Children and Vulnerable Adults: Abuse

Baroness Northover Excerpts

Thursday 26th June 2014 Lords Chamber

[Baroness Northover (LD)]

My Lords, I, too, thank my noble friend for tabling this important topic for debate today. As other noble Lords have said, the fact that the reports on Jimmy Savile’s reign of abuse have been published today shows how extremely timely it is and how we must all be vigilant to ensure that everyone, however old, young or vulnerable, can live free from abuse and neglect. The noble Baroness, Lady Howarth, explained that that often happens in the home or in familiar places with familiar people.

In all respects, we must counter abuse, as my noble friend Lady Walmsley said, through culture change, or legislation, regulation and training. We need to support professionals in this difficult and complex work—I pay tribute to them, as did the noble Baroness, Lady Howarth—but we also need to challenge them and agencies to do the right thing and act quickly when things go wrong. That also means holding people and organisations to account. We also need to be aware of the cultural shifts, such as those manifested and driven by the expansion of the internet, as the noble Baroness, Lady Howe, and others mentioned.

There is a well established legislative framework for social care and support for children set out in the Children Act 1989, including the duties of local authorities in relation to children in need in their area, as well as their child protection duties, but we know that child protection does not always work as effectively as we would want. As the noble Lord, Lord Bichard, noted, continued and repeated serious case reviews and other investigations provide stark reminders that there is much more to be done. He is right about ensuring that we learn from them.

The right reverend Prelate the Bishop of Durham noted the long history of abuse in our institutions, whether schools, hospitals, the police or even churches. My honourable friend the Minister of State for Crime Prevention, Norman Baker, is leading a national group of experts urgently to address missed opportunities to protect children and vulnerable people. He is assisted by members of the NSPCC, Barnardo’s and Rape Crisis. The group is looking at lessons that could be learnt from recent and current inquiries to see what should be taken forward.

There were noble Lords on either side of the question of holding a public inquiry. I note what the noble Baroness, Lady Howarth, and the noble Lord, Lord Bichard, said, about following through on the reports that we already have, but I also noted what the right reverend Prelate the Bishop of Durham said. What it comes down to is that nobody is satisfied with where we have got to; we have to ensure that we do better.

The noble Lord, Lord Stevenson, mentioned Professor Eileen Munro’s review of the child protection system in England and her report in 2011, with all her recommendations. Most of them have been implemented. In the Working Together to Safeguard Children statutory guidance, we have focused more clearly on the core legal requirements that all professionals should follow so that children are kept safe. We have also sought to put the needs of individual children back at the heart of the assessment process by removing the requirement to have separate initial and core assessments.

As noble Lords are clearly well aware, changes to the overarching framework on their own are not sufficient to ensure real improvement on the ground. That is why improvements to social work practice are crucial. For the first time, a Chief Social Worker for Children and Families has been appointed in England to provide independent, expert advice to Ministers on social reform and act as a leader for the profession.

Following Sir Martin Narey’s review, we are taking forward a number of reforms to improve the calibre and confidence of the workforce by improving social work training and developing further the skills of existing social workers via programmes such as Step Up to Social Work and Frontline. The new Ofsted single inspection framework looks at the child’s experience from the point of needing help and protection right through the system. In addition, CQC has also introduced a new programme to inspect local health service arrangements for these groups, and we are planning further improvements, with multiagency inspections due in 2015. By ensuring that serious case reviews are published we are seeking to improve public accountability where there have been failures to keep children safe.

The new children’s social care innovation programme should help us to support the development, testing and sharing of new and effective ways of supporting children who need help from children’s social care services. My noble friend Lady Walmsley rightly emphasised the need for research and practice to be evidence-based, a point that the noble Lord, Lord Bichard, echoed. My noble friend Lady Walmsley commented on the Government’s consultation on the outsourcing of children’s social care functions. Following that consultation, as she noted, we announced last Friday that profit-making organisations would not be able to take on outsourced functions, including those relating to child protection, and draft regulations have been amended accordingly.

The issue of mandatory reporting was raised by my noble friend Lady Walmsley, the noble Baroness, Lady Hollins, and others. This is one of a number of possible future approaches that the Government are considering. The Government are reviewing the specific case for mandatory reporting in regulated activity and the Home Office is looking across government at options to strengthen the system. I note the comments of the noble Baroness, Lady Howarth, and the noble Lord, Lord Bichard. I hope that the noble Lord will be reassured that we will continue to examine the evidence on this, both nationally and internationally.

My noble friend Lady Walmsley mentioned PSHE and how it could help to protect individuals. We believe that all schools should teach PSHE, drawing on good practice. My noble friend Lord Paddick spoke about victims and survivors and the need to believe them. The Crown Prosecution Service published final guidelines on prosecuting cases of child sex abuse in October 2013, setting out a new approach to dealing with the particular issues that differentiate these cases. Focusing on the credibility of the allegation rather than the credibility of the individual is a significant cultural shift which recognises and addresses the particular vulnerability of some of these potential victims. We published the new victims’ code in December 2013. I hope that my noble friend Lord Paddick has seen it and feels that it is a positive move.

On health services, the Government’s mandate to NHS England sets it an objective of continuing to improve safeguarding of both adults and children in the NHS. One issue that has come up here is making sure that information sharing is done early and systematically. This was emphasised by my noble friends Lady Walmsley and Lady Sharp, the noble Baroness, Lady Hollins, and others. We know that early information is the key to providing effective early help where there are emerging problems. No professional should assume that someone else will pass on information which they think may be critical to keeping someone safe. We have recently rolled out the first wave of sites on the child protection information sharing project. This aims to help health professionals to make clear, timely judgments on potential safeguarding concerns and enable more rapid contact with children’s social care. We have emphasised in statutory guidance, Working Together to Safeguard Children, that effective sharing of information between professionals and local agencies is essential.

For adults at risk of abuse and neglect there needs to be a keen focus on the quality as well as the length of life. I note what my noble friend Lady Browning said about the quality and valuing of staff and about training them so as to ensure that they are looking after people with empathy. We need radical reform of how health and social care are experienced and delivered. The Care Act 2014 starts this process by providing a legal framework placing the well-being principle, prevention and early intervention at its heart. However, we are under no illusion that legislation alone will eradicate the type of behaviour that leaves people feeling distressed, frightened and humiliated. This can be realised only through a change in culture that leaves no tolerance of abuse, supports individual and collective responsibility for detecting abuse and challenges corrosive practices.

With services, people must be held to account for the quality of care that they provide. We are taking measures to ensure that company directors who are complicit in, or turn a blind eye to, poor care will be liable to prosecution. In future, they and provider organisations could face unlimited fines if found guilty. This could provide additional incentives for the effective management and support of staff—and those staff must be properly valued, as the noble Baroness, Lady Hollins, and others have argued.

Systems and processes are already in place to provide public assurance, including the Care Quality Commission registration requirements and the Disclosure and Barring Service. I note what my noble friend Lady Walmsley and the noble Lord, Lord Bichard, have said about the falling numbers of people barred from working with children. We note that, and the Government are currently reviewing the position. When we conclude, I am sure that noble Lords will be interested in what we have found. However, those processes alone do not go far enough. That is why, following the publication of the Francis report into the failings of Mid Staffordshire, we asked Camilla Cavendish to review how healthcare assistants and support workers in health and care settings were valued and supported. We are also considering the proposals in the Law Commission’s review very carefully.

My noble friend Lord Eden and others will be interested to know that the introduction of a certificate of fundamental care, the care certificate, will, we hope, give clear evidence to employers, patients and service users that the person in front of them has been trained to a specific set of standards and knows how to act with compassion and respect. Health Education England, working alongside key partners, has already begun piloting this across England. Subject to evaluation, there will soon be a standard national approach to training on the skills and values needed to be an effective healthcare assistant or social care support worker. It is planned to roll this out in March 2015.

As with children’s social care, we recognise that the system of regulation and inspection for adults needs to improve; I hear what my noble friend Lady Sharp said. The CQC is currently introducing a new system of inspection of social care providers, based on much tougher fundamental standards of care, which places the individual at its heart. It will be structured around five key questions that matter most to people: are services safe, caring, effective, well led and responsive to people’s needs?

New measures in the Care Act make clear the responsibilities of local authorities and key partners, such as clinical commissioning groups and local police, in safeguarding adults. This is vital in ensuring clear accountability, roles and responsibilities for helping and protecting adults who are experiencing, or at risk of, abuse and neglect. The Department of Health is working with the College of Social Work, the Social Care Institute for Excellence, the College of Policing, Health Education England, Skills for Care and others to ensure an integrated approach to adult safeguarding that is reflected in the training that different staff receive.

In response to my noble friend Lord Eden, who made an important point about the contribution that carers make, the Care Act 2014 gives carers parity with those using services. I also mention to the noble Baroness, Lady Howarth, and my noble friend Lord Thomas that a review was recently conducted looking at ways in which to reduce the distress to victims of sexual violence in trials. The Crown Prosecution Service has set up a network of specialist prosecutors, and only advocates from that panel can be used to prosecute child sexual abuse cases. All judges receive training that includes the treatment of vulnerable witnesses, and no judge involved in a serious sexual offence case, whether the child is a victim or a witness, can do so without being specially authorised to do so by the senior judge. I listened with care to what my noble friend Lord Thomas said about sexual offences right across the age range.

Finally, on the point of child sexual exploitation, we have established a national group that seeks ways to prevent sexual abuse happening in the first place. In relation to the report from Barnardo’s, we remain committed to ensuring that all necessary legislation is in place to tackle child sexual abuse. We welcome the recent inquiry and we are reassured by the conclusion that there is no evidence to show that justice could not be served due to a lack of a specific child sexual exploitation offence. We are considering its findings and wider recommendations and deciding how they can inform the national group’s ongoing work.

There have been many important contributions in this very thoughtful debate and I will make sure that this debate is flagged to my colleagues both in the Department of Health and the Department for Education. I will also write to noble Lords on specific points that I have not covered here. These are very important and interlinked issues but, in essence, it is indeed, as was mentioned before, about how civilised we are. It is about how even the most vulnerable in our society should feel safe and cared for and, as my noble friend Lord Eden put it, we must be more aware of our common humanity.