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The Parliamentary Under-Secretary of State for Health (Miss Melanie Johnson): It is with pleasure that I congratulate my hon. Friend the Member for Tooting (Tom Cox) on introducing a debate on a subject so important to many men, women and children throughout England. I appreciate and share his concerns about meeting their needs.

First, by way of an overall response, let me talk for a few minutes about the extent of child abuse and domestic violence and their effects on the health of victims and their families. Domestic violence, child sexual and physical abuse and rape occur in all social classes and ethnic groups, but the prevalence rates of child sexual abuse are high—20 to 30 per cent. of girls and 5 to 10 per cent. of boys—and up to 20 per cent. of children are regularly subjected to physical violence. Research shows that in at least 40 per cent. of domestic violence cases, there is also child physical and sexual abuse involving the same perpetrator—usually the
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father or the father figure. Thousands of children witness domestic violence every day—not just hearing verbal abuse but seeing their mother being physically abused and sexually assaulted. My hon. Friend commented on the number of deaths of children that occur.

All of that has a huge effect on the general health, sexual health and overall well-being of victims. In addition, every week two women are killed as a result of domestic violence. Many studies show that domestic violence impairs children's emotional, behavioural and cognitive development. Its effects include anxiety, fear, withdrawal, highly sexualised and aggressive behaviour, reduced educational achievement, failure to acquire social competence, antisocial behaviour and use of drugs. None of us disputes or fails to recognise the sort of problem that my hon. Friend has described.

It might be helpful if I outline some of the Department's current work before dealing with the   funding issue. Work is going on between the Department of Health and the National Institute for Mental Health in England on establishing a violence, abuse and mental health programme. The whole of that programme is being implemented in partnership with the Home Office. I am sure that my hon. Friend will be keen to learn that its objective is to address the health and mental health implications of domestic violence and child sexual abuse. Over the current financial year, it will be working with the Home Office to match existing services, of which the phone line of the National Association of People Abused in Childhood is one. It will be establishing expert groups to manage the development of service guidelines in this area.

Clearly, NAPAC will have a role to play in contributing to this exercise, but as one of the many organisations that are providing services of this sort. It is perhaps worth while mentioning that there are some 117 different helplines nationally to provide information and support of one sort or another to those who have been abused. There is an extensive network of different organisations that is currently providing support.

The Department wants also to ensure that issues involving the interests of adults abused in childhood are recognised through our White Paper on public health. It has ensured that the issue is also being addressed in the National Institute for Clinical Excellence guidelines on self-harm and post-traumatic stress syndrome, too.

There is a great deal of work going on in the voluntary sector and there are several relevant documents, including the mental health national service framework, the national suicide prevention strategy, the women's mental health strategy into the mainstream and the implementation guidance from that, the personality disorder policy, "No Longer a Diagnosis of Exclusion", and the public health White Paper, "Choosing Health".

My hon. Friend may be aware that the Department of Health, in partnership with the National Institute for Mental Health, is developing the programme that I have already mentioned. In September, the Department drew   up a new strategic agreement with the NHS, the voluntary sector and the community sector. This agreement, exclusively between the Department, the NHS and the voluntary and community sectors, will benefit patients, carers and service users by providing them with real alternatives so that they can choose
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services that are best suited to their needs. We recognise the tremendous role that these sectors play in the provision of our mental health services. That is why they are being recognised in the way that I have described. I   am sure that every Member of this place has good examples of the way in which services are being provided by these sectors.

The Department has also supported and funded a considerable volume of work through the section 64 grant scheme, which my hon. Friend mentioned. The Government publicly supported NAPAC through section 64 funding over the past three years. My hon. Friend mentioned the £50,000 a year that was made available to do that. As a result, it has been possible to run the helpline, but sadly, recently, it fell into some difficulties of both a financial and a management sort. That led to the slightly premature closure of the helpline. As a consequence of that, the Department's health officials have met the chair of the organisation and its development officer to discuss how to help the organisation to move forward.

The Department is working closely with the Home Office in supporting the violence and abuse voluntary sector. NAPAC has been invited to contribute to the   development of future services, especially the development of the national telephone helpline.

Ministers in the Home Office have already suggested that NAPAC might want to bid for Home Office funding in addition. However, the Department understands that NAPAC is liaising with the Survivors Trust about the future of the helpline. The trust represents some 80 organisations that provide specialist services and operates an umbrella organisation for adult survivors of child sexual abuse. It is a leading voluntary sector organisation nationally to advise on developing services in this area. It was established with financial support from the National Institute for Mental Health in England to support the work of the expert group that we have with that institute, and it is also in receipt of section 64 mental health grant core funding for 2004–05.

We are therefore doing a huge amount to help adults who were abused in childhood. It is a live agenda, which means that a great deal of new work is being done in collaboration with the voluntary and community sectors, and work is also going on between the Department and the Home Office and with the Survivors Trust. That should reassure my hon. Friend that we take the issue seriously.
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The new mental health programme aims to address the mental health implications of domestic violence, child sexual abuse and sexual violence for services and professionals working to identify and respond to the needs of the victims of rape and sexual assault and the survivors of child sexual abuse. We have recognised that NAPAC has a role to play in that. Unfortunately, as I   mentioned, we recently became aware of some of the internal financial and organisational difficulties that NAPAC has been experiencing, which led to its helpline being temporarily suspended.

The Minister of State, Department of Health, my hon. Friend the Member for Doncaster, Central (Ms   Winterton) has met members of the organisation, and my hon. Friend the Member for Lancaster and Wyre (Mr. Dawson) was also present at the meeting, where the difficulties were discussed. At that time, the problems relating to the continuation of the helpline were not known, so some of the suggestions made at the meeting might no longer be appropriate. I am pleased to say that the issues are being addressed, and I understand that NAPAC is liaising with the Survivors Trust about the future of the helpline. There is much work still to be   done and some investigations to be undertaken. I   cannot commit my hon. Friend the Member for Doncaster, Central to a meeting with my hon. Friend the Member for Tooting. This does not seem the best moment for such a meeting, but it may be appropriate at some future time.

I hope that I have conveyed the importance that we all   place on the issue of abuse and the partnership working across Government and across the statutory and non-statutory sectors. I am confident that with the leadership, vision, dedication and skills of everyone involved, we can continue to transform the health and social care provision for all the victims and survivors of domestic violence and child abuse, recognising, as my hon. Friend has in raising the issue, how important these matters are and how much assistance people in that situation need and deserve.

I join my hon. Friend the Deputy Leader of the House of Commons in wishing everybody—Members and Officers of the House—a happy Christmas, and thank my hon. Friend the Member for Tooting for raising an extremely important matter on this occasion, as we close the debate for Christmas.

Question put and agreed to.

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