Schools (Mental Health Professionals) Bill [HL]

Baroness Wyld Excerpts

2nd reading
Friday 1st March 2024 Lords Chamber

[Baroness Wyld (Con)]

My Lords, I refer the House to my education interests as set out in the register, including as a non-exec board member at Ofsted, though of course I am speaking in a personal capacity. I am also the mother of three young girls, aged 13, 11 and nine, all in state schools. I am not sure whether that makes me more or less qualified to speak in this debate—I think they would probably say less.

Before I get to the noble Baroness, Lady Tyler, I say to the noble Earl, Lord Russell, as my noble friend did, that I was profoundly moved by what he said about his daughter. I know he has referred to her in a previous debate, and I send my very best wishes to the family. I very much back his point about continuing to speak up and talk about these matters. We are fortunate to have someone such as him to speak on them, as we are to have the noble Baroness, Lady Tyler, whom I congratulate on her Bill and her tireless work for children and families. I have been lucky to work with her on numerous committees in this House, and it is a pleasure. We are very lucky to have her.

I want to try to weave a message of hope into my speech, without sounding like I am being dismissive or not calling out where there are major problems. We all care passionately about this issue, and inevitably we have to call out where things are going badly wrong. It is essential that we do that for the children we want to help.

It is also very important that young people know that many people are committed to this cause, including, I know, my noble friend the Minister. The tone of the debate generally has recognised some of the work that the Government have already done, and I endorse that.

I absolutely support the principle of the Bill. Like the noble Baroness, Lady Tyler, I have campaigned for better mental health provision in schools for some years. I promise that this is not a co-ordinated move, but I share most of my noble friend Lady Berridge’s concerns and am not completely convinced that the practicalities of the proposed legislation would work. However, I acknowledge that the noble Baroness, Lady Tyler, would want to explore this if the Bill were to get to Committee. I think it will take a lot of work.

I want to use my time to talk a bit more about the wider context and the critical role that schools play. I have three points to make. My first point is about homes and families. I agree with the analysis of the noble Baroness, Lady Tyler, of the scale of the problem. Everybody has set it out very well, so I will not repeat what has been said. Under the strain of the pandemic, every young person in this country, at whatever stage they were at, spent some formative years at a time of extreme national anxiety. I do not think we yet fully understand the full impact that that has had, but we are recognising it and we are taking children’s mental health seriously. It is important to do this thoughtfully.

To go back to parents, one of the most important and hardest jobs for parents and carers is being able to strike a balance and understand when difficult feelings are normal and part of growing up and when professional intervention is appropriate. I do not know who said that there is a lot of jargon in this area—and there is—but somebody apologised for the jargon which makes it more difficult for parents and families. I have raised before the difficulty of navigating the system.

Even before we get to the school stage, I draw attention to the family hub model, which again has been mentioned. It should be able to help with this and create a partnership between homes and schools. In the same way that, in the early years, people have been able to turn to their health visitor and ask whether development is normal, we need to have a culture whereby people can say, “Is this mental health development normal, or do we need something else here?” The partnership between homes and schools is so important.

Attendance at school is so important for mental health and well-being. I see the stress on attendance as coming from a place of caring, not wanting to be punitive. The Chief Medical Officer was entirely right to say that it is often better for children with mild or moderate anxiety to be in school. I saw myself, during the pandemic, the impact on many children in our local community, and how they missed the structure and the social side of school, and the fun they had, even if they were not missing double maths.

However, provision has to be there. The noble Baroness, Lady Tyler, is entirely right: the key point about mental health is the importance of early intervention and tackling problems, rather than letting them fester and escalate. We should applaud, and we have, the work already being done in many schools. I am grateful for all the briefings we received. I am aware that I am beginning to sound like a stuck record in my pleas to the Minister, which are straightforward, but this needs to be prioritised in funding decisions.

I hope my noble friend is shining a spotlight on the evidence base; I know she will be. The data from NHS Digital and Place2Be around school attendance is compelling, and I have seen the impact of these projects myself on school visits. I have seen the work of charities such as Place2Be. When you hear it from the children and see the development that is made, it is really heart-warming. We should acknowledge that the Government are rolling out services and targets.

Like everyone else in this debate, I remain hugely worried about the number of children who fall through gaps in support. The “missing middle” is a horrible term, but there is no other way to say it quickly. We need to make people’s experience of navigating the whole system kinder and more human, because the people who work in this field are kind and human, and there is help out there, but the system sometimes feels impossible to navigate. Signposting and possibly better use of government communications could help with this.

My final point, and the thing I really want to say, is about admiration for the current generation of children and young people. As policymakers, we all need to be more adult in the way we talk about them. I hate seeing anything about “snowflakes”, or “Why aren’t they more resilient?”, because on Select Committees with the noble Lord, Lord Hunt, and the noble Baroness, Lady Tyler, we have taken evidence from the bravest, most resilient children I have ever met. It is our job to speak up for them. I wish they did not have to be so brave and resilient, because the fact is that they are having to be resilient every single time something happens to them and it is impossible not to be despondent when a young person does not get the treatment that they deserve.

However, there are absolutely brilliant people working in this area. There is proof that early intervention works. The system can work incredibly well, with insightful triaging and access to the right help at the right time. Young people need to know that feelings do not have to last for ever. I was trying to think of an equivalent song to counter the example from the Who and I cannot think of one—but we have got to give them some hope.

Once again, I congratulate my noble friend Lady Tyler and thank her for her commitment to children and young people. I know that I keep saying, “Can you just do more?”, but that is my message: just do more.

A Failure of Implementation (Children and Families Act 2014 Committee Report)

Baroness Wyld Excerpts

Wednesday 6th September 2023 Grand Committee

[Baroness Wyld (Con)]

My Lords, I remind the House of my registered interest as a non-executive board member at Ofsted. I recused myself as appropriate from the committee when those issues came up.

I warmly thank the noble Baroness, Lady Tyler, for her characteristically thoughtful and comprehensive speech. As others have said, it very much reflected her chairmanship of the committee, on which I was privileged to serve. She is one of the most fair-minded Members of your Lordships’ House; I have never once seen her tempted by political point-scoring, but that should not lull anyone into thinking, as we have seen, that she will not fight hard for her chosen causes. Her commitment to the welfare of children knows no bounds and she brings great expertise from her wider career. I also thank the team who supported the committee and, in particular, a lot of the witnesses who came to see us, some of whom were very vulnerable and had experienced trauma. They were very brave and generous in what they shared with us, which was hugely helpful.

Although our report pulled no punches in holding departments to account, I often stressed to the committee that we should not underestimate the original initiative taken by the coalition Government back in 2014 with the passing of the Act. Although I worked in a different area during my time as a No. 10 adviser, there was a collective sense across that Government of the coalition partners’ priorities. Life chances were up there in lights. Anyone who has worked at or near the centre of government, including probably most people in this Room, knows that central political will is the only way that priorities are felt across Whitehall.

I regret as much as anyone else the subsequent political instability and Whitehall churn that has, I have no doubt, resulted in patchy implementation and not good enough measurement of outcomes. That is entirely fair. However, we should recognise that the intentions were right. I think this Prime Minister and this Minister in particular are deeply committed to ensuring the best outcomes for the most vulnerable children and their families. We have had great stability with my noble friend Lady Barran, who has bravely held the fort—when I was speaking last summer, things were not great.

I am being a bit flippant but there is a serious point around responsibility. I accept that politics is politics and we all do it, but when you talk to children and young people about how the system works and where the levers are on what government can deliver, it is irresponsible to overstate failure. We can be robust about failure, but we must accept that there is will and good people working on these issues and that some progress has been made, which I will come to.

For once, the title of the Act is admirably simple: the Children and Families Act. It has often struck me how often in politics we talk about children with very little reference to families or parents. It is understandable that we devote much of our time to discussing, for example, curriculum content, online harms or, in the case of a Private Member’s Bill that I sponsored, Botox and body image, but too often as policymakers we all forget the most important thing in the world for a child: who is the person, or people, who looks after them? Are they kind to them or do they harm them? Are they safe or dangerous?

I am glad that the Government have spelled this out in Stable Homes, Built on Love and that, for example, kinship care is at last recognised. That was an astonishing omission from the original Act. I know the Minister will underline the importance of the pilot schemes and taking time to get the strategy right, but I add my voice to the calls for pace. I go back to my opening point—when political will is there, Governments can cut through complexities and deliver.

Looking more generally at adoption, the committee observed that, in England, between 2,500 and 3,000 children are adopted from care each year—about 3% of the total care population. Most of these children, some 76%, first became looked after because of parental abuse or neglect. Adoption is the most stable of all placement types: approximately 3% of those adopted return to care over a 12-year period. It thus provides a family life for most children. However, the effects of children’s pre-adoption adversities and maltreatment can be long lasting, and support for these young people and their families might be needed throughout the lifespan.

It is one thing to see the statistics but, like many others here I am sure, I had not fully appreciated the breadth and depth of support that many adopted children and their families need until I started to see it directly when friends adopted. Clearly, I am not going to share specific private stories as that would be inappropriate, but I have no hesitation in arguing that, where difficult funding decisions have to be taken, expert support for children who have experienced trauma has to be at the top of the priority list.

Across the parts of the Act on which the committee focused, two worrying themes emerged. One was crisis, which others have alluded to. Why is it the case that too many children and families cannot access support until things have escalated, whether that be into mental health crises, which I will talk about, or relationship breakdown? The second was the voice of the child. Too often it is lost. We heard this when it came to court proceedings for separating parents and made recommendations accordingly; others have focused on those so I will not run through them.

Although this Act was well intentioned and necessarily had to deal with the reality of separation, I do not believe that, as a society, we have done enough to address the causes of family breakdown. As legislators, we of course have to use parliamentary time to deal with the reality of divorce and make sure that the law works as effectively as possible. However, as I said during the passage of the divorce Bill, I believe that all those in a position of leadership—including, of course, the Church—should talk more about families sticking together wherever possible. The Minister will be pleased to know that I am not asking her to become the nation’s marriage guidance counsellor—she has a lot on her plate—but, as my noble friend Lord Farmer powerfully said, family hubs can play a role in relationship support at pressure points for families.

I hesitated about the next section of my speech, because I thought that people would say, “You’re saying you should stick together if you’re being abused or desperately unhappy”. Of course I am not saying that, but we have national conversations about all sorts of issues—identity, beliefs, Brexit—but we shy away from conversations about, for example, the reality of marriage once the honeymoon is over, the huge responsibility involved in bringing up children and the fact that individuals have responsibilities for others beyond themselves.

I turn to mental health, which was not included within the Bill but the evidence the committee took was so powerful across nearly all areas of the inquiry that we felt we had a duty to include it as a significant part of the report. We took evidence from experts, and from children and their parents or carers. We were careful to consider the danger of medicalising normal reactions to difficult experiences—somebody mentioned the Chief Medical Officer, who talked about cases of mild anxiety and the importance of being in school—but, for more severe cases, the impact of lockdown in particular was stark.

Increased prevalence of mental ill-health has put strain on services. Between April and June 2021, 190,271 under-18s were referred to children and young people’s mental health services. This compares with 81,170 in the same period in 2020. Responses to our online survey included:

“Appalling. We’ve been waiting for CAMHS for 9 months so far, and no indication how much longer”,


and

“My teenage son attempted suicide THREE times CAHMS did not help”.


Al Coates, the founder of the Adoption and Fostering Podcast and an adoptive parent, told us:

“I have a friend whose child made a viable attempt at suicide. They were put on an emergency referral to CAMHS—six months. That is an emergency referral”.


We heard that there are long waiting lists for post-adoption trauma support and that post-adoption teams are asking untrained school counsellors to do life story work with children, which they do not feel qualified to do. Looked-after children are four times more likely to experience mental health issues than their peers.

I and others have brought this issue to the Minister many times before. I am willing to acknowledge that the Government have recognised the scale of the problem and supported initiatives such as counsellors in schools, but my concern is whether the strategy is tightly focused enough and adequately resourced. Perhaps the Minister could set out for us—in writing, if there is not time today—how she sees the pathway working for children and young people. I acknowledge that there is no one-size-fits-all approach but there should be clarity for parents and carers on who to go to at different points in a mental health journey, according to severity, and assurance that the provision will be adequate when they get there.

I just have time to make a few points on flexible working. We debated at length how far we wanted to go on this, to strike the right balance between the needs of employers, and the desire among many to address gender imbalances in the workplace, and domestic duties, which has been a topical issue in my household for 13 years since my first daughter was born. My view is that parental leave is very generous in comparison with many other countries, but it was right to set an ambition for paternity leave. I also put on record again my thanks to the Government, who supported the Private Member’s Bill for additional leave for parents whose children are in neonatal care. We have to be nimble on this and recognise where the need is greatest.

In conclusion, it was an absolute pleasure to serve on this committee. I end by praising the resilience of the children and young people we heard from, and many more around the country from whom we did not hear. They are the leaders of tomorrow, and we must give them the chance to get there.

SEND and Alternative Provision

Baroness Wyld Excerpts

Thursday 9th March 2023 Lords Chamber

[Baroness Wyld (Con)]

My Lords, I welcome the plan and declare my interests as a non-executive board member at Ofsted and a member of the court of the University of Newcastle upon Tyne. I want to ask about an important part of the plan, which is transition to adult services, employment or higher education, which the Government have set out clearly as an ambition. Can my noble friend say a little about how the Government will assess whether things are getting better and whether the experience of when children are often at their most vulnerable is improving? What will be the measurement for that?

[Baroness Barran (Con)]

My noble friend will have seen from the plan that, particularly in relation to employment, we are investing £18 million to double the capacity of the supported internships programme. We will work with the Department for Work and Pensions on the adjustment passport so that young people do not have to retell their story endlessly and that employers are clear about what support they need. On accountability, together with parents, local authorities and health partners, we will develop local inclusion plans and local inclusion dashboards—I appreciate that that sounds slightly Sir Humphrey-ish, if that is a term. Importantly, parents, providers and local authorities will be able to track and see the impact of their plans, to compare their performance to that of other local authorities, and to understand how they can build, improve and learn. We are committed to improving the quality of data that we use so that everyone in the sector, who are all doing their absolute best to deliver for those young people, can work as effectively as possible.

Child Vulnerability (Public Services Committee Report)

Baroness Wyld Excerpts

Monday 11th July 2022 Lords Chamber

[Baroness Wyld (Con)]

My Lords, it has become customary to say it is a pleasure to follow the previous speaker, but it is a real pleasure and honour to follow the right reverend Prelate. There were so many interesting insights but also challenges to the committee, so I thank him for that. I need to draw attention to my interests as set out in the register, in particular my current interest as a non-exec at Ofsted; I recused myself where necessary during the inquiry.

I start by paying tribute to the chairmanship of the noble Baroness, Lady Armstrong. I miss serving on her committee, as it was a natural move for me to go over to the committee on the review of the Children and Families Act 2014, so ably chaired by the noble Baroness, Lady Tyler of Enfield. I want to take a moment to say that the noble Baroness, Lady Armstrong, chaired this inquiry with real verve and sensitivity. She and I disagreed from time to time, but she never got into political point-scoring, although some may say that she has now got plenty of opportunity. I have observed her throughout the pandemic and beyond; she is somebody who has continued to work tirelessly for vulnerable children and women in the most horrendous circumstances. I thank her wholeheartedly.

I hesitated but I feel that I need to say a few words about the wider context for tonight’s debate. I am very glad that my noble friend the Minister is the person to respond to it. I am not sure how she feels about it, but she too has dedicated a lot of her life to helping those in need. She certainly needs no lectures from me about how frustrating it is for many of us to debate this in the current circumstances, but we must plough on because we owe it to those people that we have heard about who gave evidence to the committee, sometimes in private and with exceptional bravery. We need to ensure that their voices are heard.

As we have heard, one of the most disturbing realisations highlighted by many of the witnesses was the fact that the pandemic silenced many of those most in need of attention. We have heard again about the number of vulnerable children who became invisible to services, which is why there was such a sense of urgency in the committee’s recommendations. I pay tribute to the millions of public servants and voluntary workers doing sterling work up and down the country. We were lucky to hear from many of them first hand, but we also heard of structural or systemic issues that mean services too often are piecemeal or almost impossible to navigate.

What really struck me and, I am sure, other members of the committee when we took evidence from people who had needed to access public services in times of crisis was the number of times that the system had broken down due to poor communication or data-sharing issues. I take all the challenges on funding and agreed with some of them but, interestingly for me, a lot of the witnesses did not come forward and say it was about funding. They said that something which seems very simple, such as changing GP practice, can then have a domino effect. We heard of one example that really stuck with me, in the treatment of postnatal depression, where something that should have been handled quite simply—and could have been avoided—then had ramifications not only for the mother but for the whole family, at the heart of which sits the child.

I lost count of the number of times on this inquiry, and during the one we did before on public services in Covid, when we heard from people who had faced awful situations. It was not people who had made mistakes or could have tried harder but because of situations that anyone in this Chamber would, I am sure, have found it incredibly difficult to deal with. They said, “I had to tell my story over and over again”, because the system was so disjointed. It was bad enough when you heard adults telling you this but when you hear young people and children say it, that is terrible. Despite the fact that we were hearing that, still the voices are not heard when the services are created, as the noble Baroness, Lady Pitkeathley, and others have said.

I note that the Government “partially accepted” recommendation 10 of the report on co-production and co-design. There were some promising examples on parent and carer panels. Can the Minister set out how we are going to know whether these are effective? What metrics are in place for them and the other examples that the Government gave?

Others have talked about family hubs. I was going to go through them but have listened to every word, so I do not want to replicate. I will just give my observation: the Government are doing a lot of good work here and I thought there was a genuine acceptance that this was a good solution. I liked the fact that Minister Quince came with a great passion and said that he saw them as “Sure Start-plus-plus-plus”. All that was there. I accept the need for evidence-based policy-making, obviously, but I had a nagging feeling the whole way through that there was not quite enough urgency around implementation and delivery. The Government recognised that there were problems in rollout but did not say what steps were being taken to cut through the complexity, which is the job of governing. Again, I have cut short the points I was going to make, but I would be grateful if my noble friend could provide an update to the House. The noble Baroness, Lady Armstrong, raised that point as well.

I want to talk briefly about mental health again, because I expressed my concerns during the committee—and years before that, actually, with many others, including the noble Baroness, Lady Tyler, who have been talking about the fact that this has been a neglected area for so many years. Again, the Government have done some good work here and taken a thoughtful approach over the years. I have seen, first hand, some brilliant examples of mental health services delivered in schools by charities and I am a huge champion of early intervention, which was one of the core themes of the committee, but some children need further specialist support. Not everything is solved at that earlier stage, and I do not think we heard from anybody, and I do not know anybody, working with children in a professional capacity who is not hugely worried about the pressure on CAMHS. I probed this at the committee and did not think we got a particularly strong answer from Ministers, but maybe I am being unfair.

I want to talk briefly about the fact that I know some commentators feel we are in danger of medicalising what are normal anxious or low feelings. I agree that there is a balancing act in early years when you talk about emotions, mental health and mental well-being, but I am talking about young people who are self-harming or those who have eating disorders or suicidal thoughts. There are awful situations with thresholds, where their parents are told that they do not meet them. The system seems very painful and difficult to navigate in the worst circumstances. Can my noble friend kindly update the House on what assessment the Government have made, or whether she thinks I am overstating it, of the immediate requirements for CAMHS? What steps are being taken to address this in terms of both the crisis and immediate response, some of which can be blamed on the pandemic, and longer-term workforce planning?

To sum up, as we have heard, all children faced a huge burden during the pandemic. but many or most of them will be able to move on. They will recover without needing the support of public services beyond what anyone might expect. However, as the noble Baroness, Lady Armstrong, said: for those who cannot, for whatever reason, we have one chance to help them urgently, so please do not let us miss it.

--- Later in debate ---

[Baroness Pinnock (LD)]

My Lords, this has been an excellent debate, with many issues raised, questions asked and challenges given. I am sure that the Minister will be able to respond with her usual careful consideration.

This important report starts by reminding us that over 1 million children are growing up with reduced life chances. This stark reality has negative implications for us all, not just those children and their families. For the children concerned, it may lead to lower educational attainment, with a knock-on impact on their life chances in employment, for example. When policymakers focus on skill levels that are not meeting our current needs, as they often do, they should be required to consider the evidence in this ground-breaking report. It demonstrates that too many of our nation’s children are raised in family circumstances that restrict their development. The sad fact is that intervention by the state is too little and far too late for many of these children. Worse still, the evidence gathered by the report points to the colossal waste of public funding in the failure to intervene early in these children’s lives.

I record my thanks to the chair of the committee, on which I was lucky enough to serve, the noble Baroness, Lady Armstrong of Hill Top, for her leadership and her persistence in following the evidence and then finally gathering us all together to agree—which was not always easy—in the production of this report, which I sincerely believe is invaluable.

I will focus my contribution this evening on funding issues. This is where I will disagree with the noble Baroness, Lady Wyld, because I think funding, and the lack of it, is at the heart of this report. Lots of other issues are very important and have been raised, including data sharing.

[Baroness Wyld (Con)]

I do not think I said that funding was not important. I said that some witnesses had pointed to problems that I thought were not necessarily directly related to funding; they were about communication issues and join-up. Indeed, at times I have called for extra funding for early years myself.

[Baroness Pinnock (LD)]

I thank the noble Baroness for putting that on the record and I withdraw any criticism that I have wrongly made.

The numbers of children likely to benefit from external support from local services are staggeringly high. We heard that 1.6 million children—that is an awful lot of children—were helped by local authority children’s services in the six years between 2012 and 2018. In addition, the Office of the Children’s Commissioner estimated that as many as 750,000 were known to social services but “received no support”. Further, as we have heard in other contributions this evening, an additional 800,000 children were deemed “completely ‘invisible’ to services”, although likely to “need help” because of the circumstances in which they were living.

The committee was mindful of the wise words of Martin Lennon of the Office of the Children’s Commissioner, who said:

“Not all vulnerable children are poor, and not all poor children are vulnerable.”


However, he then went on to make clear that there was a definite “correlation between poverty” and children being, and becoming, “vulnerable”. Since the report was completed, families are now having to contend with the cost of living crisis. Those families who are just managing now will have very considerable additional costs for basic essentials. All commentators expect that there will be even more children living in poverty with the consequences enumerated by this report. The challenge for the Government is to determine the most effective and cost-efficient ways of supporting vulnerable children for their, and our, benefit.

The committee heard from many witnesses that the key to cost-effective support is to provide help “as early as possible” in a child’s life. Obviously, that means that funding for early intervention is critical. However, early intervention funding is not statutory. Admitting children into the care of the local authority is a statutory reaction in response to a family in crisis. This is done at very considerable cost to the public purse: for example, foster care rates are between £140 and £200 a week, depending on the age of the child. This is for local authority foster care; it is considerably higher for agency foster care.

As the report concludes: early intervention is a key to enabling better lives for vulnerable children. Unfortunately, local authorities saw a £1.7 billion yearly reduction in early intervention programmes since 2010. Those communities in highest need experienced the largest cuts to these services: councils with the highest levels of deprivation saw reductions of over 50% in real-terms spending—therefore, a per-child average of £141 where poverty is highest. From 2010 to 2019, those with the lowest levels of poverty had budget cuts of only £182 million per annum.

Early intervention is based on supporting a family in their own home; later interventions—such as foster or residential care, as I explained—are much more expensive. Yet the report found that, while there was a 48% reduction in early intervention services, there was a 34% increase to “higher-intensity” late interventions, which, as the evidence from Barnardo’s showed, despite being vastly more expensive, had worse outcomes for children.

One statistic clearly shows this failure of public policy. The number of children looked after in England has risen from 65,520 in 2011 to over 80,000 now. Andrea Leadsom’s review of child health inequalities quoted research by the LSE which showed that £16 billion of public money was spent in a single year on children and young people who have serious problems, all of which could be traced back to their early experiences. Her review said that

“you can certainly argue that you will save a good portion of that by investing earlier.”

The Government have made some welcome moves towards the provision of early intervention in the creation of family hubs, but much more needs to be done. As the report recommends at paragraph 60:

“To underpin a strategy on child vulnerability and its ambitions for ‘levelling up’, the Government should restore ringfenced funding for early intervention to its 2010 levels.”


I agree.

Other noble Lords have highlighted the other key recommendations in the report such as listening to the voice of the user—what a powerful experience that was. It was a privilege, actually, to hear the voices of the users. How great their contribution could have been to improving the quality of the services they need and to the Government having an effective strategy. It is appalling that there is no strategy. It is apparent that there is no strategy for helping 1 million of our children and, from all the evidence that we have heard, saving lots of money at the same time. Why do we not get it done? Finally, there is the importance of the professionals working with the users and the voluntary sector to the benefit of children. I just hope that this excellent report has the impact on decision-makers that its quality deserves.