Education and Adoption Bill

Lord Watson of Invergowrie Excerpts

Tuesday 1st December 2015 Lords Chamber

Moved by

[Lord Watson of Invergowrie]

2: Clause 13, page 8, line 25, after “authorities” insert “and voluntary adoption agencies operating in the area jointly”

[Lord Watson of Invergowrie (Lab)]

My Lords, I shall speak also to Amendments 6 and 7, which I thought would be treated as individual amendments but, to my surprise, have been grouped. So here we are.

Amendment 2 has been resubmitted, because we share the concerns of the professionals in the field about what the future might hold for voluntary adoption agencies after the full establishment of the regional adoption agencies. Having said that, I think that moving Amendment 2 should be a formality, because, within the past few days, the Minister has to all intents and purposes already indicated—in writing no less—his tacit acceptance of it.

In moving what was then Amendment 32ZA in Committee, I highlighted the fears of many voluntary adoption agencies that they could be squeezed out with the establishment of the regional agencies and that considerable difficulties remained as far as their involvement was concerned. I went on to say that we owed a duty to them to air those views and seek the Government’s help in prioritising them. Well, we did, and the Government did. In fact, those of us involved with the Bill received letters from Ministers in both Houses, and both responded positively. The Minister of State for Children and Families, Edward Timpson, clearly stated the Government’s commitment to making sure that voluntary adoption agencies are involved in regional adoption agencies. He stated that,

“the excellence in practice of VAAs is at the heart of the regionalised system”,

and that he wanted VAAs to be leading players in the design of that system, which was why,

“I have not approved a proposal to set up a regional adoption agency without a clear commitment to involving voluntary adoption agencies in the design of the service—and I will make sure local authorities keep that commitment”.

That is very welcome—so far, so good—but it leaves the umbrella body for voluntary adoption agencies, the Consortium of Voluntary Adoption Agencies, with concerns, because it believes that the Minister’s commitments do not go far enough in explaining how the Government will achieve that aim. In the letter of the noble Lord, Lord Nash, the paragraph on the matching process is important—and this refers also to Amendment 7. The Minister states that a regional adoption agency will have one pool of adopters that it will draw on when matching children in its area and that this will minimise sequential decision-making.

However, the issue of concern is that, within that single pool of adopters, those approved by a voluntary adoption agency will have a price attached to them in some way. Voluntary adoption agencies somehow have to cover the cost of recruiting, training and approving those adopters, as well as supporting them after placement. This may be through the current inter-agency fee of £27,000, through “block purchase” arrangements where a regional adoption agency pays for a set number of VAA adopters a year, or through other arrangements. It is not yet known how this will be arranged in the various regions; the point is that individual regional arrangements will decide it, and that is an area of uncertainty for the voluntary agencies.

If that means that voluntary adoption agency-approved adopters will be seen as coming with a cost attached to them in a way that adopters approved by the regional adoption agency will not, that is potentially an issue. Of course, adopters approved by the regional agency also come with a cost, although that is less visible. The evidence also suggests that, despite perceptions of voluntary adoption agency-approved adopters being expensive, the costs of providing an adopter are virtually the same across both the statutory and the voluntary sector. There are further concerns, as it is accepted that the inter-agency fee does not cover this full cost. Indeed, the CVAA, the consortium, estimates a shortfall of at least £10,000 per placement, which suggests that local authorities get excellent value for money from using voluntary adoption agency adopters.

In Committee, I raised the issue of what is known as sequential decision-making. In his letter to noble Lords, the Minister said:

“A regional adoption agency will have one pool of adopters that it will draw on when matching the children in its area. Individual local authorities will therefore no longer have their ‘own’ adopters to match their children with ‘in house’ as they do currently. This will ensure that sequential decision making is minimised”.

Yes, it will be minimised, but not ruled out. That remains an issue for the voluntary adoption agencies.

Part of what drives that behaviour, understandably, is the fact that local authorities often have a preference for adopters they have approved. This, in addition to the perception that voluntary adoption agency-approved adopters involve an additional cost, causes a mindset that leads to sequential decision-making. There is no reason to suppose that this mindset would be any different in a regional adoption agency. Voluntary adoption agency-approved adopters would still have to be paid for by some means, and that would not be approved in-house by the statutory part of the regional agency.

The basic issue is that, within regional agencies, voluntary adoption agency-approved adopters will still be the second preference of those deciding on matches. This is bad for children because it causes delay, and bad for local authorities because delay in placing children incurs huge costs. I was surprised—I wonder if Ministers are aware—that providing local authority-based residential care costs more than £100,000 per child per year. That is why there is a need to reform the matching process to ensure that those making the decisions are focused solely on finding the best match for the child as quickly as possible. This would be better for all parties involved and would help the Government achieve their aims of reducing delay for children and involving voluntary adoption agencies in regional adoption agencies.

Further, there is the issue of voluntary adoption agencies having to divert resources towards administrative and governance processes during the transition. We know that the Department for Education has allocated £4.5 million for this purpose but can the Minister say whether any further funding will be made available? Voluntary adoption agencies are already saying that the funding is beginning to dry up and, with the transition likely to be spread over a number of years, the problem can only intensify.

The final reason why the ministerial letters have not assuaged the concerns of those involved at the front line is that it is unclear how the Department for Education will influence the role for voluntary adoption agencies and a given regional agency. That is where typically smaller specialist voluntary agencies would be contracted to regional agencies. The assumption is that it will be for a regional agency to decide when to contract out and to which agencies. Given such uncertainties, there is clearly an issue about predictability of income for smaller voluntary agencies, some of which have already expressed fears that they will be at risk. Can the Minister offer any encouraging words to the voluntary adoption agencies to meet those worries?

Amendment 6 aims to clarify whether the Secretary of State’s powers in relation to adoption functions could be used in respect of a particular group. The key concern is about accountability and ensuring that the new system results in meaningful improvements for vulnerable children, especially the harder-to-place ones, and specifically those in the categories listed in the amendment.

The overhaul of the adoption system introduced by this amendment to the 2002 Act will have failed in its objective if it does not meet the challenges inherent in the current system. There is universal agreement that where adoption is in the best interests of the child, that child should be placed with a suitable family at the earliest opportunity. That must not mean a wait of more than two years, which it often does.

Overall there is not a shortage of prospective adopters. In March of this year, across England there were 2,810 children waiting to be matched and 3,350 approved adopters. The mismatch between these figures highlights the need for an improved system and the introduction of regional adoption agencies may in time produce that. However, there is an existential shortage of prospective adopters for certain groups of children. These groups contain harder-to-place children and include those over the age of four, those with disabilities, black, Asian and minority ethnic children and sibling groups.

The length of time between the decision being made that adoption is in the child’s best interests and the adoption taking place is, of course, key. According to the Adoption Leadership Board, in June of this year no fewer than 71% of children waiting more than 18 months between the placement order and the placement fell into a harder-to-place category; more than half of children from black, Asian and minority ethnic back- grounds waiting to be placed had been waiting 18 months or more since the placement order was made; and 64% of disabled children had been waiting 18 months or more, as had 47% of sibling groups. These indicate the scale of the problem, the extent of the improvement needed in the adoption system and the need for greater emphasis to be given to harder-to-place children.

For the new regional adoption agencies to be deemed a success, it is essential that the time these children spend waiting to be adopted is reduced, and quickly. Understandably, it will always be more difficult to find prospective adopters willing and able to adopt children in the groups to which I already referred. Part of the rationale offered by the Government for the introduction of the regional agencies is that they will lead to a larger pool of adopters from which it will be easier to find a match for harder-to-place children. There is some justification for that, and I certainly hope it proves correct. There is, however, no automatic link between creating regional adoption agencies and improving outcomes for these groups. In fact, there is a risk that the new agencies might feel under pressure to increase the overall numbers and speed of adoptions, creating an incentive to concentrate on the most straightforward matches which, of course, involve babies.

The Prime Minister’s speech on 2 November mentioned new measures to double the number of children placed with adoptive families sooner, halving the time they spend in care waiting to move into their new home. That was greeted with caution among professionals, who have serious doubts that the necessary resources will be forthcoming to allow that increase to become reality. I hope the Minister might be able to offer some reassurance to them in his reply. Equally, concern has been expressed that what I call this “hell-for-leather approach” might contravene the legal duty of local authorities under Section 17 of the Children Act 1989. That legislation states that it is the general duty of every local authority to,

“safeguard and promote the welfare of children within their area who are in need; and … so far as is consistent with that duty, to promote the upbringing of such children by their families by providing a range and level of services appropriate to those children’s needs”.

Therefore, for the Government to prioritise more and quicker adoption is questionable both morally and legally, unless local authorities are providing a good Section 17 service to families. As a consequence of the cuts that local authorities are required to make—ironically, not least in Oxfordshire, about which the Prime Minister himself has been moved to complain—there is major concern among professionals that this is not so.

Equally, there is real concern that the process of creating new regional adoption agencies will divert existing resources, leading to an undermining of current relationships. The new system will inevitably take some years to become fully effective, and there are concerns among the various agencies as to whether they will have the necessary resources during the transitional period to invest in effective services and support for children and adopters.

The £30 million made available by the Government to assist harder-to-place children is welcome, but it will not last long. It was disappointing that the Autumn Statement seemed to have nothing to say regarding additional resources for these children. Without that, it is not clear how the Government can ensure that the system will improve the waiting time for harder-to-place groups. That brings us back to voluntary adoption agencies, which have particular expertise in working with harder-to-place children; perhaps that is another aspect of their invaluable work that should be recognised.

In Committee, the Minister stated that regional adoption agencies would be,

“incentivised to find the right family for a child as quickly as possible”.—[Official Report, 17/11/2015; col. GC 47.]

Can he outline what form these incentives might take?

Returning to Amendment 6 specifically, the Government must prioritise and ensure that these groups do not continue to be left on the fringes of the adoption system. One means of achieving that would be to accept the addition to Clause 13 contained in this amendment, to allow them to become a full part of the Secretary of State’s powers under that clause. As I stated at the outset, this seems to be very much in line with the content of the Minister’s letter, so I hope he will not find any reason not to accept this amendment. I beg to move.

[Lord Storey (LD)]

My Lords, I will speak to Amendment 4, which is in my name and that of the noble Earl, Lord Listowel. I think that the noble Earl has withdrawn from that, so I am now—

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[Lord Nash]

My Lords, I will speak to Amendments 2, 6 and 7, which aim to ensure that voluntary adoption agencies play an important role in the move to, and the future services provided by, regional adoption agencies. Broadly, the amendments in the names of the noble Lords, Lord Watson and Lord Hunt, and the Government’s intentions are in the same place.

First, I take this opportunity to again set out our commitment to the voluntary adoption agency sector. Its expertise and the services that it provides have already been central to the improvements we have seen in the adoption sector. We absolutely want this to continue. As I have previously told the House, these organisations have a central role to play in regionalisation, as referred to in the letter that my honourable friend the Minister of State for Children and Families recently sent to the chief executives of all VAAs, reiterating our commitment to their involvement.

Voluntary adoption agencies have knowledge and specialist skills that will be crucial in ensuring that the new regional agencies provide the high-quality services we expect to see. That is why all the projects we are funding this year include VAAs. We have also been clear with projects that VAAs should not simply be involved once decisions about the design of the new regional adoption agency are made. We have required all projects to commit to involving voluntary agencies in the early design phase of their work.

Amendment 2 would mean that local authorities and VAAs would jointly decide who should deliver the adoption functions on behalf of the local authorities being directed. I absolutely agree that it is important that VAAs have a role in any conversations about using the power introduced through the Bill, and I assure noble Lords that this will be the case. As I set out in our last debate, where the power is needed, decisions about its use will be made following extensive discussions with all those involved or affected, including VAAs. All relevant agencies will have the chance to comment on the proposal before a final decision is taken. In addition, the Adoption Leadership Board, of which the Consortium of Voluntary Adoption Agencies is a key member, will have an important role to play in shaping any decisions about regionalisation.

It would, however, be impractical and unbalanced to give a VAA joint decision-making power with the local authority in relation to the question of which agency should carry out the functions on the authority’s behalf. The local authority has statutory responsibility for delivering its functions. Although it is appropriate for the Secretary of State to make a decision, instead of a local authority, about who should carry out those functions in the limited circumstances where this proves necessary, it is not appropriate to give a VAA the power to make that kind of decision on behalf of a local authority or to veto a local authority’s proposed course of action. Instead, we need to use the mechanisms I outlined above to ensure that the views of VAAs are taken into account when decisions are made about how the power will be used.

Amendment 6 would allow the Bill to be used in relation to particular groups of children. This would enable the legislation to be used to make specific arrangements relating to hard-to-place groups of children. Over the last few years we have made significant strides to improve things for this section of children but there is a lot further to go. I completely agree with the motivation behind this amendment. We know that certain groups of children wait much longer for adoption than others. In 2014-15, hard-to-place children waited, on average, almost seven months longer for adoption than other children.

I am pleased to be able to clarify that subsection (5) of the clause is intended to enable it to be used in exactly this way. Subsection (5) enables a direction to be made in relation to certain categories of children. If, for example, arrangements between a group of local authorities are not working well enough for disabled children, this legislation could be used to direct those authorities to make different arrangements for them. This could, for example, include requiring local authorities to make arrangements for their family-finding functions in relation to those children to be undertaken by a specific, specialist VAA.

Finally, I turn to Amendment 7. When we discussed this issue previously, and again today, the noble Lord, Lord Watson, expressed his concern that VAA adopters would not be used by regional adoption agencies in the future because of financial considerations, and that this would lead to a continuation of the practice of sequential decision-making, which we are all keen to see end. First, I can clarify that VAA adopters do not represent a higher cost than adopters recruited by a local authority. A report by the University of Bristol in 2009 found that interagency fees were perceived as excessive by local authorities, despite the fact that they were found to be lower than what local authorities spend on placing children internally. It is crucial that we address this myth, as it is damaging to VAAs and drives the poor practice of sequential decision-making. I emphasise again that one of the key objectives of the policy is that each regional adoption agency will have a single pool of adopters. This is key to ensuring that swift, non-sequential matching decisions can be made. This is what we all want to see.

The local authorities and VAAs which make up a regional adoption agency will need to come to an agreement about which adopters are part of their central pool, and how the VAAs are remunerated for their investment in recruiting and approving adopters. The department is not prescribing the financial arrangements that will underpin new regional agencies, as we want to be led by what VAAs and local authorities think works. However, we are providing a comprehensive package of support to help local areas work through issues such as these, and come up with models which enable VAAs and local authorities to work together seamlessly and fairly.

Some regional adoption agencies may have the VAA partners doing all the adopter recruitment, given their skill and track record in this area. This would certainly be an interesting model. We will be working with VAAs and local authorities to develop fair and robust financial models which ensure that VAAs are not disadvantaged. However, I note the concerns of the noble Lord, Lord Watson, about the financial drivers in this. He raised a number of points that we want the sector not to be nervous about. I think that it would be helpful—if the noble Lord is willing to do this—if I organised a meeting with the noble Lord, the Consortium of Voluntary Adoption Agencies, Minister Timpson and officials, to discuss these issues in greater detail. I am glad to see that the noble Lord is nodding in agreement to that.

Finally, I remind noble Lords that regional adoption agencies will not be, and are not intended to be, entirely self-sufficient. There are, of course, some children for whom even a regional agency’s larger pool of adopters will not suffice, either because the child has particular needs or because the agency does not have an appropriate approved adopter ready at the point the child needs a match. Social workers in regional agencies will be expected to identify these children quickly and act promptly on their behalf by engaging with the national pool of adopters using national matching tools.

In view of my comments, I hope that the noble Lord will feel reassured and will withdraw the amendment.

[Lord Watson of Invergowrie]

I thank the Minister for that comprehensive reply, much of which I welcome. The noble Baroness, Lady Pinnock, commented on the Yorkshire pilot and the support for voluntary adoption agencies. Given the very sad episode that she related, I could not agree more that permanence has to be the aim when children are being placed. It is not just a question of finding a place fairly quickly but of finding one that both the child and the family have a good chance of making sustainable and, ultimately, permanent. That is what we are looking for. That is why I raised concerns about the Prime Minister’s comment that we should simply look to double the number. It is not a numbers game in that sense. I will raise this issue again in the next group of amendments, but I point out that Clause 13, on the terms of adoption, concerns only 5% of the children in care.

I was pleased to hear the Minister stress what he called the essential role of voluntary adoption agencies—those agencies will also be pleased to hear that—and that he foresees them having a role at the early design phase. That is what they are looking for. I do not doubt the Government’s will in this regard, and nor do the voluntary adoption agencies, but it is a question of how they intend to make it happen. This is a case of walking the walk and talking the talk, and doubts remain about how they will match the intention with the reality. Of course, it is not me, my colleagues or, indeed, the other opposition parties that the Minister needs to reassure on this point, but the CVAA and its member organisations. The CVAA was obviously centrally involved in the Adoption Leadership Board and those discussions can—and I am sure do—take place, but I simply reiterate that that the voluntary adoption agencies need that reassurance.

The Minister said that he agreed with the motivation behind Amendment 6. It is helpful to have his comments on the record that subsection (5)—if I am quoting him correctly—is designed to enable the measure to be used in the way the amendment suggests. That is useful and will be welcomed by organisations such as Barnardo’s, which has real concerns about harder-to-place children and the fact that the numbers are increasing and the resources to tackle that are at least in doubt, although the hope is that additional resources will be made available. The Minister may be able to reveal that in the near future.

I understand what the Minister is saying on the sequential decision-making issue but am slightly puzzled when he says that there is no difference in cost between voluntary adoption agencies and local authorities in this regard. He referred to the Bristol University study. I had not heard of that but, even more surprisingly, it seems to have eluded the Consortium of Voluntary Adoption Agencies, which is saying there are situations where local authorities may have—I will put it no more damagingly than this—a back-scratching operation whereby there might be a bit of a trade-off, such as the whole interagency fee not being required to be paid in certain situations or an understanding about some future arrangement between the two. Voluntary adoption agencies are effectively excluded from that. The new arrangements will certainly make that more difficult but they may not rule it out and that needs to be taken into account. I will look at the Bristol University survey and see what it says. I very much hope that that is the case but it may not be. Finally, I thank the Minister for the offer of a meeting and I would certainly be pleased to take that up.

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Moved by

[Lord Watson of Invergowrie]

3: Clause 13, page 8, line 35, at end insert “including but not limited to mental health support for children and adolescents prior to the making of a placement order;
(f) the provision of a mental health assessment prior to the making of a placement order.”

[Lord Watson of Invergowrie]

My Lords, we turn now to mental health support, which is very important indeed. Amendment 3 follows on from what was Amendment 33 in Committee, to which I spoke. I emphasised then that the issue of support once a child is placed in adoption can be crucial to whether that adoption becomes permanent—the point we were making a few moments ago in response to the noble Baroness, Lady Pinnock. Often, specialist support is needed to care for a child appropriately.

I also quoted figures supplied by the NSPCC which I think bear repeating because they show that 45% of children in care have a mental health disorder, compared with only 10% of the general child population. The mental health needs of children in care were debated thoroughly in relation to that amendment and those in the name of the noble Earl, Lord Listowel. The NSPCC has now met with Ministers, yet the organisation still believes that specific measures need to be included in the Bill to provide mental health assessment and support as early as possible during a child’s time in the care system. Amendment 3 sets the placement order as the milestone point by which children should have received that assessment.

What is needed is to prioritise vulnerable children, particularly those who have experienced abuse or neglect, which includes a significant majority of looked-after children. The Government must give a commitment to create the earliest possible provision of automatic assessment and support for those children within the adoption system. I will not repeat the point I made in Committee—that Clause 13 aims to provide for only 5% of children in care. We believe that the Bill is wrongly skewed in favour of adoption to the exclusion of all other forms of care. The vast majority of professionals in the field want nothing more than good provision for all looked-after children, whether their welfare be met by adoption, special guardianship, a child arrangements order—what used to be a residence order—long-term fostering or kinship care.

I say in passing that Sir Martin Narey’s announcement that he will be standing down as chair of the Adoption Leadership Board next year offers the Government an opportunity to demonstrate that they value all forms of care equally. The arrival of a new person to head the board should be used as an opportunity to broaden its remit to include all forms of permanency.

Recent research carried out by the NSPCC highlighted that one-fifth of children referred to local specialist NHS mental health services are rejected for treatment. This was described by the NSPCC as creating,

“a ‘time bomb’ of serious mental health conditions”.

Children in care not being able to access the mental health support they need to rebuild their lives represents a serious gap in provision—one that I highlighted in Committee—but I am afraid the Minister did not provide an answer as to how that gap might be filled. I ask him again: does he grasp the extent of the problem being set out for him by the professionals, the people working daily with children with mental health problems? If so, does he believe that sufficient resources will be made available to meet the needs of children in care who are not currently receiving the support they desperately need? Ultimately, the care that can be provided in mental health and other areas for children in care comes down to resources.

In Committee the noble Baroness, Lady Evans, referred to the £1.25 billion that the Government have made available to improve mental health services for children and young people over the next five years, through the implementation of the report Future in Mind. She also mentioned that clinical commissioning groups were involved in that process, although how that huge sum of money is being spent continues to be something of a mystery. Although Future in Mind makes a number of recommendations, there is real doubt as to where we are in the delivery of those recommendations or detailed plans for spending the promised funds. With the majority of that money being spent through clinical commissioning groups, and given all the layers of devolution that there are in the National Health Service, it remains unclear just how that report’s priorities will be met.

The answer to those questions seemed to become less, rather than more, clear last week with the Autumn Statement, when the Chancellor said that “we build on that”—the £1.25 billion—

“with £600 million of additional funding, meaning that by 2020 significantly more people will have access to talking therapies, perinatal mental health services and crisis care”.—[Official Report, Commons, 25/11/15; col. 707.]

The question is: what might this mean for the mental health needs of children in the care system? The Chancellor did not indicate whether the extra resources were for children, but—let us look on the positive side— he did not rule out children being prioritised within its reach either.

In response to a Question from Luciana Berger in another place as to how that £600 million will be prioritised, the Minister of State at the Department of Health, Alistair Burt, confirmed that the sum is to be spread,

“over the next five years … and … is additional to current spending. The levels of funding in individual years and the specific mental health service improvements it will fund will be determined in the new year, once the Mental Health Taskforce has reported”.

We know that there are to be additional resources available, so my question to both Ministers today is: what representations will they and their officials in the DfE be making to ensure that a proportion of that money is earmarked to fund the improvements required in mental health services for children and young people in care over the five-year period that is meant to be covered?

In conclusion, given the spending pressures which councils face and a situation that can only deteriorate still further as a result of the Autumn Statement, surely the Government should now be prepared to acknowledge that all children entering the care system should receive an automatic mental health assessment, in addition to the physical assessment that they currently receive. Why on earth should that not happen? Children in care should then immediately receive the report that the assessment shows is necessary to enable them to deal with their condition. Thereafter, common sense surely dictates that there must be regular monitoring of children’s mental health while in care to ensure that the support they are being given is contributing to their improved state of health. I suggest that these demands are not unrealistic and should become expectations on behalf of children who need support to enable them to develop into adulthood. I beg to move.

[Lord Storey]

My Lords, I shall speak to Amendments 3 and 4. I was taken with the comments made by the noble Baroness, Lady Evans, in Committee when, speaking for the Government, she said:

“I absolutely agree that the mental health of adopted children is a key issue”.—[Official Report, 17/11/15; col. GC 38.]

She went on to say that the £1.25 billion would be available and how the Future in Mind report would be implemented. Of course, we all want to see children who are in adoption find the right parents to adopt them as quickly as possible, but we also want to make sure that that adoption works. It is no good children being adopted if the adoption then breaks down.

One of the reasons that adoption regularly breaks down is that we have not properly assessed the children, particularly in relation to mental health. If we want to make sure that adoption works, we must put this crucial area right. I will not—well, I will—repeat the figures that 45% of children in care have a mental disorder, which is a huge number, while 60% of those who come into care have experienced neglect or abuse.

How do we ensure that we get this right? To me, it is very simple; to use an old expression, it is not rocket science. It is about providing the expertise and the resources but also about making sure it happens, which is why these amendments actually specify how it should happen. Like the noble Lord, Lord Watson, I cannot understand why the Government would not agree to that. It will be to their credit, and to the success of the Bill, that children who are adopted or who go into care are in the right situation and getting the right support.

We have come a long way in terms of mental health issues in the last few years—and it literally is only in the last few years. One of the areas I am concerned about is that we say, “Oh, there’s a strategy; there’s X amount of money available”, but often those resources do not go to the right people. I know from experience and from talking to other teachers that getting CAMHS into schools now is much harder than it was a few years ago. Never mind a few weeks’ wait, it can often be several months before that support is given. So I wonder whether, when the Minister replies, we might hear how mental health support might be given to schools in a more orderly and speedy way.

I repeat that I want it enshrined in the Bill that we do the assessment for children and young people as soon as possible so that we get it right. In replying, perhaps the Minister could say whether, if the mental health strategy comes out and says that, the Government will agree to it and implement it as well.

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[Baroness Evans of Bowes Park (Con)]

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

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

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

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

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

[Lord Watson of Invergowrie]

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

[Baroness Evans of Bowes Park]

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

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

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

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

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

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

[The Earl of Listowel]

In welcoming what the Minister said, and in noting that the noble Lord, Lord Prior, is sitting next to her, which is comforting in this current discussion, I ask her whether she has quite recognised the nub of the concern of Peers all around the House. While current practice is that a GP, a generalist, will give a health assessment that will include mental health elements when a child comes into care, many of us believe that that is inadequate, and we have been trying to communicate this to the Government. While there is a strengths and difficulties questionnaire, which is useful, it simply does not meet the need for a mental health professional to undertake an initial assessment of all children coming into care so that their mental health needs can be identified early on and they can then be met with services following. I listened with great care to what the Minister said and it was very helpful, but I hope that she can assure us that the Government recognise that that is the concern that many noble Lords are raising—the need for a specialist mental health professional to do that initial assessment for every child coming into care.

[Lord Watson of Invergowrie]

My Lords, I thank the Minister for her reply, along with all other noble Lords who have contributed to the debate on this group of amendments on this important area.

I was very pleased that the noble Earl, Lord Listowel, had received a letter from the Minister for Children and Families, I think he said, subsequent to our last sitting in Committee. I wonder whether he might be prepared to share that with us because it might have information of general interest to those of us who have been involved with the Bill and are looking to take these issues forward.

My noble friend Lady Massey raised an important point about what the outcomes of not providing this proper mental health care could be. You do not need a very vivid imagination to foresee that there will be many effects, once children reach adulthood, if some of the issues with which they are trying to deal in childhood are not adequately cared for and are allowed to get worse as they approach adulthood, not least at a time when they have to go out into the world and live on their own. That is an important point and it was well made.

The noble Baroness, Lady Howarth of Breckland, if I noted her point down correctly, talked about the resources being targeted at need rather than category. I very much agree, as she will know. Despite what the Minister said, I do not doubt that the Government are committed to other forms of care but it looks as if this is given a disproportionate amount of attention; it is the only one involved in the Bill, and then there were the remarks—attributed to, I think, the Prime Minister in his speech in November—that further legislation was somewhere in the pipeline,. Those working in the other categories would value something of substance from the Government to say, “We’ve looked to beef up the ability of the adoption sector; now this is what we are doing for the other sectors”. I hope that the Minister will bear that in mind and that the Government will come forward with that in due course.

The Minister said that mental health care for children in adoption was a key issue for the Government. I am perfectly willing to accept that, but I come back to the point made on Amendment 2 that there should be an assessment prior to placement. In response to that, the Minister said that assessments were carried out prior to placement but she seemed to say, and I hope that I am quoting her correctly on this, that both types of assessments—that is, physical health assessments as well as mental—were included. That is very welcome, but it is not understood by the organisations involved in adoption, judging by the comments they have made to me and other noble Lords as the Bill has progressed through its various stages. It therefore might be helpful if she could write to me, perhaps to expand a bit about what mental health assessments are given prior to placement, as I think everyone involved sees that as a key issue.

The Minister also mentioned the £4.5 million that the Government have provided to accelerate the establishment of the regional adoption agencies. While that is welcome, I made the point in moving the amendment that that is seen to be if not running dry then already running a bit thin, and I wanted some assurance of what might follow that. She mentioned another sum of £12.5 million. I do not know whether that will be used in the same way. Some of it might be, but certainly the feeling among the adoption agencies is that £4.5 million will get things started but will not take the whole process very much further, and that additional resources will be necessary.

When the Minister assured me that the Department for Education works closely with the Department of Health, I thought, “Well, of course you would say that, wouldn’t you?”. However, a serious point is: how will the progress of implementing the recommendations of Future in Mind be reported? How can they be monitored and made available to organisations in the field that are involved in their delivery to some extent but which also care about being able to trace the effectiveness of those recommendations that are put into place? Some form of reporting would therefore certainly be valuable. Again, I ask either of the Ministers whether they would be prepared to write about that, because £1.25 billion, which is over a five-year period, is a huge sum of money—although I am not sure when the five-year period started. I think I am right in saying that Future in Mind was published in 2012 but I do not know whether that was the start of the five-year period. However, that is one of the questions that may well be answered in the Minister’s response.

We have had a number of helpful comments from the Minister. Those involved will be happy to take some of them forward and, I hope, to build on them, but at this stage I beg leave to withdraw the amendment.

Amendment 3 withdrawn.