Special Educational Needs and Disability Code of Practice: 0 to 25 years
Baroness Hollins Excerpts(10 years, 5 months ago)
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Lord Storey (LD)
My Lords, I want to be very positive about this code of practice because I think that this is an historic moment for special educational needs and disability. I start by paying tribute to everyone involved because we are light years away from where we were before. Two years ago I was a teacher who had to look at colleagues who were not prepared to offer a duty of care to children with medical conditions. Now that will change, and it is to do so straightaway. Two years ago, schools did not have to have a qualified teacher as a SENCO, but now they do. I would reflect on the fact that after three years in post, those SENCOs must have the national qualification. To my mind, in terms of mainstream schools, we are light years away from where we were before. As I say, I pay tribute to all those who have been involved in putting together this code of practice. The 270-odd pages that make up the code are actually very clear and readable. I would guess that if this document was handed over to the plain English society, it would probably get a high score. Ministers, the Government and all those involved have listened and consulted, which means that changes have been made.
I have a number of particular questions, some of which have been raised already. Perhaps I may go over them. I should like to know what the process will be when changes occur. What is the procedure for adding something to this document? I have already mentioned to my noble friend the Minister that I am particularly concerned about the issue of young people sustaining concussion as a medical condition in school. At some stage we will need clear guidance on that. However, it is only one of a number of things. How, in the months and years to come, do we go about looking at those areas where we have real concerns?
I should have thought that 12 months was too short a period for a review, but an appraisal needs to be made at some stage of how this document is actually working in practice in schools. I would also be interested to know, perhaps through Ofsted visits and through general feedback, how the clear responsibilities for SENCOs in schools work in practice. A noble Lord asked who the responsible people are to be. For the first time, for mainstream schools, what SENCOs have to do and are responsible for doing is clearly set out and there is no hiding from that. They are responsible to the head teacher and the head teacher is responsible to the governing body of the school.
Mention has been made of local authorities. Again, we know that practices vary widely across different parts of the country. This code of practice means that local authorities will have much greater clarity about what they are responsible for and what they should do. Again, that is light years away from where we are.
A hugely important issue is that of continuing professional development. The schools have now broken up and this document will land on desks in September—it will be a soft landing, I hope—but we need to make sure that over the coming terms, all staff in schools have access to professional development so as to be able to understand their responsibilities, the importance of the code, and what should now happen.
Again, issue has been made about those young people who are not on an education, health and care plan. I am used to a system of school action and school action plus which is replaced by a graduated approach. As the debate has taken place, I have had reservations about the graduated approach because it is not absolutely clear how children will progress. I do not expect the Minister to answer—we have had that debate before—but at some stage we need to come back to that issue and be satisfied that that graduated approach is working.
I am going to end as I started by congratulating everyone involved. I am sure that in years to come this time will be regarded as, if you like, not the end of the matter—of course that will not be the case because the points made by the noble Lord, Lord Low, will happen, but over time—but as the starting point to allow those changes to take place.
Baroness Hollins (CB)
My Lords, I echo what other Peers have said about the welcome strengthening of the code, if not its length. I know many in the sector are appreciative of the changes. Having been a member of the recent post-legislative scrutiny committee on the Mental Capacity Act, I would like to comment on the sections of the code that interpret how the law will apply to young people who may lack capacity.
The Bill, quite rightly, gives new rights to young people over the age of 16 to make decisions about their support, subject to their capacity to do so. However, it is unclear in the code who decides whether a young person lacks mental capacity. Is it the young person, their parents, the school or the local authority? The voices of the young person and the parents should, of course, be heard throughout this and I would welcome clarification from the Minister on this point.
Building on this, it is critical to ensure that decisions that young people make are not overly shaped by the desires and agendas of others, including local authorities and other professionals. Mencap has discussed its point of view with me. It would like to see emphasis placed on ensuring that young people get the support they need to understand properly the decisions they are making and to be helped to make an informed choice, both about their support and what they might wish to do after school.
I refer to Annex 1, which sets out the five key principles in decision-making when someone may lack capacity, but clarification is needed about the process to follow regarding a young person who is judged to lack capacity. The code states that in such a situation decisions will be made by a representative who is,
“a deputy appointed by the Court of Protection”.
Currently, under the Mental Capacity Act, a formal process is not always needed and a formal deputy does not always need to be appointed. Can the Minister clarify this and say whether the code is implying that a new type of education deputy will be introduced rather than following the best-interests process currently used for adults? It is not clear from the code how a decision on whether a young person has capacity can be challenged and I would welcome the Minister’s response.
We must remember that the Children and Families Act 2014 brings in new decision-making rights for young people aged 16 to 18 in terms of education. This is a very new area for the Mental Capacity Act to be applied in. I agree with my noble friends that it would be sensible to review how the code is working at an appropriate point and to focus specifically on this area of implementation of decision-making capacity judgments within such a review.
Schools: Emergency Life Support Skills
Baroness Hollins Excerpts(10 years, 11 months ago)
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Lord Nash
As the noble Lord will know, this Government believe as a matter of policy that prescription from the centre has not worked. The evidence of the performance of our school system over the past 15 years speaks for itself. However, we believe, as we have debated many times in this House, that PSHE and programmes such as first aid are incredibly important, and we are sending out messages as far as we can. We have a new PSHE review and we are engaging with bodies such as the PSHE Association to get the message out to all schools that this kind of programme is very important.
Baroness Hollins (CB)
What impact assessment has been made of the effect of relying on voluntary organisations such as the Boys’ Brigade, the Scouts or St John Ambulance to teach vital emergency life-saving skills, instead of including this on a national curriculum? I agree with my noble friend that the biology course could teach these highly relevant practical skills.
Lord Nash
I am not aware of any impact assessments. If I hear of any I will send them to the noble Baroness. The view of the Government is that, as with PSHE, rather than have prescriptive detail—in words on a piece of paper—of what should be taught, it is much better to encourage schools to engage with expert organisations, such as the ones to which the noble Baroness referred. They are the professionals: they are focused on a particular area and can constantly update their material.
Children and Families Bill
Baroness Hollins Excerpts(11 years ago)
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Lord Low of Dalston
My Lords, my name is on the amendment and I wish to give my full support to my noble friend Lord Rix, who moved it. It would place a duty on local authorities to deliver the social care services identified in education, health and care plans. The contention of the noble Lord, myself and the other noble Lords who have their names on the amendment is that there is very little point in assessing a child or young person’s needs, identifying social care needs and putting them in the education and health plan, and then not making the plan enforceable in respect of social care as it is in respect of education provision.
As I think the noble Lord, Lord Rix, indicated, the amendment would add no new duties on local authorities to provide social care in addition to those that already exist. It merely brings together the legislation on education, health and care plans and existing social care legislation. There is currently a misconception that the social care duties in respect of disabled children are not specifically enforceable for an individual child. However, as I think the Government accept, this duty does already exist under Section 2 of the Chronically Sick and Disabled Persons Act 1970. The proposal contained in this amendment would help to correct this misconception.
The Government have argued that a proposal to create an individually owed duty in relation to social care would prioritise one group of children in need over another. However, there is already an individually owed duty to disabled children in Section 2 of the Chronically Sick and Disabled Persons Act, as I indicated, which is not enjoyed by other children in need. We had a good discussion about this in one of the Minister’s meetings with Peers, which I think we all found very valuable in developing our understanding of the Bill. I think we managed to elucidate in that discussion that if one were going to establish priorities between different groups of recipients of social care, it would have to be done at a prior stage to the formulation of the education, health and care plan. If the authority has got to the point of identifying social care needs and putting them in the plan, it really does not make any sense in terms of integrated education, health and social care provision not to make the provision identified in the plan enforceable.
Baroness Hollins (CB)
My Lords, I, too, add my support to the amendment moved by my noble friend Lord Rix, which aims to ensure that children and young people receive the care to which they are entitled. I empathise with the battle to get health, education and social care agencies to work together; it is one that I waged on behalf of my son in the past. I know, of course, that I am not alone here and that parents across the country face this uphill struggle.
The absence of a duty to deliver the social care elements of the plan sends out the dangerous message that care is unimportant alongside education and health provisions. It is, as my noble friend says, the poor cousin. For children and young people with a learning disability and their families, this could not be further from the truth. Good social care plays an important part in helping the child or young person achieve their educational goals. That is accepted, whether it is in relation to independent living, supported employment, employment or moving on to further learning. Good social care prevents burnout in families. I understand and am glad that the Government have accepted that there is an issue here, and I look forward to the Minister’s response.
Baroness Hollins
My Lords, I, too, added my name to this amendment. My noble friends Lord Rix and Lord Low have eloquently set out the logical intention behind the request to create a single point of appeal across education, health and care. If we are to create a truly joined-up system that really works for children, young people and their parents, this seems to be an absolute necessity. I speak as a parent who has worked hard to get the right support across all three systems and cultures for my son. The Government propose a single point of assessment, but the same old separate routes for redress and complaint, which will continue to bewilder and confront parents. We should aspire to more.
To focus on health needs for a moment, there are significant concerns among those in the sector that the health service is far from prepared to deal with appeals for the new plans when they are introduced from September this year. We should be mindful of the culture in which complaints and appeals happen in the NHS, and it is not quite clear where parents who are concerned about the health component of the plan would start. Ann Clwyd’s excellent recent report concluded that the NHS complaints system was confusing, lacked accountability and was subject to often long and frustrating delays. The system has been particularly unsatisfactory in the face of complaints from families of people with a learning disability.
Prior to a debate that I secured last year on the premature deaths of people with a learning disability, I met with a number of families who had lost loved ones to neglect and discrimination within the health service. Their experience of going through the NHS complaints process was that, in addition to being overbureaucratic and time-consuming, it was very defensive. They explained that it took years in many very serious cases to receive any sort of answer. A single appeal process for a single education, health and care plan might help us move closer to the joined-up system we are looking for, and ultimately help parents get what is needed for their sons and daughters.
Lord Storey
My Lords, I, too, moved an amendment in Committee on a single point of appeal. It beggars belief that you would have progressive legislation that creates for the first time a joined-up approach to education, health and social care but not a joined-up approach to an appeals mechanism. Everybody I have spoken to agrees with that.
Of course, the problem is the current systems that we have, so the notion is that we establish a Bill that creates single education, health and social care plans but then the appeals mechanism is threefold. We expect in this child and family-friendly approach for parents then to navigate their way through these different systems. Currently, the health appeals mechanism is not very transparent and on patient or family satisfaction ratings is very low indeed. Local authorities, as we know, vary.
What do we need to do? First, the code of conduct very much highlights the need for mediation—but it talks about mediation in terms only of education, not on the health and social care side. I hope the Minister might respond by telling us how we bring the mediation together for all three strands of the plan. In my view, mediation could considerably reduce the number of people wishing to appeal.
Then you come to the appeals mechanism itself. Whatever happens here today, I am utterly convinced that, in the years that follow, there will be one tribunal for these plans. The difficulty is the bureaucratic systems, as eloquently extolled by the noble Lord, Lord Low. Currently, the bureaucracy is not fit for purpose. My great fear is that we push the bureaucracies to agree one tribunal, they go kicking and screaming, and the whole thing does not work. We have to negotiate and make sure that everybody is on board to make this happen. Having talked to Ministers in health and education—though having been slightly disillusioned by officials—I am sure that we can achieve that eventually. We need to give my noble friend Lord Nash more time to continue those negotiations. Again, as has been said, I am sure that on the education side we all agree.
Children and Families Bill
Baroness Hollins Excerpts(11 years, 2 months ago)
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Baroness Gardner of Parkes (Con)
My Lords, I support the noble Lord, Lord Low, on this amendment. I have not taken part in this Bill so far because I do not consider myself to be an expert on education and know little about it, but my concern is that, with the timing of the Care Bill being taken in the main Chamber along with this Bill in here, the whole thing might fall between two stools. In responding to the last amendment, my noble friend Lord Attlee said that there might be some duplication. I should say that I would rather see duplication than a hole. It is terribly important that this is taken into consideration. Even for those most in need of special educational support, there seems to come a time when education comes to an end. However, care needs continue in terms of the social behaviour of the person as much as anything else, and that can be quite a worry if someone falls into bad company. It is important that their social condition as much as their mental and physical condition is watched.
The noble Lord, Lord Low, has made the extremely valuable point that this goes right across these different services. For years, I have been involved in health issues, and there is always an argument about whether health or social care should deal with certain problems. Every time, each sector wants to push them on to the other one. If this provision reached over all of the services, as the noble Lord proposes, it would do away with trying to work out how the other fellow should pay for something rather than you. It would be very valuable if we could simplify this area and I therefore support the amendment.
Baroness Hollins (CB)
My Lords, I speak in support of this group of amendments. They aim to achieve equal standing for social care provision in the new education, health and care plans, and they have been ably introduced by my noble friend Lord Low. I pass on the apologies of my noble friend Lord Rix, who had hoped to be able to support these amendments.
Statements of special educational needs specify the special education provision that must be provided by the local authority. The Government have now recognised that health should also be an enforceable part of the new EHC plans, and the Bill has been amended accordingly. But if education, health and care plans are to live up to their name, we need to decide how to put the final piece of this jigsaw in place, which is the duty to provide the social care services that are set out in the plans. This is critical to children and young people with learning disabilities, a significant number of whom need care to help them to achieve their educational and personal aspirations. Let us imagine the position of a parent. They receive an education, health and care plan for their child which sets out all the education, health and social care provision that their child needs. Their child has a legal right to receive the education and health components of the plan, and the parent can hold those agencies to account if the services are not delivered.
However, the social care element seems not to be as enforceable. If the social care services identified in the plan are not delivered, there is nothing that they can do about it. We know that there can be problems with the way in which social care is currently delivered. Ofsted’s thematic inspection of social care for disabled children in 2012 found that social care was not always well co-ordinated and that many social care plans were not detailed enough or focused on outcomes. In a small number of cases, children had no plans or reviews were not held. Surely, those are precisely the types of problems that EHC plans are meant to solve.
We know that similar amendments were tabled in the House of Commons. The Minister in the other place said that he saw the rationale for placing the same duty on the provision of social care as for health and education. Therefore, what is the Government’s objection to these amendments? In many ways, they have already done the hard bit. Placing a specific duty on health to deliver the services set out in EHC plans is a major step forward and should be commended. That is why it is hard to understand a reluctance to consider the duty to deliver the social care part of an EHC plan.
As my noble friend Lord Low has helpfully set out, there are existing duties to deliver social care. This seems to be a matter of aligning existing legislation rather than creating a whole new set of duties. Parents’ expectations have been raised. This Bill will create education, health and care plans, and people will expect the plans to be delivered. At the moment, we are only two-thirds of the way there. I urge the Minister to consider taking the final step to create the truly joined-up plans that everyone is hoping for.
Baroness Hughes of Stretford (Lab)
My Lords, I also support this group of amendments and will speak to Amendments 162 and 163 in my name. Although Amendments 143 and 144A, which relate to Clause 37, are about the assessment process, they return to the heart of one of the most important debates that we had earlier in our deliberations; namely, the need to include all the needs of all disabled children. We will turn to the failure of the Bill to be sufficiently comprehensive on Report.
Turning to Amendments 162, 163 and 164, Amendment 164 essentially does the same as Amendment 163. The noble Lord, Lord Low, and the noble Baronesses, Lady Gardner and Lady Hollins, clearly have made the case as to why, in a new system that the Government are proposing in which all three elements of a child’s need—education, health and social care—are being brought together in an integrated system, it is very important that all three elements have the same status in terms of accountability. As the legislation is drafted, ECH plans would offer no more legal entitlement to support from social care services than do statements at the moment. We know that there is a great deal of variability in the extent to which children receive the social care provision that they need, as the noble Lord, Lord Low, has said.
In anticipation of what the Minister might say, he has already said in a letter to Peers that, first, the Government want, if you like, to square off the health provision because the health service is changing dramatically and he wants to make sure that health has a duty alongside the local authority to provide special educational need. That is why the Bill was amended from its first form to include health. I agree with the noble Baroness, Lady Hollins, that that is very welcome. He went to say:
“However for those with social care needs, the section 17 duties”—
in the Children Act—
“are a long-standing means to protect vulnerable children, including those with SEN and disabilities. Social care for vulnerable children under section 17 of the Children Act encompasses a wide range of needs and disabilities to emotional and family problems. It would not be right to prioritise as a matter of course the needs of those children with ECH Plans over all other children in need, for example young carers, asylum seeking children, or children suffering neglect”.
In saying that, the Government are admitting to what we fear, which is that there will not be an entitlement to provision for their social care needs in the way that there will be, under Clause 42, for their healthcare and special educational needs provision.
Are the Government really happy with that? They are proposing an excellent tripartite system. My noble friend Lord Touhig has drawn an analogy in discussions between us on this side of the Committee with a three-legged stool. The problem is that the three-legged stool will have one leg shorter than the other two, so for many families it will topple over because the social care elements—the needs and provisions specified in the plans—will not be enforceable. That is a real problem. It is very important that the three elements are equally visible and accountable and are seen as complementary. The absence of social care from the clause, although possibly technically and legalistically workable, sends entirely the wrong signal to service providers and, in particular, to parents and children. As the noble Lord, Lord Low, said, there needs to be clarity about the parity between those three elements of the service.
Children: Looked-after Children
Baroness Hollins Excerpts(12 years, 2 months ago)
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Baroness Hollins
My Lords, I thank my noble friend Lord Listowel for securing this debate and for his important opening speech. I worked for many years as a child psychiatrist and a psychiatrist with children and adults with learning disabilities, and have had a research and clinical interest in the mental health and behavioural consequences of abuse.
My daughter is also a consultant psychiatrist working with troubled parents and their infants, so I will start my contribution by reflecting on the importance of secure attachments for all children. As my noble friend said so powerfully, children who have been rejected, neglected or abused have to learn to love and learn to trust—possibly for the first time. Early intervention is critical, and we know from American research that family health partnerships are effective in reducing the need for care away from the child’s own family, and have longer-term intergenerational benefits. Do not forget that a large percentage of girls leaving care are pregnant within a year. The provision of peer mentors is a promising initiative that is being evaluated in a study at St George’s, University of London by Gill Mezey and her team in the hope of easing the transition to adulthood for these vulnerable young women.
Some of the most vulnerable parents are those with learning disabilities. This is a group that I have worked with as a psychiatrist. It is almost standard practice for their children to be taken into care. I will say more about this shortly. I will also draw attention to the high number of children with learning disabilities placed in care. Commissioning the right mental health services is very important. Child and adolescent mental health services treat serious diagnosed disorders, but we need more preventive services too and we need more skilled practitioners who recognise the signs of abuse and its emotional and behavioural impact. This means better training of front-line staff, but also more integrated services and better awareness of the mental health needs of disabled looked-after children. In the light of recent child protection failures, the emotional well-being of looked-after children must be first and foremost. It is the key to the prevention of abuse and exploitation, and it is equally important in the healing process after abuse has occurred. What we see time and time again is how crucial early identification and intervention are for those entering the care system. Crucially, since the national child and adolescent mental health services review report in 2008, little seems to have changed according to both young people in care and professionals.
Children under five raised in institutions experience more psychiatric disorders, but those placed in stable foster homes have much better mental well-being and securer attachments. One review of data sources in England estimated that disabled children constitute between 10% and 25% of the looked-after population. Disabled children may be particularly vulnerable to abuse and neglect, which is a common reason for entry into care. The NSPCC reports that children with disabilities are 3.8 times more likely to be neglected, 3.8 times more likely to be physically abused, more than three times more likely to be sexually abused and four times more likely to be emotionally abused than other children. Children with learning disabilities in care are even more likely to run away than other children.
Disabled children in England are a distinct subgroup who are less likely to achieve a permanent placement. Research suggests that disabled children are more likely to display a high level of behaviour that their carers find challenging. This is particularly relevant when we think about stability. Evidence suggests that emotional and behavioural problems have a strong association with placement breakdown. Research shows that the prevalence of mental disorders decreases with the length of time a child has spent in a stable placement. Half of those who have been in their current placement for less than a year have mental health problems compared to a third of children who have been in their current placement for at least five years. That is an improvement.
The findings show that, despite various changes in policies and provision of care, the prevalence of children with recognisable mental health disorders—around three-quarters—has not diminished. For those trying to access services, Sheffield City Council and NHS Sheffield found that in February more than 260 looked-after children had been waiting for child and adolescent mental health services for more than 18 weeks, with some facing waits of up to 44 weeks. This is not acceptable. Services are not flexible enough. Children are expected to go to them instead of the services being flexible and approachable, which these children need.
Difficulties that local authorities have in finding placements for disabled children result in inappropriate placements, including the use of 52-week-a-year boarding schools or, and I myself know of examples of this, disabled children being placed in respite provision, where every week different children will be sharing their corridor, their bathroom and their mealtimes. Permanent placements for disabled children in respite facilities are not acceptable. Disabled children might be placed in adult residential facilities rather than family placements. Local authorities have also documented an increased use of out-of-area placements for disabled children so they are likely to live further away from their families and communities, creating problems in monitoring and problems for their families in maintaining contact. This is especially the case for children with learning disabilities, who may sometimes require psychiatric in-patient admission as well. There are very few specialist units that would accept children with a learning disability who had mental health problems or challenging behaviour. One of the learning points from the Winterbourne View abuses was that abuse is more likely to happen when the person is placed far from home. The victims in that case were adults, of course, but we should have the same concerns for disabled children who are placed away from home.
Then there are the children with a mild or borderline learning disability. They are unlikely to attend youth groups of any sort and often have a background of abuse, making them more vulnerable to sophisticated grooming techniques. This form of exploitation, as we know and have heard today in several speeches, often begins with positive attention from adults, something that these children particularly crave. Flattery and gifts are a new experience for them and they welcome it. They may not have the insight into social behaviours and relationships to determine that while this is how things are beginning, it is most certainly not how they will end.
The education of front-line staff is necessary with regard to spotting the tell-tale signs of possible abuse: a new mobile phone, new clothes or an older man presenting as a boyfriend. Not only is education necessary but the empowerment of front-line staff and carers to communicate their concerns to relevant bodies is essential. Carers may not have the confidence that they have the skill set necessary to make a judgment call over a complex situation. They may feel that they are not expert enough to determine a young person’s capacity to engage in a particular behaviour. These carers need support and training to help them with these difficult situations. Even for a professional it can be difficult to make a capacity assessment on a 17 year-old girl with a mild learning disability, a complex social background and mental health issues who is engaging in sexual behaviours.
Education is also needed before children reach care. Many parents try to use social services to assist them with the emotional and behavioural difficulties that they are experiencing with their children, but they often do not get past the duty desk. Those who do not meet the threshold criteria for a service but who often have a need for mental health services may not be recognised, and may not know where to turn for help. A survey of 440 childcare social workers found that 30% were unaware of local resources available to support the children and families of, for example, those with ADHD. Many inexperienced practitioners did not recognise the importance of psychiatric assessment.
Without appropriate support, training and confidence, how can we expect carers to know that they are the ones probably best placed to carry out such an assessment and, if required, intervention? Empowering those who care is the key to offering these children the protection that they deserve and the chance to enjoy the innocence of childhood.
Marriage
Baroness Hollins Excerpts(13 years, 11 months ago)
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Baroness Hollins
My Lords, I, too, am grateful to the right reverend Prelate for securing this debate. I declare an interest as an honorary member of the British Society of Couple Psychotherapists and Counsellors. I especially enjoyed the maiden speech of the noble Baroness, Lady Tyler, and agree wholeheartedly with her emphasis on the need for good preparation for marriage.
Extensive research has now documented that the breakdown of couple relationships has deleterious effects on the psychological and physical health of the couple, as well as on their children. Children suffer not only from the upheavals of the divorce process but from the impact of turbulent, conflicted marriages. Although divorce has apparently reached a plateau, couples that divorce today do so at an earlier age, with an anticipated 45 per cent of British marriages in 2005—perhaps more now—expected to end in divorce. As fewer couples marry, much relationship breakdown remains unreported.
The right honourable Iain Duncan Smith, in his comments earlier this week as part of National Marriage Week, estimated that the costs of relationship breakdown could be somewhere between £20 billion and £40 billion—rather more than the 1995 estimates of only £5 billion—in health consequences, the impact on children and lost working income. As the noble Baroness, Lady Tyler, alluded to, while the Government have committed support to relationships, they have allocated only £7.5 million per year for marriage support.
I am also very concerned about the lack of financial support for marriage, especially since results from the 2007 adult psychiatric morbidity survey showed that the second most important predictor of mental illness was family debt. A recent international tax comparison by the charity CARE highlighted the fact that among OECD countries Britain is relatively unusual in failing to recognise marriage in the tax system. This has unfortunate effects, including the tax burden on one-earner married couples with two children, who have an average wage a third greater than the OECD average. There is clearly a need for the Government to fulfil their promise to recognise marriage in the tax system. I refer noble Lords to page 30 of the coalition agreement.
Although the consequences of relationship breakdown can be devastating, mental health professionals can now treat relationship breakdown, as well as contribute to its prevention through strengthening couple relationships. When breakdown occurs, mental health professionals can minimise the harm to children, adults and families. Vulnerable periods in the life cycle of a couple can be identified so that targeted interventions can be offered, as was suggested by me and others in the debate about early intervention and parent-infant relationships just last week.
There are also some vulnerable groups of couples in society. Perhaps surprisingly, young marriage and young parenthood are actively discouraged today, with young mothers feeling criticised by first-time mothers old enough to be their grandmothers, despite the biological advantage of young parenthood. They also increasingly have to begin married life without the advantages of support from their extended family.
Another group among whom marriage and parenthood are discouraged are people with learning disabilities—a group that I have worked with for the past 30 years. Research shows that such families do well when there is a reliable and constant supporter, such as a grandmother, social worker or health visitor. These parents may also benefit from relationship support when they have difficulties in sustaining their intimate relationships. However, such relationship support requires rather more specialist skills from the marriage counsellor.
Very little funding has been made available thus far to evaluate the effectiveness of psychotherapeutic interventions, and the lack of an evidence base, relatively speaking, impacts negatively upon the funding situation for organisations that study and treat dysfunctional relationships. What plans do the Government have to provide more research funding to evaluate the effectiveness of support, given the huge cost to society of marriage breakdown? What plans do they have for support in the tax system for married couples?