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We remain of the view that a social workers assessment of age, drawing on that persons professional experience in dealing with children, should remain the primary means of assessing age. However, we believe that a dental X-ray can be a useful additional tool in the overall decision-making process. As the noble Lord, Lord Avebury, has said, some local authorities already arrange a dental X-ray and subsequent report by an expert in the field to assist in their final decision. It is entirely up to the individual to decide whether he or she wishes to undergo such an X-ray. Nothing that we propose will
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X-rays cannot determine age absolutely precisely; indeed, no procedure can give that certainty. We do believe, however, that they can provide a better means of narrowing the range of possible ages than other techniques, and can thus assist the decision maker. It is true that any X-ray procedure involves some exposure to ionising radiation, but we have been advised that the risk of harm is extremely small. Most children, regardless of their immigration status, are likely to undergo dental X-rays as part of routine healthcare checks.
It is our policy, in the absence of any credible documentary evidence or other persuasive evidence to demonstrate the age claimed, to accept a social workers assessment of age. This is widely supported by most stakeholders, including the main childrens charities and, importantly, by refugee organisations. This amendment, if accepted, would make the operation of that policy very difficult. It would appear to mean that an immigration officer would not be able to take into account a social workers assessment if it depended in any way on dental analysis. Equally, it would appear to prevent an individual from obtaining an expert opinion on his age through a dental X-ray. Therefore, it could work both ways.
The establishment of a code of practice to keep children safe from harm, which we debated on the first Committee sitting, will provide additional safeguards to those which will be included in the arrangements for dental X-ray. We are committed to finding ways to improve the current process for age assessments and to minimise the serious child protection issues that arise following incorrect assessments. Many EU member states, for example Denmark, France and the NetherlandsI believe that I mentioned those countries at Question Timeuse dental examinations for the purposes of age assessment. However, there is variation between EU member states. We have commissioned a review of existing research in response to some claims that there might be ethnic variations in dental development. It is right that we should consider these findings and responses to the consultation before taking any further action.
I have dealt in part with the point raised about the accuracy or otherwise of dental X-rays. I explained that we have commissioned a further review. As for why the Government have changed their position on the use of X-rays since the 1981 report, the answer is twofold. First, the number of people claiming to be children has risen dramatically since 1981 because the level of claims for asylum has gone up dramatically. Although the general asylum intake figures have reduced in the past five or six years, the number claiming to be children has remained constant, at
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Lord Avebury: I think that the noble Lord gave figures for the years up to 2005. As he knows, the immigration statistics for 2006 are not yet published and are not due until August. It would be very useful if the noble Lord could give us the number of children whose age was disputed in 2006 and, if possible, in the months up to June 2007, because I believe that the numbers are reducing and that the 3,000 a year mentioned by the Minister in previous debates is no longer applicable.
Lord Bassam of Brighton: I certainly undertake to find as current data as we possibly can. The noble Lord may be right; I do not know. It is likely that he is. But my point is that, given the criticality of age in the assessment process generally for consideration of asylum cases, it is right that we should have proper procedures in place. The heightened concern about child protection issues underpins that.
Further, it is right that we should explore the medical and technological advances made in the past 20 years, which have been mentioned, with a view that X-rays may be able to contribute to an overall holistic and more scientific approach to age assessment. That would be in everyones interest. As I say, we have committed to review ethnic variation in the development of teeth. We have commissioned a leading ordontologist to research ethnic variation issues relating to tooth development. Of course, we will be willing to share the findings from that report with the Committee.
A question was also asked about who we had consulted about the use of dental X-rays. As I have explained, we published a paper earlier in the year. The consultation period ended on 31 May and we are carefully considering the responses received. There have been more than 100, from a number of local authorities, NGOs, and childrens and refugee organisations. The consultation paper included the proposals to use dental X-rays for the purposes of age assessment. Separately, officials have met with the Royal College of Paediatrics and Child Health, the Healthcare Commission and the Department of Health. We have spent some time on this and are approaching the subject with considerable care. It is a serious issue, as we all appreciate. The age assessment issue is important for a number of reasons, not least child protection and making a proper assessment of entitlement to reside in the UK.
Lord Avebury: First, there is no argument between us about the necessity for having as reliable a procedure for determining age as is technically and scientifically possible, while always bearing in mind that this is not an exact science. However you refine the procedures, there is always going to be a residue of children whose age is indeterminate, where one would suggest that the immigration authorities should give the benefit of the doubt. The consequences of a child being wrongly classified as an adult can be immensely
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We are not aiming at perfection. The Minister will concede that nobody claims a great deal of accuracy for the assessment of age by dental X-rays, even within the populations of western Europe and North America. The techniques usedthe Tanner-Whitehouse atlases and the Greulich-Pile atlas, developed in the United States and imported into this countryrefer to well fed, middle-class American children. As my noble friend was trying to point out, when you are looking at populations of Ethiopian children, you have no idea whether the mean and standard deviation of a particular development in a childs skeletal or dental structure are the same as those in the host population. In spite of what the noble Baroness, Lady Anelay, was saying to contradict my noble friend about paediatricians coming into the family courts and making age assessments of malnourished children in the United Kingdom, those would certainly not be applicable to populations, let us say, of Somali or Afghan children. You have no knowledge whatsoever of the mean and standard deviation of the dental and skeletal developments in those populations.
Baroness Anelay of St Johns: I know that the noble Lord has a great technical grasp of these matters, but I was arguing that paediatricians in this country are able to give informed interpretation of the information before them. As the Minister has said, the use of dental ionisation X-rays is just one part of the way in which an age assessment is made. It may be a useful part. It is right that we have had the debate today, from the noble Lord, Lord Avebury, to put in context how valuable or not that X-ray system may be. That is the important thing.
Lord Avebury: What the noble Baroness said about the use of dental X-rays in family courts was news to me. I hope that that will be referred to the Royal College, which, when I last asked, was opposed to the use of X-rays, and so were the British Medical Association and the British Dental Association. The Minister said that 230 organisations responded to the consultation.
Lord Avebury: I would like to know whether any special notice was taken of ethical considerations. Not long ago, when I asked the BMA, the BDA and the Royal College of Paediatrics and Child Health, they said that the use of ionising radiation for non-clinical purposes was not ethical. Irrespective of the accuracy of the process, that fundamental question needs to be determined before one ever considers whether it should be used as an adjunct to other methods.
Baroness Anelay of St Johns: I hesitate to intervene, but I must, even though I know we are to finish dead on a quarter to eight. When I spoke, I very
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Of serious concern to me is the Home Offices proposal that the assessment of skeletal maturity by x-rays of the teeth or skeleton be used routinely to determine age. I base my condemnation of this proposal on the fact that for 30 years I have been a full-time paediatric endocrinologist, that is, a specialist in the role of hormones in the mechanisms of growth and sexual maturation in children and young people. There is substantial normal variation in the speed with which young people attain sexual and skeletal maturity.
and so on. That remark is made by an expert, and he reinforced it in the discussion which we had in the Committee Room upstairs last week. I imagine that that view would be reflected if the noble Lord cared to consult the Royal Colleges, the BMA, the BDA and so on. I hope he will do that.
Lord Bassam of Brighton: We are getting close to the cut-off time. We consulted and we have heard their comments, so we are well aware of those issues. I do not like the implication that somehow we failed to consult extensively because we have.
Lord Avebury: Then why cannot the noble Lord produce those opinions? Let us hear them. It is getting a bit late; we have only a couple of minutes; we are under pressure from the clock. Before I finish, I want to challenge the noble Lords assertion that there had been enormous advances in medical and technological assessment of age by the use of X-rays. That simply is not true. I challenge him to produce a single, authoritative scientific survey, which is accepted by the professions, to substantiate what he
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Lord Bassam of Brighton: I thinkI was almost going to say that we have had enoughthat this might be a convenient moment for the Committee to adjourn until Monday at 3.30 pm. I am grateful to noble Lords for their contributions today.
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