APPENDIX
Memorandum submitted by the Department of Health
PREGNANCY
1. The Committee members asked for information about counselling for pregnant teenagers, whether adoption is raised as an option, research into counselling, and for figures on teenage pregnancies. This note also provides information on adoption in general maternity and pregnancy counselling.
Teenage pregnancy strategy and advice
2. The Government's teenage pregnancy strategy aims to reduce the number of teenage pregnancies through a network of local teenage pregnancy co-ordinators, jointly nominated by local and health authorities. In developing strategies to tackle teenage pregnancy, local co-ordinators are required to produce and disseminate a service directory listing sources of advice on options, which range from keeping the baby, adoption or abortion. Local co-ordinators are also required to produce a checklist referral system for professionals most likely to come into contact with pregnant teenagers and a summary service checklist for young people. Both checklists should provide information on the sources of advice on counselling on options, which include adoption and future contraception needs.
3. Nineteen Sure Start Plus pilots, announced in March, have been approved to provide a personal adviser service to support pregnant teenagers in making their decision between continuing with the pregnancy, adoption or abortion. The advisers are required to provide comprehensive advice, which includes facilitating access to services offering support and advice on adoption.
4. The Sure Start Plus service aims to provide support for teenage parents by ensuring that services are sensitive to their needs and user-friendly. The pilots will also identify gaps in existing local services and put forward proposals to close them.
Advice to pregnant teenagers on adoption as an option
5. Guidance to social workers and youth workers on the provision of information on contraceptive and sexual health advice is being prepared and will be issued later this year. Both sets of guidance, which professionals have had an opportunity to develop, will signpost sources of information on options, including adoption. Officials are also in the process of assessing all local teenage pregnancy strategies, prepared by co-ordinators, and annual reports, which include information on the provision of information on adoption.
6. When the Sure Start Plus proposals were received, they were checked for the planned provision of counselling on choices available to pregnant teenagers as part of the Sure Start Plus service. In order to ensure that this service is provided and that the options of keeping the baby, adoption or abortion are considered, the pilot areas will collect information each quarter to monitor:
— the number of pregnant teenagers who were provided with advice and counselling before and after the 12th week of pregnancy;
— the outcomes and decisions made by the pregnant teenager.
Research
7. The Sure Start Unit will be commissioning an evaluation of the Sure Start Plus pilots, which will include the counselling services provided and their quality. An evaluation of the teenage pregnancy strategy will run, in the first instance, for four years to October 2004. A final report will assess the impact of the strategy up to March 2004. In the interim, the evaluation team will produce annual reports in November of each year, with a six month progress report being produced each May. A three year evaluation of Sure Start Plus will end in March 2004 and a full report is expected before the end of that year. In addition, quarterly interim reports, starting from July this year, will be used to inform and further develop the existing Sure Start Plus programme.
Teenage conception rates
8. The Office of National Statistics published details of conception rates for 1999, including those amongst teenagers, on 22 March this year. The statistics show that in England conception rates amongst the under 16s fell by 7 per cent and by 4 per cent amongst the under 18s. Information on conception rates between 1995-99 is set out in the table below.
| |
England |
|
|
Under 16
(per 1,000) |
Under 18
(per 1,000) |
|
Year |
|
|
|
1995 |
8.5 |
41.6 |
|
1996 |
9.3 |
45.9 |
|
1997 |
8.8 |
45.5 |
|
1998 |
8.8 |
45.6 |
|
1999 |
8.2 |
44.7 |
General counselling where there is a doubt about continuing with a pregnancy
9. When a pregnant women expresses doubts about whether to proceed with the pregnancy, counselling is generally provided by health professionals, such as her GP or medical staff in a private or NHS abortion clinic. Successive Governments have always recognised the importance of objective counselling for women seeking abortion treatment. All UK health authorities and private sector places carrying out abortions have Department of Health guidance on the provision of counselling services, which makes clear that counselling should include the provision of advice and information about all the possible alternatives to abortion, including adoption.
10. Where it appears that a woman wishes to continue her pregnancy, she will be referred to midwifery services. If she subsequently becomes uncertain about the prospect of becoming a mother, we would expect the midwife or GP to use their discretion and professional judgement in giving advice that helps the woman reach a decision that she is content with, in a manner appropriate and sensitive to the circumstances of the individual case.
LOCAL AUTHORITIES' ADOPTION SERVICES
11. Committee members asked for information about the variable performance of local authorities' adoption services and we promised to provide the percentage of looked after children who have been adopted for each local authority.
12. There are indeed large variations in the performance of adoption services run by councils. Of 150 councils, only 22 managed to find adoptive parents for 7 per cent or more of children they were looking after during 1999-2000. Over the same period, the variation across local authorities for the adoption of looked after children ranged from 0.5 per cent to 10.5 per cent.
13. Detailed figures for 1999-2000 are set out in the attached Annex,which shows by authority the number of looked after children, and the numbers and percentage adopted. I have also enclosed:
— "Social Services Performance in 1999-2000"[1], a Department of Health statistical publication, which includes explanatory text and a table on local authority performance on adoptions of looked after children, pages 64 and 65.
— "Adopting Changes
", a survey and an inspection of 10 local authorities' adoption services by the Social Services Inspectorate, November 2000.
ADOPTED CHILDREN REGISTER
14. Committee members asked about the Adopted Children Register and in particular whether birth relatives could use information contained on the Register to trace the adopted child, with the risk in certain circumstances that the placement might be disrupted.
15. The Registrar General is responsible under the Adoption Act 1976 for maintaining the Adopted Children Register. Each entry in the Register contains information on the adopted person and his or her adoptive parents. The index for the Register enabled an adopted person, and others who know them, to obtain a record of their adoption.
16. At present any person may search the Register's index. If they can identify an entry, they may have a certified copy of that entry, on payment of a statutory fee. It contains information about the adopted person and his or her adoptive parents, including their address at the time of the adoption. Birth relatives and others seeking to trace an adopted person have occasionally misused the paper index. Therefore, Clause 61(8) provides for the computerisation of the index to the Register and so restrict the searching of the index to the computer system provided by the Registrar General.
17. The aim is twofold:
— to restrict access to information about the entries for adopted children up to the age of 18, so that they are protected from possible placement disruption on the part of birth relatives or their representatives;
— and to provide a more up-to-date and user-friendly system for legitimate searching.
18. In respect of adopted persons upt to 18 years of age, it is envisaged that any new software would require the applicant to enter the first name and adoptive surname before access could be gained to the full entry in the index. In respect of all other adopted persons, full electronic browsing facilities and a search engine would be provided.
19. The intention of the new legislative provision is both to maintain broadly the position set out in section 50(3) of the Adoption Act 1976 and to address concerns that the paper index has occasionally been misused. The new computerised index would continue to enable adopted persons or those who know or knew their adoptive details to obtain certificates in accordance with Parliament's intention under the 1976 Act, and at the same time prevent unwarranted use of the index.
ADOPTION CONTACT REGISTER
20. Contact between adopted people and their birth family is a complex issue. In many cases it can be helpful and beneficial to both parties. The Government's aim is to strike the right balance between the needs of the adopted person and the needs of relatives, and we set out to achieve this by providing for contact between the two parties where it is jointly requested. This is facilitated by the Adoption Contact Register, which is also maintained by the Registrar General. It has two parts. Part I contains the names and addresses of adopted persons who have given notification that they wish to contact their relatives. Part II contains the names and addresses of birth relatives who have given notification that they wish to make contact with a specific adopted person.
21. If both the birth parents and the adopted person (over 18 years of age) wish for contact and this is recorded on the Register, the Registrar General will send the adopted person the name and address of the relative. However, he will only inform the relative that his details have been passed on to the adopted person. It is for the adopted person to make up his own mind if and when to initiate contact with the relative.
22. The Bill extends the provisions of the Adoption Contact Register by providing that a desire for non-contact, or for contact with specific relatives, may be registered. This allows birth relatives to be clear about an adopted person's wishes. Of course individuals may change their mind about non-contact, and the Bill will provide for changes to the original notification and for subsequent checks to be made on the Register.
23. The Government believes that the adopted person's wishes and welfare are the most important considerations concerning contact and that adopted individuals should be free to decide whether they want contact to take place or not.
LISTENING TO CHILDREN
24. Members of the Committee also raised concerns about ensuring that children had the opportunity to have their say in decisions connected with adoption. The Government recognises the importance of taking the views of children into account. The steps being taken by the Government to listen to children and protect their interests are described in more detail below. These measures will help all children looked after by local authorities, including those affected by adoption.
Quality protects
25. Listening to the voices of looked after children and young people is an integral part of the Quality Protects programme to improve local authority children's services. The programme encourages the growth of high quality independent advocacy services in every council and allocates special grant funding for this purpose. There are already many good examples of advocacy in social services and the Government recognises how vital it is to listen to children and young people.
26. The Local Authority Circular (LAC(2000)22) issued on 13 November 2000 continues to place listening to children as a priority area for 2001-2 and requires local councils to involve young people collectively and to enhance their individual voices through, for example, the development of indpendent advocacy services. In addition, local councils are encouraged to speed up their complaints procedures, so that children's concerns can be dealt with promptly and sympathetically.
27. A Quality Protects Children and Young People's reference group has been established to ensure the contemporary views and opinions of children and young people are informing policy development. Young people aged between 14 and 21 from councils across England are taking part in the core group. Many of the young people are linked to their local in care group and this ensures the Department of Health can tap into the views of more young people locally. Young people have access to Quality Protects policy papers and are supported by their participation officer.
Children's participation in "looked after children" reviews
28. Most children and young people looked after by local authorities are invited to attend regular reviews, which are the main means of reviewing their progress and planning for their future. However, many find that the reviews are conducted in such a way that it is difficult for them to take an active part.
29. Many councils are already addressing this issue and taking steps to improve the review system under the Quality Protects programme. The Government will be building on the best practice in the work currently underway to redesign the planning and reviewing system to ensure that all looked after children and young people are able to genuinely participate in reviews from April 2002.
Review of Social Services complaints procedures
30. Members of the Committee asked about the mechanisms for children and young people to make complaints about their case in connection with adoption. The Department of Health has developed a number of proposals for improving the current Social Services complaints procedures in the light of the responses to the recent "Listening to People" consultation exercise, and in conjuction with developments on the NHS complaints procedure. These include a proposal to introduce a local resolution stage into the Children Act complaints procedure, with a 14-day timetable to ensure that complaints are dealt with promptly. The Government is also considering whether it is possible to introduce a statutory right of access to an advocate for children under the Children Act complaints procedures.
31. The Department of Health is currently considering what needs to be done to implement the proposals. The intention is to introduce changes to the procedures around the end of 2001. However, before implementing any changes the Department intends to carry out a further consultation exercise.
Children's Rights Director
32. Through the Care Standards Act 2000, the Government is committed to establishing the post of a national Children's Rights Director as a senior appointment within the newly created National Care Standards Commission.
33. For the first time, the Children's Rights Director will be able to take a national overview of the rights of children in receipt of services regulated by the National Care Standards Commission. This is an important development for the welfare of vulnerable children.
34. The core tasks of the Children's Rights Director are expected to be to:
— help the National Care Standards Commission to give full and effective coverage of children's services and children's rights in its statutory regulatory responsibilities and in the reports it makes on the discharge of those responsibilities;
— ensure that the views of children to whom services regulated by the National Care Standards Commission are provided are given due weight by the Commission; and
— report directly to the Chief Inspector of the Social Services Inspectorate any sigificant evidence relevant to the rights and safety of children gained from the Commission's regulation and assessment of services for children, including adoption services, which might help local authorities or other providers to improve the services and support they give to children.
35. Although the precise role and functions of the Children's Rights Director are not set out on the face of the Care Standards Act 2000, provision is made in Schedule 1 of the Act for the post's functions to be prescribed by regulation. The Government plans to publish the draft regulations covering the work, key tasks and responsibilities of the Children's Rights Director for consultation in the near future. This post was recently advertised.
2 May 2001
Annex
|
1999-2000 PAF Indicator |
|
|
C23 |
|
KS1 Data Item |
1.11A |
1.11B |
1.11C |
|
Revised 29 November 2000 |
No of children adopted from local authority care during the year ending 31 March |
Total no of children looked after at 31 March (This is the same as cell 1.1B) |
Percentage of children looked after adopted from local authority care |
|
Metropolitan Districts |
|
|
|
|
Barnsley |
20 |
337 |
5.9 |
|
Birmingham |
83 |
1,754 |
4.7 |
|
Bolton |
19 |
315 |
6.0 |
|
Bradford |
32 |
687 |
4.7 |
|
Bury |
13 |
197 |
6.6 |
|
Calderdale |
23 |
219 |
10.5 |
|
Coventry |
15 |
489 |
3.1 |
|
Doncaster |
28 |
435 |
6.4 |
|
Dudley |
14 |
382 |
3.7 |
|
Gateshead |
18 |
259 |
6.9 |
|
Kirklees |
25 |
329 |
7.6 |
|
Knowsley |
9 |
248 |
3.6 |
|
Leeds |
69 |
1,273 |
5.4 |
|
Liverpool |
17 |
1,217 |
1.4 |
|
Manchester |
42 |
1,237 |
3.4 |
|
Newcastle upon Tyne |
38 |
446 |
8.5 |
|
North Tyneside |
18 |
280 |
6.4 |
|
Oldham |
8 |
300 |
2.7 |
|
Rochdale |
18 |
256 |
7.0 |
|
Rotherham |
22 |
371 |
5.9 |
|
Salford |
16 |
569 |
2.8 |
|
Sandwell |
13 |
438 |
3.0 |
|
Sefton |
13 |
301 |
4.3 |
|
Sheffield |
46 |
695 |
6.6 |
|
Solihull |
6 |
178 |
3.4 |
|
South Tyneside |
20 |
293 |
6.8 |
|
St. Helens |
13 |
271 |
4.8 |
|
Stockport |
15 |
351 |
4.3 |
|
Sunderland |
24 |
465 |
5.2 |
|
Tameside |
3 |
264 |
1.1 |
|
Trafford |
14 |
151 |
9.3 |
|
Wakefield |
22 |
455 |
4.8 |
|
Walsall |
25 |
367 |
6.8 |
|
Wigan |
11 |
465 |
2.4 |
|
Wirral |
13 |
393 |
3.3 |
|
Wolverhampton |
17 |
381 |
4.5 |
|
Shire Counties |
|
|
|
|
Bedfordshire |
13 |
357 |
3.6 |
|
Buckinghamshire |
18 |
253 |
7.1 |
|
Cambridgeshire |
35 |
396 |
8.8 |
|
Cheshire |
18 |
476 |
3.8 |
|
Cornwall |
31 |
567 |
5.5 |
|
Cumbria |
28 |
515 |
5.4 |
|
Derbyshire |
28 |
646 |
4.3 |
|
Devon |
29 |
690 |
4.2 |
|
Dorset |
12 |
271 |
4.4 |
|
Durham |
22 |
524 |
4.2 |
|
East Sussex |
19 |
463 |
4.1 |
|
Essex |
41 |
1,207 |
3.4 |
|
Gloucestershire |
19 |
507 |
3.7 |
|
Hampshire |
42 |
905 |
4.6 |
|
Hertfordshire |
40 |
810 |
4.9 |
|
Isles of Scilly |
0 |
0 |
|
|
Kent |
58 |
1,498 |
3.9 |
|
Lancashire |
51 |
1,447 |
3.5 |
|
Leicestershire |
21 |
277 |
7.6 |
|
Lincolnshire |
34 |
518 |
6.6 |
|
Norfolk |
39 |
679 |
5.7 |
|
North Yorkshire |
26 |
340 |
7.6 |
|
Northamptonshire |
22 |
611 |
3.6 |
|
Northumberland |
15 |
298 |
5.0 |
|
Nottinghamshire |
54 |
530 |
10.2 |
|
Oxfordshire |
32 |
471 |
6.8 |
|
Shropshire |
16 |
189 |
8.5 |
|
Somerset |
24 |
336 |
7.1 |
|
Staffordshire |
42 |
571 |
7.4 |
|
Suffolk |
41 |
533 |
7.7 |
|
Surrey |
33 |
671 |
4.9 |
|
Warwickshire |
10 |
349 |
2.9 |
|
West Sussex |
36 |
750 |
4.8 |
|
Wiltshire |
21 |
258 |
8.1 |
|
Worcestershire |
23 |
640 |
3.6 |
|
Unitary Authorities |
|
|
|
|
Bath and North East Somerset UA |
10 |
147 |
6.8 |
|
Blackburn with Darwen UA |
9 |
277 |
3.2 |
|
Blackpool UA |
7 |
283 |
2.5 |
|
Bournemouth UA |
11 |
203 |
5.4 |
|
Bracknell Forest UA |
1 |
65 |
1.5 |
|
Brighton and Hove UA |
20 |
344 |
5.8 |
|
Bristol UA |
33 |
556 |
5.9 |
|
Darlington UA |
3 |
117 |
2.6 |
|
Derby UA |
31 |
443 |
7.0 |
|
East Riding of Yorkshire UA |
16 |
241 |
6.6 |
|
Halton UA |
7 |
174 |
4.0 |
|
Hartlepool UA |
4 |
116 |
3.4 |
|
Herefordshire UA |
13 |
197 |
6.6 |
|
Isle of Wight UA |
4 |
177 |
2.3 |
|
Kingston-upon-Hull UA |
41 |
645 |
6.4 |
|
Leicester UA |
30 |
464 |
6.5 |
|
Luton UA |
18 |
306 |
5.9 |
|
Medway Towns UA |
16 |
344 |
4.7 |
|
Middlesbrough UA |
18 |
201 |
9.0 |
|
Milton Keynes UA |
21 |
323 |
6.5 |
|
North East Lincolnshire UA |
14 |
275 |
5.1 |
|
North Lincolnshire UA |
4 |
188 |
2.1 |
|
North Somerset UA |
11 |
151 |
7.3 |
|
Nottingham UA |
30 |
603 |
5.0 |
|
Peterborough UA |
16 |
391 |
4.1 |
|
Plymouth UA |
7 |
405 |
1.7 |
|
Poole UA |
6 |
144 |
4.2 |
|
Portsmouth UA |
11 |
222 |
5.0 |
|
Reading UA |
8 |
132 |
6.1 |
|
Redcar and Cleveland UA |
9 |
166 |
5.4 |
|
Rutland UA |
0 |
9 |
0.0 |
|
Slough UA |
3 |
136 |
2.2 |
|
South Gloucestershire UA |
7 |
139 |
5.0 |
|
Southampton UA |
28 |
383 |
7.3 |
|
Southend-on-Sea UA |
11 |
252 |
4.4 |
|
Stockton-on-Tees UA |
13 |
204 |
6.4 |
|
Stoke-on-Trent UA |
24 |
344 |
7.0 |
|
Swindon UA |
8 |
179 |
4.5 |
|
Telford and the Wrekin UA |
16 |
155 |
10.3 |
|
Thurrock UA |
14 |
184 |
7.6 |
|
Torbay UA |
6 |
216 |
2.8 |
|
Warrington UA |
7 |
166 |
4.2 |
|
West Berkshire UA |
12 |
131 |
9.2 |
|
Windsor and Maidenhead UA |
1 |
89 |
1.1 |
|
Wokingham UA |
8 |
85 |
9.4 |
|
York UA |
9 |
142 |
6.3 |
|
Inner London |
|
|
|
|
Camden |
12 |
328 |
3.7 |
|
City of London |
0 |
6 |
0.0 |
|
Greenwich |
24 |
465 |
5.2 |
|
Hackney |
9 |
494 |
1.8 |
|
Hammersmith and Fulham |
13 |
366 |
3.6 |
|
Islington |
13 |
546 |
2.4 |
|
Kensington and Chelsea |
9 |
215 |
4.2 |
|
Lambeth |
24 |
734 |
3.3 |
|
Lewisham |
23 |
494 |
4.7 |
|
Southwark |
12 |
599 |
2.0 |
|
Tower Hamlets |
19 |
278 |
6.8 |
|
Wandsworth |
6 |
346 |
1.7 |
|
Westminster |
11 |
288 |
3.8 |
|
Outer London |
|
|
|
|
Barking and Dagenham |
8 |
236 |
3.4 |
|
Barnet |
9 |
264 |
3.4 |
|
Bexley |
10 |
198 |
5.1 |
|
Brent |
17 |
294 |
5.8 |
|
Bromley |
17 |
254 |
6.7 |
|
Croydon |
7 |
397 |
1.8 |
|
Ealing |
7 |
431 |
1.6 |
|
Enfield |
9 |
252 |
3.6 |
|
Haringey |
10 |
434 |
2.3 |
|
Harrow |
6 |
177 |
3.4 |
|
Havering |
8 |
167 |
4.8 |
|
Hillingdon |
8 |
384 |
2.1 |
|
Hounslow |
12 |
257 |
4.7 |
|
Kingston-upon-Thames |
3 |
106 |
2.8 |
|
Merton |
1 |
185 |
0.5 |
|
Newham |
13 |
486 |
2.7 |
|
Redbridge |
5 |
142 |
3.5 |
|
Richmond-upon-Thames |
7 |
111 |
6.3 |
|
Sutton |
3 |
146 |
2.1 |
|
Waltham Forest |
6 |
323 |
1.9 |
|
England |
|
|
|
|
Average# |
2,732 |
58,138 |
4.7 |
|
Median |
|
|
4.7 |
|
Quartile 25% |
|
|
3.4 |
|
Quartile 75% |
|
|
6.5 |
|
Minimum |
|
|
0.0 |
|
Maximum |
|
|
10.5 |
|
Metropolitan Districts |
|
|
|
|
Average# |
802 |
17,068 |
4.7 |
|
Median |
|
|
4.8 |
|
Quartile 25% |
|
|
3.4 |
|
Quartile 75% |
|
|
6.6 |
|
Minimum |
|
|
1.1 |
|
Maximum |
|
|
10.5 |
|
Shire Counties |
|
|
|
|
Average# |
993 |
19,553 |
5.1 |
|
Median |
|
|
4.9 |
|
Quaritle 25% |
|
|
4.1 |
|
Quartile 75% |
|
|
7.1 |
|
Minimum |
|
|
2.9 |
|
Maximum |
|
|
10.2 |
|
Unitary Authorities |
|
|
|
|
Average# |
596 |
11,114 |
5.4 |
|
Median |
|
|
5.1 |
|
Quartile 25% |
|
|
3.4 |
|
Quartile 75% |
|
|
6.5 |
|
Minimum |
|
|
0.0 |
|
Maximum |
|
|
10.3 |
|
Inner London |
|
|
|
|
Average# |
175 |
5,159 |
3.4 |
|
Median |
|
|
3.4 |
|
Quartile 25% |
|
|
2.0 |
|
Quartile 75% |
|
|
4.3 |
|
Minimum |
|
|
0.0 |
|
Maximum |
|
|
6.8 |
|
Outer London |
|
|
|
|
Average# |
166 |
5,244 |
3.2 |
|
Median |
|
|
3.4 |
|
Quartile 25% |
|
|
2.1 |
|
Quartile 75% |
|
|
4.7 |
|
Minimum |
|
|
0.5 |
|
Maximum |
|
|
6.7 |
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