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Children's Plan

My Lords, I, too, warmly welcome the Government’s strategy for children. I am grateful to the noble Baroness, Lady Massey of Darwen, for giving us the opportunity to debate the plan and for all the work that she does for children. Most recently, of course, she reminded us of the importance of the Government’s education maintenance allowance and the difference that that is making to the engagement of looked-after children. I was delighted to see that the strategy makes a commitment on play, with an investment of £225 million over three years. Many years ago I worked as a children’s play supervisor and I therefore recognise the importance of play. I particularly welcome the emphasis on the children’s workforce and the need to further develop play workers’ skills. I remember one boy who always behaved in such a difficult manner that he had to be excluded from a visit we made to Chessington Zoo. The more skilled the workforce, the easier it is to include boys like that one who might benefit most from communal visits to such areas. In another case, the child’s parent was a milkman. Although I was delighted to take the child ice-skating for the first time, to help him and see him develop, it would have been much better if the father could have been there with his son to see that happen. Again, the more skilled the workforce, the more innovative it can be. Perhaps that milkman would have had time one afternoon to go and enjoy that experience with his son. Those are the sorts of things that I welcome in the proposals. The proposal on respite care for families with children who have disabilities is extremely welcome. Having spoken to such families I know, and I think we all recognise, how important and welcome this step is. The respite provided to these families will prevent some children having to enter care. The proposal is most warmly welcome. We must not forget the importance of play in school. The Government will eventually oblige 17 year-olds to stay on in school or training. These children will be far more likely to wish to do so if they are enjoying school. The Nuffield Foundation research to which my noble friend referred has found that the most important issue for children attending school is their relationships with other children. Children value play times because they can be with their friends and develop relationships. It is an important factor, but the length of time allowed for play has been slipping. I hope the Minister will use his influence to encourage schools to protect play times during the school day. I wish to concentrate on children in care, on a document related to the children’s plan entitled Care Matters: Time to Deliver for Children in Care and on the impact on outcomes for children and young people in public care and on leaving care. The Government are absolutely right to wish to raise our aspirations for these children, to be concerned about our failure to ensure that they do better at school and to be frustrated at the welcome but limited improvement in outcomes for looked-after children despite substantially increased investment. I pay tribute to the Ministers who have taken forward this portfolio while I have been a Member of this House: the noble Lords, Lord Hunt of Kings Heath and Lord Filkin, the noble Baroness, Lady Ashton of Upholland, and now the noble Lord, Lord Adonis. It is a difficult brief—these are challenging children—and the Government deserve commendation for wrestling with the problems, sustaining improvements and seeking better outcomes for them. I applaud the prioritisation of admissions for looked-after children so that they can enrol in the school best suited to them and not in the least popular school with the only remaining school places. The position of a designated teacher for looked-after children has been placed on a statutory basis. I applaud that as it should help to ensure that this important role is given proper priority and that teachers are equipped to deliver it. The new duty on local authorities in the Children and Young Persons Bill to place children locally where that is in the child’s best interests should assist in preventing the disruption of a child’s education, and the new duty on local authorities to provide a range of appropriate placements should help to ensure that that becomes a reality. However, we must not overlook the trauma that most of these children have experienced. To do so would seriously put at risk the chances of success in these children’s schooling. Sixty per cent of these children arrive in care as a result of abuse and another 10 per cent because of family breakdown. We are right to have the same aspirations for these children as for our own children, but we must not forget—thank heaven—that our children have not experienced the trauma, loss, rejection, broken relationships, abuse of trust, and often violence that many of these children have experienced. For many of these children a close relationship with an adult is a fearful thing. Paradoxically, they will automatically seek to avoid, undermine or destroy such a relationship as much as a part of them is desirous for it. Feelings arising from their past may well turn them inwards, possibly resulting in depression, self-harm and drug or alcohol abuse; or turn them outwards, possibly resulting in verbal or physical attacks on others or on their physical environment. On Monday, 28 April 2008, evidence was given to the Children, Schools and Families Select Committee in the House of Commons. I should like to quote from the uncorrected transcript of the oral evidence of Dr Rita Harris, clinical director of the child and family department at the Tavistock and Portman NHS Foundation Trust, who said: "““Emotional understanding is central to care, and opportunity alone is not enough. From a mental health point of view, the profound impact of early trauma on children—such as the trauma arising from separation and loss—just cannot be overestimated. We know that people have a built-in propensity to react to new experiences as if they were like previous experiences, and they do not necessarily interpret good intentions in the way in which they were intended. A child may react to very good care by experiencing it as quite damaging and rejecting.""““The profound effect of trauma and loss on children also profoundly affects adults and those who care for them. Children will often identify with their abusers and be physically and verbally abusive to their carers. They can communicate feelings of inadequacy and worthlessness. Carers often end up wondering why they have lost all the confidence that they had gained with their own child to parent a child. Placements often break down because of carers’ feelings of inadequacy and impotence ...""““The last point that I want to make is that the needs of such children are long term. Short and quick measures do not work with these kids; they have needs that last a lifetime … parenting is a lifelong exercise. Quite often, looked-after children are the most damaged in society. They need long-term services and have long-term needs. They probably do not need to leave home at the age of 18 and have nowhere to go back to””." We should take from that that there is a need for long-term commitment and the involvement of sophisticated health support agencies, particularly in the area of mental health. It is therefore no surprise that the Office for National Statistics found that 45 per cent of children in foster care and approximately 68 per cent of children in residential care had a mental disorder. Conduct disorder ranked highly among those disorders and can include fire-setting, theft and attacks on others. The very children who are most in need of a stable relationship are also the most prone to disrupting one. I should emphasise that there is a range of children in this group and certainly not all of them fit this description. However, a significant number of them do. Like those who gave evidence to the Select Committee I pay tribute to the work of the specialist nurses who deal specifically with looked-after children, particularly Miss Kathy Dunnett, whom I have known for some time. She was for seven years a specialist nurse in Hertfordshire and has edited a helpful book entitled Health of Looked After Children and Young People, which I commend to the House. The Government recognise these children’s need for stability. It is most welcome that they are piloting programmes that allow looked-after children to continue in care to the age of 21 if they so wish. It was encouraging to hear the Minister, Kevin Brennan, at a recent meeting and to learn that he is increasingly of the opinion that all children and young people in foster care should have the choice of staying to the age of 21. That is most welcome. Stable relationships of this kind are exactly what is required to enable a young person to recover from earlier trauma and re-engage with the world, to study, to make loving relationships, and to have the possibility of not repeating the cycle of abuse and the recurrence of that abuse in their relationships with their own children. However, continuing patchy access to child and adolescent mental health services jeopardises the outcomes that the Minister wishes to deliver. Mental health services are overstretched and CAMHS is a small fish in a large pond as far as mental health is concerned. Looked-after children are a small part of CAMHS’ concerns; they can be at the bottom of the pecking order. Looked-after children have been prioritised in schools by local authorities and this is very welcome. Similar prioritisation needs to be given to them in health. The Government propose to introduce statutory guidance for health authorities. I regret that this is unlikely to be sufficient. A stronger duty is necessary and more effective means of monitoring its implementation need to be made available. Does the Minister recognise these concerns? There need to be more specialised child and adolescent mental health service teams focusing on looked-after children and there needs to be research into their efficacy. Specialist CAMHS are very expensive and need to be evidenced if they are to survive in the long term. Will the Minister consider this particular area? In the Children and Young Persons Bill my noble friend Lady Meacher has emphasised the need of looked-after children, when they enter care, for improved assessments which look far more effectively at their psychological and mental health needs. I hope the Minister will think further about what she has proposed. On Tuesday I was introduced to four people by the Children’s Bereavement Network. I think I should stop now—but I look forward to the Minister’s response.