Health: Obstetrics and Gynaecology

Earl of Listowel Excerpts

Monday 17th July 2017 Lords Chamber

[Lord O'Shaughnessy]

I shall certainly give that consideration. There may be specific reasons why, in particular instances, that might not be possible or even desirable, but I shall certainly look into it. Take one of the instances: the tragedies at Morecambe Bay. It was found that there was a lack of objectivity in investigations and that that—along with other problems such as a lack of good data—led to the kinds of tragedies we saw, not happening once but over and over again. I completely take the noble Lord’s point, and I will look into it.

[The Earl of Listowel (CB)]

Is the Minister aware of the excellent work of the charity Best Beginnings, of which I am a patron, which provides perinatal support to families? The charity has, for instance, created videos to support families with very premature children, helping them to bond with their children. With the Royal College of Gynaecologists and Obstetricians, it has developed the Baby Buddy app, which gives parents exactly the information they need during and after pregnancy, so that they can have the safest pregnancy possible.

Queen’s Speech

Earl of Listowel Excerpts

Thursday 29th June 2017 Lords Chamber

[The Earl of Listowel (CB)]

My Lords, I declare my interests which are set out in the register. I am a trustee of the Brent Centre for Young People, a mental health service for young adolescents, and two other mental health and child welfare charities. I welcome in particular what the noble Lord, Lord Ashton of Hyde, said in his opening remarks about the forthcoming Green Paper on children and young people’s mental health. It is encouraging to see the work being done on all sides to raise the profile of mental health in recent years and I know that the whole sector is grateful to those members of the Royal Family who have chosen to champion a number of charities that are working with young people with mental health issues. We can see the consequences of this as more and more grant-procuring bodies are choosing to fund this kind of work, and that does make a difference.

I want to ask the Minister about looked-after children and care leavers. The Government have done much good work over the previous years, but the concern is that given the current changes going on, some of the forward momentum in this area might be lost. I seek a reassurance from him on those matters in the form of a letter or perhaps a meeting which his colleague the noble Lord, Lord Nash, might arrange along with Robert Goodwill, the new Minister of State, and interested Peers in order to talk about the issues relating to looked-after children and care leavers.

The Government have been funding the family drug and alcohol court, an innovative system where judges oversee a family over the course of a year. They work with social workers to ensure that parents stay off drugs and alcohol. If the parents succeed in doing so, their children can remain with them rather than being taken into care. The President of the Family Division has recently alerted us to the fact that there is a crisis in terms of the number of children coming into care since the death of Baby Peter. The numbers are continuing to increase so this is very important work. I look forward to receiving a reassurance about the future of the FDAC.

When we were considering the then Children and Social Work Bill the noble Baroness, Lady Tyler of Enfield, who is the chair of CAFCASS, persuaded the Minister, the noble Lord, Lord Nash, that we needed to look at the assessments, particularly the mental health assessments, of young people being taken into care. The Minister undertook to commission six pilots in local authorities to look at different ways of assessing the health needs of young people entering care. Again, a letter and a meeting would be helpful as a reassurance that the work is going forward.

The Government have produced a helpful report of Sir Martin Narey’s review of children’s homes. Unfortunately, I still have some concerns about the care and indeed the safety of children in residential care, and that is another topic I would be grateful to hear about, although it ought to be more a subject of conversation with the Minister.

Out-of-authority placements have always been a difficult issue. This is when a foster child or a child in residential care is placed in another local authority. The danger is that the child may be out of sight and therefore out of mind. Recently a designated nurse for looked-after children raised a concern that young people from her local authority were being placed in another local authority. I shall pull out of the air the names of two authorities, Lambeth and Southwark. Lambeth has a boy who is placed in Southwark. That boy will not have the same rights to mental health and other services which looked-after children from Southwark may have. It is likely that another boy from Southwark will have access to better services. We need clearer guidance on what local authorities should be doing in this area to ensure that children who are given an out-of-authority placement are entitled to the same services as those who are not.

We heard earlier today about the importance of apprenticeships and of opportunity. A young person, Fatima, talked to Peers three months ago about her difficulties. She was in an excellent City apprenticeship with an accountancy firm but was struggling with her housing, which she was just holding on to. She also has a disability. She is very bright. English is not her first language. She was doing well. I heard her speak at a conference. She could not hold on to her housing and lost her apprenticeship. This is the case for many young people leaving care in London and the south-east. They are placed in private rented accommodation and are caught in a trap. If they start working, their housing benefit begins to reduce and they cannot therefore hold on to their accommodation. Edward Timpson listened to these concerns when he was an MP. I want to be sure that consideration is given to that issue. It is another issue for a letter and perhaps for discussion in the meeting. I say in passing how much I regret that Edward Timpson is no longer Children’s Minister having lost his seat at the last election. I had the privilege of working with him when he was chair of the parliamentary group for young people in care. Even at that time, he took great interest in the education of looked-after children. He produced a report on which many of the changes he introduced as Minister were based; for instance, the introduction of virtual school heads. I think that we are all grateful to him for his outstanding work as Minister of State for Children, and I hope that he will return to Parliament soon and be able to continue that work.

My noble friend Lord Kinnoull referred to his colleagues’ report on improving social mobility. Nick Chambers, chief executive of the charity, Education and Employers Taskforce, said that,

“young people’s perceptions … are formed at an early age, even at primary, and they rule out all sorts of routes. It is really important that young people have a wide experience of the world of work”.

I first visited France at the age of 12—a colleague talked earlier about being placed in Germany at the age of 14. As we move out of the European Union, it becomes even more important that we provide opportunities for young people to travel back and forth, particularly between the UK and Germany and France. Germany and France do a much better job of that at the moment. I hope that the Minister and perhaps Mr Goodwill in particular, given his experience as an MEP and a speaker of French and German, might look at what can be done to encourage more such exchanges and ease any safeguarding worries that might inhibit them. I look forward to the Minister’s response.

Nursing and Midwifery: Student Applications

Earl of Listowel Excerpts

Tuesday 7th February 2017 Lords Chamber

[Lord O'Shaughnessy]

That is a hypothetical situation. Health Education England remains confident that we will fill the places. Critically, the universities—I mentioned the Council of Deans of Health—also think that we will still fill them.

[The Earl of Listowel (CB)]

My Lords, is the Minister aware of the increasing concern about perinatal mental health for mothers and the great importance of this to the future well-being of their children? In this context, is he concerned that there should be continuity of care for such mothers and that we therefore must avoid at all costs finding ourselves in a situation where there are not enough midwives to give that continuity to these mothers?

[Lord O'Shaughnessy]

I thank the noble Earl for that question. He is quite right that continuity of care is important. That is why we have brought about these changes to lift the cap on the number of places and become less reliant on foreign nurses filling those positions. It is also the reason, as he knows and I hope would welcome, that the Government have introduced a mental health strategy and are spending considerably more on it, with a Green Paper to come later this year.

Mental Health: Children and Adolescents

Earl of Listowel Excerpts

Wednesday 16th November 2016 Lords Chamber

[Lord Prior of Brampton]

My Lords, I cannot answer that question effectively and would like some time to think about it. Clearly, the mental health of teachers, nurses and doctors is critical. Certainly in the medical profession we are doing quite a lot to help doctors who are going through periods of mental health problems. If it is all right with the right reverend Prelate, I shall reflect on his question and write to him at my leisure.

[The Earl of Listowel (CB)]

My Lords, does the Minister recognise the harm to children’s mental health when they and their families live in temporary accommodation? Is he concerned that there will be 120,000 children living in temporary accommodation this Christmas and that the use of bed and breakfast has increased by 15% over the last year? Will he discuss this matter with colleagues developing the housing White Paper and impress on them the importance to children’s mental health of finding stable accommodation for families on low incomes?

[Lord Prior of Brampton]

My Lords, there is no doubt that whether it is housing for young people or loneliness for old people, many factors affect people’s mental well-being. The noble Lord may be interested to know, as I know that his particular interest is in looked-after children, that we have set up an expert working group to look particularly at that case. Interestingly, 85% of the local transformation plans that have been developed single out looked-after children as a group that requires special attention.

National Health Service: Workforce Race Equality Standard

Earl of Listowel Excerpts

Wednesday 24th February 2016 Lords Chamber

[Lord Prior of Brampton]

My Lords, I am not sure that the noble Lord is quite right. I can certainly think of two people from BME backgrounds on the board of NHS England. We can influence this, but it is important that the appointment process is independent of political bias. We have to rely on the chairs and the boards of these arm’s-length bodies to make those appointments.

[The Earl of Listowel (CB)]

My Lords, I am stretching the point rather, but given the increasing awareness that not only the education needs but the health needs of looked-after children and care leavers have been neglected in the past, might the Minister consider looking at how many care leavers and care-experienced adults are represented at senior levels of governance in the health service to ensure that these young people and adults get better support in the future?

[Lord Prior of Brampton]

I think we are probably straying quite a long way from the Question, but I will certainly consider what the noble Earl said.

Health

Earl of Listowel Excerpts

Thursday 26th November 2015 Lords Chamber

[The Earl of Listowel (CB)]

My Lords, it is a privilege to follow the considered and humane words of the noble Lord. I, too, am most grateful to my noble friend for calling this debate, for opening it so helpfully and for his courtesy in preparing for it. I will make five points on loneliness.

I begin by praising the Government. Evidence is clear on the benefits of employment for mental health. The Government have done a tremendous job here. The latest employment figures—with the lowest rate of unemployment since 2008 and the highest rate of employment since records began—speak to that success. That is so important in combating isolation. At my local cash desk there is a pregnant woman due to give birth in December. She had her last week at work a fortnight ago. While she has never given birth before, she was working beside a woman who has a child, so she could speak to others who had given birth. She had customers going up to her to wish her well. She was not isolated. As the Minister knows very well from the recent report on perinatal mental health, we must be concerned about mothers during pregnancy becoming isolated and depressed, and the cost to the nation as a result of that. I strongly praise the Government for their achievements in this area.

I have a number of concerns. I am very worried about the housing insecurity that so many families in this country experience. I call on the Government to bring forward a strategy along the lines that the noble Baroness, Lady Jay, called for, with a senior Minister developing and implementing a strategy to address housing insecurity. Increasing numbers of children grow up homeless and in bed and breakfasts. I speak to mothers with young children who look forward to the prospect of being sent to some distant local authority outside London where they will know no one and where their child will lose their school. This is a growing problem. Of course, there is an increasing issue with questions about immigration there as well. I hope the Minister will speak to his colleagues about that.

So many looked-after children speak of the experience of care as a lonely one, going into adulthood isolated. Because of their early experiences, they may well not trust others and find it difficult to relate to them. It is imperative that, the moment that they enter care, mental health professionals provide them with a proper, dedicated mental health assessment—as the NSPCC called for—and that the services they need follow on from that.

Furthermore, I really stress to the Minister that the best difference that mental health professionals can make is to support the relationships between adoptive parents and children, foster carers and children, and residential childcare workers and children. Supporting those stable relationships over time and making them work is the best way to help these children recover from trauma, rather than, important as it is, working directly with the children. I am afraid that that is often not recognised by the health service, where, unless one is working directly with the child, it is not recognised as helpful—because the child is not seen as “sick”—to support the foster carer or residential childcare worker.

Moving on, adolescence is a time of upheaval. Anna Freud entitled her last writings on the subject, Adolescence as a Developmental Disturbance. There are huge challenges throughout adolescence. It is important to meet those and not allow adolescents to become isolated, as they so easily can be. I commend to the noble Lord the institution in north London, the Brent Centre for Young People, which since 1989 has provided excellent specialist service in mental health for adolescents. If he ever has the time to go up there, I am sure he will find that a most interesting experience.

Early years were mentioned by the noble Baroness, Lady Neuberger, and, I think, others. I recently had the privilege of visiting a nursery in Hayes Park School, west London, and watching a nurture group in action. The Minister may be aware of the Nurture Group Network. These were eight disadvantaged three year-old children. One young girl, blonde, went up to the board, picked up a piece of paper with the word “embarrassment” on it and said “I am embarrassed”. She was shy. She was learning to talk about her feelings, as were her neighbours, so that they could communicate their feelings to each other. They sat at a table and enjoyed toast together. They may never have sat together in their own homes around a meal—they may never have had that experience—but here they were getting a chance to sit with others, to eat toast, to say “please” and “thank you”, to learn how to relate to others, so that they could be reintegrated into the larger group, know how to relate to other children, and thereby not grow up lonely and possibly depressed because they just did not know how to manage relationships with other people.

To sum up, so many people in this country, because of early disruptions in their lives, find relating to others an uncomfortable experience. If we want to build a healthy society, we really need to enable all our citizens to feel comfortable in themselves and with each other, so that they go on to lead full and productive lives. I look forward to the Minister’s response.

Health: Multiple Pregnancy

Earl of Listowel Excerpts

Monday 13th July 2015 Lords Chamber

[Lord Prior of Brampton]

The NICE guidelines for mothers expecting twins or more have an enhanced pathway as well, in which there will be a specialist named obstetrician and a mental health specialist. The Government have committed an extra £75 million over the next five years to increase the availability of mental health expertise to women who have multiple births.

[The Earl of Listowel (CB)]

Does not the Minister take pride in the fact that his Government—or the coalition Government—were so successful in recruiting many more health visitors, so that vulnerable families such as these get the support that they need?

[Lord Prior of Brampton]

Yes, I believe that under the coalition Government an extra 4,000 health visitors were recruited, and they are very important.

Health: Children and Young People

Earl of Listowel Excerpts

Tuesday 7th July 2015 Lords Chamber

[The Earl of Listowel (CB)]

My Lords, it is a pleasure to follow the noble Baroness, Lady Walmsley, and particularly her words on the physical health of children. She reminded me of the importance of my parents to my physical health—and not only genetically. My mother used to take us for two-hour walks across Hampstead Heath. I also remember my father’s hand on my back when I learned how to cycle, pushing me forward and helping me to balance. He taught me to swim and we would go swimming together. He taught me to play tennis and we would play tennis together. So I think that we need to reach the parents, as they probably have the most influence on our children’s physical health—which may be one of the most difficult things to influence. Of course we need to try in schools but we also need to begin at the beginning with parents.

I went ice-skating over the weekend and asked whether there were any family concessions. The answer was no. Part of this strategy, which I hope the Minister will talk about and perhaps write to us about, is asking how to get fathers-for-free passes for leisure activities so that they can engage in them with young people. It would strengthen their relationship with their children and also be a good model for healthy activity. So I was grateful for what the noble Baroness said about that.

I will speak a little more about the importance of strong families in terms of the mental and physical health of children. In particular, I want to talk about father-daughter relationships. I think that the noble Baroness, Lady Stedman-Scott, covered this, but I would be grateful to hear the Government’s strategy for families, and particularly for engaging fathers in families. Perhaps the Minister would write to me about that.

I want to say a few words about the mental health of looked-after children. I remind your Lordships of a report produced last month by the Alliance for Children in Care and Care Leavers. There have been a couple of recent reports on the mental health of looked-after children and the key themes are the importance of stable relationships with these children when they come into care and the importance of recognising their need to recover from early trauma. Enver Solomon, one of the co-directors of the alliance, is quoted as saying:

“Ultimately, the care system should help children overcome their past experience and forge the lasting and positive relationships that we know are vital”,

to their future well-being.

The NSPCC produced a report yesterday on the emotional well-being of children in care. In the executive summary are five key points, the first of which is to:

“Embed an emphasis on emotional wellbeing throughout the system”.

The report goes on to develop that idea, saying that a key part of the job of foster carers and residential childcare workers should be helping young people to recover from their earlier trauma.

The fourth of the five key points is that we should support and sustain children’s relationships. A key means by which these children can recover from early trauma is by having strong relationships with their foster carers, their residential childcare workers and their teachers. Today I met a few young people in care. I heard from Ethan, who is a 10 year-old. He was complaining about the number of different social workers that he has experienced, and which other young people are still experiencing. I also heard from a 10 year-old girl who expressed concern about the number of changes of foster placements for young people in care. When we mentioned to her the very welcome introduction of the Staying Put scheme, she wanted to be reassured that many young people would now be able to stay with their foster carer from the beginning of their time in care to the age of 21, as Staying Put allows. So young people in care also believe that this is the right thing.

The Future in Mind report on child and adolescent mental health support services looks at the care of the most vulnerable children. I want to highlight to the Minister and your Lordships a key passage in the report. Paragraph 6.9, “A consultation and liaison mental health model”, is a bit jargony, I am afraid, but I will quote a little from it:

“Applying an approach whereby specialist services are available to provide advice, rather than to see those who need help directly to advise on concerns about mental health … is already best practice in some areas … Consultation and liaison teams can be used to help staff working with those with highly complex needs”.

Let me give an example of that. Kent, for instance, offers that kind of support to groups of its foster carers. A very experienced clinician will work with groups of foster carers. They may present a particular child and talk about them, share that experience with the group and then the clinician will facilitate the group.

Another example is my experience of 11 or 12 years ago, when I was told that there was a very effective hostel for young people in Olympia—effective in terms of keeping young people off the streets. I went along to visit Lydia Beckler, the manager of that hostel. She said that a clinician—a child and adolescent psychotherapist—visited the home every two weeks and the staff had a couple of hours with them to present a child to the group and get the clinician’s input. She said that the secret of their success was that kind of support.

It was a Centrepoint organisation—a large organisation for vulnerable young people—and these staff were working with perhaps the most challenging young people in the whole of the organisation. Miraculously—perhaps not so miraculously—they had the lowest sickness absence rates in the organisation. It supports the staff and helps them to be resilient in the face of very challenging young people. One young woman there had an unmentionable number of scars on her wrists from self-harm. These were really troubled, difficult young people, supported well.

Unfortunately, that kind of approach is so vulnerable, and it was lost to that particular institution after a couple of years because of financial worries. It seems costly to have staff spend time away from clients to sit with the clinician and think about what needs to be done. In fact, it is very efficient. In terms of making the best use of scarce CAMHS resources, having a clinician supporting the staff in that way enables them to make the right choices about when to refer children to more intensive services. I commend that to the Minister and to your Lordships as an approach.

Moving on—I am aware of the shortage of time—I would like to talk again about families. We have spoken about the importance of perinatal support, but I draw the attention of the Minister to a report from the OECD from 2011 entitled Doing Better for Families, which highlights that, in 2011, the percentage of children in this country growing up without a father in the home was approximately 21.5%, in the United States it was somewhere in the region of 25%, in Germany it was, I think, 15% and in Italy it was 10%. The report also projects that, by 2025 or 2030, we will have overtaken the United States considerably, when beyond 35% of children will grow up in households with just one parent. That really means without a father—nine out of 10 of those absent parents will be a father. That poses some challenges for us. President Obama, when he was Senator Obama, spoke very movingly and powerfully about his experience growing up without a father and the experiences of other young men growing up without fathers.

However, I think that girls are less talked about, and we really should think about the relationship girls have with their fathers, which may also have a strong influence on the future relationships that they make with men. We may be setting up a very perverse cycle of failed partnerships leading to further failed partnerships down the line. I want to quote from a book on father-daughter relationships that quotes an American journalist—I need to find my glasses before I do so—although it is a bit alarming. I have not looked at the research that this is based on; it is quite personal, as it is about her experience, but she is a well-respected journalist. I wanted to quote from Linda Nielsen’s book, Father-Daughter Relationships: Contemporary Research and Issues, but I see that my time is up. However, I hope that we will have another opportunity to discuss these matters very soon. I look forward to the Minister’s reply.

Mental Health: Young People

Earl of Listowel Excerpts

Tuesday 30th June 2015 Lords Chamber

[The Earl of Listowel (CB)]

My Lords, it is a pleasure to follow the well-considered words of the noble Lord, Lord Patten, who of course quite rightly emphasises that there is a moral and an economic case here. The moral case is that unhappy children grow up into very unhappy, miserable adults, and the economic case is that unhappy children grow up into very unhealthy, unhappy and often troubling adults. Of course, the prison system is full of such adults, and that costs the state many tens of thousands of pounds each year per person. I am also very grateful to the noble Baroness, Lady Tyler, for again bringing us back to the issue of mental health, in particular the mental health of children and adolescents. She is indefatigable and I am so grateful to her for her work. I welcome the Minister to his portfolio. I know that it is some time since he took it, but I welcome him, and I look forward to having these discussions with him in future—I hope I can say that.

This is a very timely debate, an observation which I make particularly from my position as vice-chair of the All-Party Parliamentary Group for Looked After Children and Care Leavers. Two important reports have come out this month on looked-after children’s mental health. The first report, A New Vision, came out on 10 June. Enver Solomon, the director of the National Children’s Bureau and co-director of the Alliance for Children in Care and Care Leavers, said:

“The care system is not just about removing children from harmful situations and putting a roof over their heads. Many children in care have been seriously abused or neglected, and rely on local authorities as corporate parents to help them get back on their feet. Ultimately, the care system should help children overcome their past experience and forge the lasting and positive relationships that we know are vital to their future wellbeing”.

The NSPCC also briefed me this afternoon on a report coming out this Monday on achieving the emotional well-being of young people in care. This is the result of work it has done consulting people involved in the NSPCC childline and looking at case studies and at the costs of failing to meet the mental health needs of 13 to 16 year-olds. Therefore, this is a timely debate.

I have three requests to put to the Minister. First, I hope that he might consider arranging a meeting with the leads at the Department of Health and the Department for Education on looked-after children, including himself, if he has the time, together with me and the noble Baroness, Lady Tyler, given her role as chair of CAFCASS, so that we can discuss what practical steps might be taken to improve the mental health of looked-after children.

Secondly, will he look at conducting another survey of the mental health of looked-after children similar to that carried out in 2004? It was a thorough and deep survey published mainly by the Office for National Statistics, and it was very helpful in judging the scale of the mental health needs of looked-after children.

Thirdly, can the Minister say—perhaps he would like to write to me—how our specialist looked-after children’s mental health service provision is performing? There has been a lot of concern that these specialist groups may be suffering under the austerity measures. They are quite expensive to run but they are invaluable. The support that they provide, in particular to children’s homes, can make a big difference. I would be grateful if the noble Lord could write to me on how these groups are doing.

I am very grateful to the authors of this extremely helpful report. As has been said, this Government and, previously, the coalition Government have shown great leadership in looking at mental health and, more specifically and more recently, at child and adolescent mental health. Today, I attended a conference on early intervention and I thought about the importance of the leadership of the right honourable Iain Duncan Smith and Graham Allen MP, as well as others such as Andrea Leadsom MP. Their consistent championing of early intervention over a number of years has raised the matter much higher up the political agenda and has brought in more funding for it. I hope that we will see the same thing in this area through the championing of mental health by various Members of Parliament.

I turn to the report and shall focus on Chapter 6 on care for the most vulnerable. I begin by challenging one particular notion. I am concerned that we sometimes overvalue an evidence-based approach. It is important, but it is also important to value professional judgment—not in some way to fetter our humanity because we are busy waiting for the next piece of evidence-based research to be produced. Perhaps I may pray in aid the experience of Louise Casey. Many years ago when she was the tsar for homelessness, she complained, “I shall be really annoyed if I am presented with one more bit of evidence-based research from civil servants”. Looking at her working in practice, she has vision, experience and understanding, as well as a drive to take things forward. Balancing that sort of approach with an evidence-based approach is most important.

Those on the continent are not very interested in evidence-based approaches or in gathering data. In terms of looked-after children, they have very developed social pedagogues and highly trained and highly qualified reflective practitioners. Fundamental to their training is the ability to make and keep relationships with vulnerable children. Therefore, they learn skills such as cookery, art and music to engage these young people. Theoretically, as we all understand, the key to good mental health and recovery from trauma is the ability to keep and maintain an enduring relationship—to learn to endure in intimacy. Research on the continent into the educational outcomes for looked-after children is very positive, and it appears that the children perform better. Therefore, there is more than one way to approach these things.

I see that my time is about to run out but I want to pray in aid briefly the consultation and liaison mental health model, which is referred to in the report. It is important to provide staff in children’s homes and foster carers with good clinical support. They are the ones who see the children day to day and build relationships with them, so they should be supported on a regular basis by excellent mental health professionals, as the report suggests.

When consulted, children in care say, “I want one person to follow me all the way through care. I don’t want multiple placements. I don’t want multiple social workers. I don’t want multiple schools. I want continuity of relationships”. If this recommendation is adopted, we will see many more healthy young people leaving care. I look forward to the Minister’s response.

Gender-based Violence: Screening

Earl of Listowel Excerpts

Monday 9th March 2015 Lords Chamber

[Earl Howe]

Yes, my Lords. The Government hosted the first ever Girl Summit last year on ending female genital mutilation as well as forced marriage and other issues. We set up a specialist female genital mutilation unit following that summit. We provided money last year for the FGM prevention programme, and as part of this we introduced the first ever data collection in the NHS for all acute trusts, which are now required to record in a patient’s healthcare record whenever FGM is identified. We have also said that front-line professionals will in future have a mandatory duty to report cases of FGM in those under 18.

[The Earl of Listowel (CB)]

My Lords, following on from my noble friend Lord Laming’s question on children in these circumstances, is the Minister ensuring that where gender-based violence is at play, any children in those circumstances are being identified and getting the help and support that they need?

[Earl Howe]

The noble Earl makes an extremely important point. I can reassure him that children and young people are very much the focus of the work that we have been doing, and that a guidance document was issued recently to that effect.