Children and Social Work Bill [HL]

Lord Mackay of Clashfern Excerpts

Report: 1st sitting: House of Lords
Tuesday 18th October 2016 Lords Chamber

[Lord Lester of Herne Hill]

I am very grateful. I gather that the reason for my mistake is that version that we now have does not have the compatibility statement, but I think that the original version did. I am grateful.

[Lord Mackay of Clashfern (Con)]

My Lords, I wonder how the Government’s amendment can be carried out without giving effect to the other amendments in this group. Amendment 1 has the effect of requiring that in carrying out its functions, a local authority must,

“have regard to the need … to act in the best interests, and promote the physical and mental health and well-being, of those children and young people”.

How one could promote their health without knowing what they may need in the way of health I cannot understand. Therefore I assume that these amendments are all covered by the generality of the words in Clause 1(1)(a) as amended.

[Lord Nash]

My Lords, I start by responding to the point made by the noble Lord, Lord Ramsbotham, about the preparation for the Bill and consultation. The Bill has been very widely consulted on, and impact assessments have been conducted, including a full assessment in respect of children’s rights. Ministers and officials meet regularly with representatives of local authorities and the voluntary sector to discuss all aspects of the Bill, and their views are always listened to very carefully. In relation to the provisions on looked-after children and care leavers, we have spoken to the ADCS, the LGA and approximately 20 local authorities on the corporate parenting principles and local offer. Our thinking was also informed by eight meetings of care leavers organised by voluntary sector organisations as we developed Keep on Caring. However, I take the noble Lord’s point about, at certain times, the rush of correspondence and the flurry of activity, for which I apologise. It has not been easy for any of us, and I will take his points back, again, and ensure that they are taken very seriously.

I now turn to the amendment in the name of the noble Baroness, Lady Tyler, which would place a duty on local authorities to promote the mental health of looked-after children and care leavers. I am grateful to the noble Earl, Lord Listowel, to my noble friend Lord O’Shaughnessy, to the noble Lords, Lord Warner, Lord Watson and Lord Judd, to the noble and learned Lord, Lord Mackay of Clashfern, and to the noble Baronesses, Lady Murphy and Lady Benjamin, for their contributions to today’s debate.

All mental health-related amendments have been discussed with the co-chairs of the expert group for mental health for looked-after children. One of the co-chairs, Alison O’Sullivan, attended a meeting with some noble Lords in September to present the work plan and ambition for its care pathway project. Assessment, and how children access the right support, will be at the very heart of its work. The next stage of the group’s work will see the development of options for a care pathway along with models of care and quality indicators for the mental health of looked-after children. A care pathway is an evidence-based journey that outlines possible treatment options, timescales and the professionals involved in a person’s care. It will consider, explicitly, the pros and cons of carrying out a full mental health assessment on entry to care.

The expert group plans to share the evidence base behind the chosen models and the pathway with interested parties, including noble Lords, in the spring. We are committed to acting on the findings of the expert group, and will fully consider all the recommendations it makes, including any recommendations to legislate. Every local authority is already under a duty to safeguard and promote the welfare of the children it looks after. That means not just keeping them safe but considering their emotional well-being. Looked-after children already must regularly receive a comprehensive health assessment by a registered medical professional on entry into care.

Where there is concern about possible mental health or special educational needs issues which require further investigation, local authorities must ensure the appropriate professionals undertake necessary next steps. Access to NHS services is based on the clinical needs of each individual. The current approach of undertaking further specialist assessment where there is an established need allows resources to be targeted appropriately.

Transition between children’s and adult mental health services needs to be managed effectively. However, prescribing the age at which a young person leaves CAMHS fails to recognise looked-after children as individuals with varying needs. NHS guidance is clear that the transition must be carefully planned with the young person and should take place at the time which is right for them. Services should, wherever possible, accommodate this flexibility.

Co-operation between local authorities and clinical commissioning groups is vital. That is why CCGs are relevant partners under Section 10 of the Children Act 2004 and must co-operate with local authority arrangements to promote the welfare of children. That includes those looked after and care leavers in their area. Innovation projects such as No Wrong Door in North Yorkshire show what can be achieved through multiagency team approaches.

There are numerous examples of joint working across local authority and mental health teams: North Tyneside, Kensington and Chelsea, Croydon, Hartlepool, Sheffield and Trafford to name but a few. So what we want to see is already happening, but just not everywhere. Through initiatives like the Innovation Programme, the Government are supporting this work and will be helping the wider sector to learn about what really works in this area. Services are improved through better planning and commissioning. The needs of this vulnerable group should be addressed through local health and well-being boards and the local transformation plans that all CCGs have produced with local authorities, together with other local partners.

I completely agree with the importance to be placed on identifying and responding to the mental health needs of children in care. That is why, as I have said, every looked-after child is subject to regular physical and mental health screenings. Where any potential issues are identified, a more intensive specialist mental health assessment should be pursued. But we must remember that around 50% of looked-after children have a mental health problem; 50% do not require intensive specialist assessment—these assessments should be used where there is cause for further investigation, not indiscriminately. As I say, if the expert group on mental health recommends that we reconsider this position, we will do so, properly considering all its recommendations, including legislation.

The noble Baroness, Lady Tyler, clarified some of her concerns and who she proposes would carry out these assessments, which I personally found extremely helpful. I will commit not only to meet her to discuss this matter, but also to try to ensure that the co-chairs of the expert group are also at that meeting to listen to and discuss her points.

I turn to the amendment from the noble Lord, Lord Ramsbotham, which focuses on the needs of looked-after children and care leavers with neurodevelopmental disorders or neurodisability needs. The ability to communicate in order to access learning and improve life chances is something to which the noble Lord is deeply committed. The Government share that commitment, both to looked-after children and care leavers and those with special educational needs. However, we need to take a proportionate and targeted approach to assessing and meeting needs.

The amendment includes a long list of issues that a proposed mental health assessment should cover, all of which may require a specialist assessment. We do not think that screening all children for every condition on that list is appropriate, with children only being sent for specialist assessment where the earlier general assessment has indicated this is necessary. An assessment framework for looked-after children and young people is already in place to ensure their needs are addressed.

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[The Earl of Listowel]

My Lords, Amendment 2 is in my name and that of the noble Lord, Lord Warner. I should apologise briefly for not recognising the importance of government Amendment 1 in the last grouping. I welcome that important amendment to make clear to local authorities their duty to consider both the physical and the mental health of looked-after children. I was grateful for the opportunity to meet with the Minister this morning to discuss my amendments in this part of the Bill.

I welcome the inclusion of the corporate parenting principles in Clause 1. However, I believe that these could be further strengthened by adding a new principle, as my amendment does, to support relationships between children and young people and their families and carers. The Care Inquiry report, Making not Breaking, concluded that,

“the relationships with people who care for and about children are the golden thread in children’s lives, and that the quality of a child’s relationships is the lens through which we should view what we do and plan to do”.

By allowing the child to stay in touch with people whom they feel are important to them, this new principle would support principles (b) and (c) in Clause 1(1), on listening to the views of the child, and principle (f), on the stability of relationships.

Research shows that one-third of children and young people in foster care and care-leavers have been prevented from having contact with a former foster carer. More than half have said that their social worker does not support them in keeping in contact at all. Good- quality relationships impact on social and emotional development, educational achievement and mental health. Children who have secure attachments have better outcomes in all of these areas than those who do not have secure attachments. We need to keep in mind the history of broken relationships that many of these young people have had: broken relationships with their birth parents and siblings as they enter care; with their schoolmates and teachers as they move placements; and with their social workers, as those change.

The practice of cutting off the relationship between the child and their former foster carer is very damaging, and social work practice needs to recognise this. Amending the corporate parenting principles in this way would provide a strong foundation from which to build this change. I hope that I may pay tribute to the Government for their “staying put” legislation and the forthcoming proposal on “staying close”, with regard to children’s homes. I think that the Government have really recognised the importance of the principles that I have just been describing.

I would like to end with the comments of a few young people. One young man said:

“Because... I don’t even know! I’d like to, I keep in touch with one of my foster families. But the ones I really want to keep in touch with are not allowed, and I think it is wrong that we can’t do so as maintaining a secure relationship with foster families makes the child feel valued and still loved and cared for. I hope in the future that this changes”.

Another young person said:

“I have asked but it wasn’t allowed and they want to see me too we had a good bond. It should have happened”.

Finally, another said:

“Foster parents are, or can be, like parents: they are the ones who care for you on a day-to-day basis. The idea that you can live in a home for years and then be expected to move to a new home and never look back is abhorrent”.

I look forward to the Minister’s response, and I beg to move.

[Lord Mackay of Clashfern]

My Lords, I am responsible for Amendment 9 in this group. I had the honour of introducing the Bill that ultimately became the Children Act 1989, and I am glad that it has survived since then. Although it has been subject to improvements as time has gone on, the main structure of that Bill has lasted well. Ever since, I have been concerned about the progress of the care system. I have felt sad when it has been shown to have failed in various ways.

One of the important points made by the noble Lord, Lord Judd, earlier was that a good family promotes very close relationships between the parents and the children. Sadly, those who come into care are normally without that provision, and it is the task of the care system to provide for it, as far as possible. One aspect that has troubled me—and those with more hands-on experience of the system than I—is that when a child is in residential care, the people looking after the child change often, and often suddenly. The result is that it is very difficult for the child to build up a relationship with any particular person who has responsibility for their immediate care. As we heard from the noble Earl, in a foster care relationship a very good relationship is often built up, which should be protected thereafter, as far as possible. That is the purpose of Amendment 2. My amendment is related to that, and it is therefore appropriate that they be dealt with together.

I moved a similar amendment in Committee, but I found the Minister’s response somewhat disappointing. I thought he had not quite understood what I was trying to get at—no doubt that was entirely my fault—so I arranged for a meeting with the Bill team to discuss my amendment, and a very full meeting we had. Incidentally, in relation to what is now Clause 29, I proposed a redrafting which I thought would deal with a good many of the objections raised to it in Committee. I am not sure whether that was brought to the Minister’s attention, but in raising it with the Bill team I obviously intended that it should—but that is not for today.

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Moved by

[Lord Mackay of Clashfern]

9: After Clause 1, insert the following new Clause—
“Member of care staff to be responsible for the well-being of a child in local authority care
(1) When a local authority receives a child into its residential care, it must forthwith appoint one of its care staff to be responsible for the well-being of that child and, subject to subsection (2), the appointment shall endure for so long as the child remains in the care of the authority.(2) If a change of circumstances makes necessary the termination of the appointment under subsection (1), the authority must forthwith appoint another member of its care staff to be responsible for the well-being of the child.”

[Lord Mackay of Clashfern]

My Lords, I do not propose to elaborate because we have already discussed this, but I want to take the opportunity to answer the point made by the Minister. It is in relation to the Barnardo’s release from the National Independent Visitor Development Project, dated 8 August 2016, that the figure of 97% is mentioned. I am a member of Barnardo’s but had nothing whatever to do with the preparation or publication of this report. It came as a rather sad message to me.

I am sorry that, due to the same sort of considerations that the noble Lord, Lord Ramsbotham, mentioned, I have not been able to attend the briefings that have been held because I have not been here, but I would be very happy to meet the Minister. I sincerely hope that, at least, the Government will be able to incorporate this amendment by way of guidance in the standard that they have set out. I beg to move.

[Lord Nash]

I would be delighted to meet my noble and learned friend Lord Mackay to discuss this further. It is important that we do so.

[Lord Mackay of Clashfern]

I beg leave to withdraw the amendment.

Amendment 9 withdrawn.

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I heard the encouraging words that the Minister said earlier on. He sounded very sympathetic to this amendment, so I am very much looking forward to his response.

[Lord Mackay of Clashfern]

My Lords, I am happy to support the amendment. Everything that I said earlier was about relationships and how vital they are, so it gives me great pleasure to support my noble friend’s amendment.

[The Earl of Listowel]

My Lords, perhaps I may speak briefly in support of the amendment. Earlier we debated my Amendment 2, and I indicated this morning to the Minister that I would not be seeking to move it. I must say that, listening to the debate in the Chamber, I was almost tempted to change my mind. The amendment was brought to my attention fairly late, which is why I was reluctant to push it as hard as I might. This is an excellent amendment, if I may say so. I understand that the Minister is going to give a very sympathetic response. I hope he can go as far as possible towards enshrining this in statute. I look forward to his response.