Education and Adoption Bill

Baroness Evans of Bowes Park Excerpts

Tuesday 1st December 2015 Lords Chamber

[Baroness Benjamin (LD)]

My Lords, I rise to support Amendment 4. As I have said at all stages of this Bill, with the support of the NSPCC, every single child entering care should receive an automatic mental health assessment in addition to the physical assessment they currently receive. Children in care should then immediately receive the subsequent necessary support to help them to deal with the issues of mental health identified in the assessment. There should be regular monitoring of children’s mental health while in care to inform what support that child receives and ensure that it contributes to their improved well-being. These provisions are essential to strengthen the Bill because they will help towards making significant savings for the NHS, the prison services and society in general.

The NSPCC, myself and many others welcome the Government’s announcement of an additional £600 million for mental health and see it as a great opportunity to make sure that more of the most vulnerable children get access to the mental health support that they need to overcome the trauma they have experienced. As I have said time and again, childhood lasts a lifetime, so let us give all children the best start in life, including children in care and children in the adoption system. They need to be cared for and looked after in every way possible. We owe it to them, so I hope that the Minister will include these provisions in this important Bill.

[Baroness Evans of Bowes Park (Con)]

My Lords, I shall speak to Amendments 3, 4 and 5, tabled by the noble Lords, Lord Watson and Lord Hunt, the noble Earl, Lord Listowel, and the noble Lord, Lord Storey, which focus on improving the mental health needs of children adopted from care. I thank noble Lords for raising these issues. As the noble Lord, Lord Watson, said, we had a detailed discussion in our previous debate in Committee, when I set out that improving the mental health of both looked-after and adopted children is a key issue for the Government. Following the debate, the Parliamentary Under-Secretary of State for Schools sent a letter to the noble Earl, Lord Listowel, and the noble Baroness, Lady Benjamin, describing in more detail the actions that we are taking to improve the assessment and support that these vulnerable children receive.

As the noble Lords, Lord Storey and Lord Watson, said, I set out that the Government have committed £1.25 billion to improve mental health services for children and young people over the next five years through the implementation of Future in Mind, the report resulting from the Government’s review of child and adolescent mental health services. I can give noble Lords an assurance that we are now working closely with the Department of Health and NHS England on the implementation of Future in Mind. The NHS England guidance on completing local transformation plans stipulates that they should cover the needs of the most vulnerable children, such as looked-after and adopted children. Key to this is that local areas must work together to understand the vulnerabilities of these children and young people and transform their services accordingly. We are absolutely committed to looking at the needs of children and making sure that they are properly addressed. This will include addressing the important point made by the noble Lord, Lord Watson, about filling in the current gaps in services.

Local NHS clinical commissioning groups, in developing their local transformation plans, have worked closely with their local health and well-being boards and partners in local authorities, youth justice and education. All clinical commissioning groups have now submitted their plans, which are currently being assessed by NHS England. Improving the assessment of and support for looked-after children will be a key priority for our programme of work. I agree with all noble Lords and with the NSPCC, which has been cited a number of times in this debate, that getting the assessment right when children enter and leave care for adoption is important.

All looked-after children already have a health assessment at least once a year which must include an assessment of their emotional and mental health as well as their physical health. That assessment, which informs the development of their health plan, should take account of the information provided from the strength and difficulties questionnaire that is completed by their carer. I accept the point made by the noble Baroness, Lady Massey, that for some young people with a range of problems, a follow-on referral to a specialist health service is required.

Turning to the provision of a mental health assessment prior to adoption placement, when an agency is considering adoption for a child, it should immediately consult its medical adviser to determine whether the health information obtained through the most recent health assessment is sufficient, up to date and as broad-ranging as it needs to be. Where a new health assessment is needed, this should be organised in time for the medical adviser to complete their part of the child’s permanence report. That is because, as a number of noble Lords have mentioned, permanence is key.

[Lord Watson of Invergowrie]

I hesitate to break the noble Baroness’s flow. She mentioned that a new health assessment will be undertaken, but she did not specifically mention a mental health assessment. That is the point. The physical assessment is always done, so why should the mental health assessment not always be done at the same time or immediately afterwards to make sure that any problems are spotted at the earliest opportunity?

[Baroness Evans of Bowes Park]

The broad health assessment will include those elements. It must include a summary by the agency’s medical adviser of the child’s current physical and mental health, so both are included. When an application is made to a court for a placement order, the agency is required to submit the summary as part of the application. Local clinical commissioning groups should use these assessments of looked-after children and adopted children to inform their local transformation plans to ensure that they can meet the needs of their local population.

At the national level, the Department for Education hosted a roundtable event last month bringing together children’s social care and mental health stakeholders to discuss how to improve mental health services for looked-after children and adopted children. As a result, we are considering how centres of excellence, possibly linked to regional adoption agencies, might enable the mental health needs of looked-after children and adopted children to be better met. Following that roundtable event, Edward Timpson, the Minister of State for Children and Families, met Alistair Burt, the Minister of State for Community and Social Care, to discuss how to ensure that mental health services can meet the particular needs of these children and young people in an effective and timely way. I should like to reassure the noble Lord, Lord Watson, that the two departments are working closely together.

In addition, we are providing £4.5 million of funding in this financial year to accelerate the development and implementation of regional adoption agencies. Adoption support, including mental health, is a key element of that. We are clear that regional adoption agencies should have a focus on improving the assessment of adopted children’s mental health needs and the provision of appropriate mental health support services. I should also mention the government-funded adoption support fund. More than 2,000 families have already benefited from £7.5 million of therapeutic services provided by the fund for adopted children and their families. We know that getting a high-quality assessment of need is critical, and local authorities are increasingly using the fund to pay for specialist assessments and, where appropriate, specialist therapeutic support.

The noble Lord, Lord Watson, raised concerns about this Government’s focus on adoption. We are engaged in comprehensive reform, but we are also doing a number of other things. For instance, we have established a programme of reform for social work, including the development of new assessment and accreditation systems for three levels of professional practice for children’s social workers in England. We have created the children’s services innovation programme and we have introduced “staying put” to allow children to remain with their former foster carers after the age of 18. We are engaged in reform across children’s services that will benefit all looked-after children.

The noble Lord, Lord Storey, asked about getting CAMHS into schools. We heard from head teachers who came to the briefing a few weeks ago that one of the benefits of multi-academy trusts is being able to recruit professionals to work across a number of schools, so we are seeing improvements in that. Alongside this, the Future in Mind report says that there will be mental health training for health professionals and others who work with children and young people, such as staff in schools, to help them to identify problems and ensure that young people get the help that they need. So it is something that is on our agenda and we are continuing to look at how we can improve that.

I hope that the explanations I have given will reassure the noble Lord that we are committed to meeting the objectives of these amendments, and that he will be feel reassured enough to withdraw his amendment.