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Mental Health Services (Birmingham)
3. Lynne Jones (Birmingham, Selly Oak): If he will make a statement about funding for child and adolescent mental health services in Birmingham. [52774]
The Minister of State, Department of Health (Jacqui Smith): In the past three years, we have invested some £85 million across the national health service and local authorities for child and adolescent mental health services.
Birmingham has received significant investment for those services during that time and has been allocated £549,000 from the West Midlands modernisation fund to develop an acute assessment unit due to open later this year.
Lynne Jones: May I thank my hon. Friend for the substantial increase in the resources that are now coming through for this vital service for children? Does she agree that it is not just funding that is a constraint but the desperate shortage of psychiatrists and other therapists? Furthermore, as my inquiries into the service provided by the Children's Trust in Birmingham seem to indicate, management is poor and protocols inconsistent. When the Commission for Health Improvement visits the trust in the near future, will my hon. Friend ask it to pay particular attention to those matters, especially in relation to the suspension of one consultant psychiatrist? She was able to manage her work load and keep waiting lists down so that the children did not languish on waiting lists for up to two years, as is the case for children in my
constituency. Might I add that that is not the first suspension by the Children's Trust that has caused me concern?
Jacqui Smith: I agree that we need to address the issue in several ways. My hon. Friend is right to say that there is a challenge in recruiting and retaining the skilled staff that we need to provide child and adolescent mental health services. There is also a challenge, as she suggested, particularly in Birmingham, in managing resources effectively. Work is under way to build on the four new primary care trusts as localities for delivering child and adolescent mental health services.
Finally, we must also consider other examples. Solihull, near my hon. Friend's constituency, is reorganising the way in which it offers child and adolescent mental health services and considering in particular tier one, early intervention and ways in which other professionals can be used to help support children and families who have mental health problems. In that way, we can deliver a better service for my hon. Friend's constituents and throughout the country.
Sir Michael Spicer (West Worcestershire): What are the plans for the provision of secure units in Birmingham and elsewhere for severely mentally disabled and ill people, many of whom end up, quite wrongly, in prison?
Jacqui Smith: As I suggested in my first answer, the regional specialist commissioning group has allocated £549,000 from the West Midlands specialist modernisation fund to develop an acute assessment unit at the Park View clinic in Moseley, Birmingham, which is due to open later this year. I agree with the hon. Gentleman that, with young offenders, it is also important to ensure better joint working between youth offending teams and the child and adolescent mental health services. In addition, we are investing in mental health services in prisons and for young offenders so that they receive the treatment that they need when in prison in a way that has not happened previously.
Fiona Mactaggart (Slough): Does the Minister also recognise that many young people with mental health problems never reach the health service? Often, in constituencies like mine, their problems arise from traumatic experiences overseas from which they have fled, and they report their concerns in schools. What work is my hon. Friend doing with the education service to ensure proper care for children and adolescents with mental health problems such as those?
Jacqui Smith: My hon. Friend makes an important point. It is crucial that we work across the agencies in a better way than we have done previously. First, we shall include in the national health service framework for children work on standards to improve child and adolescent mental health services. We have recently worked with colleagues in the Department for Education and Skills on promoting mental health in early years and school settings. We are working with it on its programme on improving behaviour. In addition, we are funding, and will continue to fund, innovation projects that look particularly at how to get professionals such as health visitors, teachers and primary care workers working
together earlier so that we prevent the escalation of some of the mental health problems that my hon. Friend has outlined.
Mr. Oliver Heald (North-East Hertfordshire): In Birmingham, child psychiatrists do not have the nurses that they need—they are able to treat only emergencies. The waiting time for seeing a patient on the list is18 months. At a time when the Department for Education and Skills and the Home Office are making announcements about the problem of disaffected youngsters, will the Minister explain what the Department of Health is doing about adolescents and children with mental health problems? Given that children and adolescents form 20 per cent. of the population, why does only 5 per cent. of the mental health budget go to services for them? Why do places such as Birmingham spend so much less than elsewhere? Is it not time that the Government dealt with the problem of child and adolescent mental health instead of cutting the money as they did last year? Last year, £10 million allocated for mental health was chopped out of the budget and sent off to other priorities. Is it not time that those services were given the priority that they deserve?
Jacqui Smith: In fact, the out-turn figures for 2001 suggest that, for child and adolescent mental health services, Birmingham was the second highest spending authority in the west midlands. Of course, the authority was able to spend that money because of the extra£85 million invested in child and adolescent mental health services by the Government. This year, there are plans to increase services in Birmingham: better services for 16 to 18-year-olds and better services for early intervention, so that the whole of Birmingham is covered. Once again, Opposition Members are willing to whinge about money, but they are not willing to vote for it.
Adoption
4. Ms Meg Munn (Sheffield, Heeley): What his policy is on extending the right to adopt to unmarried couples; and if he will make a statement on the technical and practical problems in incorporating such a right into the Adoption and Children Bill. [52775]
The Secretary of State for Health (Mr. Alan Milburn): The Government's objective is to increase the number of children who have the opportunity, through adoption, to grow up as part of a loving, stable and permanent family. On Second Reading of the Adoption and Children Bill, I told the House that I believed that there should be a debate on adoption by unmarried couples. Since then, there has been a wide-ranging debate and during the passage of the Bill we have received many representations on the issue.
I understand that, last week, my hon. Friend the Member for Wakefield (Mr. Hinchliffe) tabled amendments to the Bill to allow, for the first time, unmarried couples to apply—as couples—to adopt children. Given the different views on the issue on both sides of the House, and after carefully considering the representations that we received, the Government have decided to make consideration of my hon. Friend's amendments subject to a free vote in this place. Should
they be passed, it is my intention to table further amendments in the other place to deal with any legal and technical implications.
Ms Munn: I thank my right hon. Friend for his answer. I am delighted to hear that the issue will be subject to a free vote. The proposal has support on both sides of the House and is likely to increase the number of adopters for the many children in care who need permanent families. Should the amendments be accepted—as I hope they will be—will my right hon. Friend ensure that there is a rigorous process so that the needs of the child are always paramount, rather than the needs or wishes of the adopters?
Mr. Milburn: I very much agree with my hon. Friend's assessment. Indeed, it is important that we understand, when considering the issue and the amendments—which I personally support—that they are simply about widening the pool of potential adoptive parents so that more vulnerable children, rather than being stuck in the care system, have the chance of the stable family life that adoption can bring. If the amendments are passed, it will be for adoption agencies and, ultimately, the courts to decide who is suitable to adopt. No one has a right to adopt. There is a rigorous assessment process and it would not change if the amendments were passed. Indeed, under one of the amendments tabled by my hon. Friend the Member for Wakefield, a couple wanting to become adoptive parents will have to prove not only that they can provide a loving family environment but also that they have formed a long-term, stable relationship. In the end, that assessment process will not be a matter for politicians—still less for Parliament—to determine; it will be for the courts to decide what is in the best interests of the child.
Dr. Evan Harris (Oxford, West and Abingdon): The Secretary of State will know that the new clause tabled in my name and in the names of many colleagues on both sides of the House is similar to the newly tabled amendments of the hon. Member for Wakefield(Mr. Hinchliffe). I welcome a free vote as progress on the Government not giving their view on the matter. British Agencies for Adoption and Fostering, which represents a coalition of relevant bodies in the interests of children, also recognises that concession. Having said that, does the Secretary of State agree that it is unfortunate that he has not been able to give full Government support for something that he accepts is in the best interests of children and provides for equality in this area? Liberal Democrats look forward to a time when there will be an opportunity to expand the number of people who can adopt children into suitable homes.
Mr. Milburn: I am grateful—at least I think I am—for the hon. Gentleman's support. Let us remember that, during the passage of the Bill, we established a Special Standing Committee to look in depth at those issues and to take evidence from a variety of quarters. What the hon. Gentleman recognises, and what I recognise, is that there are many different views on this issue. Given the
sensitivities of the issue and the fact that there are many different views, it seems appropriate to have a free vote as the right way forward.
Mr. David Hinchliffe (Wakefield): May I welcome my right hon. Friend's statement today and thank him and the Minister of State for listening to the representations made from both sides of the House on this issue? Does he accept that the welfare principle—the duty to secure the best interests of the child—has been at the heart of the success of the Children Act 1989? Does he agree that our difficulty with the Adoption and Children Bill as drafted is that children's best interests would not be secured if those interests would be furthered by their being adopted by an unmarried couple?
Mr. Milburn: I agree with my hon. Friend's remarks. I am grateful to him for his consistent support on the issue and for the help that he has given to many organisations in taking forward their views on it. There is a simple principle here: it is not about extending the right to adopt to anybody, but about extending the right of more children to be adopted. Surely, if we can do that, and if we can make it easier for more children to be adopted, to form part of a stable, loving family environment, that is precisely the right thing to do. I hope that right hon. and hon. Members on both sides of the House will feel able to lend their support to the amendments tabled by my hon. Friend the Member for Wakefield.
Mr. Gary Streeter (South-West Devon): The whole House will acknowledge that we should congratulate all adults who step forward wishing to adopt children, which must be a better option than the alternatives. In saying—rightly so—that the interests of the child are paramount, will the Secretary of State confirm that the stable, loving environment about which he talks must, in every situation, include a mother and a father? Will he confirm that that is the kind of stable couple that he has in mind?
Mr. Milburn: The amendments tabled by my hon. Friend the Member for Wakefield refer to two-sex couples and same-sex couples. He is aware that, under current adoption law, it is perfectly possible not just for married couples to adopt but for single people, regardless of their sexual orientation, to adopt. In the end, my view is that the question of who is suitable to adopt is a matter for the courts to determine.
The fundamental principle that should always be uppermost in all our minds is whatever is in the best interests of the child. I do not believe that it is in the best interests of children to remain stuck in the care system. Despite the best efforts of foster carers or people working in local authorities or in the private or voluntary sector, far too many children do not get the best chance in life because they are stuck in the care system. It seems right and proper to me, at least, that we should make sure that not just some children but every child in our country has the best start in life. To do that, every child should have the opportunity of growing up in a stable family environment.
Jonathan Shaw (Chatham and Aylesford): We have only one opportunity in a generation to implement adoption law, and the last time was 1976. Children have waited too long, so it is vital that we get the legislation
right. We must also remember that 19 out of the20 professional and voluntary agencies that gave evidence to the Special Standing Committee supported the amendments that I tabled in Committee and that have subsequently been tabled by my hon. Friend the Member for Wakefield (Mr. Hinchliffe). May I also praise the Minister of State, Department of Health, my hon. Friend the Member for Redditch (Jacqui Smith), for her excellent work in taking the Bill through Committee?Can the Secretary of State give any indication when the Bill is likely to come back to the House? Agencies are keen to move on, and not least of them is Medway council, which was recently offered beacon status for its work on adoption. I am sure that my right hon. Friend will be keen to praise it, but can he give us a date for when the Bill will return to the House?
Mr. Milburn: It will be for the business managers to agree when the Bill should come back to the House on Report. Obviously, the amendments will be dealt with then.
My hon. Friend is right. Many representations on the issue have been made from inside and outside the House. Many Members on both sides of the House have signed an early-day motion, and Ministers have received many representations. The Special Standing Committee heard evidence from a variety of organisations and all right hon. and hon. Members have received letters supporting the general approach that will extend the pool of potential adoptive parents. Among them were organisations such as the National Society for the Prevention of Cruelty to Children, Barnardos, NCH Action for Children, the National Children's Bureau, British Agencies for Adoption and Fostering, the Law Society and the Family Law Bar Association.
Inevitably, there will be debates on this issue, and rightly so. It is a sensitive matter that we have a once-in-a-generation opportunity to get right. I hope that Members on both sides of the House will consider the amendments tabled by my hon. Friend the Member for Wakefield and give them a fair wind.
Rev. Martin Smyth (Belfast, South): Given the House's concern for the well-being of children, we want to ensure that we get the legislation right. However, has the Secretary of State been made aware of recent figures that show that, when a child comes along, there is a higher degree of breakdown in relationships among people who cohabit? We must therefore be careful that children who have already suffered one trauma do not suffer another.
Mr. Milburn: I understand that and the hon. Gentleman's views on the issue. I am also very familiar with the statistics. When the hon. Gentleman has an opportunity to consider the amendments tabled by my hon. Friend the Member for Wakefield, he will see that they amend the Bill so that couples wishing to go forward as potential adoptive parents will have to demonstrate that they have formed an enduring, long-term relationship. However, that is not a matter for me or the hon. Gentleman to determine; it must be a matter for the courts to decide. If we can make it easier for more children to be adopted, that surely must be the right thing to do.
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