Policing and Crime Bill

Debate between Baroness Howe of Idlicote and Earl Attlee

Report: 1st sitting: House of Lords
Wednesday 30th November 2016 Lords Chamber

[Baroness Howe of Idlicote]

My Lords, I think I will leave aside the contribution of the noble Viscount, Lord Hailsham. I do not really agree with what he said. My name is on this amendment and I support it because it would create a clear and explicit referral pathway for child victims of a sexual offence or other forms of child abuse for an assessment of their mental health needs.

As we have heard, the amendment would deliver on the Government’s own commitment in Future in Mind and work to put in place policies that go a step towards creating parity between physical and mental health. The Government say that they want to develop:

“A better offer for the most vulnerable children and young people”,

including by ensuring that,

“those who have been sexually abused and/or exploited receive a comprehensive assessment and referral to the services that they need, including specialist mental health services”.

The amendment would deliver on that ambition.

It is important to recognise that the Government have made welcome steps in this area, in particular through their investment of £1.4 billion over the course of this Parliament in children’s and young people’s mental health services. However, there is evidence to show that this is not yet reaching the most vulnerable. According to research from the Education Policy Institute, in the first year of funding, of the expected £250 million only £143 million was released—and of that, only £75 million was distributed to clinical commissioning groups. For 2016-17, £119 million has been allocated to clinical commissioning groups—but this has not been ring-fenced, risking that it will be spent on other priorities.

It is clear from the evidence available and what we have heard today that these young people are at extremely high risk of developing a mental health condition. Lifelong difficulties can result in drug and alcohol abuse, mental ill-health, homelessness, gang affiliation and/or disability if the underlying trauma of their experiences is not met with swift and appropriate intervention. Research has found that up to 90% of children who have experienced abuse will develop a mental illness by the time they are 18. In the spirit of parity between physical and mental health to which we all aspire, in a comparable physical situation people would be screened and have regular check-ups, yet we do not offer the most vulnerable children the same opportunity to receive the help they so vitally need.

National policy is increasingly focused on the social determinants of long-term health. Evidence has shown that adverse childhood experiences are a key risk factor for poor outcomes such as worse health, coming into contact with the criminal justice system and worse employment and educational outcomes over the life course. Children who are victims of a sexual offence are often left without support for their mental health difficulties, which are likely to develop into more entrenched mental health conditions later in life, because they do not meet the thresholds for clinical interventions or because a suitably trained professional does not properly assess their mental health needs.

This amendment would provide national consistency, as we know that the situation across the country is inconsistent and young people are not always getting the holistic assessment they need to meet their needs. Thresholds for mental health clinical interventions are inconsistent across the country and referral routes into CAMHS are varied, with some areas not allowing the local voluntary sector to refer directly. Some sexual assault referral centres refer children for mental health support, but others do not.

In her response in Committee, the Minister mentioned the commissioning framework for adult and paediatric sexual assault referral centre—SARC—services, published in August 2015. However, case-tracking evidence from the Havens in London found that, of the 24 children under 13 who were reviewed, only three were referred to CAMHS and that, of the 56 young people aged 13 to 17 who had their cases reviewed as part of the study, only five were referred. It was acknowledged in the same report:

“Few children are referred to CAMHS from the Havens, most likely as interventions are generally at the forensic examination stage and it is difficult to determine longer term emotional support needs at this … stage”.

It is therefore necessary to ensure that other agencies have a duty to refer for a mental health assessment, in order to guarantee that a young person’s holistic mental health needs are assessed after their traumatic experience.

Alongside providing national consistency, this amendment would introduce a referral for an assessment and enable better understanding of the level of support that needs to be provided both by CAMHS and outside CAMHS. This will lead not only to better responses and referral routes for young people but a greater understanding to inform commissioning at local level, so I hope that the Minister will be able to accept this amendment.

[Earl Attlee (Con)]

My Lords, I accept the principle in the amendment of the noble Baroness, Lady Walmsley, in cases of persistent abuse but I am afraid that I am with my noble friend Lord Hogg. There is—

Children and Families Bill

Debate between Baroness Howe of Idlicote and Earl Attlee

Wednesday 6th November 2013 Grand Committee

[Earl Attlee]

I think it would be helpful if I reminded the Committee that provisions in the Bill do not change any arrangements. If it is found to be cost-effective to send a child overseas as part of the EHC plan, no doubt that will be done. However, as the noble Baroness explained, that will be an extremely expensive option and therefore will be most unusual.

[Baroness Howe of Idlicote (CB)]

My Lords, I must say I find this extremely confusing. I share the concern that the result of it all may be that the opposite happens: that is, that there is rather more demand for this activity once it looks as if this sort of arrangement could be made almost around the world. Do noble Lords think that it might be more sensible to devote a little more time to this issue and perhaps have a meeting with the experts so that the right wording is put into the Bill? I do not know whether others feel as I do, but this is a bit confusing.

[Earl Attlee]

My Lords, I am always delighted to have meetings with noble Lords and I am sure that my noble friend Lady Northover would be delighted to have a meeting on this and perhaps look into it in a bit more detail.

--- Later in debate ---

[Earl Attlee]

My Lords, I am grateful to the noble Baroness, Lady Howe, for moving this amendment and for continuing to raise this issue. In tabling this amendment, she is highlighting a specific need for local authorities to secure provision to support parents of children with a hearing loss. I think that the noble Baroness spoke in a recent debate in the Chamber when I was supporting my noble friend Lady Jolly. I agree that where there are identified needs, local authorities should provide communication support for parents of children with hearing loss. I recognise the importance of early access to language to help children to learn and to thrive, and it is vital that parents and families get support to communicate in those early months.

The noble Earl, Lord Listowel, mentioned the importance of early bonding between the child and the parents. I am not trained in social work, but even I understand that that is extremely important to the development of the child. If that does not take place, the development of the child will be permanently set back.

As noble Lords will note, the Bill already places duties on local authorities to identify, assess and secure special educational provision for all children and young people with SEN. This could include sign language support for those who need it. During the recent debate that I referred to, one of the issues raised was sign language training for parents, of which more later. Your Lordships may find it useful to refer to the Hansard of that debate, because I found the response of my noble friend Lady Jolly very interesting.

The Bill also requires local authorities to set out a local offer of the support that is available so that parents are aware of what is available to them. Clause 32 requires local authorities to provide parents of children and young people with advice and information about matters relating to special educational needs, which will include parents of deaf children. However, it is for local authorities to decide the appropriate way to structure that support. I can see that the noble Baroness is not entirely content with that statement.

There is already support available to assist parents of deaf children. Through teachers of the deaf and sensory support services, local authorities are providing support to parents of deaf children on communicating with their child, which can include sign language training. The Department for Education is working with the voluntary and community sector to enable local areas to benchmark the support that they provide to deaf children and to access tools and information on the most effective approaches. In particular, we are funding the National Sensory Impairment Partnership, NatSIP, to carry out a benchmarking exercise and develop an outcome framework for local authorities to assess how well they are supporting deaf pupils. They will work with sensory support services across the country in the development of a local offer for deaf, blind and multi-sensory impaired children and their parents. The noble Earl, Lord Listowel, talked about multiple sensory impairment.

We funded the development of an early support guide for parents of deaf children and the I-Sign project to develop a family sign language programme. We are funding the I-Sign consortium to build on the learning from this project and improve the availability of sign language support for parents and families. As part of this, I-Sign is testing the use of personal budgets to fund sign language.

As I have already explained, there is already support available for parents of deaf children in addition to the duties in the Bill. It will not be appropriate to have specific duties relating to specific types of need and support as this would lead to confusion and gives precedence to particular types of need over other, equally pressing types of need. With this reassurance I hope that the noble Baroness will feel able to withdraw her amendment.

[Baroness Howe of Idlicote]

My Lords, I thank the Minister for his considered reply. I am not entirely happy with what he said, although I was not expecting to hear a great deal of detail. He gave some moments of hope with the I-Sign consortium being funded but, as we all know, that will go only some way. I thank the noble Baronesses, Lady Wilkins and Lady Walmsley, and my noble friend Lord Listowel for their brief contributions. I cannot say that I am not going to bring the amendment back because I and others will want to think about whether there is a better way of getting rather more out of this section. This is such an important group, and their basic human rights are at least as important as everybody else’s. We need to ensure that they have the proper proportion of whatever resources are available. I beg leave to withdraw the amendment.