have statutory duties to safeguard and promote the welfare of trafficked children. They should be treated and supported in the same way as a local authority should support any child whom it is looking after.
Parental responsibility in law is not required to fulfil the duties of a parent in practice. Where local authorities are failing in this duty, they should be held to account. The noble Baroness, Lady Jones, pointed towards that, too. But requiring that they gain shared parental responsibility would not in itself bring the improvement provided. There was an interesting mini-debate about cost; the noble and learned Baroness, Lady Butler-Sloss, and the noble Baroness, Lady Howarth, reassured the noble Lord, Lord Northbourne, on that, and we are grateful for that.
Assigning parental responsibility could have unintended consequences. A trafficked child may well have a parent somewhere who already has parental responsibility for them. Although the local authority should act as a parent until the family is reunited, it should not automatically acquire parental responsibility towards that child. While it is clear that some local authorities are not performing adequately their statutory role to promote the interests of trafficked children, adding a requirement on them to seek parental responsibility for these children could create legal complexity without addressing the reasons for these failures. Instead, we believe that we must continue to pursue the programme of reforms to the care system that are already under way. As we implement these programmes to provide more stable placements, improved education and health outcomes and support towards independence and adulthood, I assure noble Lords that we shall take account of the particular needs of trafficked children. Already, for example, we have published revisions to statutory guidance on missing children which strengthen advice on identifying and meeting the needs of child victims of trafficking. The consultation on that has just finished, and we will take the comments from tonight into account in the final version of that guidance.
I mention to the noble Earl, Lord Listowel, that the number of unaccompanied asylum-seeking children has in fact dropped over the past two years, which is of course very welcome.
This is a very vulnerable group of children, and we fully recognise that. We understand what the noble and learned Baroness, Lady Butler-Sloss, and others are arguing. We will be very pleased to arrange a meeting with noble Lords to discuss this issue and consider whether more could be done. In the mean time, I hope that the noble and learned Baroness is willing to withdraw her amendment.
Baroness Butler-Sloss
I thank all noble Lords for their contributions. Perhaps I should have said earlier that this was a probing amendment. I see disadvantages in local authorities having parental responsibility, but I never suggested in the amendment that they should hold it exclusively. It would be similar to a care order, where the local authority and the parents share parental responsibility. There is no suggestion that it should be a sole responsibility.
It is important to recognise that asylum-seeking children are not necessarily trafficked. I am talking about a relatively small number of children, in the hundreds, but they are the most vulnerable children coming in from outside.
Baroness Northover
Perhaps I should clarify my comments to the noble Earl, Lord Listowel. He suggested that local authorities, because they are dealing with large numbers of asylum-seeking children, were therefore not dealing with trafficked children. I simply wanted to place that in the context that the numbers there are dropping. In case I caused any confusion, perhaps I can clarify what I was saying.
The Earl of Listowel
Just to clarify my position, I was simply using that as an example: that occasionally local authorities are overburdened for one reason or another and we need to support them as far as possible to meet those needs.
Baroness Butler-Sloss
I am talking about a very specific group of children. Some trafficked children may seek asylum, but that is a completely different matter. I am talking about children who have through the NRM been positively identified as trafficked or are going through the process of identification—one or the other. I am not talking about children who might possibly be trafficked but who have not yet gone through that identification.
The reason for tabling the amendment was as a wake-up call to local authorities. I totally understand the extent to which they are overburdened and underresourced—I said that—but this small group of children is slipping through the net. I was delighted to hear what the Minister had to say about missing children, because there is a serious lack of data from local authorities on children who go missing. They ought to be able to identify what sort of children they are. Are they the children who keep going missing from children’s homes? We know that there are children who go missing three, four or five times a week. That is not the sort of child we are talking about. The group we should worry about is the child who goes missing and is never identified again as a child who was in a children’s home or a foster home. Local authorities do not even know. They have to get their act together to know that those are trafficked children.
I welcome the opportunity to discuss that further with the noble Baroness. I have no doubt that the group of which I am a co-chairman would very much like the opportunity to do that, particularly the chairman of the Human Trafficking Foundation, Anthony Steen, who was previously an MP who worked tirelessly for this cause. This children issue is one that we are truly concerned about. I very much welcome what the Minister said and I am happy to withdraw the amendment.
House of Lords
Introduction: The Lord Bishop of Sheffield
Introduction: Lord Bourne of Aberystwyth
Supermarkets: Pricing
Lord Kennedy of Southwark
To ask Her Majesty’s Government what discussions they have had with the major supermarkets on delivering simple and clear pricing for consumers.
The Parliamentary Under-Secretary of State, Department for Business, Innovation and Skills (Viscount Younger of Leckie) (Con)
The Government agree that supermarket prices should be clear so that consumers can make informed choices. The Minister for Employment Relations and Consumer Affairs held a working group meeting with the supermarkets in May to discuss unit pricing and clarity of shelf-edge labels. We are working closely with the supermarkets and look forward to their continued positive engagement to make improvements that help consumers compare pricing information.
Lord Kennedy of Southwark (Lab)
Does the noble Viscount not realise that we have a cost of living crisis in this country? Can he tell the House why the Government are not doing more to ensure that consumers are properly informed of the cost of everyday essentials?
Viscount Younger of Leckie
I should reassure the noble Lord that we are doing much. Since the working group in May, BIS has continued to engage with supermarkets to explore where further improvements can be made, and has agreed to work with supermarkets to identify barriers to doing this. We are aware that there is a bite on household spending and we are doing as much as we can to deal with that.
Baroness Gardner of Parkes (Con)
My Lords, is the Minister aware of the problem for older people, or people in single family units? The advantageous deals are three for two, or buy two and get one for a much cheaper price. While I think that is very desirable for people who have large numbers to feed, it is definitely a disadvantage for people who want smaller quantities. Quite a lot of food must also be wasted, because people cannot use it. Will he take up with the supermarkets the possibility of providing these large super-deductions, but also providing things that can be bought in smaller helpings?
Viscount Younger of Leckie
My noble friend makes a good point, and it is one of the issues that we are discussing earnestly with the supermarkets. However I should point out that “buy one, get one free” deals represent a small proportion of supermarket promotions, the majority of which are temporary price reductions. We are also in discussions over the Waste and Resources Action Programme, which works with retailers to encourage alternative promotions for perishable goods.
Lord Kinnock (Lab)
My Lords, is not the sense of crisis heightened by the fact that the Prime Minister appears not to know the price of a loaf of bread? Could the Minister show rather more urgency in trying to insist that retailers, including supermarkets, have a uniformity of descriptions of the pound and kilogram cost of items on their shelves so that people can make a cogent choice in deciding what the best value for money is?
Viscount Younger of Leckie
The noble Lord raises an important point. He may be aware that there is legislation in place, in the form of the Price Marking Order 2004, which requires the selling price and, where appropriate, the unit price—65p per 100 grams, for example—to be clearly displayed on products being offered by traders to consumers. We take this seriously and we are working hard to improve communication about and the display of these items.
Lord Razzall (LD)
My Lords, I assume that the Minister would wish to be congratulated on the forthcoming introduction of a consumer affairs Bill sponsored by his ministerial colleague, Jo Swinson. Can the Minister confirm that the Bill will deal with the sort of practices to which the noble Lord, Lord Kennedy, has referred?
Viscount Younger of Leckie
Indeed, although I have not yet seen the details of that particular Bill. Much is being done with the OFT, which is working with the supermarkets to develop a set of principles to address the concerns over special offers and promotions for food and drink. For example, the principles state that pre-printed value claims on packs, such as “Bigger pack, better value”, must be true.
Baroness Hayter of Kentish Town (Lab)
My Lords, given the cost of living crisis, will the noble Viscount apologise to consumers for doing nothing about price increases, particularly the latest energy price rise? Will he tell the House why, for the first time since the war, he thinks that the Red Cross has had to launch an emergency food aid plan for our own hungry, asking volunteers in supermarkets to get shoppers to donate goods?
Viscount Younger of Leckie
I have no intention of apologising but I have recognised that there is a bite on household expenditure. I point out to the noble Baroness that the biggest drivers of UK food price inflation are global commodity prices, exchange rates and oil prices. As regards energy pricing, the Energy Bill, which is being led by the Department of Energy and Climate Change, will ensure that all households get the best deal for their gas and electricity by giving legislative backing to Ofgem’s retail market review.
Lord Tebbit (Con)
My Lords, in view of the crisis in the cost of government, would my noble friend consider getting together a group of senior retailers who would be asked to look at manifestos before an election, price up the promises and make sure that we know the unit price of government as proposed between the various parties?
Viscount Younger of Leckie
My noble friend makes an interesting point and it is firmly noted.
Lord Harris of Haringey (Lab)
My Lords, given the very rapid rise in food prices in this country, which is double the rate in Germany and France, can the noble Viscount comment on the fine of £300,000 imposed on Tesco for not properly declaring or misrepresenting a cut in price it claimed that it had made? Are the Government putting enough resources into the consumer protection world to make sure that consumers are protected against unfair offers of that sort? I declare an interest as chair of the National Trading Standards Board.
Viscount Younger of Leckie
I can reassure the noble Lord that we take enforcement very seriously. As the noble Lord will be aware, enforcement of the legislation is undertaken by the Office of Fair Trading and trading standards boards. If there is an issue, the first thing that complainants should do is go to trading standards. I am also extremely aware of the major supermarket that was prosecuted for giving a misleading price on strawberries.
Lord Elton (Con)
My Lords, will the Minister take on board the plight of elderly single people trying to follow a balanced diet? They have to try to find a loaf of bread that does not go stale before they have finished it because the loaves are all too big.
Lord West of Spithead (Lab)
My Lords, so that I am not caught out in the future, will the Minister tell us exactly what is meant by a loaf of bread? There seem to be so many of them.
Viscount Younger of Leckie
I hope that the noble Lord will forgive me if I say that that goes slightly beyond my brief. However, I happen to know the price of a loaf of bread.
Bank of England: Monetary Policy Committee
(11 years, 1 month ago)
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Lord Barnett
To ask Her Majesty’s Government when the Chancellor of the Exchequer last met the Governor of the Bank of England in his capacity as chairman of the Monetary Policy Committee, and what they discussed.
Lord Newby (LD)
My Lords, I am sure that the whole House will wish to join me in congratulating the noble Lord on his 90th birthday. There are clearly two Barnett formulae. There is first the public one that we regularly discuss in your Lordships’ House, but secondly there must be a secret elixir that enables the noble Lord to continue to play an energetic part in our deliberations undiminished by the passage of the years. We wish him many happy returns.
The UK’s Monetary Policy Framework, set out in the Bank of England Act 1998, gives operational responsibility for monetary policy to the independent Monetary Policy Committee. The Chancellor of the Exchequer has frequent discussions with the Governor of the Bank of England on a wide range of issues in the UK economy.
Lord Barnett (Lab)
My Lords, I thank the noble Lord for his initial comments. In the light of those, I had better be kind to him, but I am afraid that when he answered a similar question on 9 July, I believe that he misled the House on an important issue of the independence of the Monetary Policy Committee and the Governor of the Bank of England. I gather that he was depending on a command paper and on an exchange of letters between the Chancellor and the governor, but surely you cannot change a major Act of Parliament—the Bank of England Act 1998—by an exchange of letters and a command paper. That is clearly impossible. Can he explain how he has done that? The independence of the Monetary Policy Committee is important, as the new governor has told the country that he believes in long-term forecasts. He has forecast interest rates which clearly would be affected by QE, on which he is apparently being given unfettered power. Whether or not he has those powers, could the Minister explain and confirm that the Chancellor has agreed to allow the governor and the Monetary Policy Committee unfettered control over interest rates and QE?
Lord Newby
My Lords, that is what the Bank of England Act says. The Monetary Policy Committee is operationally independent. The remit of the Monetary Policy Committee has to be set by the Governor of the Bank of England. It has to be renewed every year. It was renewed this year. The difference between this year and previous years is that the Chancellor asked the governor to look at possible methods of forward guidance which would give greater certainty to the markets about the medium-term movement of interest rates and, indeed, QE. That is exactly what the governor did, in line with the request from the Chancellor which was in line with the provisions of the Bank of England Act.
Lord Bilimoria (CB)
My Lords, I join in wishing the noble Lord, Lord Barnett, a very happy 90th birthday. He has asked an excellent question in that it relates to forward guidance. For a long time I have been saying that when setting interest rates the Governor of the Bank of England and the Monetary Policy Committee should look not just at inflation targeting but at the wider economy. This is excellent news. However, is it wise that the governor should tie himself down to a specific level of 7% unemployment, after which interest rates are to be raised, unless inflation is going out of control? When does the Minister think that the 7% will be achieved? Secondly, would it not have been wiser to have had a wider remit taking into account other aspects of the economy, not just inflation targeting?
Lord Newby
As the noble Lord says, the governor is now looking at unemployment in terms of when interest rates might change, but there is no iron rule that the moment unemployment rates hit 7%, interest rates will go up. There are three potential arguments which would mitigate against that, of which by far the most important is if the outlook for inflation was higher. As to when we might reach 7%, in August when the Bank of England published its report suggesting this, it thought it would be in the third quarter of 2016. The good news is that since then the economy has grown more quickly, and the consensus is now settling around summer 2015.
Lord Peston (Lab)
My Lords, will the Minister cast his mind back to when your Lordships debated what is now the Bank of England Act? My noble friend Lord Barnett and I put down an amendment precisely to achieve the flexibility which is in this command paper. We were not told that the flexibility was already there, which is what the command paper says. We were told that we were idiots, and that the remit of the Monetary Policy Committee was to hit the inflation target—only after that could it look at anything else. The Government have produced a sleight of hand here. I favour it, let me add, but it is a sleight of hand.
Will the noble Lord consider the central question which arises in this context, bearing in mind that the two greatest liberal thinkers of the 20th century, Lord Beveridge and Maynard Keynes, both placed the attainment of full employment at the centre of government macroeconomic policy? Can the noble Lord tell us whether under the new regimen that we are now offered, there is any hope within my lifetime—younger Members may have something more to look forward to—that we shall at last get back to what those two great thinkers said: full employment is a must?
Lord Newby
My Lords, I am sure that the noble Lord welcomes the fact that, for the first time, the Bank of England is looking at the employment rate as a way of deciding on the speed at which interest rates might change. I am sure he would agree, as Keynes probably would, that the quickest way to bring the rate of unemployment down is to get the growth rate moving more quickly. I am sure that he will be pleased that all the projections of growth are now being revised rapidly upwards. The IMF, for example, last week revised upwards its growth rate for this year from 0.09% to 1.4% and for next year from 1.5% to 1.9%.
Lord Flight (Con)
In the discussions that the Minister is having with the Chancellor and the Governor of the Bank of England, are they focusing on what the extent is of imported inflation or deflation compared to domestic inflation? It was largely a failure to understand that domestic inflation was far higher than the mixed bag that led monetary policy under the previous Government to go off the rails.
Lord Newby
My Lords, in recent years, there has been a very different mix of imported and domestic inflation, and we have not seen any significant degree of domestically generated inflation. That remains pretty much the same today. Fortunately, we are a very long way from the 1970s and 1980s, when domestically generated inflation was the single biggest problem of macroeconomic management.
Church of England: Appointment of Bishops
(11 years, 1 month ago)
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Lord Trefgarne
To ask Her Majesty’s Government what discussions they have had with the Church of England about the procedure for the appointment of bishops in the Church of England.
Lord Wallace of Saltaire (LD)
My Lords, the current procedure for the appointment of bishops to the Church of England was agreed by the previous Government in 2008 after consultation with the church and the publication of a White Paper, The Governance of Britain. There have been no further discussions between the Government and the church on this issue since 2008 and the Government see no need to initiate any such discussions.
Lord Trefgarne (Con)
My Lords, I am grateful to the Minister for that Answer. Is it not the case that bishops are retiring faster than they are being appointed? In a little while, there will be none at all. If the most reverend Primate’s diary is so congested that he cannot find time for additional meetings of the Crown Nominations Commission, would it not be a good idea to reappoint the noble Lord, Lord Luce, who chaired that committee so effectively when it came to choosing the most reverend Primate?
Lord Wallace of Saltaire
My Lords, I am informed that there are currently four vacancies for diocesan bishops and two forthcoming retirements. There is also the issue of the new combined diocese of Leeds. I accept that the Church of England has a rather lengthy consultation procedure before new bishops are appointed. I spoke to the joint secretaries of the Crown Nominations Commission last week, who were in Hereford consulting members of the diocese on the nature and needs of the diocese and thus the characteristics they wanted in a new bishop. That seems entirely desirable. I understand that in the diocese of Guildford, with which the noble Lord, Lord Trefgarne, will be concerned, the bishop is due to retire at the end of November. It is likely that his successor, after this consultation, will be agreed in June or July next year.
Lord Faulkner of Worcester (Lab)
My Lords, what assistance are Her Majesty’s Government giving to the most reverend Primate the Archbishop of Canterbury in redressing the gender imbalance on the Bishops’ Benches in your Lordships’ House?
Lord Wallace of Saltaire
My Lords, the Church of England is moving with all deliberate speed towards the appointment of women bishops. I think it quite possible that the first women bishops will be consecrated before we have reached the next stage of House of Lords reform.
Baroness Brinton (LD)
My Lords, synthesising the two previous questions, will the Minister tell us how many women clerics are in a senior position in the Church of England? Does he agree that a large number of vacancies might be helpful for the promotion of the majority of very good senior women to bishoprics as and when the Church of England approves their appointment?
Lord Wallace of Saltaire
It is desirable that dioceses nevertheless continue to appoint bishops. I know a number of senior women in the Church of England and have a great deal of respect for them. One of them is the wife of my good friend the Vicar of Putney. I have no doubt that in time, the Church of England will have a number of excellent women bishops in the same way that it now has a number of excellent archdeacons, canons, and others from the female sex.
Lord Foulkes of Cumnock (Lab)
My Lords, will the Minister confirm that one of the great things about Church of England bishops is that their number in this House has an upper limit, whereas coalition Peers seem to be flooding in with no apparent upper limit? Are there any members of the Liberal Democrat Party who are not in the House of Lords?
Lord Wallace of Saltaire
I am sorry that the noble Lord, Lord Foulkes, did not take the other path appropriate to the Question, which is that the Bench of Bishops is the only section of this Chamber that has an upper age limit, which is 70.
Lord Cormack (Con)
My Lords, after that hilarious question from the noble Lord, Lord Foulkes, does my noble friend agree with me that it is somewhat unfortunate that Episcopal vacancies are now advertised? Is there not an anti-vocationary element there?
Lord Wallace of Saltaire
It may simply be a useful movement towards transparency. I know there are those who would like the Church of England to remain as it was 150 years ago or more, but as a member of the Church of England, I am extremely happy that it has moved and modernised over the last few years.
The Lord Bishop of Leicester
My Lords, is the Minister aware that, typically, the Crown Nominations Commission consults some 100 members of civil society in each region to which appointments are made; that legislation to bring forward the possibility of women bishops is now before the General Synod and it is anticipated that it will be brought into law within two years; and that the Archbishop of Canterbury takes a very keen interest in the proceedings of this House, and will take careful note of any concerns about the speed of Episcopal appointments made in the course of this Question Time?
Lord Wallace of Saltaire
I thank the right reverend Prelate for his question. In consulting when preparing for this Question, I was struck by how many of the people I spoke to said, “You have to understand that the workload of a diocesan bishop is enormous and that some wish to retire before the age of 70 because they feel they have done more than they can sustain for more than 10 to 15 years”.
Baroness Royall of Blaisdon (Lab)
My Lords, will the Minister join me in congratulating the Church of England on all the splendid work that it does in its dioceses, especially with people who are suffering so much under the austerity programme of this Government? Will he also join me in congratulating the Church of Wales on its vote in favour of women bishops?
Lord Wallace of Saltaire
I am very happy to do so, and I look forward to the Church of England following in good time.
Ministry of Defence: Dogs
(11 years, 1 month ago)
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Baroness Oppenheim-Barnes
To ask Her Majesty’s Government what steps are taken by the Ministry of Defence to retrain and rehome dogs when their period of duty in the military at home or abroad is complete; and what proportion of those dogs are returned to the United Kingdom.
The Parliamentary Under-Secretary of State, Ministry of Defence (Lord Astor of Hever) (Con)
My Lords, military working dogs and their handlers provide a valuable range of specialist roles worldwide. The dogs’ welfare is a primary consideration during and after their service. The MoD rehomes all suitable dogs, often with someone closely involved when the dog was serving and with families who are carefully vetted. There are no time restrictions on a dog being kept while a suitable home is looked for. The majority of dogs serving overseas are re-homed in the United Kingdom.
Baroness Oppenheim-Barnes (Con)
I thank the Minister for that reply. Is he aware that I am extremely pleased with it, as will be the highly regarded Dogs Trust? These dogs have served their country very well at the side of the brave soldiers, whose lives they often save, and it is good to hear that the Army is treating them humanely on retirement.
Lord Astor of Hever
My Lords, I am delighted that my noble friend is pleased with my Answer. I join her in paying tribute to the wonderful work done by the Dogs Trust. All personnel from the military working-dog community do everything that they possibly can to rehome all suitable dogs at the end of their service life. Many dogs, understandably, are adopted by their handlers. We have rehomed around 360 dogs during the past three years and currently have 150 people waiting to offer a home to a suitable dog.
Lord Tomlinson (Lab)
When the Minister has solved the problem of dogs, will he turn his undoubted abilities to solving the problem of the £2 billion cash surplus that the Ministry of Defence has apparently been unable to spend, as was reported in the Sunday Times yesterday, to the detriment of major missions in the Middle East, where we have significant defence interests?
Lord Astor of Hever
My Lords, I am sorry to disappoint the noble Lord but this Question is specifically on dogs. He can table a Question on the issue that he has raised at some other point.
Lord Trefgarne (Con)
My Lords, is my noble friend aware that I have had the privilege of owning two dogs that were retired from military service, which of course I purchased from the Ministry of Defence, and that both were beautifully looked after and were quite excellent?
Lord Astor of Hever
My Lords, I am really pleased to hear what my noble friend says. There is great interest in this issue, particularly in the different types of military working dogs. I have asked my department to put in the Library a list of all the different types of specialist and protection dogs, as well as the reasons why a small number of working dogs were killed during the past three years—I think that it was two this year, one the year before and one the year before that—along with information on the number of dogs that were put to sleep and the reasons for that.
Lord Harris of Haringey (Lab)
My Lords, I accept that this Question is primarily about the rehoming of military dogs, but is there not also a problem with the substantial number of ex-servicemen who end up sleeping on our streets because they are not afforded the proper moves into civilian life? I would be grateful, if he cannot do so today, if the Minister could perhaps report to the House at some future stage on the steps being taken to ensure that ex-service personnel are treated appropriately by this society?
Lord Astor of Hever
My Lords, I am very happy to do that at a future point in a defence debate, but this is a good-news story about what we are doing for military dogs. I am very unhappy to see us going off-piste.
Baroness Doocey (LD)
My Lords, will the Government examine the enactment of “Robbie’s law” in the United States, which has led to a huge reduction in the number of retired dogs that have to be put to sleep, with a view to introducing a similar system in this country?
Lord Astor of Hever
My Lords, I am very happy to look at that. The situation in this country is that the decision to put a dog to sleep is taken by a veterinary officer and only after all possible avenues have been exhausted. From 2010 to June 2013, sadly, 300 dogs had to be put down, and the reasons for this included injury, illness and age-related welfare reasons. As I have said, those cases were looked at by veterinary officers and the decision was taken only as a last resort.
Lord West of Spithead (Lab)
My Lords, does the Minister agree that we have a good track record in this country of looking after animals within the military? I am sure he will be interested to hear that when we did Options for Change at the beginning of the 1990s, our one study into animals within the forces, known colloquially as the Winalot study, discovered, to the surprise of the Navy, that Army and Air Force dogs had a higher per diem rate for food than officers and men within the Royal Navy.
Lord Astor of Hever
My Lords, that is a very interesting question and I will consider it closely.
Lord Brooke of Sutton Mandeville (Con)
My Lords, if I may shift the emphasis from the Government to dogs, is my noble friend aware that Greek vases demonstrate a considerable use of dogs two-and-a-half millennia ago? That tradition has been maintained for a very long time—to the enormous credit of the dogs.
Lord Rosser (Lab)
My Lords, last week it was government policy being thwarted by badgers moving the goalposts; this week it is defunct, deceased dogs causing headaches. Presumably the Minister can give an assurance that no decisions to put down dogs are made on financial grounds, bearing in mind the recent disclosures about the hundreds of thousands of pounds being consumed within the Ministry of Defence on calls to 118 numbers at a time when money is in short supply. Will the Minister also clarify what percentage of military working dogs are put down before they are retired, and what percentage are retrained or re-homed on retirement?
Lord Astor of Hever
My Lords, I can give the noble Lord the commitment that no dogs are put down for financial reasons. The vast majority of dogs had to be put down as the animals’ condition impeded and reduced their quality of life. As noble Lords may know from sad personal experience, everyone will at times have to put animals to sleep when it is the only option. The death or destruction of a military working dog is subject to formal investigation and report, as required. Dogs are not usually retrained during their military service. The role that a dog undertakes is normally one which the dog has a natural inclination to perform as a result of breed characteristics and behavioural traits.
Lord Elton (Con)
My Lords, there are occasions when it is impossible to find a successor owner for the dog. Would my noble friend bear in mind the work of the Cinnamon Trust, which has a fascinating remit of supplying bereaved people with dogs which have also been bereaved, and homing other difficult cases in a way which promotes the happiness of both the animal and the human?
Lord Astor of Hever
My Lords, my noble friend makes a very good point. I will certainly study carefully the excellent work of the Cinnamon Trust.
Inheritance and Trustees’ Powers Bill [HL]
(11 years, 1 month ago)
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Lord McNally
To move that the Bill be referred to a Second Reading Committee.
Care Bill [HL]
(11 years, 1 month ago)
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17:48 - Division on Amendment 63 - Ayes: 202 / Noes: 224 - Amendment 63 disagreed.
19:55 - Division on Amendment 77 - Ayes: 72 / Noes: 143 - Amendment 77 disagreed.
The Parliamentary Under-Secretary of State, Department of Health (Earl Howe) (Con)
My Lords, I shall speak also to the other amendments in this group, Amendments 33, 36, 37, 39, 40, 42 to 45 inclusive, 62, 90, 91, 100, 101 109, 112, 115, 116 and 117. In Committee, we had a wide-ranging and informed debate on assessment. I have reflected on the issues raised and I have tabled amendments which I hope noble Lords will agree address those concerns and clarify our intentions around the assessment process.
In Committee, we considered a provision which was intended to ensure a focus on the adult’s strengths and how these can contribute towards the outcomes they want to achieve as part of the assessment. This provision was drafted to support our aim to build the care and support system around the person and to consider the adult’s own capabilities: what they can do—as well as their needs—and what they cannot do. While most noble Lords agreed with the principle, a concern in Committee was that the provision set out in the Bill might be wrongly interpreted by local authorities as allowing them to place additional caring responsibilities on family and friends rather than providing care and support. Amendments 32 and 33 look to address the concerns that arose.
Amendment 32 removes the requirement to assess the adult’s capabilities and other matters as part of the needs assessment. Amendment 33 provides for a consideration of such matters to happen separate to, but alongside, the needs assessment. Local authorities should have a discussion with adults or carers in parallel to the assessment, considering how their own capabilities and any other matters can help to achieve the outcomes they want to achieve on a daily basis. These amendments remove the source of concern, while retaining the important point of policy on which we agree.
In Committee, there was also concern as to whether the assessment process was sufficiently supportive of the focus of the Bill on the prevention of need. We have considered this and have also brought forward amendments to strengthen this focus. The second part of Amendment 33 and Amendment 45 require a local authority to consider at the time of the assessment whether any universal services available locally, whether provided by the local authority under Clause 2 or Clause 4 or by another organisation, would be of benefit to the person. This replaces the previous provision in which such a consideration took place only after the eligibility determination. This would support situations where, for example, a local authority might decide to defer the final eligibility determination until the person or carer has taken part in a preventive service, such as a reablement programme. Amendments 36 and 37 make similar provision in relation to carer’s assessments. Amendments 90, 91, 100, 101, 109 and 112 make equivalent changes in relation to the assessment of children, child carers and young carers.
In Committee, the noble Lord, Lord Low, pointed out that while the regulation-making powers would provide for an expert to carry out complex assessments, they did not require it. I assured the noble Lord that this was not our intention and that I would look again at the provisions to ensure they provided for this. Having considered the provisions I have concluded that they needed to be strengthened to provide for when an expert must carry out an assessment for complex needs, such as for a person who is deafblind. Amendment 39 rectifies this, and I would like to thank the noble Lord for raising this in Committee.
Through Amendment 40, we will require assessors who are trained but may not have experience of carrying out an assessment for a specific condition to consult a person with experience in that area. For example, an assessor who normally assesses older people who is asked to assess a person with learning disabilities would have to consult a person with experience in that condition.
I turn now to Amendments 42, 43, 44, 62, 115, 116 and 117. Members of the Committee asked to see clear links between this Bill and the Children and Families Bill, which is also before the House. I share their view that both Bills must work together so that no one falls through a gap in the legislation. Amendment 42 ensures that a local authority can combine an adult’s assessment with any other assessment it is carrying out, whether under this Bill or other legislation, as long as the individual or individuals being assessed agree. For example, it clarifies that the authority can carry out a needs assessment with a young carer’s assessment. Amendment 43 allows the authority to carry out a needs or carer’s assessment jointly with another assessment being carried out by another body, whether of that person or a person relevant to the situation, as long as the individual or individuals being assessed agree. Amendment 62 ensures similarly that local authorities have powers to combine care and support plans and support plans with any other plan of that individual or another. Amendments 115, 116 and 117 make similar provision for a child’s assessment, a child carer’s assessment and a young carer’s assessment when they are transitioning to adult services. These amendments reflect similar government amendments tabled to the Children and Families Bill and reflect the synergy between both Bills and how they work together to ensure that the needs of children and young carers are considered during the adult’s assessment.
I have listened to the strength of the arguments made in Committee. I hope your Lordships will agree that the amendments I have tabled address the concerns that were raised and that they strengthen and clarify the assessment provisions. I beg to move.
Baroness Pitkeathley (Lab)
My Lords, the changes that the Government have made concerning assessments are very welcome. I particularly thank the Minister for the careful and considered way in which he listened to the issues around young carers, and particularly the way in which these now mesh with the Children and Families Bill, which was a concern to many of us. That is very welcome.
Amendment 32, which removes the reference to support available from families and friends, is particularly welcome. Disability and carers’ organisations have very serious concerns that the original wording would lead to local authorities making assumptions about what families could provide without conducting a thorough assessment of a person’s needs and then carefully considering how those needs could best be met, particularly taking into consideration the family’s willingness to provide that care.
Amendment 33 also includes a requirement that when an assessment is carried out it is also considered whether the person would benefit from prevention services or from information and advice. That greater emphasis is also very welcome. However, I would like the Minister’s comments on one concern about Amendment 33. It refers to,
“which might be available in the community”.
If this wording is included in the Bill, it is vital that strong guidance is given to local authorities not to run the risk of negative, unintended consequences. There will be guidance, regulations and assessments, as we know. What assurances can the Minister give that community services will not be seen as an automatic alternative to statutory services and will not therefore create a further barrier for those in need of statutory support?
Can the Minister assure me that guidance will make it clear that local authorities cannot make assumptions about the availability and appropriateness of other support from community services and whether it is wanted by the disabled or older person? The Government have made it clear that they do not intend local authorities to look to families and friends to provide care and support, potentially taking on a greater caring role. Can the Minister give assurances that local authorities should also not be looking to families and carers to provide more care as a get-out clause, if you like, from providing statutory services? This is particularly important given the great variability in so-called community services from area to area and, of course, the huge stress on local authority budgets, which is a fact of life for all local authorities at present.
Lord Low of Dalston (CB)
My Lords, I very much welcome the Government’s Amendments 33, 39 and 40. So far as Amendments 39 and 40 are concerned, in Committee, as the Minister has remarked, I sought a strengthening of Clause 12(1)(f) to ensure that regulations would specify the circumstances in which a specially trained person must carry out an assessment or a reassessment of persons who need one. The Minister was kind enough to thank me for raising the point, and I thank him very much for bringing forward these amendments. I am delighted that the Government have come forward with amendments that effectively meet my wishes, recognising that the Bill, as initially presented to the House, did not precisely reflect the Government’s intention.
Talking of specialist provision, I kick myself that I forgot to refer to this in connection with Amendment 26 from the noble Baroness, Lady Meacher, about the need for local authorities to commission a full range of services to meet the diversity of their residents’ needs. I meant to illustrate this by reference to the situation of deafblind people who are all too often offered mainstream services or services designed for those with a single sensory loss instead of the specialist provision appropriate to their particular needs. Perhaps, in welcoming the Government’s amendment on specialist assessments, I can slip in the thought that if local authorities are required to ensure that sufficient services are available for meeting the needs for care and support of adults in their area, they would rightly be under some pressure to identify the full range of deafblind people’s needs, and those with other specialised needs as well, and plan accordingly.
Baroness Meacher (CB)
My Lords, Amendment 41 is a probing amendment, so I will speak briefly. Before I say anything else, I applaud the Minister for the raft of amendments in this group. I was particularly pleased to see the amendments in relation to young carers, although this is not relevant to Amendment 41. However, government Amendments 32, 33, 36 to 38 and—perhaps in particular—39 and 40 are, of course, relevant to this amendment. My Amendment 41 requires that regulations that make further provision for carrying out a needs or carers’ assessment will specify the circumstances in which a person’s social care needs are to be regarded as complex—the amendments do not refer to that term, so I would like a further clarification of that—and that having defined “complex needs”, social workers should always be involved in the assessment of cases meeting that criterion. That is the proposal of the College of Social Work. I should say that the involvement of a professional social worker does not mean the exclusion of all others. Clearly, if a professional social worker is dealing with a deafblind person, he would need to involve a specialist in that particular group of disabilities.
The college makes the first point that a good assessor sets out to create a complete picture of a person’s situation, strengths, capabilities and aspirations. Social workers are trained and recruited on the basis that they have the necessary cognitive and emotional depth to undertake those assessments. The second point is that people with complex needs generally have an awful lot of different services to which they need to relate if all their complex needs are to be met. The role of the care co-ordinator therefore becomes vital in those situations; care co-ordinators tend to be professional social workers.
As the noble Earl knows, the Law Commission argued that where a person has complex or multiple needs, a proportionate assessment would require an in-depth and comprehensive exploration of those needs. It is difficult to imagine that somebody other than a professional social worker would be equipped to do that. The types of situation which would be treated as complex cases include: where a person is subject to legislation or national guidance; where a person is or may be subject to abuse; where there is conflict between a person and a member of their family or their carer; and where there is a need to support the applications of individuals or their families for continuing healthcare funding.
Government Amendments 32, 33, 39 and 40 could pave the way for regulations which would meet the concerns addressed in Amendment 41. The noble Earl will know that our particular concern is for clients with learning difficulties, mental health problems and, in particular, dementia—people whose needs will be quite complex and difficult to assess. You need people who have been trained in that sort of work. Can the Minister say, with respect to these vulnerable groups, whether regulations will clarify their need for a professional social work assessment, albeit involving others as well? If regulations will not deal directly with the assessment of people with complex needs, and in particular with those who have all those mental health problems, can the Minister explain what provision he plans to make in order to ensure that the needs of these particularly vulnerable people will be properly assessed and addressed?
Lord Dubs (Lab)
My Lords, I welcome how far the Minister has moved from Committee to today. I hope that noble Lords will not think it churlish of me to say that perhaps he might be persuaded to move a little further. I will speak first to Amendment 60, which seeks to oblige a local authority to provide advice and information about what can be done in the event of an emergency, or if needs change. I am specifically talking about what I think we have referred to before as people with fluctuating conditions and needs. We know that there are many millions of people in the country who have fluctuating conditions such as multiple sclerosis, rheumatoid arthritis, HIV, Crohn’s, colitis, epilepsy and Parkinson’s disease, and there may be many others. Therefore, we are talking about a significant number of people who will be affected by the provisions of this Bill.
Not long ago I was talking to a woman in a wheelchair who had MS. She was very lively, bubbly and sparky, and she said to me: “You know, I’m not always like this. Some days I go down and I can’t even get out of bed, so don’t judge my condition by the way you see me today”. I took that very much to heart, and it is clearly the sort of situation that this amendment is about. As the Bill is currently drafted under Clause 25, it would not really make provision for such situations.
This amendment is actually operationally simple. It would help to ease the pressure placed on formal and informal carers, and would give them more certainty. Not only will it ensure that individuals get the timely care that they need when they need it but, equally importantly, it has the potential to prevent costly and unnecessary hospital admissions. If this amendment is not in place, there is always the possibility that with a downward fluctuation in condition, the person without the support will then have to be hospitalised. That in itself is costly and is utterly undesirable from the point of view of the person who could be helped in the home if this amendment were to be passed.
Local authorities are surely in a position to provide better tailored care, to promote confidence and control and allow people to prepare for such rises and falls in their care needs. The current drafting does not allow for it. A snapshot was taken by the NRAS—the National Rheumatoid Arthritis Society—which indicated that currently more than 30% of respondents with rheumatoid arthritis have been admitted to emergency care as a result of a flare-up in the disease in the past year. This is something which I trust could be prevented if we changed the way in which this clause was to operate. A survey of 1,000 people with MS revealed that 95% of respondents felt that better services during a relapse or a sudden deterioration of their condition would help them to maintain their independence. More than 80% said that they want to be able to plan their care and support in advance of that care being required. This amendment would help people whose conditions might suddenly worsen and, as I said earlier, would potentially prevent unnecessary and costly hospital admissions.
I turn to Amendment 61. As the wording of the Bill in Clause 27 states, local authorities have the power to generally review care plans. However, they are not required to specify when they anticipate that these reviews will take place. This amendment seeks to put some certainty into the process. There should be an agreed date between the adult and the local authority upon which a review of the care and support plan would be offered. I envisage a discussion between the local authority and the person concerned about the best way in which their care needs can be met.
An anticipated review date, agreed between the local authority and the adults, would provide stability and certainty to those being cared for. It is not a large change but it would be beneficial for the people concerned. I do not want to spell out with examples where people have said what a difference it would make if they had this element of certainty. I would like this amendment to be passed, which will give the adult the confidence that their care would continue as agreed until the specified date or until the adult themselves chooses to request a review in line with Clause 27(1)(b).
Lord Mackay of Clashfern (Con)
My Lords, I generally support these government amendments, and thank the Minister for introducing them. There is just one small point I want to mention, which has been raised in my mind by the observations made by the noble Baroness, Lady Pitkeathley, in relation to Amendment 33.
I had understood paragraph (b) of Amendment 33 to carry the implication that if something was found that would benefit the person in question as a result of examination of what is in (b), the needs assessment would include that. However, I just wonder whether the last part creates the possibility that if the benefit can be received from something in the community, outside the provisions that the local authorities have made, that would be excluded; in other words, it would tend to reduce the needs assessment. I had rather thought that the proper construction of this phrase would mean that that also should be taken into account as included in the needs assessment, and that, where it was available, the cost of it should be included in the needs assessment. Perhaps my noble friend will be able to clarify that point for me.
Baroness Wheeler (Lab)
My Lords, this large group of amendments reflects issues that we covered extensively in Committee. We largely support the amendments as they address the suitability of the extent to which friends and family should be acknowledged in the process of assessment of the needs of adults, carers and young carers for care and support.
The group includes amendments on young carers’ support and assessment needs in relation to the Care Bill and its interface with the Children and Families Bill, about which I spoke last week. I do not intend to go into this issue again, other than to stress our support and relief that young carers are recognised in a joined-up way in both Bills. In particular, we welcome the safeguard in this group of amendments, which ensures that local authorities are able to combine assessments relating to adults being assessed with assessments relating to young carers only with the consent of both. The new provisions also make it explicit that it will be possible to join up care plans with other types of care plan only with the consent of the relevant parties, and we welcome this too.
We were very concerned that as originally drafted, Clause 9, which sets out the assets-based approach to assessment, could have been misinterpreted and used to push greater responsibility for meeting needs from the local authority to carers, family and friends. It blurred the distinction between an assessment being about what the needs are and the ways of meeting them by looking at how needs are met by other ways through the provision of services before any decision about eligibility has been made.
Thankfully, the Government’s amendments addressing this problem are now more in accord with the Law Commission review of adult social care legislation, which made a clear distinction between consideration of care and support needs and how the needs should be met. On specialist assessments, we are pleased to see the amendments upholding the current practice and guidance, which provide for assessments to be undertaken by people with expertise. It is an issue on which the House expressed itself very strongly, especially the need for specialist assessors in the case of people with complex health or mental health needs. The noble Lord, Lord Low, and the noble Baroness, Lady Meacher, have set out these issues again today very clearly, and I look forward to the Minister’s response to their questions on the outstanding issues.
Finally, I support the intention of my noble friend Lord Dubs in Amendment 60 to ensure that the care and support plan provides contingency planning for an emergency, such as the carer suddenly being ill or unable to provide care. The self-directed assessment model does include discussion on contingency and risk but the extent to which clear provision is covered in the care and support plan is patchy. Indeed, it is not always easy to be specific about what would happen because often the reality is that instant emergency cover is hard to organise when relatives live a considerable distance away or the cared-for person is not able to summon up emergency help. My noble friend is right to reinforce the point about the need for emergency contingency planning, especially where people have fluctuating health conditions, such as MS, rheumatoid arthritis and HIV.
In Amendment 61, my noble friend also underlines the importance of including a review date in the plan. It would be very valuable to require social services departments and providers to be clearer about not just the review date for the plan but what the monitoring and review process is and what kind of client feedback or complaints process there would be, as well as client-carer involvement in assessing quality of care and standards of service. I suspect that very few care plans currently measure up to these requirements and I would be grateful if the Minister could tell me what requirements the Government will place on local authorities and commissioners in this respect.
Earl Howe
My Lords, I am grateful for the support that noble Lords have given to the government amendments. Perhaps I may start by covering the questions that were put to me. The noble Baroness, Lady Pitkeathley, and my noble and learned friend Lord Mackay of Clashfern asked for assurances that the guidance will make clear that local authorities cannot assume that support will be forthcoming from community services or carers as a get-out. I assure the noble Baroness and my noble and learned friend that the intention in Amendment 33 is not to place extra responsibilities on carers and families, nor to delay local authorities in providing statutory services. I will commit to making this absolutely clear in the statutory guidance that will be co-produced with stakeholders. I hope that that is a valuable reassurance.
The noble Lord, Lord Low, asked for reassurance about preventive services remaining universal and free of charge, as well as intermediate care. I can reassure him that certain services will be provided free of charge, and regulations will set out which types of prevention services must be provided free of charge. Regulations will also set out which types of prevention services local authorities can charge for. It will then be for local authorities to decide whether they charge for such services. This will maintain the current position, where charging for preventive services is determined locally, in accordance with local requirements. Additionally, we would expect intermediate care, including reablement and community equipment such as aids and minor adaptations, to remain free of charge. That is a minimum. The regulations will allow for flexibility to keep the list up-to-date as services change over time.
The noble Lord, Lord Low, also asked whether the commitments in Clause 13(2)(b) will apply also to Clause 9. Will an assessment be deemed necessary where preventive services may be of benefit, even if someone is unlikely to be eligible? The duty to assess in Clause 9 is independent of the provisions on prevention. Amendments 33 and 45 make it clear that preventive services should be considered during the assessment rather than having to wait for the eligibility determination. This will mean that people can be advised during the assessment on their preventive needs, whether or not they have eligible needs. I hope that that is helpful.
Perhaps it will be helpful if I move on to the amendments tabled by the noble Baroness, Lady Meacher. Amendment 41 seeks to ensure that an appropriately qualified social worker will carry out complex assessments. I absolutely sympathise with the noble Baroness’s amendment and believe that my Amendments 39 and 40, to which she referred, will go some way towards addressing her concerns. I also reassure her that, through the powers in Clause 12, we will require local authorities to ensure that assessors have the appropriate training to carry out the assessment. We have listened to the concerns of adults who use care and support, and to their carers. They are right to say that assessors should receive appropriate training.
Amendment 39 will enable us to specify circumstances in which a specified person, such as a social worker, must or may carry out an assessment. We believe that an expert must carry out an assessment for a deafblind person. We will consult stakeholders during the development of these regulations to identify any other conditions where a specified person should carry out the assessment.
I am grateful to the noble Lord, Lord Dubs, for raising in his Amendment 60 the issue of fluctuating and emergency needs, and, in his Amendment 61, anticipated review dates in the care and support planning process. Clause 25 sets out the minimum framework for the planning process, and balances the need to set out standards for care and support planning while not constraining the ability of local authorities to fit the planning process around the person. I reassure the noble Lord that providing advice and information on what can be done to meet or reduce a person’s needs will include providing advice and information where an adult may be experiencing fluctuating or emergency needs.
In addition, where it is clear that an adult experiences fluctuating needs, the care plan should reflect this by specifying how the needs will be met. I undertake to the noble Lord to ensure that statutory guidance clarifies this, and that fluctuating and emergency needs are included in what advice is to be provided.
The issue of timescales of reviews is something we have considered carefully. The review is an important part of the process as it can identify where a person’s needs have changed and if their care and support plan should be revised to reflect this. Clause 27 on the review of care plans creates a general duty for the local authority to keep plans under review as well as a specific duty to review the plan when the authority believes the person’s needs or circumstances have changed. In addition, the clause contains a right to request a review. I reassure the noble Lord that nothing in the Bill prevents the local authority and the adult agreeing a time for the next review if they wish to do so. We believe this to be a more pragmatic way of fitting reviews around the lives of people, and one which supports our policy of personalised care. I reassure the House that we intend to detail these issues in statutory guidance on care planning.
I hope that I have reassured the noble Baroness and the noble Lord and that they will feel able not to move their amendments.
“( ) When carrying out a needs assessment, a local authority must also consider—
(a) whether, and if so to what extent, matters other than the provision of care and support could contribute to the achievement of the outcomes that the adult wishes to achieve in day-to-day life, and(b) whether the adult would benefit from the provision of anything under section 2 or 4 or of anything which might be available in the community.”
“( ) When carrying out a carer’s assessment, a local authority must also consider—
(a) whether, and if so to what extent, matters other than the provision of support could contribute to the achievement of the outcomes that the carer wishes to achieve in day-to-day life, and(b) whether the carer would benefit from the provision of anything under section 2 or 4 or of anything which might be available in the community.”
“(5) A local authority may combine a needs or carer’s assessment with an assessment it is carrying out (whether or not under this Part) in relation to another person only if the adult to whom the needs or carer’s assessment relates agrees and—
(a) where the combination would include an assessment relating to another adult, that other adult agrees;(b) where the combination would include an assessment relating to a child (including a young carer), the consent condition is met in relation to the child.(5A) The consent condition is met in relation to a child if—
(a) the child has capacity or is competent to agree to the assessments being combined and does so agree, or(b) the child lacks capacity or is not competent so to agree but the local authority is satisfied that combining the assessments would be in the child’s best interests.”
“( ) A person is a “relevant person”, in relation to a needs or carer’s assessment, if it would be reasonable to combine an assessment relating to that person with the needs or carer’s assessment (as mentioned in subsection (5)).”
(a) different amounts for different descriptions of care and support;(b) different amounts for different descriptions of support.”
Earl Howe
In moving Amendment 49, I wish to speak also to the other government amendments in this group, Amendments 50, 51, 52, 53, 54, 59 and 169. We are currently consulting on the detail of our reforms to care and support funding, including charging. This consultation and the accompanying engagement are looking at key issues around future charging for adult care and support. We need to ensure that the Bill has sufficient flexibility to take account of the views expressed through this consultation and the on-going engagement. This work has highlighted areas where the Bill as drafted may not be sufficiently flexible. I turn to my Amendments 49, 51 and 52 concerning local flexibility in charging policies.
Currently, local authorities are free to set their own charging policies for non-residential care. The intention was to create a more consistent framework for charging across local authorities. However, there was uncertainty whether the regulation-making powers as drafted would have allowed local authorities to contribute towards the care and support costs of people who have resources above the financial limits. A rule which prohibits local authorities from making any contribution towards the care costs of such people would restrict the ability of local authorities to use different arrangements when these would best meet local needs. For example, local authorities sometimes subsidise services such as telecare. We wish to allow this to continue and do not want to require local authorities to charge people the full cost of these services.
My other amendments, Amendments 50, 53 and 54, concern circumstances in which a financial assessment has not taken place or a local authority considers that a full assessment is unnecessary. We wish to encourage people to undertake financial assessments because this will enable local authorities to charge them a fair contribution towards their care costs. However, we recognise that some people are likely to refuse to undergo a financial assessment; for example, someone may be unwilling to allow the local authority to access their financial information. In order best to promote these people’s well-being, it may be appropriate for local authorities to arrange care on their behalf. The local authority would be able to charge individuals the full cost of this care and any arrangement fee.
These amendments will therefore allow regulations to enable local authorities to broker care on behalf of people who do not wish to undergo a financial assessment. The regulations will also make provision for light-touch financial assessments where a full financial assessment would not be proportionate, such as for low-cost care packages, in particular for carers. Regulations and guidance will be designed to ensure that such assessments are used appropriately.
The remaining government amendments in this group ensure that all those who should get an independent personal budget receive one and that the regulation-making powers retain their intended flexibility. I hope noble Lords agree that the additional flexibilities provided for by these amendments will equip local authorities with the tools they need better to promote individual well-being and that noble Lords can therefore support my amendments. I beg to move.
Lord Lipsey (Lab)
My Lords, I shall speak briefly to Amendment 55 on top-ups and comment, also briefly, on the proposal for a ministerial advisory committee.
I can be brief about top-ups but not because the issue is not important. Indeed, its substance is vital if the Government’s scheme for a cap is to work. We made good progress on the basis of the Minister’s remarks in Committee, and further progress was made in the Government’s consultation document, published on 17 July. I hope that he will indicate that things are still on the right track towards reaching final solutions in the near future.
I recapitulate the argument from Committee. You cannot at the moment top up your own care home fees. If you go into a care home, a third party—your son, daughter or friend—can top them up but you cannot put in your own money. That is important now, and the statutory bar is often got around or simply ignored. However, it will be a lot more important once the Dilnot scheme incorporated in the Bill takes effect.
Consider an old person who is living in a home in which the fees are £800 a week. Suppose that the limit to what the local authority will pay in fees is £500 a week. What happens when the person has spent up to the cap, at the local authority rate of course? It may be that a third party can give them the extra money to pay up, but suppose they are isolated and on their own. I am afraid that the answer is simple and stark. The individual would have to choose between only two alternatives. One is to accept the £500 a week from the local authority and move into a cheaper, perhaps worse, home, with all the disruption to that person’s life that that would involve. The other would be waive the local authority contribution and continue to pay the £800 themselves. That would mean that the cap had not done them a blind bit of good. The way round this is to permit individual top-ups, so £500 would come from the local authority, £300 from the individual. The noble Earl endorsed this in Committer when he said that,
“people should be able to use their savings to purchase more expensive care if they want to”.
He went on to say that revised arrangements to this effect would,
“be set out in regulations made under Clause 30(2) of the Bill”. —[Official Report, 16/7/13; col. 736.]
This is spelt out in paragraphs 263 to 266 of the consultative document, which also has pointers to some of the potential risks. I hope that this was with a view to solving those risks and not to coming along at a later stage and saying that they are insuperable. I ask the Minister to make a brief progress report to reassure the House that this bar on individual top-ups is going to be rescinded. Without it, the Dilnot scheme simply will not work.
I will now say a word on the ministerial advisory committee amendment in the name of my noble friend Lord Hunt of Kings Heath, who kindly adopted a proposal that I made in Committee. As the House knows, I have previous in this field, having been working on long-term care since I was on the royal commission in 1999. I also have a bit of previous on public policy in general because I started working for Tony Crosland when he was shadow Environment Minister in 1972. Of all the myriad subjects on which I have had to do reasonably serious work in this time, this is by far the most complicated. It involves a mix of financial and administrative problems with the most sensitive human considerations, particularly since it concerns people at a stage of their life when they are going into the second age of vulnerability due to age. Public and private are inextricably mixed in a way that complicates things. The whole cap is part of a private/public co-operation; therefore, it is crucial to align what both parts are doing.
The scale and range of the stakeholders involved is enormous. The Care and Support Alliance had more than 100 individual voluntary organisations which came together to promote a solution in this Bill. There are also a lot of nooks and crannies that are not obvious. I am going to come to one in a speech later this afternoon, a feature of this Bill which only became known to me on Friday which greatly changes the deferred payment scheme under the Bill. There are nooks and crannies that can be simply ignored. We had another one earlier in the Bill. It suddenly turned out that if somebody had an income close to the top for which they could claim means-tested support, they had better not claim it, because otherwise they would lose more than they gained through attendance allowance. So it is a hugely complicated field.
I am not a critic of the department on this, nor of its Ministers. They have wrestled bravely with this, helped of course by the superb Dilnot report—I am standing behind my noble friend Lord Warner, who was involved in that process—which helped hugely to clarify the intellectual framework. But there are complications as yet unfathomed. As the scheme goes forward I promise that there will be lots of unexpected and unintended effects. In particular, how people register they are getting care needs, how they are then assessed, and how it builds up towards a care cap will work out quite strangely. The Government will need the best possible advice on how to do it.
All I am suggesting, as my noble friend Lord Hunt will propose in his amendment, is that it would be well for us to set up right at the beginning a ministerial advisory committee that includes everyone—the voluntary groups, the financial services industry and those who regulate it, and government departments—that can keep on top of these things. As major problems are identified, the committee can report to the Minister on them. As I say, it is not a vote of no confidence in the Department of Health. Indeed, I hope that the department will welcome the proposal because it has shown itself to be willing to talk openly throughout this progress of this Bill. The Minister used a good phrase to describe it when discussing the regulations earlier—co-production. We will need co-production as much after the Bill and the regulations have gone through as before. An advisory committee would provide that.
Lord Hunt of Kings Heath (Lab)
My Lords, I welcome the noble Earl’s amendments. As we start another day on Report I should declare my interests as chair of a foundation trust, as a consultant trainer with Cumberlege Connections, and as president of GS1. The noble Earl said that the first group of amendments is designed to give more flexibility to local authorities so that they can make a contribution to a person who might normally be affected by the means test. That is entirely reasonable, but I wonder if he could tell us a little more about the consultation timetable from which this has clearly flowed.
I have also noted the amendments that will allow the local authority to charge the cost of care to those people who refuse to undergo a financial assessment. Again, this seems reasonable, but given the difficult circumstances in which that scenario might arise, does the noble Earl not consider that that lends support to those noble Lords who think that there ought to be appeals systems in place? When we come to appeals, I wonder whether the noble Earl might be a little more sympathetic to those amendments.
I want to lend my support to my noble friend Lord Lipsey in relation to top-ups. He argued persuasively in Committee to allow self-funders to top up if they reach the cap but wish to remain resident within a care setting where the costs are higher than the local authority is paying. That is a strong argument, and I, too, welcome the progress that has been made. However, like my noble friend, I hope that the noble Earl will be able to give us a further report on progress on this matter.
I come now to my Amendment 56, which has been very effectively trailed by my noble friend; in fact, it is difficult for me to do as much justice to the amendment as he has done. It requires the establishment of an independent ministerial advisory committee to keep under review the workings of the cap and the means-testing arrangements set out in Clause 17. It is fair to say that all noble Lords who have debated this Bill have welcomed its general intent and the principles that underpin it. The Dilnot commission marked a significant step forward in creating consensus on how people are to be protected from financial catastrophe if they have to fund their own care. We have debated in detail the Government’s response as set out in this Bill: the establishment and operation of the cap, the level of the cap, the continued financial risk to self-funders, the deferred payment scheme, the capacity of local authorities to accept the responsibilities being placed on them, and in particular, I would identify the responsibility for assessing thousands of self-funders who will come into contact with the local authority for the first time. We have discussed the advice to be made available to vulnerable people in a complex area and its interrelationship with the eligibility criteria.
No one, in welcoming the general thrust of the Bill, will believe that this is the last word. I am sure that the operation of the care packages set out in this Bill will need to be kept under frequent review by the Government and particularly by the noble Earl’s department. Oversight of the system would surely benefit from a bipartisan group of people from whom the Government could continue to take advice. My noble friend Lord Lipsey has gone back many years in relation to the debates in this area. Of course, he served on the 1999 Sutherland royal commission. In parallel we have had the Turner commission on pensions and we have seen the benefit of a bipartisan approach in relation to Dilnot.
We would all agree that the funding of long-term care requires stability as far as possible and, even more importantly, a long-term political consensus. As my noble friend Lord Lipsey said, this is a very complex, complicated set of arrangements. We would be best served by the establishment of an independent group that could advise Ministers on how the system was working and enable politicians from all sides to benefit from serious, impartial advice.
I know that the noble Earl has yet to be persuaded of the benefits of an advisory committee, but it would be an effective way to build on the consensus that I think has been created. I hope that even at this late stage, he might be sympathetic.
Lord Warner (Lab)
My Lords, as the self-appointed keeper to this House of the Dilnot tablets, I support Amendments 55 and 56, spoken to so ably by my two noble friends. Turning to Amendment 55, in framing our recommendations in our report, it was never our intention to impose a new set of rigidities in place of the old set of rigidities. It is important that the new system retains as much flexibility as possible. It is worth thinking about what lies behind much of the argumentation in our report and the new architecture that that report proposes. It is all about people, in as fair, orderly and manageable a way as possible, making contributions from their own resources to the rising costs of adult social care as we cope with, live with and adapt to an ageing population. Given the messiness of the present arrangements for top-ups, it would be perverse not to create the maximum flexibility for people to top up, particularly where these top-ups relate to their ability to stay in a home where they and their family have been very comfortable with the arrangements. Preventing such top-ups would be a truly perverse way of implementing the Dilnot architecture. We need a more flexible way of coping with this. Therefore I support my noble friend Lord Lipsey’s set of amendments.
On Amendment 56, my noble friend has a very strong point. I say this as someone who spent 10 years wrestling with means tests as a senior civil servant coping with social security. In those 10 years, numerous were the times when we had to cope with unforeseen consequences of what we thought were well designed social policy changes, but which turned out not quite to work when subjected to the scrutiny of the real world across a large population. I congratulate the Government on taking our report and turning it into a largely workable—we have a few doubts, but largely workable—set of arrangements that can be brought into operation quickly. However it would be very optimistic to think that there would be no unforeseen consequences—wrinkles, if I may use the word—which needed to be looked at, in particular in the areas of means-testing and the working of the cap. I emphasise that this is not a job application from the Dilnot commission to make, like Frank Sinatra, another return appearance, but we do need some kind of credible, independent body to take a look at this.
I would just gently remind the noble Earl that, at the end of our report, on page 69, we talked about some of these potential wrinkles, including the potential further changes in and around means-testing, which we did not have time to wrestle with but which we just flagged up for the Government. I will go not into the details but just the headlines. Under “Consistent treatment of housing assets”, we noted the way they are treated differently across the social care means test in terms of domiciliary and residential care—they are not treated on the same basis. There is also the issue of whether the means-test taper actually disincentivises savings and the issue of consistency between the way people in residential and nursing care, where it is not continuing care, have to meet general living costs but do not have to meet them where it is continuing care. We know that there are already some potential anomalies in the way that the new architecture will interact with some of those areas. We flagged that up in the report.
My noble friend has argued for some kind of independent advisory committee. He may not altogether thank me for raising some of these potential further changes but they are issues that have to be wrestled with. The new set of arrangements will throw up their own issues, which will also have to be wrestled with. Some kind of independent advisory committee, looking at the way in which the new scheme has worked and has bedded down, particularly in the area of the means test, would be a valuable contribution. I do not think it is a partisan issue. It would be welcomed across the parties and I hope that the Minister can look a bit more favourably on my noble friend’s amendment.
Baroness Greengross (CB)
My Lords, first, I add my voice in support of Amendment 55, in the name of the noble Lord, Lord Lipsey. We have not fully taken into account the impact that the Bill will have, when it becomes an Act and is brought into being, on the many people who are now in care homes and where the funding of those homes will suddenly become much more public. Everybody will report to the local authority to get on the meter and the extent of people’s self-funding will become better known. There will be a sort of explosion if we do not get this right and do not allow people to make top-ups. What are we going to do: assume that some of these people will be moved from the care home that they are in and where they are, we hope, happy to another care home because there is inflexibility with the top-up system? That would be really cruel and I hope that we can get as much flexibility and remove as many restrictions on people as we can.
Several cases have been brought to my attention of people who are already in a care home running out of money. They, or their relatives, cannot afford the whole amount but want to be able to top up the local authority amount, which, at the moment, nobody is fully aware of. As this is all going to become much more public knowledge, it is important to have as much flexibility as possible. I hope the Minister will have another look at this.
Earl Howe
My Lords, first, I turn to Amendment 55, in the name of the noble Lord, Lord Lipsey, which concerns the circumstances in which people wish to top up their own fees to pay for more expensive accommodation. To begin with, and for the avoidance of any doubt, I will emphasise that I agree that people should be able to choose to spend their own money on more expensive care, provided it is affordable. Like the noble Lord, Lord Lipsey, I want people to be able to choose to live in more expensive accommodation and gain from a cap on care costs, so that they pay part of the cost of care from their own savings and still receive local authority support.
Through the consultation and stakeholder engagement, we are seeking to better understand the impact of relaxing the rules on self-top-ups and to determine what protections may be needed for vulnerable people.
The answer to the question posed by the noble Lord, Lord Hunt, is that consultation will close on 25 October. The Minister of State for Care and Support and departmental officials have, over the past quarter, attended a variety of events covering the care and support sector, local authorities and financial services providers. These have been broadly supportive of the principle that people should be able to contribute towards their care costs from their own assets. Stakeholders have also recognised that people need to make decisions which are financially sustainable for the long term, and that financial information and advice need to play an important role in achieving this. We will be able to provide a more comprehensive overview of the views expressed in our response to the consultation in the new year. I repeat that we are on the noble Lord’s side. Our only concern is to ensure that when we relax the rules, there are sufficient protections, both for the individual and for the local authority.
Amendment 56 concerns review of the operation of the capped-cost system. I am sure we can all agree unhesitatingly that these reforms need to be implemented effectively to deliver the outcomes we are striving for. The capped-cost system will provide peace of mind and protection against catastrophic costs and will target most help at those with the greatest need. I am confident that we can further agree that to deliver these benefits, we need good oversight. Therefore, I am with the noble Lords opposite in spirit. To that end, we will be reviewing and assuring both implementation and funding, and have committed to reviewing the core elements of the capped-costs system within each five-year period. We will also conduct post-legislative scrutiny, as the Government have committed to do across the board for all new Acts. The agreement we have with the Liaison Committee in the other place is that this should be done between three and five years after Royal Assent.
Furthermore, we have established the Joint Implementation and Programme Board with the Local Government Association and the Association of Directors of Adult Social Services. We will use this to work with local government on continuing assurance and improvement of the arrangements. We are confident that, in their totality, these arrangements provide generous opportunity for assurance and review to ensure that the reforms remain true to our vision.
For that reason, I do not believe it would be necessary or desirable to supplement these arrangements with a further review by additional oversight bodies, such as an independent ministerial advisory committee. Such additional oversight would cut across the scrutiny conducted by the Health Select Committee and cross-government planning on spending through spending rounds. I am sure that noble Lords opposite will not be totally satisfied with that, but I hope that they will be sufficiently reassured by the confirmation I have given that we will conduct a proper review of the operation and funding of these reforms through several channels. I hope that they will agree that this amendment is, therefore, unnecessary.
Lord Mackay of Clashfern
Before the Minister sits down, is he satisfied that, without the amendment of the noble Lord, Lord Lipsey, there is sufficient flexibility under the system as it is presently provided to allow for the sort of difficulties that are envisaged as possibly coming out after the consultation?
Earl Howe
I can reassure my noble and learned friend that, if we look at the arrangements we are proposing in combination, there will be sufficient mechanisms in place to take account of any unexpected wrinkles that emerge of the kind that the noble Lord, Lord Lipsey, perfectly reasonably anticipates; and to react and respond to those difficulties as appropriate. The answer, in a nutshell, is yes.
“( ) Regulations under subsection (7) may make provision as to cases or circumstances in which an adult is to be treated as having income that would, or as having income that would not, fall below the amount specified in the regulations if a charge were to be made.”
“( ) The regulations may make provision as to cases or circumstances in which a local authority is to be treated as—
(a) having carried out a financial assessment in an adult’s case, and(b) being satisfied on that basis that the adult’s financial resources exceed, or that they do not exceed, the financial limit.”
“( ) A local authority may meet an adult’s needs under subsection (3) where, for example, the adult is terminally ill (within the meaning given in section 82(4) of the Welfare Reform Act 2012).”
Earl Howe
My Lords, I assure the House that the Government are in agreement with the intentions behind the amendment tabled by the noble Lords, Lord Warner and Lord Patel. We are working hard to deliver our shared objective of improving care for people approaching the end of their lives. It is in that context that I shall move government Amendment 57.
On the issue of treating the assessment of terminally ill people as urgent, I fully recognise noble Lords’ concerns. With that in view, I have tabled an amendment to make it explicit that the end of life is an example of when local authorities may treat cases as urgent. We do not believe that it would be right to require local authorities to treat all cases in this way—circumstances have to dictate the approach taken—but we agree that clarity around end-of-life cases as examples of urgent situations for the purposes of Clause 19 may provide a useful indication to improve practice. I shall not anticipate noble Lords’ remarks in support of their amendments, so at this stage I beg to move.
Lord Warner
My Lords, while I welcome Amendment 57, I want to set out the case for the Minister going a good deal further. Amendment 137 follows the discussion in Committee of amendments proposed by the noble Lord, Lord Patel, and myself. We have come back with an alternative amendment, which has also been signed by the noble Baroness, Lady Greengross. We have done this in consultation with voluntary organisations over the summer, and the wording of Amendment 137 reflects those discussions. To summarise, the amendment would enable the Secretary of State, after discussion, to make regulations that did three things: first, allow people to have their preference for place of death recorded by local health and social care services and for that preference to be implemented wherever practicable; secondly, have their care and support needs and those of carers treated as urgent in assessing needs—and we think, reasonably, that Amendment 57 deals with that; and, thirdly, exempt terminally ill patients from adult social care charges.
Since Committee the Government have brought forward Amendment 57 and, as I have said, I think that it meets many of our concerns about urgent assessment at the end of life. It has certainly had the effect of diluting enthusiasm in some parts of the voluntary sector for a more wide-ranging amendment on end-of-life choice, and I slightly backhandedly congratulate the Minister and his civil servants on achieving that. However, I would still like to have another go at trying to convince the Government, and possibly some members of my own Front Bench, that we should be a bit more ambitious.
Around half a million people die each year in England, about two-thirds of them over the age of 75. A century ago most of us would have died in our own homes. Today, most will die in hospital. The latest figures show that in April 2012, about 42% of people died at home or in a care home. This is an improvement from 38% four years previously, but on present trends it will be at least the end of this decade before half of deaths occur in the place of usual residence. These figures of improvement at the national level, however, conceal considerable regional and local variations.
If you live in the south-west, with 48% of deaths occurring in the place of usual residence, you have more choice than those of us living in London, where the percentage drops to 35%. Of course, as a Londoner I think there are many benefits of living in London, but choosing where I die is not likely to be one of them. There is an even wider variation between local authority areas. The great majority of us want to die at home or the place we normally live rather than, I suggest, the hectic and somewhat impersonal environment of an acute hospital ward. Perversely, we end up not only dying not only in the place where we least want to be but also in the most expensive place.
Marie Curie research has shown that a week of palliative care in the community costs about £1,000 a week, whereas a week of hospital in-patient specialist palliative care costs virtually £3,000 a week. The National End of Life Care Programme shows an estimated potential net saving of £958 per person if you die in the community rather than in hospital. Polling for Macmillan has shown that eight out of 10 health and social care professionals agree that community-based end-of-life care would save money. On top of this, nine out of 10 MPs think their constituents should have the choice to die at home. What is not to like about the first prong of Amendment 137?
I am not trying to dragoon people into dying outside hospital to save money. I want people to have as good and dignified a death as possible, with their friends and families around them. That is more likely to be achieved if they have a right to register their preference for dying at home or their place of normal residence. This would mean fewer people dying in hospital and it would also reduce pressure on A&E departments and acute hospital beds. I suggest that this is a not inconsiderable benefit—as Sir Humphrey would have said—in terms of the cost savings that could arise from allowing people to express their preferences on their right to die at home.
I accept that at this point it may be rushing our fences a bit to pay for exempting terminally-ill patients from local authority care charges. We need some detailed costings and possibly—I suspect the Minister will say this—we need to wait to hear what comes out of the pilot schemes in this area. However, we would also welcome having more information from the Minister on the progress being made in those pilots.
Accepting the first part of Amendment 137 would lay down a clear marker that Parliament wants government to move in the direction that most people want: which is the right to choose to die at home or their place of normal residence wherever practicable. This amendment gives the Government plenty of time to consult on all the detailed arrangements. It does not require those regulations to be made by any particular time and it gives the Government a lot of freedom about what the nature of those regulations might be. We should not miss the chance of this Bill being before Parliament to move in this area and put this change on the statute book. I hope the Minister will respond favourably and be prepared to entertain at Third Reading an amendment of the kind set out in the first prong of Amendment 137. I would certainly be happy—as I am sure my colleagues would—to discuss this further with him.
Baroness Greengross (CB)
I support the comments made by the noble Lord, Lord Warner, about this amendment. We know that the things people say they dread as their final days approach are loss of dignity and loss of respect, and we hear far too much about poor care at the end of life. Very often, it is poor care because people are not in the place they would like to be. We also know that the number of carers identified and signposted by the NHS to the enhanced support is not widely known. We know that much more needs to be done to draw together all the various approaches—I am involved in one of those approaches at the moment, looking with a group of experts at how to improve end-of-life care with doctors, professionals in end-of-life care and lawyers who deal with patients’ wishes. There is still a lot be looked at and brought together, and this Bill gives us a good chance of getting this right, or at least much nearer to being right than it is at the moment.
As the noble Lord, Lord Warner, mentioned, the coalition of charities has also suggested that end-of-life care should be free at the point of delivery. I know that this requires much more consideration—the noble Lord talked about that. I want to concentrate on hoping that this will be considered and that services to dying people and possible loss of dignity and respect will get a far higher profile as things that need urgent attention. Terminally ill people should have their preferred place of death recorded by local health and social care services. That preference needs to be implemented wherever it is practical. People must have their care and support needs and those of their carers treated as urgent by the local authority responsible for assessing those needs.
For people who are dying, every day is precious. They cannot wait while the bureaucratic wheels grind slowly along, and not always in their favour. I support the amendment tabled by the noble Lord, Lord Warner.
Lord Patel (CB)
My Lords, I spoke about this issue when we debated the gracious Speech, at Second Reading and in Committee, when I supported the amendment put forward by the noble Lord, Lord Warner, and today I support Amendment 137. Every time we have debated this, the Minister has been sympathetic to the idea of providing free social care to those who are dying. When I think about this amendment, I think of a patient who has just been told of a diagnosis of terminal cancer, that their life will now last a few months at the most, and that medicine cannot offer much more than perhaps palliative care or treatment of some kind. Once the patient and the family have recovered from the shock, their immediate thoughts are, “Can I cope with my life—which will now be very short—at home, and what support can I get?”.
Currently, the means test for free social care can represent a barrier for those who wish to die at home. It makes it unaffordable for some, but it also means that the person may be passed between the local authority and the NHS while the two systems decide who is eligible for care and whether it should be free or means-tested. Government Amendment 57 is a demonstration of the Minister’s clear intention. He wishes to see this happen, and I thank him for moving this amendment, but it does not go far enough to achieve what I think he, too, wishes to achieve.
The second subsection in the new clause proposed by Amendment 137 is addressed, at least in part, by government Amendment 57. However, Amendment 57 does not introduce any new duties for local authorities. It highlights the existing ability of local authorities to regard the care and support needs of people at the end of life as urgent. In contrast, Amendment 137 allows the Government to introduce secondary legislation to require local authorities to regard the assessment of needs at the end of life as urgent. If the intention of the government amendment is to do that, is it clear enough? The final part of Amendment 137 relates to free social care at the end of life. Research suggests that the introduction of free social care at the end of life has broad-based support. I believe this will help to prevent expensive, unnecessary hospital admissions, prevent burdensome financial assessment during a difficult time and is an important part of giving people genuine choice at the end of life.
Baroness Finlay of Llandaff (CB)
My Lords, I declare all my interests in this field, which are listed. These amendments are incredibly important for patients who are dying. The Government’s amendment is to be welcomed; I can see no problems with it. It might sound bizarre but I have some slight anxieties over the wording in two places in Amendment 137. It refers to a preferred place of death, whereas I would rather see the words, “preferred place of care”. Many people who are dying know that they want to spend their last days, weeks or months at home. They want to have everything done to support them at home, particularly out of hours. We have debated this for some time within my own specialist teams and specialist services. We are worried that there could be two unintended consequences. People who are not yet ready to confront the fact that they really are dying will be pushed to have that conversation before they are ready, which would be traumatic. There could also be the unintended consequence of some kind of target developing and patients being whipped out of one place of care.
The difficulty we see clinically is that when clinical situations change, patients sometimes change their mind. It is not uncommon for someone who originally said they wanted to die at home to say, when they really are dying, that they feel safer where they are and want their family brought in and as much of a home environment created as possible. It may be the regulations at ward level, or the way in which they are interpreted, which are blocking that and need to be addressed. For example, it does not matter at all if you have a husband on an all-female ward, but I have occasionally known staff to think that it does and that it is not appropriate to have a man stay overnight, which is absolutely appalling. Staff need to recreate the home environment where that person is as much as possible. However, if they have complex needs or unstable symptoms, they may well feel safer in whichever place they are, whether it is hospice or hospital.
In looking at the amendment I also tried to get some details of how many patients are successful under the DS1500 special rules. It is quite difficult, because I understand that the Department for Work and Pensions does not routinely collect that data. However, it seems as if in the year 2011-12, 11% of all successful claims were for the category of patients who were deemed to be terminally ill. One of the difficulties when you are looking at local authority charges for adult social care is that we cannot predict prognosis. That is always the catch with defining terminal illness. We are making our best guess, as it says in the Welfare Reform Act, as to whether someone can “reasonably be expected” to die within six months, but it is no better than that. It is a guess. There are patients who outlive their prognosis. I understand that the DWP does not push for reassessment inside three years, so there is quite a lengthy period of leeway. The potential difficulty that I can see unless this is really thought through and costed is that if somebody turns out not to be dying, what will then happen? Would they be forced to go through a reassessment? Would that then be used to try to claim back money from them afterwards? I raise those questions which would have to be thought through very carefully.
I certainly find it difficult—in fact, offensive—when people have to be assessed for care when they are quite clearly dying. However, there is that group of people you really do not know about. They appear as if they are dying. They tend to be more in the non-cancer rather than the cancer population, where their prognosis prediction becomes really difficult.
Those are just some caveats, although I support the spirit of the amendment wholeheartedly in terms of having patients where they want to be. However, as I said before, we need to focus on their place of care during their last days, weeks and months, and not only on their place of death.
Lord Mackay of Clashfern
My Lords, I very much welcome government Amendment 57. Of course, I have supported the recommendation of the Joint Committee on this matter, and continue to do so. Subsection (a) of Amendment 137 is important as a way forward. However, the difficulties to which the noble Baroness, Lady Finlay, has referred, are quite important in this connection. Many people in terminal situations would find a hospice one of the best places to go if that choice were open to them. Many people, of course, would prefer to die at home in a family situation. The hospices are normally able to engender a family atmosphere around death. People I have spoken to in the hospices have said, “If you have to die, this is the place to do so”; the “if” is not all that important.
There are practical questions to be taken into account, but it would be quite a step forward if the Government were able to come forward at Third Reading with an amendment which allowed some form of indication of the place of care, as the noble Baroness, Lady Finlay, says, or the place where one would wish to terminate one’s life in a way that was registered, so that those responsible would be able to give effect to it, so far as is possible, having regard to the changes that can take place in the last few months, days and hours.
Baroness Wheeler
My Lords, we welcome another opportunity to consider the very important issue of how people are cared for at the end of their life. The Joint Committee on the Bill urged progress on this vital matter and strongly endorsed the case for the introduction at the earliest opportunity of free social care for terminally ill people. In this context, the Government’s amendment is very much work in progress as it makes explicit the local authority’s power to treat end-of-life care as urgent, in a similar way to how fast-tracked access to welfare benefits such as the disabled living allowance is expedited and works in practice under other legislation, which the noble Baroness, Lady Finlay referred to. The amendment makes it clear that local authorities have the ability to consider the needs of terminally ill people as urgent and to meet their needs ahead of conducting assessments.
We welcome this provision. Many councils already fast track social care in this way, and I hope that this amendment will give those councils that do not the push and impetus that they need to take up this very self-evident and fundamental requirement. The new clause in the Bill is rightly welcomed by the Sue Ryder Foundation, Help the Hospices and Macmillan Cancer Support. However, as Macmillan also points out, the provision is permissive and does not legally require local authorities to meet a terminally ill person’s need for care and support without a needs or financial assessment.
We recognise that there is still much work to be done on this matter. The Government are currently undertaking a review and refocus of the end-of-life strategy and I read in the press over the summer that it was shortly to be published. It is now six years since the strategy was introduced under Labour so I would be grateful if the Minister could update the House on the timetable for that.
As we recognised during the debate in Committee, the results of the seven adult and one children’s palliative care pilots will be crucial to considering the move towards the provision of free end-of-life care as called for by the Joint Committee and as set out in Amendment 137 in the name of my noble friend Lord Warner, supported by the noble Baroness, Lady Greengross, and the noble Lord, Lord Patel. We need to understand current patterns and resource use across health and social care at the end of life, and to have the vital data—from across care provided by the NHS, social care, and the voluntary and private sectors—from which the costs of an integrated end-of-life care system can be properly assessed. The Minister reassured the House that the pilots are on track, despite the handover of responsibility to NHS England and concerns that the work was falling behind. We certainly hope that this is the case as the pilot findings will be so important to how future services can be shaped and delivered.
We acknowledge and share the Government’s concerns about the issues raised in Amendment 137 that the infrastructure may not be in place to support people’s preferences about where they wish to die; commissioners need to be sure that the right services are in place in the community to support people being looked after in their home. My own party is currently working on this as part of our policy review and whole-person care commission, and I know that my noble friend Lord Warner’s contribution to that work will be much appreciated and valued. Enabling NHS patients to have the right to die in the place they regard as home or their normal residence can be achieved only if end-of-life care is fully integrated across the NHS, local councils and hospices, to foster mechanisms to make it achievable and not simply an aspiration.
Once again, the position of carers of people who are terminally ill, as well as those they are caring for, needs to remain to the fore when we are looking at this matter. In Committee my noble friend Lady Pitkeathley cited the Carers UK survey that showed just how much more support is needed for carers to help them think and plan for the end of life of the person they are caring for—something that we can and should be taking action on now. Many carers just do not know how to plan for the death of a loved one and how to try to look ahead when caring ends—returning to or taking up work, social contact and managing financially.
One of our bereaved carers I spoke to recently through our local Carer Support Elmbridge had had a nightmare experience over funding and not being able to ascertain who was paying for what in the transition from social care to NHS continuing care before her husband died. This included two months’ overpayment by social services, which had to be sorted out after the death, at a time of great anxiety about family finances. To add to this, an ambulance turned up two months after her husband’s death to take him to his routine blood test at the local hospital. Your Lordships can imagine how devastating this experience was for the carer. Sadly, this is not an isolated case, and an integrated end-of-life strategy has to make sure that these things do not happen.
Finally, in Committee I raised the issue of access to palliative care and end-of-life care for BME groups following the recent and alarming findings of the Marie Curie Cancer Care and Public Health England survey and the shockingly low use of these services among black, Asian and ethnic minority groups. The report identified major problems involving lack of knowledge about services, misunderstanding, mistrust and a lack of cultural sensitivity on the part of providers. In his August letter to noble Lords, the Minister referred to the work that NHS England is undertaking on this in conjunction with palliative care pilots. Will the Government be responding specifically to the Public Health England report, or is it part of the strategy review and refocus? Will the Minister set out for the House the Government’s outline timetable for the review and publication consultation, the timing of the publication of the pilot’s results, as requested by my noble friend Lord Warner, and the introduction of the new funding system for palliative care as promised for 2015?
Earl Howe
My Lords, I am grateful to noble Lords for expressing their views on this important subject so eloquently. As I said in Committee, I support the intentions behind the amendment tabled by the noble Lords, Lord Warner and Lord Patel. In looking at the amendment, the first essential question is whether we need to take legal powers in this Bill to fulfil those objectives.
I want to assure noble Lords that we already have the necessary legal powers to implement both choice in end-of-life care and a new palliative care funding system. In relation to choice, there is already a power in Section 6E of the National Health Service Act 2006 to make regulations, or standing rules, to require NHS England and clinical commissioning groups to make arrangements for patient choice in respect of specified treatments or services. We would use these powers to implement a choice offer in end-of-life care.
As noble Lords know, making the changes to the system required to offer real choice, which includes enhancements in community palliative care services, will not be straightforward. Not least of the issues is the cost of making these changes. I agree with noble Lords that there is the potential for savings to be made in moving these services out of hospitals and into the community. However, one of the most comprehensive studies in this area, the Cochrane review, found that while there were small but significant improvements from community-based palliative care, the evidence for its cost-effectiveness was inconclusive.
We must also guard against the danger of making changes too quickly, and I am thinking of a particular danger. It would be in no one’s interests if the upfront investment required to enhance community services came at the expense of existing services. That is why the Department of Health and NHS England will be working together, and with organisations from across the end-of-life and palliative care sector, on a review of the timescale for introducing this choice offer at a time that will be right for patients and for those in the NHS working in this vital area. We have to ensure that when a choice offer is introduced, it will be a real choice backed by a system that is able to deliver it.
On palliative care funding, as I stated earlier, the Government’s position remains that there is much merit in providing free health and social care in a fully integrated service at the end of life. One of the key conclusions of the Palliative Care Funding Review was:
“There is a stunning lack of good data surrounding costs for palliative care in England”.
We responded to that by establishing eight palliative care funding pilots, involving more than 80 organisations. The noble Lord, Lord Patel, asked me whether those pilots were essentially big enough to produce meaningful results. The palliative care pilots cover 80 organisations in those eight areas and we are confident that they will give us sufficient evidence to design a new palliative care funding system. We need to be absolutely sure that the evidence being gathered by the pilots, which are running for two years, until 2014, is thoroughly analysed and a complete picture is available to both the department and NHS England before the details of the new funding system are finalised. To answer the noble Lord, Lord Patel, yes, we are acutely aware of the benefits of introducing a new system in this important area.
The noble Baroness, Lady Wheeler, asked about the pilots. The Public Health England review that is taking place welcomed the work that is going on. NHS England is also looking at this, in conjunction with its review of the end-of-life strategy. As regards the timetable for that, NHS England is working to publish early in the new year. Supported by the data from the pilots, we aim to have a new funding system in place by 2015, a year sooner than the review proposed. Similar to any new policies on choice in end-of-life care, this can also be introduced through secondary legislation. In this case, Clause 14(6) of the Bill provides powers to make regulations that prohibit local authorities from making charges in specific cases.
I hope I have convinced noble Lords that I am very much behind their laudable aims in tabling this amendment and I completely understand their desire for us to do the right thing. I am grateful for the opportunity to set out on the Floor of the House the Government’s commitment to delivering solutions in relation to end-of-life care. But I hope I have also persuaded noble Lords that decisions on end-of-life care funding and on choice of place of death cannot be taken lightly or inadvisedly, and that we must first take account of the evidence and implications.
I am doubtful that I will be able to say anything further on these subjects at Third Reading beyond what I have said today, but I would of course be more than happy to meet with the noble Lords, Lord Warner and Lord Patel, and other noble Lords, after Report to explore the practicalities around all these issues, and indeed some of the very pertinent issues raised by the noble Baroness, Lady Finlay. I hope that for now noble Lords are assured that our plans for quality and choice in end-of-life care will deliver improvements, and that they feel sufficiently assured to withdraw their amendment.
Lord Warner
I thought I had a right to respond to the noble Earl on Amendment 137.
The Deputy Chairman of Committees (Lord Colwyn) (Con)
It was the noble Earl’s amendment. Can we go back to it? We cannot.
Clause 20: Duty and power to meet a carer’s needs for support
“(3) Where a local authority is not going to meet an adult’s needs for care and support, it must nonetheless prepare an independent personal budget for the adult (see section 28) if—
(a) the needs meet the eligibility criteria, (b) at least some of the needs are not being met by a carer, and(c) the adult is ordinarily resident in the authority’s area or is present in its area but of no settled residence.”
“(11) A local authority may combine a care and support plan or a support plan with a plan (whether or not prepared by it and whether or not under this Part) relating to another person only if the adult for whom the care and support plan or the support plan is being prepared agrees and—
(a) where the combination would include a plan prepared for another adult, that other adult agrees;(b) where the combination would include a plan prepared for a child (including a young carer), the consent condition is met in relation to the child.(11A) The consent condition is met in relation to a child if—
(a) the child has capacity or is competent to agree to the plans being combined and does so agree, or(b) the child lacks capacity or is not competent so to agree but the local authority is satisfied that the combining the plans would be in the child’s best interests.”
Lord Lipsey
“( ) Regulations under this section must provide that—
(a) a local authority shall direct anyone considering a deferred payment arrangement to an appropriately qualified financial adviser or to appropriately qualified financial advisers; and(b) any loan under this scheme shall be sufficient to pay for advice under paragraph (a) above.
Lord Lipsey
My Lords, am I speaking at the right time on the right subject?
Lord Lipsey
That is a great relief to me. I will come to the narrow-ish point in the amendments shortly but I want to put them in context.
One of the reasons why advice is absolutely crucial in the deferred payments scheme is that this is one of the least understood and least explored facets of the Bill. I will come on to one or two aspects of that. In a way, it makes it hard to make the case for the importance of advice, because so many things on which advice will be needed have not yet seen the light of day. In Committee I referred to some of the unresolved issues that have been raised by Partnership, the Equity Release Council and others. They will emerge, and this will make it clearer why advice is needed.
I will first put the issue in the following context, to show how unexplored it is. If the noble Earl, Lord Howe, will forgive me, I will correct something that he said in Committee. He said that 40,000 people each year have to sell their house to pay for care. I think that the noble Earl mis-spoke and that he meant to say, “up to 40,000”. That is the explanation that has come to me of what he said. I make no complaint; it is hard when one’s words are examined in such terrible detail.
I have spent a surprising—perhaps wasted—amount of my time trying to trace the figure that 40,000 people each year are forced to sell their home to pay for care. I have been doing it ever since I sat on the royal commission 15 years ago. When we were sitting on the royal commission, we eventually found a very dodgy piece of research, now more than 20 years old, which kind of concluded that the number might be about 40,000. Of course, what happened was not that the piece of research was examined and found to be accurate but that the figure got into the Daily Mail cuttings library, so that every time that paper campaigned against people having to sell their house to pay for care—I praise it for this—the figure was repeated, until it became accepted throughout the world as the number involved.
Having spent all these years studying the subject, I am very tempted to go into greater detail, but I do not think that the House would thank me for it. However, I refer any noble Lord who might be interested to the Full Fact website. It is a fact-checking organisation, of which I am a director, which goes into the matter in minute but very clear detail, and points out that the Government’s claim is based on exploratory research that is almost 20 years out of date.
More importantly, the 40,000 figure is used as if it were the number of people who are forced to sell their house. “Forced” is a funny word in this context. For most people who go into a home, selling their house is the sensible thing to do to fund the cost of care. You do not want to leave the house empty; that benefits nobody. It does not provide housing for anybody; the house starts to crumble and is worth less to you and your family, so you had best sell it and get something that is more suitable. However, the deferred payment scheme is so important because there are people for whom that is not true. For example, some people want their families to live in their house and therefore cannot get cash for it. That is why we have a deferred payment scheme. “Forced” suggests that this is something dreadful in all cases, when in fact it is dreadful in some cases. It is absolutely right, as I said before, that we have such a scheme for some cases but not for all cases.
I now come to another severe complication, and I am afraid that I will have to resort to the vernacular in order to make clear to the House what has happened. The original scheme put forward by Dilnot has had its balls cut off by the Government in the consultation document. That is not too strong a way of putting it, and I will explain why. Yes, every council will offer a scheme, but there is now a huge restriction that will mean that very few people will take advantage of the deferred payment scheme. It would not in any case have been 40,000, but now I think that it will be nearly nil. Why is that? The consultation paper makes it clear, in paragraph 150 on page 44, that you are eligible for a deferred payment loan only if your other assets in total come to less than £23,250. If you have more than that, you have to spend down until you have £23,250 left in the bank or wherever it is, and then you can consider a deferred payment scheme. However, most people who have reasonably valuable houses, who are the people most likely to want to adopt this measure, will have far more than £23,250 worth of other assets. Most of them will not feel the least bit happy if they have to spend down until they have only £23,250 left in the bank before they can get any help from the deferred payment scheme. That hardly pays for a daily delivery of the Racing Post for the rest of their lives, their nightly gin and tonic or more important things such as the literature they want to read or all the things that make their life fuller. For those people, a deferred payment scheme is simply not available.
Lord Hunt of Kings Heath
My Lords, this is an important subject. Clause 34 provides for deferred payment agreements and loans. In such an agreement,
“the charges or loan advanced is repaid by the adult or from their estate at a later specified date, or on the happening of a specified event, such as the sale of property. The debt is normally secured against the person’s property to ensure repayment”.
I say at once that we welcome the support to be given to such a scheme. However, I hope that the noble Earl will be able to respond to my noble friend on the point that he raised. His essential argument is that the scheme as originally recommended has been severely restricted, as indicated in paragraph 150 of the consultation, whereby a person is eligible only if other assets are less than the £23,250 limit. Can the noble Earl confirm that figure? If so, can he estimate for the House how many people he thinks are likely to want to use the scheme? The 40,000 figure seems even more mythical if people’s other assets have to be reduced to such a level. We need to clear up that important point either today or, if the Minister is unable to do so, perhaps on Third Reading.
I wish to speak now to my Amendment 63. One worry which we discussed in Committee concerns how local authorities are to run these schemes, and that worry remains. My noble friend Lord Lipsey spoke in Committee of his concerns about the creation of administrative difficulties for local authorities because each local authority would have to design and implement its own scheme. There would be a risk not only that the amount of energy which each authority had to expend would be extremely wasteful but that some very poor quality schemes could be developed. My noble friend Lord Warner, when discussing the balance of arguments between a national scheme or local schemes, said:
“The worst of all worlds would be not to take hold of this issue and leave it to a marketplace of 152 different bodies”—
in other words, local authorities—
“without much guidance or assistance with compatibility of IT and issues of that kind”.—[Official Report, 22/7/13; col. 1065.]
In Committee the noble Earl seemed a bit reluctant to accept the need for national direction in this area. The fact is that only a minority of local authorities currently operate deferred payment schemes. The local authorities’ responsibilities that we have discussed in relation to the Bill are many and extensive, and I shall not go through the list again. There is no doubt whatever that there are worries about whether local authorities really have the capacity to implement the legislation as noble Lords require. Instead of these 152 local authorities having all to develop their own deferred payment schemes, surely there is a persuasive case for a model scheme to be drawn up based on the experience of local authorities which are already operating a scheme but which are in a minority at the moment.
I have little doubt that a model scheme would save money by reducing the work that an individual local authority would have to do. The scheme would be informed by best practice and individual decisions would still be left to individual local authorities because they would be given a model scheme to which they could make adjustments. I should have thought that that would help ensure that the use of deferred payments would be developed and expanded as effectively as possible. I very much hope that the noble Earl will be able to agree to this amendment.
Lord Warner
My Lords, I rise again as the keeper of the Dilnot tablets on the subject of deferred payments. If we had intended that access to a deferred payment scheme was to be limited to people with assets of less than £23,000, we would have said so in our report. That was not what we intended. I commend the report to the noble Lord, and I hope the House will forgive me if I just cite a few bits of it.
I refer the noble Lord to page 41 of our report. We said:
“Evidence submitted to the Commission suggests that the availability and use of deferred payment schemes is patchy”,
and we went on to explain that. The government consultation document suggests that it will continue to be pretty patchy as well because very few people are likely to come forward for this. We said—and this was a recommendation:
“At a minimum, the Commission recommends an extension to the current deferred payment scheme so that it is a full, universal offer across the country.”
That is what we said.
The Government have given the impression in various interviews—I have gone head to head with government spokesmen about this on a number of programmes—that they were going to support an extended deferred payment scheme and that it would be pretty much similar across the country. If you had a deferred payment scheme in Cumberland, it would look remarkably like a deferred payment scheme in Cornwall. It seems that we are getting into a position where none of this will be the case. It is pretty rough on the public if the Government and their spokesmen are giving the impression that they are implementing the Dilnot recommendations on deferred payment schemes when they are palpably not doing so under the present set of proposals as I understand them.
It is not too late for the sinner to repent—the consultation period is open until later this month. However, it is necessary to revisit this in terms of what government policy is on this particular issue, both in terms of access to a deferred payment scheme and on the issue of a model scheme. The two go hand in hand. It is no good having a model scheme if it is a model scheme for a handful of cases in different parts of the country. We need a model scheme that is actually available so that people who want to cope with the issue of how they fund their care can access a deferred payment scheme. It is always a risk when you are on a committee such as the Dilnot committee that, quietly and unobtrusively, the bureaucracies will nibble away at well intentioned recommendations. Some of us have had this experience ourselves, and some of us have done a bit of nibbling as well from time to time as civil servants, so we recognise nibbling when it is going on. We are in that position here.
It is down to the Minister to start some discussions about this issue, not to leave things to the marketplace, and not to give the public impression that there is going to be a widely available deferred payments scheme when, in fact, it is going to be available only to a fairly limited number of people.
Lord Mackay of Clashfern
I do not understand why it is necessary to have any kind of limit in relation to this matter so long as there is sufficient security to allow the deferred payment to be feasible from the point of view of the Government. The proposition that the deferred payment scheme should be limited by the amount of assets a person has strikes me as rather unnecessary. So far as a model scheme is concerned, I would have thought that there is a lot to be said for having a form of document which is universal. There would of course be the possibility of different particular provisions relating to particular cases, but the central core of a deferred payment agreement could be put in a form of universal application.
Baroness Barker
My Lords, I rise only to ask a question. I agree with the noble Lords, Lord Warner and Lord Lipsey, that a deferred payment scheme was an important selling point for the Dilnot report. Even though very few local authorities are running such schemes at the moment, it is an important and live issue in the minds of older people and their families; it is one that they dwell on quite a lot. I want to ask the keeper of the Dilnot tablets—who is not a character from Harry Potter—whether the commission gave any consideration to setting a figure as outlined by the noble Lord, Lord Lipsey. Did it have a level of assets in mind that people should be able to exclude?
When the noble Lord, Lord Hunt, talks about a scheme, is it a model that would apply to individuals or is it really a model that would apply to local authorities and their ability to carry the costs of the Dilnot scheme in their area for a defined period of time? I can see what the noble Lord, Lord Hunt, is saying in terms of having a model, but I am slightly confused about it. Perhaps when the Minister comes to reply, in telling us about the Government’s thinking on all of this, he might address what to me appears to be the key underlying factor.
Lord Warner
My Lords, perhaps it would help the House if the character from Hogwarts actually explained what was going on in our minds when we made the recommendation. I shall quote a sentence from the report:
“In making this change, we believe it would be sensible for local authorities to be allowed to charge interest to recover their costs, to make the scheme cost neutral”.
We were not trying to second-guess how many applicants there would be, but it would be sensible to set up a scheme that worked in a way which did not actually cause a charge to be made on the Exchequer for the running of the scheme.
Earl Howe
My Lords, perhaps I may deal first with the initial point raised by the noble Lord, Lord Lipsey, about the figure that I quoted in Committee. He asked whether I had in fact meant to say that up to 40,000 people might have to sell their homes every year. The answer is that I should have said “up to 40,000”. I am afraid that there is a conscious element of vagueness in the figure because there is no one comprehensive source to provide information about what the precise figure actually is. We have arrived at a figure of up to 40,000 as the best estimate. I hope and believe that over the summer my officials provided the noble Lord with a breakdown on how we reached that figure and that he has found the information useful. The point of quoting the figure is that we believe that it is around the number of people who could benefit from the arrangements we are discussing. I apologise if I misled the Committee and the House in stating a figure that sounded precise when I should have been a little more circumspect.
The second issue raised by the noble Lord was about the deferred payment scheme and his perception that the Government have effectively emasculated it. I do not share that perception. There will be some circumstances in which local authorities must offer a deferred payment, and that is when the Bill specifies that the local authority would be under a duty to offer a deferred payment. We are consulting on the eligibility criteria for when people must be offered a deferred payment, which is where the figure of £23,250 is used. The Bill has an additional power for local authorities to offer deferred payments more widely, and we are seeking views on this through the consultation. My noble and learned friend Lord Mackay asked why we need limits at all. It is our policy intent that deferred payments will be available more widely and consistently than they currently are, which I think is what the Dilnot commission intended us to do. We need to ensure, however—
Lord Warner
Perhaps I may correct the noble Earl. We actually referred to a universal and standard scheme. We assumed that such a scheme would be wider, but we were looking for a standard scheme that would make this widely available. That is the part which is missing from the Government’s reassurances.
Earl Howe
I shall come on to the standard scheme proposal in a moment. We need to ensure that this arrangement is rolled out in a way that is financially sustainable for the local authority in each case. We will be supporting the implementation of the capped costs system and an extension of deferred payments with £335 million, which should enable this to happen.
I shall move on to the amendments themselves. I hope that the House will forgive me if I do not rehearse at length the same points that I made about financial advice last week, but I should like to take a moment to reassure the noble Lord, Lord Lipsey, on the specifics of his proposal. It is imperative that everyone has access to sound, reliable information and advice while making decisions about their care to ensure that any option they choose makes good financial sense for them and is sustainable in the long term. It is clear that local authorities have a central role to play in ensuring that their local populations are aware of the range of information and advice, both regulated and non-regulated, that is available to them and that they know how to access it. Last Wednesday, your Lordships accepted my Amendments 16 and 17 which clarify this. The noble Lord’s amendment would underscore the need to make sure that everyone who decides to take out a deferred payment agreement reaches that decision in a considered and informed manner. I agree that that should be the case. All too often, people do not plan ahead for the possibility of needing care and so can find themselves having to make important and lasting financial decisions in a moment of crisis.
Deferred payment agreements can be used to reduce some of this urgency and ought to be accessible to ensure that they provide the peace of mind that they are intended to. For this reason I would hesitate to make the process through which a person can access a deferred payment too onerous. We are currently consulting on the information and advice a person should receive before taking out a deferred payment agreement. We will listen carefully to what is said and we will use this to inform the approach that should be taken. I have already given the noble Lord my undertaking to discuss further what remaining differences we have about financial advice, if any, and I hope that those discussions will allow us to explain in more detail our policy intentions and what our own government amendments in this area aim to achieve. I hope that the noble Lord will agree that we are essentially of the same view about this and that he will be content to discuss the matter with me further outside the Chamber. That being so, I hope that he is sufficiently reassured today to withdraw his amendment.
I turn to Amendment 63, tabled by the noble Lord, Lord Hunt, and the noble Baroness, Lady Wheeler. We are in concordance with them that a model deferred payment agreement would help local authorities and that is why we already have one in place for the schemes that are currently operating. What we intend to do now is build on and improve the current model. In doing that, we will work in partnership with local authorities to learn from the well established schemes, some of which have a decade of experience. While the case for a model scheme is clear, I think it would be wrong to mandate national systems and structures for deferred payment agreements. It is important that we strike the right balance between local flexibility and national consistency. Systems and structures must be developed in partnership with local government and allow for and, indeed, encourage local efficiencies to flourish. As noble Lords may know, we have established with the Local Government Association and the Association of Directors of Adult Social Services the joint implementation and programme board to support the implementation of these reforms more generally and, through this, we will support local authorities to deliver the universal scheme from April 2015. This work will include our commitment to providing a model deferred payment scheme, based on the current model, as well as statutory guidance to support local authorities in exercising these functions.
The statutory guidance on deferred payments, in particular, will have a clear legal status. Local authorities must act under this guidance. This means that they must consider and should follow it, unless they have a justifiable reason not to do so. This would seem to be the same status as is envisaged by noble Lords in their amendment. I hope therefore the noble Lord feels able to withdraw his amendment in light of the reassurance I have given on supporting local authorities to deliver the universal deferred payment scheme and the model agreement in particular.
My noble friend Lady Barker asked whether the scheme was a model for how local authorities manage the burden on themselves. This is not designed to be a scheme that makes a profit for local authorities. The interest rate is likely to be set at a rate which recognises local authority borrowing rates, and so ensures that the scheme is cost-neutral.
Lord Lipsey
My Lords, I thank the Minister for that reply. On the first two of the three legs of his argument, I am happy to support what he said. Through helpful discussions over the summer, I understood that he had meant to say “up to 40,000.” I make no criticism of him for misleading the House. Any misleading he did is on a tiny scale compared with the misleading that has taken place with the whole country through these repeated cuttings file references. History will now have on record in this debate the truth about these numbers. That is a form of progress, if not legislative progress.
Secondly, I should like to thank the noble Earl for what he said about advice. We are near to having another meeting before Third Reading on advice. We are all after the same things on advice with the same constraints. We have not quite cracked it yet, but I hope when the House comes back on Third Reading to the matter of advice, we shall do so, either in the form of an amendment, or of a shared understanding on where we are going which might take the form of regulation or guidance. On those two things, I agree with the Minister.
However the Minister did not confront my most important point. Let us be absolutely clear. This Bill does not provide a universal deferred payments scheme. It provides a deferred payments scheme only for people who have less than £23,250 in assets. There is no universal deferred payments scheme. Further, this has been done in a back-door manner which disgraces the Government. It was not in Dilnot. We have heard decisive testimony on that from my noble friend Lord Warner. It was not in the Government’s announcement of their response to Dilnot. It was not in the Second Reading speeches. It came out between stages of the Bill in this consultation document. The noble Earl suggested that there would be people with more than £23,250 who could benefit from deferred payments so we did not have to worry. The relevant bit from paragraph 154 of the consultation document says:
“More generally, we also intend that authorities should have the discretion to provide deferred payments to people in residential care who do not necessarily meet all of the mandated criteria.”
Those criteria include the £23,250, so that sounds quite good. The next sentence says:
“For example, if someone has slightly more savings”—
I stress the phrase “slightly more savings”—
“than the £23,250 threshold but would qualify for a deferred payment soon, an authority might prefer to offer the option upfront.”
That is a tiny loophole. This is essentially a £23,250 threshold that the Government have smuggled in, telling nobody until they had to produce this document and hoping no doubt that by 25 October, nobody would have noticed. I shall tell you who will notice. The Daily Mail will notice. The Daily Mail and other newspapers which campaigned so that people would not have their houses seized—I applaud them and have applauded them before for doing so—are now going to learn that the Government have welched on the deal. The tsunami that will hit the Government in consequence will hurt not only this proposal but the Government as a whole.
Lord Hunt of Kings Heath
“( ) The Secretary of State shall make available to all local authorities a model deferred payment scheme and all local authorities must follow this model unless they can show due cause not to.”
Lord Hunt of Kings Heath
My Lords, I share my noble friend’s concern about what we have heard tonight. From what the noble Earl said, in essence the mandated scheme will be a scheme in which the person’s assets will have to come down below £23,250 before a deferred payment arrangement must begin. The noble Earl went on to say that he wanted to encourage local authorities to use a power more widely. That local authority power is discretionary. The great fear must be that the mandatory scheme will in essence turn out to be the scheme that all local authorities will adopt. That is why I link that concern to Amendment 63 for a model scheme. In the circumstances it is absolutely essential. A mandated model scheme does not guarantee a universal scheme, but at least sets the framework for one. The House should consider it very carefully. I beg to move.
Baroness Campbell of Surbiton (CB)
My Lords, I shall speak also to government Amendment 63A and my Amendment 63B. Before I begin, please forgive me for my speech going in stops and starts. This is the result of being an astronaut: we speak like this.
Noble Lords will know from my Private Member’s Bill, the Social Care Portability Bill, as well as my contributions to debates on this Bill, the depth of my concern about continuity of care when an older or disabled person moves to another local authority. It is a basic human right to move freely within one’s country, whether to pursue education or employment opportunities, to improve one’s family life or to seek personal support. The Government have said on several occasions that my Private Member’s Bill has informed the provisions of this Bill. It is true and I am grateful to have helped; I must say that I am also a bit flattered. We have collaborated well and I firmly believe that workable continuity of care is in sight.
The Minister for Social Care said to me in a letter last week:
“I believe that we are both of one mind and that neither of us wants a situation where there are no services in place on the day of the move, which could result in the person falling into crisis”.
I believe that too. Throughout the passage of this Bill, my two main areas of concern have been the need for a reference to outcomes in the continuity provisions and the risk of a gap in provision of care and support. We have made good progress on the second of these concerns since Committee. I am heartened by this.
Amendment 63ZA is about equivalence of outcomes. This goes to the heart of what continuity of care is about. The underlying purpose is to enable the person who moves to do the same kinds of things in their day-to-day life as they currently do. It may not always be possible and it may be through different means, but that is the aim. Certainly there are references linking plans to outcomes elsewhere in the Bill, and that is very welcome. However, signalling the intention in Clause 37 would send a clear and powerful message which could not be misconstrued by those providers who have an “I-know-what’s best-for-the-client” attitude. That is why I have tabled this amendment.
My second amendment addresses safe and seamless transition from one authority to another. The Bill says that if the second authority fails to deliver a new care package by the day of the move, it has to meet the needs that the first authority has been meeting until it has put the new arrangements in place. This is a temporary measure to ensure there is no gap in the provision of care.
I have been concerned that, just as the new care package may not be ready in time, as Clause 38(1) acknowledges, there may also be a delay in the temporary measures, which would mean a risky gap in care and support. My amendment proposes that, in those circumstances, the first authority would have to continue to provide care until the new arrangements were in place. I remain of the view that this would provide the strongest guarantee of continuity.
The Government, however, have proposed instead a new amendment, Amendment 63A, to improve co-ordination between the person moving and the two local authorities—in effect acknowledging the importance of a dialogue between all three parties. Certainly, both local authorities working together to prepare for the person’s move is a good template for success. The amendment will require the first authority to contact the second authority and maintain this relationship until the person moves. It will also require the first authority to keep the person involved so that they are fully aware of the arrangements in advance of their move. While this is not the solution I favour, I recognise that it will help to strengthen the process by bolstering the degree of collaboration and coordination between the authorities. That would go a long way towards reducing the risk of an interruption in care and support. It would also reassure and empower the person moving.
Throughout my campaigning life, “Nothing about us without us” has driven everything. This duty is a commendable endorsement of that approach. I believe that it would be enhanced by a further small change: that the first authority remain in contact with the second authority until the new care package is in place. This would ensure a smooth transition during any temporary arrangements, when the individual would be at their most vulnerable. Moreover, it would help the second authority, which has to meet the needs that the first authority has been meeting. I believe this fine-tuning of the Government’s helpful amendment would speed up the transition and support the way that Clause 38 is intended to operate.
After some negotiation last week, I believe I reached an understanding with the Minister and his officials that there will be a review of the continuity-of-care provisions after three years. These are new responsibilities for local authorities, and it is right that we should know whether they are working and take action if they are not. I look forward to the Minister’s confirmation of this in his response.
Moving house is one of the most stressful days of your life. Let us give disabled people the confidence to move and, hopefully, improve their circumstances. To do that, they require three things: first, knowing that support is there; secondly, the knowledge about the process to reassure them during a time of potential anxiety; and, thirdly, the certainty that they can live their lives in the same way with the same outcomes in their new environment.
I am pleased that the Government have travelled a fair way in tabling their amendment and have made significant progress in strengthening the transition process. I very much look forward to being involved in the next stage of the portability journey. I believe that we are about to have the portability celebrations but the cake has not yet been finished. If we get this right, I will feel free to chase my dream of moving to the Cornish coast when I eventually retire, which will not be yet. I beg to move.
Baroness O'Loan (CB)
My Lords, I support my noble friend’s amendments, particularly because of their implication for human rights. Care and support for many older people and for disabled people underpin and enable the enjoyment of those rights. They make possible a decent life of dignity; they make possible the ability to enjoy family life, for example. Ensuring that people can continue to pursue the life that they have and that they want, with no lessening of support when they move, is crucial. I therefore warmly support my noble friend’s amendment on equivalence of outcomes. When considering the process for people moving from one local authority to another, we must consider particularly the right to freedom of movement for older and disabled people. I believe that my noble friend’s amendment on the process for ensuring no gap in services during a move guarantees such freedom on an equal basis with others.
Baroness Wheeler (Lab)
My Lords, these are mostly technical amendments, which we support. We are especially pleased that the concerns and proposed improvements to the portability process put forward by the noble Baroness, Lady Campbell, are addressed in the amendments in this group. We need to do as much as possible to reduce the likelihood of the person not having services on the day of the move to the new authority.
Continuity of care is critical to portability, and the requirement placed on the first authority to keep in touch with the second in the period leading up to the move to ensure that services are in place and ready, and that the person is kept informed and up to date, is very important for a safe and risk-free move. They are also required actively to ensure continuity of care until the new assessment is in place. That is absolutely right, as is the second authority being required to have regard to the outcomes that the person wishes to achieve in the care and support plan that they had before the transfer.
I congratulate the noble Baroness on having finally achieved most of what she set out to in her own Private Member’s Bill. As she said earlier, workable continuity of care is within sight. Her tenacity and determination will mean that many people will now be able to make the move to different parts of the country, to be closer to their families or to care and support that they have not previously been able even to contemplate.
We support the government amendments dealing with cross-border issues with Wales. They follow extensive discussion and agreement with the Welsh Government. The Minister’s detailed correspondence to noble Lords explaining the purpose of the amendments in relation to such key issues as arbitration on cross-border disputes, responsibility for mental health aftercare and sorting out direct payments for this care and residential care to reflect recent change of practice in England was very helpful to the House in getting the full picture of the proposed changes.
In respect of the amendments on ordinary residence, NHS accommodation placements, cross-border hospital stays and the need to ensure that the Care Bill provides for accommodation provided under the Welsh, Scottish and Northern Ireland legislation, the Minister’s note of last week emphasises that all changes have been agreed with each of the devolved Administrations, and obviously that is as it should be. Are the provisions for four-way reciprocity on cross-border placement in England, Wales, Scotland and Northern Ireland now fully in place with these amendments to the Bill, or does more work need to be undertaken as the detail is worked through further?
Specifically on government Amendment 64, I understand that the LGA and ADASS are looking to model the impact of a person’s place of residence on the cost pressures within the social care system. To assist this work, which will be very valuable to the whole House, will the Government now publish the information that they have on the impact of cost pressures on extending the territorial reach of the Bill into Wales?
Earl Howe
My Lords, the Care Bill will for the first time introduce a duty on local authorities to ensure that where a person is receiving care and support they can move home to another local authority area, confident that they will have services in place on the day of the move. The noble Baroness, Lady Campbell, has been a leading advocate in this area for some time, and I acknowledge that her Private Member’s Bill was a template for the provisions in this Bill.
The noble Baroness’s Amendment 63ZA looks to ensure that when the second authority is carrying out the assessment of the adult moving and, where appropriate, their carer, it meets the outcomes that they want to achieve. I reassure her that the provisions on assessment for the person needing care and their carer apply to when a person is being assessed for continuity of care. Assessments must look at achieving the outcomes that the person or carer want to achieve, and Clause 37(8) confirms that. I also give an assurance that we will emphasise this in the statutory guidance.
Amendment 63B proposes that the first authority is responsible for arranging services on the day of the move. I say immediately that I sympathise with the sentiment of the noble Baroness’s argument; neither of us wants a gap during which a person is left without services. However, our view is that the second authority is best placed to maintain continuity of care. Our reasoning is that the person will now be living in the area of the second authority and, as for anyone who has eligible care and support needs, the second authority has a duty to meet those needs. The second authority will also know its local market and will be far better placed to put in place arrangements that support the person and maintain their level of independence from day one.
My concern is that it would be difficult for the first authority to make such arrangements, particularly where the person moves a long distance away. In practice, if the first authority is responsible for making arrangements it would have to contact the second authority to discuss the local market, which raises the question of why the second authority is not responsible for putting in place services in the first instance.
For the reasons that I have explained, I believe that the second authority must be the one responsible for delivering services on the day of the move. However, in light of the concerns raised by the noble Baroness during Committee, I have looked again at the provisions in the Bill. My Amendment 63A will require the first authority to contact the second authority and maintain this relationship so that it is aware of where the second authority is with putting services in place. It will also require the first authority to keep the person involved with discussions about their services and informed of progress for putting these in place. In other words, the amendment will put the person at the centre of the process. Both ADASS and the Local Government Association have indicated that this amendment will strengthen the process.
The noble Baroness questions whether placing the responsibility on the second authority is the right approach. I believe that it is. However, I fully understand her concerns, and I commit now to my department reviewing how the continuity of care arrangements are operating three years following implementation. This will provide us with more information, which will help us to understand if the process can be improved.
We are already considering how we might implement the provisions in the Bill. The first step will be to develop the regulations and statutory guidance. Given the noble Baroness’s knowledge in this area, I hope that we can draw on her experience and that she will be able to advise us on the preparation of the regulations and guidance. I sincerely hope that in strengthening these provisions and in the commitments that I have given, I have been able to convince her not to press her amendments.
The amendments relating to ordinary residence will provide clarity in respect of three areas: the overall principle of ordinary residence; the principle of ordinary residence so that it applies to after-care under the auspices of the Mental Health Act; and finally, the cross-border placement of individuals so that service users can move between the four countries of the UK where this is deemed to be in their best interests.
The noble Baroness, Lady Wheeler, asked whether reciprocal agreements are now in place or whether there would be more changes in this area. The answer is that the basic structure is in place in terms of reciprocal arrangements on cross-border care. However, some small details remain to be finalised through regulations and statutory guidance. We will work closely with the devolved Administrations on this.
First, government Amendments 66 and 67 address a potential lacuna in respect of people who may live in England—and therefore be ordinarily resident in an English local authority—but who are treated entirely within the NHS of a devolved Administration. The amendments ensure that they would remain ordinarily resident in England. Secondly, Amendments 64, 65, 126 to128 and 132 to 136 apply consistent ordinary residence rules in England and Wales in respect of after-care under the Mental Health Act 1983, and reflect our agreement with Wales that Welsh Ministers or the Secretary of State will determine cross-border disputes according to agreed arrangements.
Thirdly, Amendments 68 to 75 relate to cross-border placements. The cross-border provisions in the Bill reflect the outcome of solid collaborative work with Scottish, Welsh and Northern Irish colleagues to remove legal barriers restricting the placement of an individual from one territory of the United Kingdom to another. These amendments make technical adjustments to those provisions, following further discussion with the devolved Administrations about the detail of the arrangements.
The purpose of the amendments on cross-border placements is threefold. First, they ensure that the established principle that the placing authority retains responsibility for the care of those individuals placed cross-border is not interrupted should the individual receiving care require a period in hospital or other healthcare accommodation. Secondly, they enable regulations to provide for the cross-border placements provisions to apply to individuals who receive direct payments. Thirdly, they provide a regulation-making power that would allow our cross-border provisions to apply to individuals placed in a setting other than a traditional care home—for example, supported living arrangements.
The noble Baroness, Lady Wheeler, also asked about the impact of cross-border placement provisions on cost pressures. It is our understanding that the number of placements between countries of the UK is likely to be minimal, certainly in terms of the overall budget. However, we will work closely with colleagues in the devolved Administrations to further understand and bottom out the financial implications.
This group of amendments provides further necessary clarity to enable people to receive care and support in locations that suit their needs and I commend them to the House.
Baroness Campbell of Surbiton
My Lords, I thank noble Lords and the noble Baronesses, Lady Wheeler and Lady O’Loan, for speaking in support of my amendment. I warmly thank the Minister for his thoughtful reflections on my amendments and for tabling his amendments to meet some of my concerns—followed up at the last minute by a very good, timely review. Although I had hoped to see both my amendments on the statute book tonight, I am happy to acknowledge that the Government’s proposal is a ginormous step in the right direction to full portability. If it reduces the prospect of a cliff-edge scenario, it will achieve its purpose. I know that disabled people will feel encouraged to move instead of staying put.
Finally, I am grateful to the Minister and especially his officials for their positive approach to this issue, which I have raised in Committee and, quite frankly, over the past three years. We have burned a lot of midnight oil together and I have been very impressed by their efforts to find practical solutions. It bodes well for our continued collaboration on this landmark reform—and it is a landmark. Do not forget, we were tied to our local authorities since time began and this is the first time that disabled people will have the right to freedom of movement if they require support. I will be pleased to be involved in the regulations and of course I will be there. Frankly, you could not stop me. I beg leave to withdraw my Amendment 63ZA.
“(8A) Pending the adult’s move, the first authority must keep in contact with the second authority in order to ascertain the progress that the second authority is making in preparing to meet—
(a) any needs for care and support under section 18 or 19 in the adult’s case, and(b) where the adult is proposing to have a carer immediately after the move, any needs for support under section 20 in the carer’s case.(8B) The first authority must keep the adult (and, where applicable, the carer) informed about its contact under subsection (8A) with the second authority and must involve the adult (and, where applicable, the carer) in the contact.”
(a) “local authority in England” means a local authority for the purposes of this Part, and(b) “local authority in Wales” means a local authority for the purposes of the Social Services and Well-being (Wales) Act 2013”
“(5A) “NHS accommodation” means accommodation under—
(a) the National Health Service Act 2006,(b) the National Health Service (Wales) Act 2006,(c) the National Health Service (Scotland) Act 1978, or(d) Article 5(1) of the Health and Personal Social Services (Northern Ireland) Order 1972.”
“( ) After subsection (10) of that section insert—
“(10A) A person who, as a result of Schedule 1 to the Care Act 2013 (cross-border placements), is treated as ordinarily resident in an area in England, Wales or Northern Ireland (as the case may be) is to be treated as ordinarily resident in that area for the purposes of this section.
(10B) A person who, as a result of that Schedule, is not treated as ordinarily resident anywhere in England or Wales (as the case may be) is not to be treated as ordinarily resident there for the purposes of this section.”
“Provision of NHS accommodation not to affect deemed ordinary residence etc.7A (1) In a case where, as a result of this Schedule, an adult is treated as ordinarily resident in an area in England, Wales or Northern Ireland (as the case may be), the adult does not cease to be so treated merely because the adult is provided with NHS accommodation.
(2) In a case where, as a result of this Schedule, an adult is not treated as ordinarily resident anywhere in England or Wales (as the case may be), the adult continues not to be so treated even if the adult is provided with NHS accommodation.
(3) In a case where, as a result of this Schedule, no duty under a relevant enactment applies, the duty does not apply merely because the adult in question is provided with NHS accommodation; and for this purpose “relevant enactment” means—
(a) Part 2 of the Social Work (Scotland) Act 1968,(b) sections 25 to 27 of the Mental Health (Care and Treatment) (Scotland) Act 2003,(c) the Health and Personal Social Services (Northern Ireland) Order 1972, or(d) the Health and Social Care (Reform) Act (Northern Ireland) 2009.(4) In a case where, as a result of paragraph 2(2), (4) or (7), an adult is treated as remaining within, or as remaining outside but ordinarily resident in, an area in Wales, the adult does not cease to be so treated merely because the adult is provided with NHS accommodation.”
“Direct payments7B (1) Regulations may provide for this Schedule to apply, with such modifications as may be specified, to a case where accommodation in England, Wales, Scotland or Northern Ireland is provided for an adult by means of direct payments made by an authority in another of the territories.
(2) The reference in sub-paragraph (1) to direct payments accordingly includes a reference to direct payments made—
(a) under section 34 or 36 of the Social Services and Well-being (Wales) Act 2013,(b) as a result of a choice made by the adult pursuant to section 5 of the Social Care (Self-directed Support) (Scotland) Act 2013, or(c) by virtue of section 8 of the Carers and Direct Payments Act (Northern Ireland) 2002.”
“Particular types of accommodation 7C (1) Regulations may provide for this Schedule to apply, with such modifications as may be specified, to a case where—
(a) an adult has needs for care and support which can be met only if the adult is living in accommodation of a type specified in the regulations,(b) the adult is living in accommodation in England, Wales, Scotland or Northern Ireland that is of a type so specified, and(c) the adult’s needs for care and support are being met by an authority in another of the territories providing or arranging for the provision of services other than the accommodation.(2) In section 5 of the Community Care and Health (Scotland) Act 2002 (the title to which becomes “Local authority arrangements for residential accommodation etc. outwith Scotland”), in subsection (1), at the end insert “or for the provision in England and Wales or in Northern Ireland of a service or facility of such other description as may be specified in the regulations”.
“( ) “NHS accommodation” has the meaning given in section 39(5A).”
“( ) In paragraph 7B, the reference to sections 34 and 36 of the Social Services and Well-being (Wales) Act 2013 is to be read as a reference to section 57 of the Health and Social Care Act 2001.”
Baroness Greengross
“Appealing decisions taken by the local authority
(1) The local authority must have in place a procedure, which includes a review element that is independent of the local authority, by which adults or carers can appeal a decision made by the local authority about—
(a) whether an adult or carer’s needs meet eligibility criteria under section 13,(b) whether to charge for meeting needs under section 14,(c) the result of a financial assessment under section 17,(d) the content of a care and support plan or support plan under section 25,(e) the amount of a personal budget made under section 26 or independent personal budget made under section 28,(f) the payment of an “additional cost” under section 30.(2) Regulations may make further provision about any aspect of the appeals procedure mentioned in subsection (1).
(3) Wherever a decision has been made of a type referred to in subsection (1), the local authority must make the adult or carer aware of their right to appeal the decision and how to request details of the appeals procedure. Details of the procedure must be made available on request.”
Baroness Greengross
My Lords, I shall also speak to Amendment 124. Amendment 76 seeks to ensure that a clear process is in place by which adults and carers can challenge decisions that have been made about their care by local authorities, and to ensure that they are made aware of their right to challenge such decisions. I am grateful to Which? for supplying me with background information on this important issue.
Under the new care and support system, there are many decisions that local authorities will take that will affect an adult’s or a carer’s access to services and what they will be required to pay towards care. These decisions can fundamentally affect families’ quality of life and financial circumstances, as we have learnt. It is right that these decisions are subject to proper scrutiny in cases where families feel that they have been made unfairly, and that those receiving care and their carers are aware of their right to challenge decisions.
Baroness Meacher (CB)
My Lords, I rise to speak to Amendment 123. In doing so, I add my support to Amendments 76 and 124, which were tabled by my noble friend Lady Greengross. Indeed, a few of my comments slightly overlap hers.
As the Bill stands, local authorities will be given many complex duties and will be required to make many decisions which will have a substantial—you could say devastating—impact on the lives of elderly and disabled people, but there is no statutory provision for any appeal or independent review process, even if decisions are made on the basis of factual or legal errors. That is the point of the comments I want to make.
I understand that the Government have committed themselves to consider a process of redress or appeal and that they recognised in their response to the Joint Committee that it is,
“vital that people have an effective way to complain and seek redress”,
but there is no assurance in the Bill that such a system will be put in place and, if one is, what its characteristics will be. As my noble friend Lady Greengross said, regulations under other legislation do not appear to do the job. I hope the Minister will comment on that situation.
For example, local authorities decide whether an elderly or disabled person should continue to receive care support. Many will lose that support as a result of cuts to local authority budgets. The impact of losing care support—an entire care package in some cases—can be catastrophic, according to Leonard Cheshire Disability and others directly in touch with disabled or elderly people. Many years ago, I worked with these people, and I find the very idea that a care package could simply be removed very frightening, even as an onlooker, let alone as somebody experiencing such a thing. People become trapped in their homes, unable to work and unable to get out. They become depressed and, in some cases, suicidal—and not surprisingly in my view. There can also be risks to people’s health. As they try to undertake tasks for which they are not well suited or which they are unable to perform on their own, they fall. Has anyone estimated the likely cost to the health service of increased falls, accidents and problems of this kind? What is the Government’s view of the economic costs to the country if family carers have to give up work in order to step into the breach when the state withdraws? The problem is that the local authority may save money but the DWP and the Treasury are likely to pick up the tab. I am not quite sure what the Minister in the other place would think about that.
It is easy for the state machinery to underestimate the incredible vulnerability of many elderly and disabled people. Applicants for care support will inevitably feel nervous and fearful of the consequences of upsetting the very people on whom they depend so heavily. It is terribly important that an appeal or review process is not only user-friendly and accessible but really is independent of the people making decisions about the person’s care. Can the Minister honestly say that care decisions will in future not vary across the country? Can he say that decisions will be made without error and always be based on the law? I do not think so. In preparing this amendment we have been mindful of the cost constraints and the need to allow Ministers flexibility to create a system that will be proportionate and sustainable. I hope the Minister will recognise this in his closing comments.
Having said that, I draw your Lordships’ attention to the fact that Leonard Cheshire Disability has specifically asked me to ensure that a full tribunal service be considered, although we did have a discussion about the financial implications of that. It argues that if such a system exists to deal with conflicts about school places, a decision to deny social care is equally as devastating. The Law Commission recognised the importance of a fair, independent and accessible system of redress.
I know that the noble Earl has discussed this issue with key stakeholders and perfectly well understands the points I am making. I hope he can give the House an assurance today that, if he is unable to accept the precise wording of the amendment, the Government will table an amendment at Third Reading that will guarantee that a suitable appeal or review process will be in place when the Care Bill comes into effect.
Lord Warner
My Lords, I support these amendments—not necessarily the specific wording but the principles behind them. I remind the House of a real difference between many of the appeals under the new framework for adult care and support and what has gone before. We are now talking about a set of arrangements with considerable financial implications for people and their families. In the social security system we set up a tribunal system to arbitrate, which has worked pretty well for a long time. Many of these issues are more akin to the social security system than to complaints about process. There will be complaints about process but many of the things covered in these amendments are about a failure to get a resource from the public purse to which people think they are entitled and have evidence that they are. This is much more akin to the arrangements in the social security system for people who have their claims rejected. It is much nearer to that than complaints about poor processes of work by a public body. The Government should think long and hard about this issue because they are in grave danger of ending up with the whole system being overwhelmed by the number of complaints. Without a convincing system for resolving appeals in the framework of the Care Bill we are heading down a path where judicial review will start to feature quite strongly.
I remind the noble Earl of some of the other issues where there could be appeals. The Joint Committee looked at some of the friction points where there was scope for dispute. There is a raft of areas for dispute over assessment of carers and service users and a whole range of areas for dispute about ability and whether you are going to be charged or not. After the previous debate on deferred payment I can think of another fruitful area for complaints—an inability to get on to some kind of deferred payment scheme. Another area, important to patients and service users, is setting the price for contracts to providers. Clearly, the price-setting mechanism may be disputed between the providers of services who may claim that the price offered by the commissioning agent will be bad for service users and patients. I am not suggesting that these could all come together under one process, but we want more convincing architecture in this Bill to give confidence that there is a sensible way of resolving and arbitrating areas for dispute and for the service user and their carers to secure redress without going through an excessively complicated process.
Baroness Hollins (CB)
My Lords, briefly, I support all the amendments in this group, particularly Amendment 124 to which I added my name. There were a number of voices calling for an appropriate system of redress for disputed decisions. Many people do not really understand social care systems and why decisions are taken and they feel powerless, often at a time when they are facing enormous challenges and may fear that complaining is going to lead to even more negative changes to their support. It seems to be a matter of justice to have a very clear and understood route to redress and I hope these amendments will be considered seriously.
Lord Mackay of Clashfern
My Lords, I support these amendments requiring a system of adjudication able to deal with the whole raft of matters dealt with under the Care Bill, including the borderline with continuing healthcare. The local authorities—152 or something of that sort—will administer the care system. It is quite easy to see that the same problems may arise in different local authority areas. Having a respected system for dealing with these matters would simplify a good deal of this area. I therefore strongly urge the Government to have in place a system which would provide reasonably rapid adjudication of all these issues. The social security commissioners provide a kind of example. One possible solution would be to extend the jurisdiction of the social security commissioners to include this area. Social security arrangements are certainly different from the care arrangements, but there may be sufficient similarity to make that possible. Something along the lines of the social security commissioners would be necessary for dealing with this and bringing into effect a system which local authorities right across the country would respect when one local authority’s decision was dealt with by this adjudicating authority.
Lord Hunt of Kings Heath
My Lords, I have added my name to Amendment 76 of the noble Baroness, Lady Greengross. I also support Amendments 123 and 124. Leonard Cheshire Disability put it so well when it said that it was concerned that the Bill, in placing a number of important and complex duties on local authorities, will have a substantial impact on the lives of older and disabled people without providing appropriate routes for appeal against unjust or factually inaccurate decisions. It says that there is a compelling case for the Government to set up a system to resolve cases where there are disagreements between the local authority and the individual.
When we think of the various ways in which local authorities can impact on individuals who have come within the care system—support eligibility criteria, financial assessment, operation of the cap, charges, personal budgets and the boundary between NHS continuing care and means-tested social care—surely there have to be opportunities for a person to appeal against decisions of the local authority. In Committee, the noble Earl relied first on the current complaints system of local authorities and, secondly, he went on to point out that if a complainant was not satisfied with the response from the local authority, they were then able to refer the case to the Local Government Ombudsman.
However, a complaints system is not really what noble Lords are calling for. Anyone who has seen responses from local authorities to complaints will know that they tend to find in favour of themselves and rarely reopen a question of substance. Noble Lords want an opportunity for a person concerned to put their case and for that case to be considered by a group of people who may be said to be independent of the local authority. Like the noble and learned Lord, Lord Mackay, and my noble friend Lord Warner, I am keen on the tribunal approach which deals with social security cases; I have witnessed these cases. Although the noble Earl felt in Committee that these would be expensive, I believe that it is a cost-effective way of allowing people to put their case and for that matter to be decided. I am sure that in the long term it will be more expensive if there is no proper decision. I suspect that we will see lots of judicial reviews being initiated against local authorities. They do not and will not have a proper system for dealing with appeals.
The noble Earl said in Committee that the Government were consulting on processes for providing redress. Although he thought that the results of that review would be available before the Bill had concluded its passage through Parliament, I suspect that that will be too late for your Lordships’ consideration. I therefore hope that the noble Earl might be able to give us some comfort that he will in fact give further consideration to this. I hope that we might return to this point at Third Reading.
Earl Howe
My Lords, at the heart of these amendments is an important issue: the voice of older and disabled people. I hope that I can give some reassurance to the House.
Amendments 76, 123 and 124 would include in the Bill provisions for an appeal system that allows individuals to appeal against decisions of, first, the local authority relating to their needs for care and support and, secondly, the relevant NHS body relating to their eligibility for NHS continuing healthcare. Of course, those are quite separate matters.
On the amendments relating to local authority decisions on care and support, I will briefly run through the current, essentially complaints-based, arrangements. These arrangements were reformed via the 2009 regulations, which require local authorities to publish arrangements for the consideration and timely handling of complaints. Local authorities have flexibility in developing their own procedures, which may of course result in varying user experiences. If, having raised a complaint with a local authority, a person is not satisfied with the response, they can refer the complaint to the Local Government Ombudsman. The ombudsman is independent of the local authority. It can investigate whether the decision-making process has been conducted appropriately and make a recommendation to the local authority.
As has been said, the Bill will result in many more people being brought into contact with their local authority, so it is appropriate that we are reviewing the current arrangements regarding appeals via a public consultation. If that is consistent with what the noble Lord, Lord Hunt, regards as the Government having a second look, I believe that we are doing so. Through the consultation we have heard from user representatives a concern voiced this evening by the noble Lord, Lord Warner: that current arrangements are not sufficient to withstand the additional pressures of the Bill reforms.
While our initial view is that it is likely that some changes are needed, we really need to wait for the consultation to close before making any judgments. I will be in a position to update noble Lords about that in December. Although I acknowledge that this is a work in progress, the Government are on the case. I hope, with that assurance, that the noble Baronesses and the noble Lords will therefore be content to withdraw Amendment 76 and not to move Amendment 123.
In response to the noble Baroness, Lady Meacher, who asked whether we would consider a formal tribunal, our current assumption is that a tribunal process would be likely to slow down the process of resolving complaints and would add significant costs which would, in turn, produce a further burden on the system. There is a range of approaches to resolving complaints and providing redress. It is advantageous to have a flexible system that works well and efficiently at a local level, in a manner that is proportionate to the type of complaint.
The noble Baroness also asked whether we might consider an independent panel rather than a tribunal, although I was not sure whether those two were the same thing in her mind. The funding reform consultation that covers this issue will close late in October. Following this review, should we decide to make a change we expect we could do so through secondary legislation. Of course, we are not ruling anything out in the consultation. If it transpires that we wish to make changes that require primary legislation we would ensure that proposals were brought forward at the earliest opportunity. However, if changes were desired—for example, to introduce a requirement whereby a decision was reviewed by an independent panel—in this case we would do that by amending existing regulations.
The noble Baroness asked whether I could assert that decisions in this area will not vary across the country and that there will not be errors. Of course, there is scope for errors to take place and for variation. I can say that we would want the following principles to underpin the mechanisms for redress and resolving complaints: clarity, local accountability, fairness and timeliness. Lastly, there should be an independent element. I hope that that is helpful as a guide at this stage.
Lord Warner
Before the Minister sits down, I will ask on a point of clarification. He made a lot of reassuring noises about the ability at the end of the consultation process to deal with some of the outcomes of that process under secondary legislation. Can the Minister clarify whether that also included—if the Government have had a damascene conversion to a tribunal-type arrangement—that secondary legislation could introduce a tribunal-type of arrangement for adult social care?
Lord Mackay of Clashfern
Again, before my noble friend finally sits down: he mentioned the principles that would seem applicable to local authority decision-making and appeals from that. I wonder whether one of the principles that should be given effect might be consistency across the country—in other words, fairness between people who live in X and people who live in Y. I suspect that there is a possibility that different local authorities will take different decisions in very similar cases, and consistency across the country would be an important element in the fairness of this new system.
Earl Howe
I take the point made by my noble and learned friend. We cannot iron out every kind of disparity, but we should aim for the kind of fairness that he talks about.
I have misled the House: we would not be able to establish a tribunal by secondary legislation—it would require primary legislation. However, as I said earlier, in the consultation that we are carrying out we do not rule out any solution. Clearly, if it transpires that we want to make changes for which primary legislation is needed, we would need to ensure that proposals were brought forward for consideration at the earliest opportunity. In general, we hope that the consultation will flush out any concerns in this area, not least in the area of fairness, as referred to by my noble and learned friend.
Lord Warner
Just to finish off this discussion, I have another point for the Minister to consider, which was made by the noble and learned Lord, Lord Mackay. The whole point about a tribunal system is that you build up case law, so you spread consistency across the country through the case law that individual tribunals have made. Without that structure of a tribunal system I suggest that it is very difficult to achieve the objective that the noble and learned Lord is seeking. Might the Minister ponder on that before we discuss this again?
Baroness Greengross
My Lords, I thank all the noble Lords and noble Baronesses who have supported these amendments. I am encouraged that the issue is being taken so seriously by the noble Earl. In a way it is a shame that the timing of the consultation is as it is, and that we will not get it through until December. I have always been worried about certain aspects of NHS complaints procedures, when the body that looks at those procedures is the NHS itself. I have felt for many years that that is unfortunate. I am very pleased that the Minister has agreed to look again seriously at all this. We need to protect these extremely vulnerable people from not getting the best level of service that they can because of a decision that could be to the detriment of their care, which could leave them feeling that their situation is hopeless and that there is nothing they can do.
I therefore thank the noble Earl. I am pleased that he is prepared to look at all this again and I hope that we can have some discussions on the outcome. This was a probing set of amendments—I did not intend to do anything other than probe—but I thank him and hope for better news about this or for more detailed decision-making in the near future. In the mean time, I beg leave to withdraw the amendment.
Baroness Greengross
“Power of access for confidential interviewAdult safeguarding access order
(1) An authorised officer may apply to a court for an order (an “adult safeguarding access order”) in relation to a person living in any premises within a local authority’s area.
(2) The purposes of an adult safeguarding access order are—
(a) to enable the authorised officer and any other person accompanying the officer to speak in private with a person suspected of being an adult at risk of abuse or neglect,(b) to enable the authorised officer to assess the mental capacity of a person suspected of being an adult at risk of abuse,(c) to enable the authorised officer to ascertain whether that person is making decisions freely, and(d) to enable the authorised officer properly to assess whether the person is an adult at risk of abuse or neglect and to make a decision as required by section 41(2) on what, if any, action should be taken.(3) When an adult safeguarding access order is in force the authorised officer, a constable and any other specified person accompanying the officer in accordance with the order, may enter the premises specified in the order for the purposes set out in subsection (2).
(4) The court may make an adult safeguarding access order if satisfied that—
(a) the authorised officer has reasonable cause to suspect that a person is an adult who is experiencing or at risk of abuse or neglect,(b) it is necessary for the authorised officer to gain access to the person in order to make whatever enquiries thought necessary and to make a decision as required by section 41(2) on what, if any, action should be taken,(c) exercising the power of access conferred by the order will not result in the person being at greater risk of abuse or neglect.(5) An adult safeguarding access order must—
(a) specify the premises to which it relates,(b) provide that the authorised officer may be accompanied by a constable,(c) specify the period for which the order is to be in force.(6) Other conditions may be attached to an adult safeguarding access order, for example—
(a) specifying restrictions on the time that the power of access conferred by the order may be exercised,(b) providing for the authorised officer to be accompanied by another specified person,(c) requiring notice of the order to be given to the occupier of the premises and to the person suspected of being an adult at risk of abuse.(7) A constable accompanying the authorised officer may use reasonable force if necessary in order to fulfil the purposes of an adult safeguarding access order set out in subsection (2).
(8) On entering the premises in accordance with an adult safeguarding access order, the authorised officer must—
(a) state the object of the visit,(b) produce evidence of the authorisation to enter the premises, and(c) provide an explanation to the occupier of the premises of how to complain about how the power of access has been exercised.(9) In this section “an authorised officer” means a person authorised by a local authority for the purposes of this section, but regulations may set restrictions on the persons or categories of persons who may be authorised.”
Baroness Greengross
My Lords, I am sorry to be popping up and down. This amendment and the others are about elder abuse. I have been involved in the issue of elder abuse for very many years—it is something that I am very familiar with. It is an issue which we have not, as yet, focused on nearly enough in this country. We have recently learnt, from data from the Health & Social Care Information Centre and Age UK, that there has been a “disturbing” rise in the number of reports of possible abuse of vulnerable elderly people in England. Unfortunately, the majority of this abuse is, as we know, by people who are close to the person—that is, family, carers and friends living in the same household, because the majority of abuse happens in people’s homes.
We have seen a 4% rise in the number of cases of alleged abuse referred for investigation in the past year. I urge the Government to do more to protect vulnerable adults. It is a serious issue and, in my view, the danger might unwittingly be increased as a result of some of the positive things that we are doing; for example, personal care planning, which gives people the opportunity to give money to relatives and to use the money for care which has not been planned in the way it used to be. There are many more doors for abuse opening than there used to be, so we have to prevent abuse even more effectively than we did in the past.
In response to the situation, the BBC has reported a Department of Health spokesman as saying:
“No-one should suffer abuse or neglect in a place they are meant to feel safe in, whether this is in their own home or in a care setting”.
Nobody is going to argue about that, but we must put this principle into practice and seek out abuse rather than passively wait for victims to appear. Sadly, some of those victims will never appear. We know why: people are not going to report their son or daughter who is hitting them, being violent or stealing their money because this might make them appear a bad mother or bring the family into disrepute. There are all sorts of reasons why very few people complain.
I am aware that new measures are being considered to make directors of care homes and hospitals personally and criminally accountable for failures in care if they allow neglect or abuse to take place. However, this will not really help people who are being abused in their own homes.
Figures from the Health & Social Care Information Centre have shown that the number of cases referred for investigation by councils in England rose from 108,000 in 2011-12 to 112,000 in 2012-13. While 45% of these cases took place in a care home, 38% of the alleged abuse took place in the older person’s own home. Physical abuse and neglect were the most common types of abuse reported. In 6% of cases the abuser was the older person’s partner; in 16% it was another family member; and in 37% it was a social care worker. Three-fifths of the referrals were for vulnerable adults—those described in the report as people who may be in need of community care services because they are elderly or suffer mental illness, disability or another ailment and are aged 65 or older.
I endorse the expressed views of Age UK and Action on Elder Abuse in that any abuse of older people is unacceptable. We need a zero-tolerance approach to any abuse, whether through neglect, financial manipulation or physical or mental cruelty. My greatest fear is that there are still many cases that are not reported. This amendment would assist the authorities in gaining access to such victims where their abusers may naturally be the very individuals preventing legitimate access.
In my first proposed new clause, I seek to support Action on Elder Abuse in its claim that there are situations where victims of abuse are imprisoned in their homes by a perpetrator who subsequently denies access to adult safeguarding staff. In such circumstances there are no current legal means by which access can be achieved. There is need, therefore, for a power of access for confidential interview, but to occur only where the reasonable suspicion of a social worker or another practitioner is tested by application to a court, which would consider whether to authorise such access. This is available in the Scottish Act and it is proposed in the Welsh Bill through application to a justice of the peace.
Lord Rix (CB)
My Lords, I lend my support to Amendment 77, tabled by my noble friend Lady Greengross. I would also like to express astonishment that we seem to have reached the target for tonight before the dinner hour.
My interest, of course, is with people with a learning disability and what is increasingly referred to as mate crime. This is where someone has befriended a person with a learning disability and is exploiting or abusing them in some way. In some cases this person may be living with them and, for example, concerns may have been raised by neighbours that the person may be being abused. Currently, the local authority would be unable to speak to the adult with a learning disability to establish if they are all right as the other person, the third party, always answers the door and will not let them in. This power would change that. I understand that the power on the statute book in Scotland is being used sparingly, and I believe that it is used appropriately.
I now turn to Amendments 79A and 81A, which are tabled in my name, on strengthening the safeguarding clause. Currently only financial abuse is defined in the Bill. However, there are of course many other types of abuse, such as physical, psychological and sexual abuse, as well as neglect. The amendment seeks to rebalance the definition. I understand that there has to be a definition of financial abuse in the Bill as there is not a legal definition elsewhere. However, limiting the definition to financial abuse, suggests that there are no other forms of abuse or that professionals and agencies should focus on financial abuse alone.
Although I do not doubt that people with a learning disability suffer financial abuse, other forms of abuse are far more common. Indeed, statistics on the number of safeguarding referrals detailed in the Abuse of Vulnerable Adults in England report for 2012-13 show that physical abuse and neglect were the most common. We would not wish inadvertently to elevate financial abuse above and beyond other forms of abuse. Of course, I understand that there is a reluctance to list types of abuse in case the list appears to be exhaustive and never-ending. The amendment adds the option to specify other forms as detailed in guidance, which I hope will allay such fears.
Amendment 81A, the second amendment tabled in my name, places a duty on safeguarding adults boards to send a copy of their annual report to the Secretary of State. These reports are important in that they detail the findings from safeguarding adult reviews that have been carried out. In addition, a welcome government amendment has added that these reports must now show the actions that boards have taken to implement the findings.
At the moment Schedule 2 says that a copy of the annual report must be sent to the CEO and leader of the local authority, the local policing body, the local Healthwatch and the chair of the health and well-being board. It is important that lessons are learnt nationally and sending these annual reports to the Secretary of State will allow us to understand the national picture and issue guidance as appropriate. People with a learning disability are some of the most vulnerable people in our country and not to monitor and respond to abuse at a national level is quite unacceptable.
Baroness Meacher
My Lords, I support Amendments 77, 80 and 82, to which I have added my name. I will also comment on Amendment 79.
I strongly support the need for adult safeguarding access orders and applaud the noble Baroness, Lady Greengross, for tabling the relevant amendments. As we discussed last week, as local authority resources shrink further—the Minister referred to a 5% reduction so far—the reality is that care will be left more and more in the hands of relatives, many of whom may themselves be elderly and frail; or indeed they may be younger, with childcare responsibilities and have great difficulty in providing support in all directions. Inevitably, many family carers will find it extremely hard to cope, and there will undoubtedly be situations when elderly or disabled people are neglected or in some way abused. I fear that the only way in which family carers will get the help they need will be if adult safeguarding access orders are available, so that following an alert the local authority can become involved, assess the situation and, where appropriate, prioritise further support.
As public services shrink, the neglect of elderly and disabled people—even gross negligence in some cases—will become a growing problem that could very easily become a national scandal. Having said all that, I part company with my noble friend Lady Greengross when it comes to Amendment 79. We have the criminal law. It may not cover absolutely everything but I would not want to see any increase in the likelihood that an overburdened family carer could face criminal charges if they reach the point where they cannot continue to care appropriately for a relative. For me, the purpose of adult safeguarding access orders is to ensure that problems are identified—they certainly need to be—and support is made available in order to enable a carer to cope in the style they would wish to provide.
Baroness Hollins
My Lords, I support the amendment in the name of my noble friend Lady Greengross on the duty to report adults at risk, which replicates a duty within the Welsh Bill. I spoke to a similar amendment in Committee.
Providers, together with other partners, will often be best placed to identify abuse and neglect, and it makes sense for them to report to the local authority. At Winterbourne View there were 40 safeguarding alerts, 29 incidents where the police were involved and 78 attendances at A&E but agencies did not take any action. They believed it was someone else’s duty to report and take action. Putting this duty in the Bill would emphasise its importance and would be a vital step in ensuring that the local authority is notified so that it can then take the appropriate action. Leaving this to guidance and local protocols is not a satisfactory solution.
I also support my noble friend Lord Rix’s Amendments 79A and 81A on safeguarding. My noble friend has highlighted how abuse comes in many different forms. The breakdown of the nature of referrals is set out clearly in the Abuse of Vulnerable Adults in England 2012-13 report. The most common was physical abuse at 38,500. There were 24,500 referrals for financial abuse, the third highest. It seems an eminently sensible amendment to add some balance to this clause.
My noble friend’s amendment on safeguarding adults boards sending copies of their annual report to the Secretary of State also seems eminently sensible. Looking at safeguarding annual reports across the country would allow the Secretary of State to see the national picture as well as to monitor what works and what does not. Guidance can be issued where worrying trends are observed and good practice shared. This is about leadership at a national and strategic level, which could help to tackle the abuse and neglect of the most vulnerable members of our society. I do not think it is about extra bureaucracy.
Lord Warner
My Lords, I rise briefly to support Amendment 77 and to ask the noble Earl whether his department has actually looked at the legislation that protects children to see whether this is in line with that legislation.
My child protection legislation knowledge and expertise are a bit rusty but the basic rule of child protection is that you see the child in their home environment. That is rule number one. If you look at many of the cases that have hit the headlines after going wrong, it is due to a failure to secure entry early on in the proceedings to see the child in their home environment. The noble Baroness, Lady Greengross, has highlighted a very important issue. I am still struggling to understand why the Scots and the Welsh think it is important to retain this kind of approach but we in England do not. There does not seem to be a consistency of purpose across the borders.
Lastly, with regard to neglect, if you look at the data on child protection, I think the fastest growing area in which courts are authorising care orders and approving care proceedings for children is neglect. We should not shy away from the fact that when times are hard this may be a growth area. I am very pleased that the noble Baroness, Lady Greengross, has included abuse and neglect in her amendment.
Baroness Barker (LD)
My Lords, I support the noble Baroness, Lady Greengross, particularly on Amendment 77 about powers of access and entry. She and I were both there at the birth of Action on Elder Abuse, which grew for a reason: people had identified and begun to codify the many different forms of elder abuse.
I absolutely sympathise with what the noble Lord, Lord Rix, is trying to do. Indeed, I had the same thought myself but I will defend the Bill by saying that other forms of abuse—physical, sexual, whatever—are set out in different pieces of legislation. What this Bill does is define financial abuse for the first time. That is really important because we know that very many older people are financially abused by relatives and until now the financial services industry has been pretty hopeless about dealing with it. That is why that is there.
A power of access is important precisely for the reasons identified by the noble Lord, Lord Warner. What we are talking about here is the right of a social worker with a police escort, having got permission via a legal document, to go into somebody’s house, where there is a suspicion that criminal activity may be taking place. That is the magnitude of what we are talking about.
Baroness Wheeler
My Lords, in addressing these amendments I once again emphasise that we very much welcome the placing of safeguarding on a statutory footing in the Bill, and the establishing of statutory safeguarding adults boards. This builds on the legislation, regulations and advice on principles and frameworks for safeguarding for both adults and children that we established up to 2009, which are now being taken forward in the Bill.
The noble Baroness, Lady Greengross, and other noble Lords, again made a comprehensive case for granting the power of access by a third party to private premises if they suspect that a vulnerable adult is being abused. The noble Lord, Lord Rix, spoke of “mate” relationships among people with learning difficulties. It was a powerful example of what we need to address.
We know that there is both strong support and strong opposition among local authorities, NHS trusts, the health and social care professions, and patients and user organisations on this sensitive and complex issue. However, we have to remember that the Government's consultation had a relatively low response, particularly in terms of local council and NHS trust participation. On top of that, many of the consultation responses appeared not to have fully understood the limited nature of the change that was being proposed: namely, that the new power would apply only to situations where it is the third party who is denying access, not the individual.
The noble Baroness’s amendment sets out tough limitations and restrictions that would apply to such a power. Local authorities would have to apply to the courts and demonstrate reasonable cause for suspecting that someone was in danger of abuse. The power of access would be to enable the local authority to access the person and speak to them alone to assess the situation. It is clear that it is intended as a last-resort power to address third-party denial of access to a vulnerable adult, for use after all other efforts and mechanisms have failed.
Getting the balance right between proactively intervening in the lives of individuals in this way and limiting the extent to which this interferes with their rights to freedom and family life is the challenge that we face. Certainly there is widespread acceptance that the existing powers to intervene under government legislation are not being fully utilised and are not addressing the issues, and that the training of specialist staff needs urgently to address this. Will the Minister explain to the House how the Government intend to deal with this?
As we said in Committee, on balance we support the case for inclusion in the Bill of the power of access by a social worker or the police where there is a danger of third-party abuse. Our work on safeguarding when we were in government, especially in relation to children, makes us sympathetic to the approach in the amendment of the noble Baroness, Lady Greengross. We recognise that safety should be paramount in this instance. However, we recognise the strong concerns of Mind on this issue, and of the Royal College of General Practitioners, which would prefer to use other powers, such as working with the sector to co-produce best-practice guidelines. Will the Minister explain how the Government propose that denial of access by a third party to a potentially vulnerable adult will be addressed if the issue is not dealt with in the Bill?
I support the intention of Amendment 79A, tabled by the noble Lord, Lord Rix, to include in the Bill a definition of abuse that reflects other types of abuse besides the financial abuse currently included in the Bill. The noble Lord has the very real concern that this would encourage hard-pressed local authorities to narrow their focus to financial abuse alone. The Confidential Inquiry into Premature Deaths of People with Learning Disabilities published its findings in March 2013. It looked at the deaths of 233 adults and 14 children with a learning disability in the south-west and found that 20% of the people concerned had experienced safeguarding concerns. While some of these may have been due to financial abuse, it is more likely that they concerned other forms of abuse: in particular, neglect. The study showed that 37% of deaths would have been potentially avoidable if good-quality healthcare had been provided. Neglect is undoubtedly one of the reasons, and thus the definition in the Bill should be broadened. I ask the Minister to look again at this and come back with a more balanced clause reflecting other types of neglect and abuse. It is important, for example, that hospital safeguarding leads should be clear that the definition is broad, and should take appropriate action.
The noble Lord’s Amendment 81A would also be a welcome alteration to the Bill. It is a small but important matter, because sending SAB annual reports to the Secretary of State will ensure that safeguarding is given the high level of oversight needed, particularly over areas that might be failing.
We also support the amendments to Schedule 2 contained in Amendment 81 from the Government, and Amendments 80 and 82 from the noble Baroness, Lady Greengross. The SABs would benefit from professional social worker representation, as would safeguarding adult review teams from having a qualified social worker supervising the review.
The two final amendments of the noble Baroness, Lady Greengross—Amendments 78 and 79—raise the important issue of establishing a new duty of care on a local authority or its relevant partner to report to the authority if they suspect that there is a failure of care, and to set out the terms of conviction for any person guilty of neglecting or ill treating an adult at risk of abuse. We share some of the concerns of the LGA, for example, on these amendments: namely, that there would need to be clarification of exactly what the care quality, professional practice and safeguarding concerns would be under the new duty, and how the duty would relate to other partners involved in service delivery. We also share concerns that while the criminal conviction provision may present the way forward in cases of neglect, it might unintentionally create a lower order of offence and tariff for older and disabled victims of crime.
Finally, I underline the vital need, when so much care now is contracted out and provided by the independent, private and voluntary sectors, to ensure that safeguarding is built into procurement and contract management in health and social care. Will the Minister tell the House how the Government intend to ensure that this will happen?
Earl Howe
My Lords, for the first time the Government will, through this Bill, place adult safeguarding in primary legislation. Local authorities, the NHS and police will have statutory duties to work together to help prevent and respond to abuse and neglect. This sends a clear message that safeguarding is not the sole responsibility of one agency but requires the very best of partnership working and information sharing. Amendment 77, which would introduce a power of access to a person for a confidential interview, runs counter to that message. Having said that, I am well aware of the strength of feeling in relation to this matter, both inside your Lordships’ House and elsewhere. Whether there ought to be a power of access or entry is a sensitive question. That is precisely why the Government launched a three-month consultation in 2012 to gauge the opinions of professionals and the public. The consultation revealed no clear consensus. Of 212 respondents, 50% backed a new power, with 40% opposed. However, among individuals, 77% disapproved. The majority of respondents in favour of a new power of access were health and care professionals, yet it was very noticeable that their responses revealed the painstaking weighing of potential benefits against unforeseen consequences.
The mental health charity Mind said:
“A power of entry risks being seen as a quick solution, in place of greater focus on community engagement, co-operation and a preventative approach that can be truly empowering to the people involved”.
This was a theme found in many responses. I stumble over the consequences of what the noble Baroness seeks to do. Here I respectfully but fundamentally disagree with my noble friend Lady Barker who said that there was no real comparison with the situation in mental health. A power such as this might well ensure access but the central issue will remain—how will the professionals then work with the situation to achieve the best outcomes? Trust will have been compromised and, short of a power of removal, which we certainly would not want to see, the options for action seem pretty limited.
Our consultation revealed no compelling evidence for further legislation. Even those respondents in favour pointed to how rarely a new power might be applied and identified potential unforeseen consequences. Proposed new Subsection 4(c) of the amendment states that an access order should be granted only if doing so,
“will not result in the person being at greater risk of abuse or neglect”.
I have to ask how a court could ever reliably make such a judgment in these circumstances.
The other key point which I would like to believe may sway the House is the following. There exists no legislative vacuum preventing care or other professionals accessing those in urgent need of assistance. Under the Police and Criminal Evidence Act 1984, the police have the power to enter premises if harm has occurred or, indeed, is likely to occur. The Domestic Violence, Crime and Victims Act 2004, the Fraud Act 2006 and, for those lacking capacity to make decisions, the Mental Capacity Act 2005, provide a wealth of powers for use at the front line, and the inherent jurisdiction of the courts to intervene provides a secure safety net. Therefore, it is not the lack of legislation; rather, as safeguarding lead directors at ADASS have put it, it is a question of a “lack of legal literacy” within the social care and other professions. What is needed is greater knowledge of existing legislative options. If they have that, professionals will be fully equipped to support people to be safe. The core role of an adult social worker is to support people. Further legislation for a new power of access risks undermining this approach, sending the message that legal intervention takes primacy over negotiations and consensus. I stress that legal intervention, on those rare occasions when it is needed, is already possible under the law. For those reasons, I cannot accept this amendment.
Lord Rix
I fully understand the argument that the Government do not want a great list of what constitutes abuse. However, the Minister said earlier that it would be possible to give local authorities a batting order, as it were, of what is in legislation. I realise that abuse is covered in legislation, but would it be possible at least to make sure that local authorities do not suddenly think that only financial abuse is to be considered when they look at this Bill? That is all I am asking for.
Earl Howe
I will gladly look into that point. I am sure that it is possible to do that but, as the noble Baroness, Lady Barker, said, many provisions on the statute book are designed to protect individuals from abuse in one form or another and make criminal offences of those actions. Nothing has changed as regards those criminal provisions. If they need to be underlined, however, and if there is scope for misunderstanding what the Government are doing here, then I take the noble Lord’s point, and will gladly reflect and come back to him on that.
Amendments 80 and 82 emphasise the need for involvement of social work-qualified staff in boards and reviews. In Schedule 2 we make it clear that chairs and members of boards must have the “required skills and experience”. It would be impracticable to put into primary legislation every possible type of expertise and professional knowledge that might be needed. We must allow boards the flexibility to appoint members as they see fit. We will, however, ensure that the importance of social work is recognised in guidance, which will also cover the importance of ensuring appropriately qualified oversight of safeguarding adults reviews.
Government Amendment 81 responds to an amendment tabled in Committee by the noble Lord, Lord Rix, and the noble Baroness, Lady Hollins. On reflection, I see merit in placing a duty on safeguarding adults boards to publish an annual report. This amendment will increase the transparency and accountability of boards.
Finally, Amendment 81A, tabled by the noble Lord, Lord Rix, requires that safeguarding adults boards provide their annual reports to the Secretary of State. With a duty on boards to publish their annual report, we can be assured that they will be publicly available. We would expect the local Healthwatch and health and well-being boards to monitor the safeguarding adults board’s progress and report to the Secretary of State if there are particular matters of concern. To require the board formally to submit a report to the Secretary of State would, if nothing else, undermine the primacy of local accountability, which is at the heart of our approach to safeguarding. I hope that, on reflection, the noble Lord will agree with me.
I hope that I have convinced your Lordships that we have done all that we properly can to provide the right legislative framework for safeguarding and, in consequence, that noble Lords will feel able not to move their amendments.
Baroness Greengross
My Lords, I have to say that I am extremely disappointed that the noble Earl cannot in some way meet the requirements that I put forward in my amendments. Unfortunately, the number of older people who suffer abuse is growing all the time. The sort of personal plans for care that we now want to introduce for everyone just make such abuse a greater risk than it was before. We know that an awful lot of older people are shoved in a room, the door is closed, they get their meal and no one does anything else. Over a long period, those people’s conditions can get worse and worse. When and if they are eventually discovered, it is too late to do anything to help them.
The sort of care that we want to provide for people might be damaged by a refusal to look at this issue in greater detail. I am really disappointed. I understand the noble Earl’s views but disagree with them. I thank all noble Lords who supported what I have said and I assure my noble friend Lady Meacher that I was not intending to persecute carers. My intention related to people who, I am afraid, inflict real harm and hurt on some of the most vulnerable people in our society. I have worked on this issue for years; that is why we set up Action on Elder Abuse, the only specialist agency to look at this. Its view is strong and has not changed. We must have some sort of protection for these very vulnerable people. I hope that one day we can get this matter looked at again and I hope that the Minister will consider it in the future. In the mean time, I withdraw my amendment.
Earl Howe
Before the noble Baroness makes a final decision, I hope that I have been clear that I have reflected on her amendment. I cannot give her false hope that I will reflect further between now and Third Reading; so if she wishes to test the opinion of the House, she should do so now.
Baroness Greengross
I am hesitating only because of time and I know that a lot of people have gone home. I thank the noble Earl for his advice and, on that basis, I seek to test the opinion of the House.
“( ) what it has done during that year to implement the findings of reviews arranged by it under that section, and( ) where it decides during that year not to implement a finding of a review arranged by it under that section, the reasons for its decision.”