Select Committee on Health Minutes of Evidence


Examination of Witness (Questions 60-79)

THURSDAY 27 MARCH 2003

LORD LAMING

Mr Burns

  60. Given this golden opportunity, do you think the Government would then listen if it did not like the question?
  (Lord Laming) Maybe I am a simple soul, but if the Government sets out a self-audit study to all of these agencies I assume they want honest answers back and they intend to take the matter forward.

Andy Burnham

  61. The ADSS also argued that child protection registers should remain in place until the national database you recommend is established. They also saw a continued role for Area Child Protection Committees, and this should be linked into some of the new local government structures which we have referred to before. What is your response to that?
  (Lord Laming) I would believe in child protection registers if I thought they did any good, but I think they have the potential to do harm. People who place a child's name on the register have the right to assume that that child is receiving services and I think there is no guarantee that a child will receive services. I have said what I think about Area Child Protection Committees. I do not want to single out ADSS. I hope that all of these bodies who have to react quite quickly to reports of this kind and say what they think, in the light of cooler reflection, they may think there is a little more in it than they had perhaps suggested.

  62. Can I bring you on to the national database suggestion. It is one I am personally very attracted to. You say in your Report, "likely to be countered by concerns about personal privacy expressed by those who oppose the use of national identity cards". I strongly support national identity cards and strongly support a database of this kind. I will quickly give you an example of why I do. Last summer two asylum seekers, two young girls, living in my constituency went missing at exactly the same time the two girls were missing in Solent, yet there was very, very little media coverage of this. What emerged was the fact that they were not known at all to any of the agencies. They were not known to the education department and were not known to other agencies who should have known about them. That brings me on to comments that you make about children slinking through the net. It is a terrible phrase, but it happens. Children are lost in the system. How feasible do you think it is to have such a database? How personally committed to it are you? Was it a bit of an add-on recommendation or is it something that you attach personal weight to? How would it work in relation to something like an asylum seeker who may come in illegally?
  (Lord Laming) First of all, let me just say about the database. I am committed to it. I believe that we live in a much, much more mobile society now than in the past and I believe that family structures are much more fluid than in the past. Children move from place to place. We do not have a system in place whereby it is possible to track children at all. In fact, in one of the seminars we were told that children are discovered by the education system as being not registered in a school much more frequently than any of us would realise. If a parent or a carer does not have the thought to tell the existing school the address to which they are moving there is no way in which the receiving authority actually knows about this child. Children can go on undiscovered. This is not about asylum seekers; these are children who are resident in our society who drop out of the system. It is one of these things where it is no use holding up our hands in horror and asking how it can happen in our society that children can be lost in the way that Mr Burnham has given a very vivid illustration and are not being prepared to do it. It is entirely feasible technologically in that it is not a huge database compared with many databases in this country. I suspect that much more is known in a whole series of penny packages about children and their families. If we put all those systems together at the present time it would ever by recorded by a national database. The fact is there is a phenomenal amount of information known about us all in penny package systems across society. I think we either say that we should not be squeamish about this and we should get on and do it, or we should be squeamish about it. It is a matter of opinion. I happen to think that we should not be squeamish about it and we should do it.

  63. We already have a National Health Service number at birth. We have child benefit details that have been administered separately by another database. The National Insurance number is another database. My view is that there are some people—mainly the civil liberties lobby—who overplay some of the dangers of such systems and that stops some of the public benefits that bringing them together would actually bring. Do you have sympathy with that?
  (Lord Laming) I certainly believe that there is a very, very strong case to create a coherent database rather than have all this fragmentation that goes on at the present time. About asylum seekers, clearly if a child is not known and has no contact with any service, then nobody can do it. Once the child has made a contact with a service—whether is it education, a GP, taken to Accident and Emergency, known to social services, a housing department, it does not matter what it is—and is identified, then it becomes part of the database system.

Chairman

  64. Would you have a requirement for that child to be entered at that point?
  (Lord Laming) Yes, exactly.

Andy Burnham

  65. You say in your Report that people who exploit the vulnerability of children often try to keep them out of sight. Going back to the database, there are systems around now, iris recognition systems, where you can actually find someone's identity very, very simply and quickly even if they do not speak English or whatever. I have seen examples of children picked up from the street in a very confused state. Would you go that far?
  (Lord Laming) I am very conscious that I have some colleagues that work with me who are sitting behind me and if I give the impression that I understand anything about technology I have to live with them afterwards. It would be quite wrong of me to give the impression that I can even operate my mobile phone satisfactorily. What I do think, however, is that in this day and age we need to recognise that technologically there are no impediments.

  66. The benefits in terms of safety to children, eliminating risks, is far greater than the perceived risks in your view.
  (Lord Laming) Yes.

Julia Drown

  67. On the database issue, for me it is not a squeamishness issue; it is an issue about practicalities and bureaucracy. You have said there are no limits in the technology aspect. Virtually every computer system, all the big government computer systems, the major companies who make computer systems, they set out the great goals that they can do this, that and the other, then actually it is not quite so simple. Quite often it is the administrative input into it that is the problem that slows it down and makes sure that the output is not so good. My concern over it is, does having a child register for everyone involve so much work that we then do not concentrate on the children who most need it. For me it has the reflections of what you were pointing to earlier. We have all these volumes of guidance which then means that the workers who are there at the front line cannot possibly absorb all that. We would deliver more for children if we took the responsibility and just gave them two sides of A4 to follow. There is a reflection for me that we are trying to do too much by checking every child. I would like to have your reaction to that, but also on your comment about the limitations of the child protection register. I recognise that that does not mean they get services when they should. Is there not also something in it that when you are putting a child on a child protection register for at least some of them it is actually getting across to their parents that we, as a community, are significantly concerned about your child and your child and you need help? Is it not the case with at least some of those people that it is actually that step that makes them realise and not turn a blind eye to what they know very well is happening to their child? For some people that actually rescues those children. I would like your reaction on those points.
  (Lord Laming) I agree with the thrust of your comments and that is why I suggested that the Government should establish a feasibility study. You have to balance usefulness against cost. The last thing I want is more bureaucracy; I hope I have conveyed that. The fact is that the data registration system seems to work extraordinarily well in this country and it is larger than the number of children that we have. The number of people who have access to the system would be much greater. I think there is a real feasibility study that needs to be considered. It is concerning that international hauliers can track their lorries across Europe by satellite and yet we cannot manage data within a hospital. We cannot manage data between two hospitals that are a handful of miles apart. These are really serious issues that need to be addressed. I do not think the answer is more bureaucracy, but I am suggesting there should be a feasibility study about its utility, whether it would aid the thing or get in the way. On your second question about child protection registers, I think that is a very interesting point you have made. I think I would be very unhappy if practice in being absolutely honest and upfront with a carer or a parent depended on our using the excuse of a child protection registration. I believe that workers in all of the different disciplines must be straightforward and open with the carers about the well-being of a child. I would like to think that practice in this country has moved to a point where devices like a child protection register are not—in my view—misused in that way.

Dr Taylor

  68. Can I go back a bit to a general point about the recommendations. Many of them are absolutely basic, common sense things that should be going on at the moment. As I was coming down this week a porter on my station was sweeping up cigarette ends and he made this extraordinary comment: "It is easy to change policies, it is very difficult to change people". These simple recommendations need people to change what they are doing. They know what they should be doing. How are your recommendations going to force that to happen? How can we help to force that to happen?
  (Lord Laming) I have said throughout that I find it very dispiriting and in some ways embarrassing to make some of the recommendations that I have made. However, the fact that I had to make those recommendations just shows how far we are from acceptable practice at the present time. I think that although people might have some reservations about the bigger recommendations that I have made in the Report, at the end of the day you have to have a system in place which actually is monitoring, checking and is ensuring that things are being delivered properly. For something like case recording, it is not rocket science to make sure the case recording is good. It is not difficult to make sure things are properly monitored, but it is absolutely crucial in good practice and especially when there is deliberate harm to children.

  69. Did you get any idea within the hospitals that you were dealing with that there was any meaningful audit?
  (Lord Laming) No.

Chairman

  70. Can I come back to an area that I though Julia was touching on a moment or two ago. You will forgive me but I was so taken aback by a comment from Andy on a kind of North Korean ID system and we were having a dialogue about the implications of it and I missed part of what Julie was asking about. You spoke earlier about labels being tied round people's necks and I was interested in that Victoria was judged to be a child in need rather than a child in need of protection in terms of the way this issue was handled. One of the points that has concerned me for many years about the 1989 Act—and I entirely concur with your views on it—was that the practical application has concentrated on where there is a statutory justification for some form of intervention and less on the preventive aspects that were clearly assumed to be a key part of that measure. What are your views on that point? What you are talking about presumably is that the law as it stands is fine, but it is the way we are applying it.
  (Lord Laming) Absolutely. How can we have a system where we describe this as being a child in need where the child is actually admitted to hospital because of suspected deliberate harm, where the police take the child under police protection without the child having been seen, without the carer being told about it, and then discharge the protection without the child ever being seen. I think this is the nonsense about trying to put a label around a child's neck before the child has ever been seen or thinking that the Children Act is only about the tip of the iceberg kind of child protection issues. The fact is that the Children Act should apply to children with needs; that is what it was intended for. You, Chairman, are one of the people who played a big part in that. I think there was enough evidence to this inquiry which was of the most alarming nature to demonstrate to you, I hope, that practice has drifted away from what you and your colleagues intended at the time. The preventive work and support for the families has become such a low priority that it is does not feature in many of the business plans that we saw from the authorities.

  71. Can I go back to a point that I raised with you earlier on, which is the issue of reasonable chastisement question. I was interested in Richard's porter and his comments about it being easy to change policies but it is more difficult to change people. You mentioned about getting the values in place. The issue of how we value children does not relate to how we treat children within law and what we can do to children that I could not do to my colleagues round the table (physical assaults). I was interested that the reasonable chastisement elements of this particular case did not seem to merit a great deal of mention within the Report. It seems to me from reading the Report and what happened to Victoria that discipline and punishment was a major context for the abuse that took place. Carl Manning said that Victoria's abuse began with little smacks. The great aunt told the inquiry that there was nothing wrong with smacking. My personal experience has been going to court on a number of occasions with child abuse cases and losing cases on a defence of reasonable chastisement. I know many social workers who share my view, that as long as we have the reasonable chastisement defence social workers—to some extent in child protection—have one arm tied behind their back when they remove a child that has been injured. Do you not see this as an issue?
  (Lord Laming) Of course I see it as an issue, Chairman. I thought that in the way in which the Report was written, particularly in the introduction, I had conveyed to you and everybody else a rather shocking story of the way in which a child can be abused and it go on undetected and uncorrected.

  72. You have, yes. My concern is the conclusions that you have reached.
  (Lord Laming) The conclusions are, I thought, all about achieving good outcomes for children and about improving the welfare of children. I thought that anybody reading this Report would also recognise something that I thought I had conveyed very strongly, which is that we seem to take assaults on adults much more seriously than we take assaults on children. Is that not extraordinary?

  73. Unless I have misunderstood the Report or missed something, have you made a specific recommendation in terms of amending the law to protect children in this respect?
  (Lord Laming) I have made a number of recommendations to protect children. I have not used the phrase "reasonable chastisement" which I take to be a phrase which is subject to a great deal of interpretation by a number of people. Reading the Report I would have thought that people would come to the conclusion that violence towards children should be taken as seriously—or more seriously—than violence towards adults. I make a claim that if you actually look at the way in which the police in particular conducted the murder inquiry—which was of a huge professional standard—where they succeeded in getting a successful outcome with convictions and life sentences, and you contrast that with the way in which an assault on a child was not investigated or looked at, then it seems to me that with the Report there are a number of key messages about assaults on children.

  74. Can I put it to you specifically that your predecessor Bill Utting was on the record in his report People Like Us as making as specific point about the need to remove the reasonable chastisement defence in terms of protecting children from being injured by their parents or carers. Do you feel it would be helpful to children and to people working in child protection for that issue to be addressed directly by the Government in a child protection strategy?
  (Lord Laming) I am here to talk about what is in the Report as you will understand and not to express personal views. We received the evidence and it was written up in the way it came to us. Whether it be about what people term "reasonable chastisement" or whether it be things like private fostering or whatever it may be, the fact is that the Report has to be confined to the evidence. I can do no more than hope that people will read the Report intelligently—as I am sure you do—and that you will see that there are some key messages in there.

Julia Drown

  75. I want to get onto the issue of racism in particular which featured in Victoria's case. Obviously they are sensitive issues, but you did suggest in your Report that cultural assumptions had been made about Victoria and her situation and that might have diverted attention from the signs of neglect and ill-treatment. Can you tell us a bit more about conclusions you reached on this?
  (Lord Laming) I take racism very seriously indeed, but not confined between people of the same colour of the skin. Indeed, I have worked in places where people of the same colour but happened to come from different backgrounds have actually been at loggerheads with each other. I am sure you have all had experiences of that. It would have been tempting in the inquiry to say that because Victoria had a black skin, her two murderers had black skins and many of the staff who dealt with her had black skins, that actually racism played no part. Indeed, we had no evidence of overt racism to the inquiry. What we did get—and I think this is a very important part of being effective in a diverse society—was staff making assumptions that because people originated from a particular culture that behaviour could be described as being culturally determined when in fact they knew nothing about that culture and had never visited the country. For example, when Victoria always jumped to attention in front of Marie-Therese Kouao but did not do so in front of nurses or doctors or social workers, it was assumed by some that that was because that was the way she had been brought up on the Ivory Coast. The reality was quite different. I believe we all need to develop a greater degree of humility about making assumptions and generalisations about other cultures. Racism is much more than the kind of unpleasant comments and behaviour with which we are familiar; it is about understanding how services need to operate in a diverse and multi-cultural society.

  76. You did mention, in answer to a question, private fostering. There are 10,000 West African children in private foster care and they remain completely unnoticed by social services. Some of them, as in Victoria's case, are extremely vulnerable. Sir William Utting did look at that. Do you agree that that is a loophole in the law that needs to be closed in terms of making sure that those private foster carers register.
  (Lord Laming) All of the agencies that dealt with Victoria assumed that Kouao was her mother so the issue of private fostering did not arise. Had they actually made what your Committee and other people would think were basic enquiries, they might have discovered something quite different. As I indicated earlier on, committees have to base their reports on the evidence they receive and not on the personal judgments or preferences of the chair or anybody else. What I did, however, feel able to do in the Report was to draw the Government's attention to what appears to be a fundamental contradiction that in the day care of children—they go home at night—it is highly regulated, but you can leave a child for weeks and months without it being as well regulated. I felt able to say that the Government should address what looks like a serious anomaly. At an earlier meeting some weeks ago the Minister said that the Report had done sufficient to ensure that the Government will be addressing these matters. I welcome that.

  77. Can I pick up an issue about cultural attitudes which is on natural parents as against others. You said then that they thought the great-aunt was Victoria's mother but they did know it was a boyfriend and not a natural father.
  (Lord Laming) Yes.

  78. We picked up twelve of the major cases that had happened since 1945 and I could not help noticing that one child was killed by her mother (but that mother had asked for her children to be taken into care). Then there was one last year, Ainlee Walker, who was killed by her parents. There were a couple by the father. Then all the others were fosters, great-aunt, boyfriends, step-father, one step-mother with a blind eye from the father and so on. Eight out of twelve were at the hands of people who were not their natural parents. Is there something else going on there or something that we need to learn as a society from that about the support that is needed to children or to the parents of children when they are not their natural children? Is that another failing that we are making as a society?
  (Lord Laming) My view is that services have to change to keep pace with the changing needs in society and the way in which family structures are created and recreated is a reality, whatever people think about the desirability or not is irrelevant. The fact is that it is a reality. Therefore, services have to adjust to meet that change in needs. I believe that there is evidence in the Report to show that it was very difficult for people to gain access to a service unless they came with a child protection label round their neck. That means that you are cutting off a huge range of social need out there for children and families who are just not getting the service.

  79. That is going back to David's preventative point.
  (Lord Laming) Yes. I believe there needs to be a refocusing of these services—dedicated outcomes for children—hence the recommendations that I have made which I think are a vehicle to achieve that.


 
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