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Debate on the Address

My Lords, I am dazzled and somewhat overwhelmed by the previous speech. I was pleased to see in the gracious Speech an emphasis on aspirations to give children the best possible start in life and on improving conditions for vulnerable children and young people, including those in care. I was uncertain about which debate to speak in. I wanted to address youth justice issues, but I am convinced that my noble friends Lord Adonis and Lord Darzi will subscribe to the concept that children, with their needs, come first, beyond any system in which they may find themselves. Much of what I want to say will be applicable to all vulnerable young people. I look forward to working on the Children and Young Persons Bill, which I hope will get to grips with a number of issues that will make a real difference to the lives of young people. Many in your Lordships' House have long been concerned for vulnerable young people; we have heard from some today. I declare an interest as the chair of the All-Party Group on Children, which has frequently expressed its concern for the education, health and well-being of vulnerable children and young people, who are too frequently not best served by public services. I also chair the National Treatment Agency for Substance Misuse, so I am very concerned about the impact of drugs and alcohol on offending behaviour. My starting points for action on children and young people are the United Nations Convention on the Rights of the Child, which makes the welfare of the child paramount; the National Service Framework for Children, Young People and Maternity Services; and the Children Act 2004, building on Every Child Matters, which states that good outcomes for children include being healthy, staying safe, enjoying and achieving, making a positive contribution and achieving economic well-being. Those should be aspirations for all children, including damaged children and those who offend—frequently the same group of children. I am aware that many good things have happened and that a health and social care strategy for young people in contact with the youth justice system is currently in preparation and will appear next year. Indeed, I was privileged to attend, earlier this week, a discussion day on that. At that seminar and from my reading and experience, several issues stand out as being in need of attention if we are to improve conditions for young people in the youth justice service, rehabilitate them and reduce offending. Very many organisations in the voluntary sector and the Children's Commissioner have expressed the view that damaged children should not be damaged further. While there are undoubtedly dedicated professionals working with children, often structures and systems militate against them. The report of the noble Lord, Lord Carlile, is certainly worth revisiting. I am aware of government action to lift children out of poverty, to increase the availability of child care, to introduce a national entitlement to free early years education, to raise standards in schools, to reduce teenage pregnancies and to reduce accidents involving children. All that is positive and to be commended, but challenges remain in both the short and the long terms. The intent of the noble Lord, Lord Darzi, to encourage healthcare that is fair, personalised, effective and safe must surely apply to all services, including those for young people who fall outside our mainstream systems. I find it encouraging that youth justice now comes under the brief of the Minister for Children, within the Department for Children, Schools and Families. Can the noble Lord, Lord Adonis, say how youth justice will be handled by the Children's Minister? What links are being made to other sections of government, the voluntary sector and the Youth Justice Board? The 2006 report from the Healthcare Commission and Her Majesty's Chief Inspector of Probation points out: "““While it is true that support and services for young people who offend has improved significantly over the last three years, ""current levels of provision of healthcare for children and young people who offend, especially mental health services, are unsatisfactory””." In addition, one study indicated that over a third of young people in custody have a reading age of seven or less, 45.4 per cent have substance misuse problems, and between 40 and 49 per cent have been in local authority care, which was referred to by the noble Lord, Lord Ramsbotham. The costs of not dealing well with young people in the youth justice system cannot be ignored. Indeed, the cost of putting so many people into custody in the first place cannot be ignored. A place in a young offender institution costs around £50,000 a year and in 2005-06 more than 212,000 disposals were given in the youth justice system with 85,467 new entrants to the system. Every year, 8,000 young people pass through the system. In September 2007, there were 3,095 under-18 year-olds locked up. England has one of the highest levels of incarceration of young people in Europe. In 2006, 76 per cent of young people released from custody reoffended within 12 months. The system simply is not working, and that is a tragedy that must be addressed. The standing conference on youth justice regrets the increase in the use of custody for children. Since 1992, custodial sentences have risen by nearly 90 per cent and the use of detention for children under the age of 15 has grown by 400 per cent, which is a shocking figure. The number of vulnerable children detained in youth offender institutions rose from 432 in 2002 to over 3,000 in 2004, and it continues to rise. There is a trend to increase the prosecution of young people, despite good evidence that prosecution tends to be of no use in preventing reoffending. The Youth Justice Board has expressed concern that the breach of ASBOs is impacting on child custody, and youth offending teams are concerned that they are rarely consulted about decisions on ASBOs. We need to prevent young people from getting into trouble in the first place. That is a difficult challenge, which may be affected favourably by government action to do more for youth. We then need to assess the needs of young people who come into contact with youth justice and try to supply interventions that will help to rehabilitate them rather than encourage reoffending. It is a retrograde step to seek to provide more correctional institutions rather than to set out to improve health and education services for offenders outside institutions or inside them, if that is what it comes to. It is also sad and counterproductive that we are increasingly tending to demonise and criminalise young people when other corrective measures would be more effective and appropriate. A punitive approach labels children early as miscreants and may well encourage bad behaviour rather than treat it. Let me now look at some of the areas that could be examined in order to tackle the problems with regard to young people's health in the youth justice system. Some of the comments made by the noble Lord, Lord Darzi, about children in care are also relevant to the welfare of young offenders; we may want to explore that later. As the noble Earl, Lord Howe, said, this depends on culture and people, not just systems and structures. The Let's Talk About It report, to which I referred, states that one of the most significant findings is a lack of strategic involvement in the healthcare of young offenders. There is no adequate engagement of healthcare professionals in 60 per cent of youth offending teams. The report recognises that that may be understandable, with changes in structures and competing agendas, but it is unsustainable, especially given that there is good practice in some areas of the country. In numerous reports over the past few years we have heard of failures to work across specialisms, but within health services for young people in trouble there must be, across mental health problems, drug and alcohol problems and physical health needs, adequate assessment of need and co-ordinated monitoring of what is being provided. Every primary care trust must have a representative on the youth offending team. I realise that multiple PCTs may serve a YOT area, which is a complication, but it is not insurmountable. Services need to be responsive to the needs of 16 to 17 year-olds, particularly as that age group is responsible for the majority of crimes committed by young people and for the more serious crimes. The joint inspection of youth offending teams in 2006-07 identified several areas that could be tackled—for example, case managers being untrained or unskilled in screening for physical health, poor communication between health professionals and case managers, and inadequate or non-existent service level agreements and protocols between YOTs and the various health providers. There was little evidence of systematic and formal evaluation of outcomes from interventions. One in six YOTs had no healthcare worker and a third of them had no mental health worker. Various government departments have been good at identifying the needs of young people and other client groups. We have got better at listening to clients, including children and young people, although I have not come across much evidence of consulting young people in trouble with the law. My plea for today is that we exercise more caution in punishing young people and that we focus more on their welfare. If young people do get into trouble—and some of them get into horrendous trouble—we should purposefully assess why they are in trouble and what their needs are, and deal with those needs rather than making assumptions, labelling and stigmatising. I hope that the two Ministers here today will take that on board and influence colleagues in other departments as well as in their own on some of the issues that I have raised today. I congratulate my noble friend Lord Darzi on his speech and look forward to my noble friend Lord Adonis responding to the debate—a gargantuan task. I look forward in particular to the new health and social care strategy for young people in contact with youth justice. I hope that it will dovetail with the Children and Young Persons Bill and that all this will benefit young lives on the ground.