| Previous Section | Back to Table of Contents | Lords Hansard Home Page |
So I sound a note of caution about putting mental health interventions in statute. Let us explore it, encourage people to develop ideas and do more research on what really works. But let us not put it in statute in quite this form at this moment.
4 pm
Lord Elystan-Morgan: I, too, wholeheartedly welcome the Bill. It is a progressive and imaginative piece of legislation. On my attitude to the matters before the Committee, I wholeheartedly agree with every word of my noble and learned friend Lady Butler-Sloss. As one who was a circuit judge dealing with family work for many years, I and all my colleagues have immense admiration for my noble and learned friend for the supreme and splendid leadership she gave as president of the Family Division, and for many years before that as a senior judge.
The Bill in its entirety is an accomplishment for those who have thought deeply and considered the needs of the community in this regard. It can be improved in many radical ways. It may well be argued that this is perhaps not the vehicle for all those possible improvements—that vehicular defence is always raised in respect of any radical legislation—but we should remember that we may not go along this way again for quite some time. It is unlikely that we will see another children’s Bill for many years. Where one is in doubt about whether a particular matter should be mentioned in the context of the Bill, it might be better to err on the side of inclusion rather than stay silent about the possibilities.
I wholeheartedly agree with the proposition that even contemplating the application for a care order on the part of a local authority should be regarded as a policy of last resort. When you consider all the sanctions that the courts have with regard to the criminal law, still one of the most impactive and significant orders dealing with human liberty that a court can ever contemplate making is a care order. I am sure that every court that has ever been seized of that jurisdiction is aware of that responsibility. That means that a local authority should consider applying for a care order only when it is convinced that it has exhausted all the other practical possibilities, as so
8 Jan 2008 : Column GC269
A great deal depends on each circumstance, but I am afraid a great deal also depends upon the financial and human resources of a local authority. I speak with regard to certain local authorities in Wales. The latest local government reorganisation in Wales allowed Wales to go back to a scheme of 22 counties. Many revelled in that; I was glad to see my ancient county of Cardigan reinstated in its full local government sovereignty. The reorganisation means, however, that many of those counties are extremely weak in financial terms. I have often thought that it might have been better, in relation to certain matters, for there to be an amalgamation of services, and children’s services might have been at the front of the queue for consideration. The poverty of many of those local authorities makes it difficult for them to commit all the resources, human and financial, that they would wish to commit to children in many circumstances, with the result that care plans are put forward, with the best will in the world, with inadequate examination and incomplete consideration. That means that often a care order will have been made in circumstances where it is not absolutely necessary—where there has been no detailed examination, as my noble and learned friend has said, with regard to all the family members who might be adequate to assist in the matter. I am not sure how one goes about that.
I salute Amendment No. 1 for everything that it represents, although it would probably never achieve its aims because it deals with children who are the subject of Clause 1 and Clause 1 deals with children who are already looked after. Most of those looked-after children will be the subject of a care order already and one has to intervene at a much earlier point. Other children who are not the subject of a care order will be looked after under the other provisions of the Children Act 1989.
Clearly, it has to be inculcated in the minds of all concerned with the care of children that one should resort to this scheme—a care order—only when all other possibilities have been exhausted. To my mind, that can never be over-endorsed or over-supported in financial and human terms. If these amendments do no more than concentrate the mind on such matters, they will have succeeded. However, I may be wrong and it may be possible for there to be a specific piece of statutory precept included which will operate at an appropriate time for the childcare case and for children who do not actually go into care.
Baroness Meacher: I offer my profound apologies for not being able to be here when the debate began. There has also been a change in the groupings so I was not aware of how wrong it was that I was not present for the beginning of the debate. I hope that
8 Jan 2008 : Column GC270
This is a probing amendment and I hope that it will begin a debate about the Care Matters recommendation that we should concentrate our efforts on avoiding the need for care—early intervention—rather than waiting years to pick up the pieces when children or young people arrive in prison. Having trained and worked with a number of therapy modalities many years ago, I am aware of the incredible power of family therapy, almost over and above the other therapies with which I have worked. I refer to an example from 30 years ago which sticks in my mind. Two children in a family were repeatedly admitted to hospital with acute asthma—they were blue and at death's door. This had gone on for a number of years and a highly skilled family therapist in the hospital where I worked at the time decided to take on this family. They were given only six sessions of family therapy, and the children never returned. I was told that their asthma disappeared. For me that was extraordinary. I was relatively young and fairly green and it was very striking. Those children had a particular sematic response to the very profound problems within the family. As we know, the great majority of children illustrate the problems of their parents through emotional, behavioural and mental health problems.
My noble friend Lady Murphy said that we do not yet know who can be helped by family therapy. The NICE guidelines are quite good on family therapy. They recommend it alongside CBT as one of the most effective interventions with specific problems, including problems such as depression and anxiety. Many parents and families have those kinds of problems and there is evidence to support the fact that family therapy works. I very rarely disagree with my noble friend Lady Murphy but on this occasion I feel that I am on reasonably firm ground. It is certainly no surprise to me that the NCH claims that, on average, in four out of five referrals to their intensive family therapy services the children do not end up in care, although that appears to be a dramatic statement.
I am sure that the intensive family work done by the NCH will be peculiarly helpful for those severely disturbed families. The sort of work that I was doing was much less intensive. Obviously, the Government will be concerned about the cost, but the NCH evidence on cost is just a no-brainer: the tiny cost of £6,000 or £7,000 for family therapy spread over those children whom it benefits as well as those whom it does not. Every child who goes into care costs £36,000 a year, or something of that kind, quite apart from all the long-term costs of youth justice courts, prisons—you name it.
Bearing in mind the Government’s commitment in their document to that sort of approach, I hope that the Minister will take the amendment very seriously and take it on board as his own.
8 Jan 2008 : Column GC271
Lord Judd: I support the noble Baroness, Lady Meacher. I say at the outset, because it is early in our proceedings, that, having been a profound sceptic about the whole process of a Committee stage in the Moses Room, I have been converted. As a hard-nosed politician, as I like to think of myself professionally, I used to feel that the trouble with the Moses Room procedure was that it was nothing: you had a lot of talk but you did not take things to a vote; what did that really add to the whole legislative cause? I have now come to see that it has a very great potential value as a kind of pre-legislative consultation. It gives my noble friends who are Ministers the opportunity to take very seriously the arguments put forward— they have been brought forward with great experience and effectiveness this afternoon—take them away and think: if there is a valid point, how can it best be met? That is a very sane approach to legislation and I hope that we will make full use of it. We know what sort of people my noble friends are, so I am sure that they will respond in that spirit.
The second thing that I want to say about our work in general, which starts with the amendments, is that, as has already been said, there are considerable resource implications to an awful lot of what we are talking about: human resource and cost resource implications. We all know that local authorities are under incredible pressure on expenditure. That is a real challenge that we see repeatedly in social policy: because of our failure to give priority and finance to the strategic things that need to be done, we are using vast amounts of public expenditure to deal tactically with the consequences of that failure. In the long term, it is therefore a totally illusory saving. It is counterproductive; it actually increases the cost.
However, although those financial implications are very important for us all and need to be thought about, we in this Committee are all primarily concerned with the children. Here, I want to make just two points in support, however inadequate, of what the noble Baroness said. The first thing that troubles me about so much of our social work, in whatever dimension it is taking place, is that so often we are dealing with the symptom of the real social issue. I hope that the great champions of children will not mind my saying that sometimes we have not only to see children as children—which is crucial—but to see the predicament in which they find themselves as a symptom of something more profound. In that sense, the great strength of the approach in this amendment, and others, is that it allows us to look at how to address a total situation and deal with the root causes rather than simply the symptoms.
Finally, some very telling points have been made. For a child with an already disturbed life, it is right that we should avoid a feeling, a sense, by the child, however inarticulately expressed, that he or she is somehow being systematised and being handed over to a system—however enlightened and committed, and no one doubts the enlightenment, dedication and commitment—for dealing with such children; as distinct from, in the best sense, a more spontaneous, emotional situation in which he or she still can feel that they belong and are a part of the situation. From
8 Jan 2008 : Column GC272
4.15 pm
Baroness Howe of Idlicote: I have the instinct that perhaps we are coming to the end of this pre-legislative part of the Bill and will move on in more detail. As another of those who, sadly, could not take part at Second Reading, although I was there for quite a lot of the time, I also want to say how much I welcome almost everything in the Bill. One big thing is that at last there will be the opportunity to hear the children’s voice itself or through an advocate.
I was particularly struck by what my noble friend Lady Meacher said. That side of preventive work, where there is a necessity for expertise and therapy, can be very useful. Above all, as the noble Lord, Lord Judd, said, there should be early intervention in almost every way before making a care order, which returns to what was said on the first amendment. On that basis, I hope to take part in the debate on some of the amendments, very much in the spirit of trying to improve things, and for a little more detailed thinking to go on before any amendment is agreed.
As someone who is to take part in the audiology debate later today, I am hugely impressed, sitting here, by the improvement in the hearing aid facilities in this Room. Instead of straining like mad to hear what is being said, for the first time in a long time I can hear every word. For different reasons, I am very much in favour of all these amendments, particularly early intervention because of the social and financial costs. I agree entirely with the need to deal with that. I was at a meeting with my noble friend Lord Listowel where the point was made that you have to look at prevention because of the social and financial costs. But, at the same time, because you have failed—and we have failed—you also have to take action and do your best for those who have been failed.
Along with my comments in praise of what Members of the Committee have said, I should also say that I have quite a lot more sympathy than I had at the time when I listened to the comments of my noble friend Lady Howarth. Above all, it often can be solved by a practical intervention, which we might think is silly and stupid, such as having a washing machine. The pressures can be so tough on some families.
Lord Rix: I had not intended to speak on these amendments, but the mention of washing machines on two occasions by my noble friends reminds me that many years ago, in the 1980s and onwards, I was part of a charity called “The Knights’ SUN Fund”, the Imperial Society of Knights Bachelor Special Unmet Needs Fund. I remember literally hundreds of letters coming to us—and I imagine that that continues to this day—from social workers saying that urine-soaked blankets, sheets and so on were incapable of being washed because of the lack of a washing machine.
I suspect that, in practical terms, for many struggling parents—particularly single parents; young mothers, in the case of quite a number of children—
8 Jan 2008 : Column GC273
Baroness Masham of Ilton: I ask my noble and learned friend Lady Butler-Sloss to tell Members of the Committee a little more about the closure of the specialist hospital. It is really dangerous to shut some of these facilities. These children fall between health, social services, education and mental health. I served for many years at a young offenders’ institution, and saw thousands of young people with problems. We should take seriously the prevention of these people becoming criminals and going to prison. It is a dangerous situation and they need all the support they can get, as do their parents. I would be grateful if my noble and learned friend would tell us more about that hospital. Something should be done to stop these facilities from closing.
Baroness Butler-Sloss: Would Members allow me to do so in three sentences? I do not want to take up the Committee’s time. The Cassel takes in the entire family, the children and both parents—if there are two parents—for up to three months, if necessary. My noble friend Lady Howarth will probably know rather more about it even than I do. I have been involved with the hospital for a number of years. Countess Mountbatten is its president.
The hospital does not fit in very well with the National Health Service. What it offers is national but it is run by, as one would imagine, a regional set of NHS trusts. It is therefore out on a limb. Over the years that I have known it—now 25, I suppose—it has been at the point of closure three or four times. I had an agonised letter from it just before Christmas, which I passed on to my noble friend Lord Listowel, and I believe he has been in touch with one of the Ministers about it. It is difficult to know how to help the organisation. It needs support from individuals and organisations, but it needs government funding as well. If the Cassel fails, there will be more children in the criminal system than there are now. I will happily discuss this elsewhere, perhaps over coffee.
The Parliamentary Under-Secretary of State, Department for Children, Schools and Families (Lord Adonis): First, I reciprocate the new year good wishes offered by the noble Baroness, Lady Morris, and extend them to all Members of the Committee. I also echo the remarks of my noble friend Lady Massey in thanking so many noble Lords for assisting us in our debates on this important Bill. There is no more vulnerable group in society than looked-after children. They deserve the fullest attention of Parliament and it is good to see that attention being given in such full measure this afternoon.
Speaking from this position, I also greatly welcome the remark of the noble Lord, Lord Williamson, that his interest in the Bill was wholly benevolent. I strongly
8 Jan 2008 : Column GC274
I entirely agree with all that has been said by Members of the Committee on the importance of early intervention and taking every possible step to avoid the need for children to go into care in the first place. As the noble Lord, Lord Elystan-Morgan, so rightly said, care orders are regarded by the courts as an absolute last resort. It is therefore all the more important that the proper support services are in place to ensure that this step does not need to be taken.
Helping children to stay with their families is an important part of the Care Matters White Paper referred to by many noble Lords. Most of chapter 2 sets out how we intend to promote the capacity for families to sustain relationships with children through times of turbulence and stress, through the increased provision of support for the most vulnerable children on the edge of care. I particularly draw attention to the plans set out in chapter 2 for multi-systemic therapy on page 37, and the new family drug and alcohol court described on page 36—which the noble Baroness, Lady Sharp, mentioned, and which has just been launched as part of Wells Street magistrates’ court in central London—and an expansion of family group conferencing to make it more widely available.
In October 2006, we published guidance to local authorities which emphasises the importance of support being available to families at the earliest point at which it is needed. As part of this, we encouraged them to develop better support services for families. Specific new services include family intervention projects to reduce anti-social behaviour, and pilots of nurse-family partnerships aimed at vulnerable new mothers.
On the statutory framework, Section 17 of the Children Act 1989 already contains a wide duty on local authorities to provide a range of services to promote and safeguard the welfare of children in need, and a duty under Section 17(1)(b) of that Act to promote the upbringing of such children by their families, defined as:
- “any person who has parental responsibility for the child and any other person with whom he has been living”.
It is therefore currently framed in a wide way. This broad legislative framework is satisfactory. Rather, we are addressing the actual services which local authorities provide, which in part—as the noble and learned Baroness, Lady Butler-Sloss, said—support the work of the courts to ensure that children do not need to be taken into care, in pursuit of the duties that local authorities already have under the Children Act.
I shall address the specific amendments—as my noble friend Lord Judd acknowledged I always seek to do—in a spirit of constructive engagement. The Government will of course reflect on all the points made in the debate to see whether it is right for us to make further changes before Report.
8 Jan 2008 : Column GC275
Amendment No. 1 of the noble Baroness, Lady Morris, relates specifically to the duties of local authorities over children placed within social work practices. This relates to the following debate, but I stress that, under the social work practice model, local authorities will retain the responsibility for providing services to children in need who live at home with their parents under Section 17 of the Children Act. Social work practices will have no role in relation to such children who have never had any contact with the care system. They can be involved only after the local authority has decided to apply to the court for an interim care order and the court has granted that order and where the child has become a looked-after child on a voluntary basis.
Those powers and duties apply equally to looked-after children to whom, in addition, the local authority owes an express duty to make arrangements to enable the child to live with his parents. That includes, as I said, a relative, friend or other person connected with him under the 1989 Act.
4.30 pm
Baroness Howarth of Breckland: Perhaps I can ask the Minister for clarification on that point. Many local authorities work with voluntary and other organisations in dealing with children who are not in care but who are in danger of being placed in care. I am thinking of the Family Welfare Association, which is now joined with other organisations and with NSPCC projects. I assume that what the Minister is saying will not prevent that work continuing. The implication was that all the work—this is only to do with private practices—that is carried out by the voluntary sector at the moment would not happen.
Lord Adonis: That is my understanding. If there is anything I need to clarify further, I will do so.
In addition, before making any decision with respect either to a child they are looking after or one they are proposing to look after, local authorities have a duty to ascertain the wishes and feelings of the child, his parents, any other person with parental responsibility and any other relevant person.
Amendments Nos. 18 and 26 specifically mention family group conferencing. The evidence that we have is that it can have a positive effect. I echo the remarks made by the noble Baronesses, Lady Howarth and Lady Murphy, that it needs to be used in a sensitive and skilful manner, and we need to be very careful about new legislative provision in this area.
| Next Section | Back to Table of Contents | Lords Hansard Home Page |