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Children and Young Persons Bill [HL]

My Lords, I, too, express my warm support for the Children and Young Persons Bill. As the noble Baroness, Lady Morris of Bolton, said so eloquently, the prospects for the great majority of looked-after children are bleak. If this situation is going to change significantly, the Bill will need to achieve four ambitious objectives. First, it must prevent if at all possible a child becoming a looked-after child. Secondly, it must keep open the option of a return to the child’s family. Thirdly, it must provide the best possible and consistent support for every looked-after child while they are in care. The Bill is clearly focused more on that issue than on others. Fourthly, it must continue that support until the child is ready to go it alone in the adult world. As the Bill partially recognises, that may be well into their 20s. We talk about the age of 24, but these children may need a great deal longer than that. I want to say a little about each of the four objectives. First, on preventing children becoming looked-after, the Government's Green Paper rightly refers to the importance of preventing the need for care. I want to talk about just one group of high-risk children who need the earliest possible intervention if they are to remain with their parents: babies born to a mother with a severe psychotic disorder. Noble Lords may see that as somewhat outwith the Bill, but it would be worth having something in the Bill about prevention. Because of the shortage of places in mother and baby units, these babies are often placed in care right from the start while their mother is admitted to hospital for treatment. From then on the system determines the long-term destiny of the child. This may well involve years in children’s homes or foster care. In April, NICE produced clinical management and service guidance for antenatal and postnatal mental health, arguing that, "““specialist perinatal inpatient services should provide facilities designed specifically for mothers and infants””." If we want to prevent these children becoming looked-after, it is essential that NICE guidance is implemented across the country. Approximately 14 to 16 additional units are needed. Will the Minister consider including in this Bill a clause placing a duty on primary care trusts to contribute to the cost of regional units to ensure sufficient places? I turn to the second major objective—to keep open the option for a child to return to his family if appropriate. I know that the Bill goes some way towards this. Here the location of the child in care is crucial. We know that nearly half the children in children's homes and nearly one-third of those in foster care are living outside their own local authority area. Of course, some children benefit from being a good distance from their families, but if there is hope of the child returning home, proximity to the family may be essential to facilitate contact and family therapy, for example. I refer to the case of a 14 year-old girl whom I heard about in east London, on a patch where I happen to chair a mental health trust. She became looked-after earlier this year; by the autumn she had moved through seven different placements in Kent and north London. That was just in a matter of months. We know of lots of other figures, too, but somehow this individual case came home very strongly to me. She had no schooling throughout this time, and she began to self harm and to behave in an increasingly risky way. She felt so hopeless and all she wanted was to be back near her family. Every local authority needs to have short-term children’s home provision—not too short but shortish—linked to intensive outreach and family work in order to restore the child home as soon as possible in every possible case. Clause 8(2) enables regulations to be made to ensure that the placement of a child is driven by the needs of the child rather than administrative considerations. I hope that the Minister will consider putting these provisions into the Bill, as this issue is far too important to be left to regulations. On the third objective, and the need for high-quality and consistent support for looked-after children, I warmly welcome most of the reforms which promise to improve the experience of looked-after children. However, I want to raise two issues. Children’s services should have a duty to provide or ensure access to specialist therapeutic services for looked-after children. If physically ill, these children will have access to medical care; if they need a school place and are settled in an area—this is a big point—they will be given priority. This is not the case for mental health services, yet Department of Health research published in 2002 showed that 75 per cent of looked-after children in residential care have a mental health disorder. The figure for all looked-after children is 45 per cent. Many of those children do not get to have mental health care in anything like the right time perspective. My second quite different but equally serious concern relates to the proposed pilots of social work practices, to which the noble Baroness, Lady Walmsley, has already referred. I realise that this is an attempt to overcome the endemic social work problems of high staff turnover, use of agency staff and complex team structures, all of which have led to a lack of consistency of support for children; but those problems have been generated substantially by the blame culture and the volumes of regulations and guidance requiring ever more bureaucracy that have followed each death of a looked-after child. As a result, money and responsibility have flowed away from front-line social workers up the line of command. That may protect the backs of Ministers and management, but the best protection for looked-after children is to have well paid, highly motivated and professional front-line social workers with manageable systems and procedures to operate, but which we do not have. The reality is that contracting work out to social work practices would involve yet more systems and bureaucracy and would ultimately divert more resources away from front-line social work. Local authorities would be required to harness social work practices to all the regulations and guidance. They will continue to have ultimate responsibility: they cannot opt out of that responsibility. Although all the meetings and paper work would continue, they would simply happen away from where the social workers were based. An improved service will be achieved only if the Government are willing to tackle the root causes of the problem. A good start would be to implement the Options for Excellence White Paper of 2006. I gather that little has been done on it yet. A working group with a remit to review and simplify all childcare regulations and guidance would be the greatest contribution to the well-being of looked-after children. Many things need to be done but it will be difficult to make improvements while the whole system is completely overwhelmed by bits of paper and the requirement to fill in forms. The fourth objective is to continue support until the child is ready to face the world alone as an adult. Although the Bill addresses it—as it partly addresses the other objectives as well—I hope that the Government may be willing to go a little further in this area, too. The decision whether a young person is ready to leave care should of course be made in conjunction with the young person. However, such a key decision should have the benefit of an independent assessment of the young person's needs, on which the care plan would be based. Many young people, and I would suggest most, will not be ready to leave care at anything like 18. If a young person wishes to leave care at 18 but is assessed as needing ongoing support—and surely that will include all of them—then a personal adviser should be made available to them, rather than limiting availability only to those intending to pursue education or training as indicated in Clause 19. Young people pursuing education are likely to be less damaged and less at risk than those who are outside the education system. If one of the Government's aims is to reduce the numbers of looked-after children who end up in young offender institutions or prison, and if we assume that a personal adviser will be an important anchor for these young people, then it cannot be sensible to exclude the majority of these young people from that service. I would be grateful if the Minister could give a little more thought to this issue—he has no doubt already considered it at great length—and advise the House of his response. Visitors will be another valuable source of support for looked-after children. My concern is that visitor appointments will end when the young person ceases to be looked after by the local authority. If young people are to leave care at 18, for example, is it not likely that it will be a time of great turmoil and insecurity when a visitor may be of particular value? I hope that the Minister can comment on that issue. We all agree that the Bill includes valuable reforms and, with some adjustments, could do much to improve the lot of these vulnerable children. I cannot promise that all the ideas suggested here will be cost-saving from day one but they will be in the longer term. I hope that the Minister will take my comments in the constructive spirit intended.