Education and Adoption Bill

Baroness Benjamin Excerpts

Tuesday 1st December 2015 Lords Chamber

[Baroness Howarth of Breckland (CB)]

My Lords, I apologise that I was unable to speak in Committee on this issue; I had to attend another committee at the same time. I just want to ask for clarity on a very narrow point—which is actually a wide point.

The amendment adds mental health services for children in the adoption process. The noble Lord, Lord Watson, made a very clear statement about the large number of other children in care who face the same needs—children in kinship care, long-term fostering, or hostels for children with special difficulties. Is the thinking clearly about basing the provision of services on the actual needs of the children as they are seen, rather than the bit of the system they are in? My concern is that we see adoption as a better placement than many others when often it is not; kinship care can be a much better solution for a child. As the noble Lord, Lord Watson, said, permanency is what actually matters. I hope that mental health services can be clearly focused on children to ensure permanency, whatever that permanency looks like.

It makes very good economic sense to ensure that money is clearly targeted to children in care—and, sometimes, children in their own families who are showing special needs. Economically, if you can get to those children early, you will improve their life chances. If they are targeted, that can be measured. Those are the things that the Government want to do at the moment: target services to see what works and makes good economic sense, because people will be able to make better sense of their own lives. Will the Minister ensure that there are adequate mental health services—we know that there is a great difficulty at the moment—and that they are targeted at need rather than at category?

[Baroness Benjamin (LD)]

My Lords, I rise to support Amendment 4. As I have said at all stages of this Bill, with the support of the NSPCC, every single child entering care should receive an automatic mental health assessment in addition to the physical assessment they currently receive. Children in care should then immediately receive the subsequent necessary support to help them to deal with the issues of mental health identified in the assessment. There should be regular monitoring of children’s mental health while in care to inform what support that child receives and ensure that it contributes to their improved well-being. These provisions are essential to strengthen the Bill because they will help towards making significant savings for the NHS, the prison services and society in general.

The NSPCC, myself and many others welcome the Government’s announcement of an additional £600 million for mental health and see it as a great opportunity to make sure that more of the most vulnerable children get access to the mental health support that they need to overcome the trauma they have experienced. As I have said time and again, childhood lasts a lifetime, so let us give all children the best start in life, including children in care and children in the adoption system. They need to be cared for and looked after in every way possible. We owe it to them, so I hope that the Minister will include these provisions in this important Bill.

[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.