Children and Social Work Bill [ Lords ] (Second sitting)

Tulip Siddiq Excerpts

Committee Debate: 2nd sitting: House of Commons
Tuesday 13th December 2016 Public Bill Committees

[Stella Creasy (Walthamstow) (Lab/Co-op)]

I will be brief; I am sure that over lunch Government Members have had a chance to contemplate the argument that I made. I am conscious that Opposition Members who have joined us might want to be reminded of them. There are three points that I want the Government to come back on if they are not going to accept our amendments. First, the idea of a basic minimum standard for care leavers. If we are not to have a minimum standard, how does the Minister intend to ensure that all care leavers are given a level of service that we can be proud of?

Secondly, on the Minister’s approach to dealing with young asylum seekers who are not part of this legislation at the moment, the amendment seeks to bring them in scope to make sure that they are given equal protection. As I said earlier, turning 18 does not stop someone being vulnerable overnight. Finally, how do we deal with the specific issue of financial management problems that many care leavers face, particularly the problems that are well documented in the benefits system? If the Minister does not intend to accept our amendments to support care leavers through the benefits system and to make sure that we recognise those problems and the cost to us of not recognising those problems, what plan does he have to address those issues? At this point, I shall let others take the debate forward.

[Tulip Siddiq (Hampstead and Kilburn) (Lab)]

I thank my hon. Friend the Member for Walthamstow for her passionate speech. Even though she was interrupted mid-flow, she has summed up very well. It will not come as a surprise to the Committee that I wholeheartedly endorse her speech and the amendment on the national minimum standard for care leavers. I want to point out that we cannot just rely on local authorities to make specific decisions, because there are different standards across the country for different local authorities, as I saw as a councillor before entering Parliament.

Various policy concerns can be addressed by introducing a national minimum standard, but I want to focus specifically on people’s mental health, especially that of vulnerable people leaving the care system. One early study of care leavers in England that I found interesting found evidence of a range of mental health problems for care leavers. One in five care leavers reported long-term mental health problems. Everyone here will be aware of the stigma surrounding mental health. One in five is probably not a true reflection of how many mental health problems there really were among care leavers, because some of them would not want to report problems for fear of being stigmatised.

The mental health problems that the care leavers spoke about included eating disorders, bipolar issues, depression and serious phobias that haunted them later in life. In addition, there were shocking statistics: a quarter of care leavers reported heavy drinking on a regular basis and two thirds admitted that they used drugs regularly. It is no surprise that many of the care leavers who spoke about their experiences said that their mental health problems originated in the life that they led before they, in a sense, entered adulthood. They said that a lot of their mental health problems came from the poor housing that they had experienced and the lack of finance and intimate relationships in their life.

The NSPCC rightly pointed out in its 2014 report that leaving care is an extended process rather than a single event, which I wholeheartedly agree with and which speaks to our amendment. Care leavers face the significant challenge of psychologically moving forward towards adulthood, often trying to make sense of their past life experiences. With the withdrawal of care services, support services and care placements, they have to test out the reliability of their network of friends and family. The shadow Minister has made the point over and over again that we should not have a postcode lottery when it comes to care and the future of care leavers. Nor should we have a lottery of personal circumstances, where those who are lucky have a network of family and friends to rely on, but those who are not often fall into either depression or a life they would not have wanted to lead.

The Opposition acknowledge that multiple changes to someone’s living circumstances will affect them, but change cuts across every aspect of the lives of care leavers; we need to be aware of that, because we are dealing with the most vulnerable people in society. Those changes relate to their finances, access to housing and search for jobs, and care leavers confront those challenges while experiencing a withdrawal of care placements and social support services as they turn 18.

I point to a few stats from the Children’s Society that I thought were particularly striking: 63% of care leavers entered the care system because of abuse or neglect, which is a figure that should put us all to shame; 50% of children in care had emotional and behavioural health that was considered normal, while 13% were borderline and 37% gave cause for concern. I am sure that everyone agrees that those statistics are worrying. They should trouble us all, and they should compel us to act in the interests of the nation.

National minimum standards will allow for a fairer system overall, for which the cost will be wholly outweighed by the benefit of ensuring that the most vulnerable people across the country are treated equally. I trust that Members across the House and from different parties will agree with that after hearing some of the shocking statistics that I have outlined.

[Steve McCabe (Birmingham, Selly Oak) (Lab)]

I will briefly comment on the part of clause 2 that relates to the local offer, before turning to the amendments and new clauses. I will try not to detain you for too long, Mr Wilson.

I am not really clear on the local offer. The Minister has a great deal of experience of the local offer; he pioneered the approach in the Children and Families Act 2014. I am not entirely sure how different what he proposes in the Bill is from the offer in that Act. I took the trouble during the lunch break to look at the rather helpful report from the Children’s Services Development Group entitled “The Local Offer, Children and Parental Rights”. It has a nice foreword by the right hon. Member for Chesham and Amersham (Mrs Gillan), who is the chair of the all-party parliamentary group on autism. You will be delighted to know that I will not read the report to you, Mr Wilson, but there are some things in it that are worth noting.

The offer, as it exists in the Children and Families Act, was intended to help local authorities to identify gaps in provision and to make sure that they were addressed, and the report assesses how successful that has been. It found that there are significant variations in the offers made across the country, with some quite good examples in east midlands, Yorkshire and the Humber, and some very poor examples in the west midlands and the south-west. It also found that less than 4% of local authorities have a named person whom anyone trying to understand the local offer can contact, while less than half of all local authorities listed independent specialist schools on their website, despite that being a requirement that the Minister set out in the Act. There is also a significant variation in the information that is provided on those websites. The Children’s Services Development Group says that a best practice guide for local authorities and a mandated template for the local offer would be helpful.

I draw the Committee’s attention to that because the Opposition suggest that it would be helpful to the local offer in the Bill if there were minimum standards by which we could judge the progress of the Minister’s proposals. I asked him to look again at the experience of the local offer in the Children and Families Act and to check whether there is a risk that local authorities will simply seek to replicate that kind of approach in this piece of legislation. I am not saying that that approach is useless, but I am sure the Minister will share my disappointment that it has not been as successful as anticipated in its operation so far.

I turn to the question that my hon. Friend the Member for Hampstead and Kilburn has just been tackling about the needs of children leaving care. The Minister and I obviously got into the wrong place before lunch when I thought that he was telling me that I should not be too concerned about the educational and mental health outcomes for children leaving care. If that is not what the Minister was saying, I am more than happy to accept that.

However, I took the trouble to go back and have a quick look over lunch at some of the things that we know. I looked at the report by Saunders and Broad which examined long-term mental health conditions—the very things that my hon. Friend has just been talking about—with a greater propensity among children in care and leaving care, who suffer from depression, eating disorders and phobias.

I looked at the mental health and wellbeing report produced by the Select Committee on Education in the fourth Session of Parliament. The first line of that report says:

“The mental health of looked-after children is significantly poorer than that of their peers, with almost half of children and young people in care meeting the criteria for a psychiatric disorder”.

That report, as the Minister knows, went on to recommend that child and adolescent mental health services should be made available for all looked-after young people up to the age of 25, in recognition of the distinct issues which this vulnerable group of young people experience as they attempt to leave the care system.

I also looked at the situation on employment. As I understand it, these are the Government’s figures: three-quarters of care leavers are inclined to leave schooling without any formal qualifications. Of the Government’s study of 26,340 former care leavers aged 19, 20 and 21, 40%—nearly 10,500 young people—were not in employment, education or training, compared with 14% of all 19 to 21-year-olds. The percentage of care leavers who could be described as NEETs has risen by 1% in the past two years.

--- Later in debate ---

[Mrs Lewell-Buck]

It is a pleasure to serve under your chairmanship again, Mr Wilson.

Amendment 28 would extend the duty on local authorities set out in clause 3 to include access to a mental health assessment for care leavers. When a care leaver requests support from their local authority and the local authority conducts an assessment of their needs, it must include an assessment of mental health and emotional wellbeing that is carried out by a qualified mental health professional. The corporate parenting principles set out in clause 1 make it clear that local authorities should promote the mental health and wellbeing of care leavers. Currently, there is huge amount of unmet need in the area due to squeezed budgets, high thresholds and the lack of relevant specialism in adult mental health services.

[Tulip Siddiq]

Is my hon. Friend aware that there are now 5,000 fewer mental health nurses than there were in 2010, and 1,500 fewer mental health beds? The amendment is more important than ever to ensure that mental health does not slip even further down the agenda.

[Mrs Lewell-Buck]

I was not aware of those statistics. I knew the situation was dire, but I did not realise how bad it had actually become.

Young people leaving care are much more likely to have mental health problems than other young people: they are five times more likely to attempt suicide; many have suffered abuse or neglect before coming into care; and they may have moved around several placements, making it hard to form stable relationships with carers, professionals or even friends.

The Government have committed to piloting mental health assessments for children in care, but there was no mention of young people over 18 who have left care. We all know that turning 18 does not mean that people stop being vulnerable and stop needing support. In fact, mental health problems often manifest at the challenging time of transition into adulthood. At 18, young people can no longer access child and adolescent mental health services; they have to rely on adult services—but only if they are lucky enough not to slip through the net in transition. The reality is that if young people with mental health needs are not getting help, it is unlikely that they will be able to make the most of other opportunities such as education, training or employment, because mental health problems can have a debilitating effect on all other areas of their life.

On Second Reading in the House of Lords, Lord Nash acknowledged that:

“All the evidence shows that care leavers are among the most vulnerable young people in our society. Many are still struggling to overcome the impact of the trauma they faced in childhood and, in most cases, they are expected to make the transition into adulthood without the unconditional love and support of a family or close circle of friends. As a consequence, they are far more likely to end up NEET, more likely to experience homelessness or mental health issues, and more likely to end up in the criminal justice system. However, with good, stable care and a more personalised and supported transition into adulthood, those stark facts need not be the culmination of their time in and leaving care.”—[Official Report, House of Lords, 14 June 2016; Vol. 773, c. 112.]

Clearly the Government know what the problem is, yet they have still failed to provide a full solution.

If the mental health and emotional wellbeing of every child leaving care is not professionally assessed, how will we know whether they are ready to cope in the adult environment? We cannot just expect them to leave care and cope in a vacuum, without some appraisal of their wellbeing. We would not allow that for a physical problem so we should not allow it for a mental health one. We must put in place measures to prevent care leavers from falling off the cliff edge of care. Assessments would provide a basis for care leavers to address their future needs, albeit under a different system.

Given the vulnerability of the young people in question and the likelihood that they will face challenges relating to mental health or emotional wellbeing coupled with the difficulty of accessing those services, it would be good if the Minister took the opportunity to extend the duty in clause 3 to include mental health. Amendment 29 would extend the duty on local authorities to include access to a mental health assessment for care leavers; and it would ensure that if amendment 28 is agreed, the assessment will be carried out by a qualified mental health professional.

The Conservative-led Select Committee on Education rightly recommended that a dedicated mental health assessment by a qualified mental health professional be completed for all looked-after children, so healthcare professionals and local authorities have a solid and consistent foundation on which to plan the best care for a child. The recommendation was based on an extensive body of evidence from experts that clearly showed why more action and less talk are needed.

The Government’s response to the Select Committee report on mental health acknowledged the vulnerability of looked-after children and the need for timely and effective mental health diagnosis and treatment. The Chair of the Committee said of the Government’s response:

“We are pleased that the Government have set up an expert working group for looked-after children’s mental health and wellbeing; however, having conducted a lengthy and detailed inquiry on the issue, we are disappointed that so many of our recommendations have simply been referred to that group.”—[Official Report, 20 October 2016; Vol. 615, c. 496WH.]

I was similarly dismayed to observe that the Government’s response to the report deflected many answers to the new expert working group on the mental health of looked-after and care-leaving children. Although I make no criticism of the experts appointed to the group, both chairs of the expert panel had already submitted evidence to the Committee, so further consultation seems a somewhat unnecessary duplication. The consultation will serve only to cause further delays, meaning that more children will suffer unnecessarily.

Services are inconsistent across the country, and initial mental health assessments are highly variable. Many local authorities are not meeting their statutory requirements to ensure that all children are properly assessed even when they enter care, so it is important that we get the basics right. We can do so only with professional assessment as children enter and leave care.

It is astonishing that currently children entering care are asked to fill in strengths and difficulties questionnaires, from which it is decided by people who are most likely not medically trained whether the child qualifies for mental health intervention. Administration of the forms from local authority to local authority is patchy, with great variations in timeliness of completing the form. It is not uncommon for the questionnaire not to be completed at all. Only a trained mental health practitioner should be able to assess a patient’s needs; such needs cannot be determined simply from ticked boxes on a form.

It is not enough just to say that help is out there. There are difficulties with the availability of mental health provision for all children, including difficulties accessing and navigating the system. Accessing mental health care, asking for help and overcoming stigma are hard enough for any young person, even those with strong, supportive families; we must acknowledge that. A mental health assessment is one step in ensuring that children get the care and support they need for healing to take place and for them to be integrated into society and feel part of it. That is why they must be assessed on leaving care as well. The whole point is to ensure that care leavers are robust enough to leave care as independent adults who can go out and find work, start families and participate in society fully, like everyone else.

Amendments 30 and 31 strengthen support for care leavers who are also parents. Despite their extreme vulnerability, the particular needs and circumstances of young parents who are looked-after children or care leavers and whose own children are subject to child protection inquiries are not sufficiently identified, recognised or addressed in care planning regulations and guidance. These amendments seek to establish a duty on local authorities to ensure that advice, assistance and support are offered to all looked-after children and care leavers who are young parents. It will help ensure that important information is not overlooked when plans for such young people are made by expressly identifying critical sources of information which should be drawn upon in formulating plans to keep the young parent’s child safely in their care.

--- Later in debate ---

[Mrs Lewell-Buck]

If I withdrew the amendments, would the Minister consider updating some of the guidance on mental health assessments? In the pathway plans I have seen in the past they are not given the prominence they should have.

[Tulip Siddiq]

I echo the shadow Minister’s comments on pathways. In the past three years, the number of female teenagers who have been admitted to hospital with eating disorders has more than doubled. That is particularly relevant for female care leavers who suffer eating disorders such as bulimia, anorexia and binge eating. A lot of these disorders were not reflected in the past and were not at the forefront of the minds of the people assessing not only care leavers but teenagers in general, especially female teenagers. The Mental Health Foundation clearly labels eating disorders as mental health problems. Will the shadow Minister comment on the fact that when we make legislation and take into account society’s problems, we need to be aware that things are changing? Things that did not previously have the prominence they have now must be acknowledged by authorities, especially with the rise of social media—

[The Chair]

Order. That was only supposed to have been an intervention.

[Tulip Siddiq]

I have made my point. I apologise.

[Mrs Lewell-Buck]

I will withdraw the amendment, but perhaps will return to the matter at a later date. However, I wish to press to a vote the amendments on recognising care-leaving parents, who have particular vulnerabilities. The Minister has not satisfied me that they are being provided for in a holistic way, as it seems to depend on which local authority area people live in. I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Amendment proposed: 30, in clause 3, page 4, line 11, after “child” insert “, including their needs as a young parent where applicable,”—(Mrs Lewell-Buck.)

Question put, That the amendment be made.