Select Committee on Health Second Report



1. Much public concern has been expressed in recent years over the treatment of children "looked after" by local authorities (formerly known as children "in care").[1] This concern has focused chiefly on allegations of physical and sexual abuse. In November 1997 Sir William Utting produced a valuable report on this subject, to which we shall make frequent reference.[2] Our report aims to be complementary to Sir William's rather than simply to replicate his findings. Our inquiry has had a somewhat different scope to his, in that where he deals very comprehensively with the issue of abuse, we have concentrated on other areas where we believe that the interests of looked-after children are neglected and that the care system is currently failing those children. These areas include assessment, planning and review, training of staff, the rights of the child, education, physical and mental health, training of staff and after-care.

2. Our inquiry is a resumption of one begun by our predecessor Committee in the last Parliament. That Committee conducted a major inquiry into health services for children and young people, and produced four reports on this subject at the start of 1997.[3] In February 1997 they began taking evidence on a distinct but related topic, that of services for children looked after. They held four oral evidence sessions, and received written evidence. Shortly before the Dissolution of Parliament, they issued a Special Report urging the Health Committee in the new Parliament to resume this unfinished inquiry, commenting that "we consider that this is an inquiry of major importance, and we have been deeply concerned and troubled by much of what we have heard from our witnesses".

3. The present Committee was nominated in July 1997. At our first meeting we discussed whether to continue our predecessors' work on looked-after children. Despite the fact that there had been a considerable turnover in the membership of the Committee (with a new Chairman, and only two Members out of 11 who had served on the old Committee), we were unanimous in deciding to resume the inquiry.

4. The terms of reference of the original inquiry were as follows:-

"The Committee will review services for children looked after by local authority social services departments in England. The Committee will consider such issues as:

    (1)  the personal and health needs of children being looked after by local authorities and the extent to which good outcomes are achieved by local authorities, in collaboration with other agencies;

    (2)  the role that foster care, residential care and other services should play for children being looked after by local authorities;

    (3)  the management, staffing and organisation of children's residential homes and fostering services; and

    (4)  follow-up care and training for children after the age of 16."

We re-adopted these terms of reference. In addition to the topics outlined above, as our inquiry progressed we found ourselves devoting much attention to the specific issue of the education of looked-after children.

5. Our predecessor Committee took oral evidence from the Association of County Councils, the Association of Directors of Social Services, the Association of Metropolitan Authorities, the Children's Society, First Key, the Who Cares? Trust, British Agencies for Adoption and Fostering, the National Foster Care Association, the British Association of Social Workers, UNISON and the then Parliamentary Under-Secretary at the Department of Health (DoH), Mr Simon Burns MP, with DoH officials.

6. Between November 1997 and January 1998 we held a further six oral evidence sessions, taking evidence from academics (Professor David Berridge, Professor Roger Bullock, Ms Hedy Cleaver, Professor Mike Stein, Dr Harriet Ward and Professor Dorothy Whitaker); social services departments (Birmingham, Royal Borough of Kensington and Chelsea, Shropshire and Wigan); individual foster carers, adoptive parents and young people who had formerly been in care; Sir William Utting CB and two members of his inquiry team; and the present Parliamentary Under-Secretary at the DoH, Mr Paul Boateng MP, with DoH officials.

7. In addition, in February 1998 we held a joint evidence session with the Education Sub-Committee of the Education and Employment Committee, at which evidence was taken from the Rt Hon David Blunkett MP, Secretary of State for Education and Employment. The Sub-Committee participated in this session as part of their inquiry into the education of disaffected children, and their report on this subject contains conclusions relating to the education of looked-after children.[4] We believe that the two committees' co-operation over this issue is an example of the way the select committee system can be flexible in exploring matters with inter-disciplinary and inter-Departmental implications.

8. During the course of the inquiry we visited children's homes in Birmingham, Kensington and Chelsea, Shropshire and Wigan, and met staff and young people at the homes as well as foster carers and others. We also visited a secure unit (St John's, Tiffield, Northamptonshire).

9. We received a large amount of written evidence from organisations and individuals. All the oral evidence taken in this inquiry (both before and after the General Election), and a selection of the written evidence, is published in the companion volume to this report.[5] We are very grateful to all our witnesses.

10. We wish to express particular thanks to our Specialist Advisers. They were Professor Jane Aldgate, Chair of Social Work and Director of the School of Social Work, University of Leicester, Mrs Rosemary Arkley, formerly Inspector in the Social Services Inspectorate, Department of Health, and Mr Chris Davies, Director of Social Services at Somerset County Council.

Historical Background

11. The origins of public provision for deprived children can be traced back to the Elizabethan Poor Law. The modern statutory framework, however, was created following the recommendations of the Curtis Committee, set up in 1944 to inquire into the methods of providing for children deprived of a normal home life.[6] The Committee criticised the way that central government responsibility for such children was diffused among several departments, and found that standards of care were poor, even Dickensian. The Committee proposed a new and unified system which would have the aim of providing substitute care which would equal loving family care as nearly as possible. It also emphasised the importance of training in child care. The Central Training Council in Child Care was set up in 1947.

12. The Curtis Committee's other recommendations were embodied in the Children Act 1948. This imposed on local authorities, under the general direction of the Home Secretary, a duty to provide care for children deprived of a normal home life, as long as this was consistent with their welfare. Each local authority was to set up a Children's Committee and appoint a Children's Officer to take charge of a Children's Department with undivided responsibility for the care of such children. The Act required local authorities to exercise their powers so as to further the child's best interests and afford him or her opportunity for the proper development of his or her character and abilities. The Act emphasised fostering as the preferred form of substitute care, and gave powers to authorities to continue assisting young people after they had left care. It provided no other means of assisting families other than the reception of their children into care.

13. The 1948 Act was concerned with providing care for children with the consent of their parents, or for children who had no parents. Children who were neglected or ill-treated or in "moral danger" could be committed to the care of a local authority under the Children and Young Persons Act 1933 and other legislation. These two routes into local authority care were unified in the Children and Young Persons Act 1969. The Local Authority Social Services Act 1971 integrated separate local authority departments, including Children's Departments, into Social Services Departments (SSDs) which were intended to serve the needs of the family as a whole, being responsible for the old, handicapped and mentally ill as well for children. Increasing emphasis was placed on support for the family and preventive work (the Children and Young Persons Act 1963 had, for the first time, given local authorities powers to spend money on help and support to families in order to prevent reception into care). Central government responsibility for social service matters rested with the Department of Health and Social Security (DHSS).

14. In 1975 Parliament passed a Children Act which contained provisions relating to care proceedings, adoption, custodianship and the treatment of children in care. The provisions of the Act were implemented in stages over the next 10 years. Various measures relating to children in care were consolidated into the Child Care Act 1980.

15. In 1984 our predecessors, the Social Services Committee, produced a detailed report, Children in Care, which examined policy and practice in regard to children looked after by local authorities, voluntary organisations or other bodies other than their families.[7] The report recommended that the DHSS establish a working party on Child Care Law. This recommendation was accepted, and the review which followed led, via a White Paper, to the enactment of the Children Act 1989, which forms the basis of current child care policy and practice.

16. The Children Act radically altered the legislative framework of services for children. The Government's intentions for the Act were set out in their first review of its operations, submitted to Parliament in 1992:

"the Act is a charter for children. Its overriding purpose is to promote and protect children's welfare and in so doing it draws together and simplifies previous legislation to produce a practical and consistent code. ... It seeks to strike a balance between the rights of children to express their views on decisions made about their lives, the rights of parents to exercise their responsibilities towards the child, and the duty of the state to intervene where the child's welfare requires it. Central to the philosophy of the Act is the belief that children are best looked after within the family with both parents playing a full part and without resort to legal proceedings."[8]

17. The Act introduced a new responsibility for social services authorities to identify children in need, provide pro-active support and, where possible, prevent them from having to be looked after away from home. Children in need were defined as those with disabilities and those whose health and development were at risk unless services were provided. The Act empowered social services to ask other agencies to help provide those services. It recommended local authorities to draw up jointly produced Children's Services Plans.

18. The Social Services Committee examined the contents of this legislation during its passage through Parliament, and issued a short report broadly welcoming it, and noting that the great majority of the recommendations made by the Committee in 1984 had been accepted and incorporated in the bill.[9] The Children Act came into force in October 1991.

19. Running in parallel with these developments in legislation over the past decade has been a deepening sense of public concern prompted by evidence of widespread physical and sexual abuse in children's homes. Several major public inquiries have taken place. They included inquiries into abuse at the Kincora boys' hostel in East Belfast (1989), the 'Pindown' regime in Staffordshire children's homes (1991), Castle Hill School (1991), Ty Mawr former approved school in Gwent, Feltham Young Offenders' Institution (1993) and Leicestershire children's homes (1993).[10] A tribunal of inquiry is currently investigating allegations of abuse in children's homes in North Wales.

20. Lord Justice Butler-Sloss's recommendations following her judicial inquiry into allegations of child sexual abuse in Cleveland led to the issue of revised Government guidelines on the detection and prevention of child abuse,[11] and the Children Act 1989 strengthened the safeguards for children living away from home. Nonetheless, as the spate of allegations continued, it became apparent that further action was needed. Following the 'Pindown' report in 1991, the Secretary of State for Health commissioned Sir William Utting, who had recently retired from the post of Chief Inspector of Social Services, to examine "the broader context to the management and control of children's homes". Sir William's report, Children in the Public Care, was published later in that year. Following the conviction of Frank Beck on child abuse charges, also in 1991, the Secretary of State set up a Committee of Inquiry, chaired by Mr Norman Warner, to examine, among other issues, the selection and recruitment methods for staff working in children's homes. The Warner Report, entitled Choosing with Care, was published in December 1992.[12] Most of its recommendations were accepted in principle by the Government, although not all have yet been put into practice by local authorities.[13]

21. In June 1996 the Prime Minister announced the setting up of the Review of Safeguards for Children Living Away from Home, conducted by Sir William Utting with a small team of seconded civil servants. The review was commissioned, in Sir William's words, "as a result of continuing revelations of widespread sexual, physical and emotional abuse of children in children's homes over the preceding 20 years".[14] This second Utting Report, People Like Us, was published in November 1997.

22. In a statement in the House, the Secretary of State for Health, the Rt Hon Frank Dobson MP, said that People Like Us was "a most serious report and the Government are taking it most seriously", adding that it "presents a woeful tale of failure at all levels to provide a secure and decent childhood for some of the most vulnerable children".[15] He announced that the Government would set up a ministerial task force, headed by himself, and containing also expert advisers from outside the Government, to prepare a detailed Government response to the report, following widespread consultation with outside agencies and the public. This task force would assess the resource implications of the Utting proposals. The Secretary of State promised to put forward a "clear, affordable and enforceable" programme of policy and management changes "to deliver the safer environment to which children living away from home are entitled". A DoH consultation paper on ways of improving inter-agency co-operation in regard to child protection was issued in February 1998.[16] The Ministerial task force met for the first time in March 1998.[17] No formal timescale has been set for the completion of its work.[18] It is not yet clear whether the Social Services White Paper expected in the summer of 1998 will report on the outcome of this activity.

1  For the precise definition of these terms, see paragraph 23 below. We use the term "child" to mean a person under the age of 18. This accords with the definition used in the Children Act 1989 and other legislation. We also refer to children in their mid to late teens as "young people". Back

2  Sir William Utting et al., People Like Us: The Report of the Review of the Safeguards for Children Living Away From Home (TSO, 1997). Back

3  The reports, which were agreed unanimously, were:

1. Second Report of Session 1996-97: The Specific Health Needs of Children and Young People (HC 307-I)

2. Third Report of Session 1996-97: Health Services for Children and Young People in the Community: Home and School (HC 314-I)

3. Fourth Report of Session 1996-97: Child and Adolescent Mental Health Services (HC 26-I)

4. Fifth Report of Session 1996-97: Hospital Services for Children and Young People (HC 128-I).

The Government's response, reflecting the views of the incoming Labour administration, was published as a single Command Paper in November 1997 (Cm 3793). The four reports and the response were debated on the floor of the House on 25 March 1998 (Official Report, cols. 415-34). Back

4  Education and Employment Committee, Fifth Report of 1997-98, Disaffected Children (HC 498-I). See paras 287, 289 below. Back

5  HC(97-98) 319-II. Back

6  The historical information in this and succeeding paragraphs is largely taken from the Social Services Committee, Second Report of 1983-84, Children in Care (HC 360-I), paras 9-12, and the accompanying evidence from the DHSS printed in HC 360-II, pp 15-28. Back

7  Social Services Committee, Second Report of 1983-84, Children in Care (HC 360). Back

8  Children Act 1989: A Report by the Secretaries of State for Health and for Wales on the Children Act 1989 in pursuance of their duties under Section 83(6) of the Act (Cm 2144), p 3. Back

9  Social Services Committee, Second Report of 1988-89, Children Bill (HC 178). Back

10  Ev p 360 (Appendix 9). Back

11  Report of the Inquiry into Child Abuse in Cleveland 1987 (Cd 412, July 1988); see HC (1988-89) 84, pp 4-5. Back

12  Choosing With Care: The Report of the Committee of Inquiry into the Selection, Development and Management of Staff in Children's Homes (HMSO, 1992) Back

13  See para 239 below. Back

14  People Like Us, p 1. Back

15  Official Report, 19 November 1997, cols. 327-338. Back

16  DoH consultation paper, Working Together to Safeguard Children: New Government Proposals for Inter-Agency Co-operation (1998). Back

17  DoH Departmental Report 1998 (Cm 3912), para 5.30. Back

18  Q902. Back

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Prepared 16 July 1998