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The health of our children is mentioned in the Children’s Plan, so I will mention just one policy relating to children’s health. The Welsh Assembly Government recently launched its Autism Spectrum Disorder Strategic Action Plan. Wales is the first country in the world to have established a cross-cutting national strategic plan for ASD, helping an estimated 30,000 people in Wales who are either directly or indirectly
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“Children deserve the best educational start in life and I strongly believe that we must ensure that they are fully equipped to meet the challenge of the future. This is particularly important for children and young people with special educational needs such as Autistic Spectrum Disorder”.
Does the Minister agree that this is an excellent plan, and would he be able to look at it to see what can be learned from it so that children in England with ASD can benefit from something similar?
The Children’s Plan talks about children in primary schools being given time to learn a modern foreign language. In Wales there are excellent policies for children learning two languages, starting as early as 12 months when babies go to playgroups with their mothers and where play is conducted through the medium of the Welsh language. More often than not the children come from English-speaking homes. Later, children can attend school from the age of three up until secondary school and can be taught in the Welsh language.
If a child is exposed to a second language early in life it is much easier for them to become bilingual, and later it is much easier for them to learn a third and a fourth language. There are so many opportunities in Wales for English-speaking children to learn Welsh. Would the Minister be prepared to consult the education Minister in Wales to look at the tried and tested methods used? They could then be employed to teach foreign languages to English children. As Wales is the only country in the UK to have a bilingual policy, much can be learned from it. This is another example of how we can learn from each other and raise the standards of all our children.
I could give many other examples of how things are done in Wales which would benefit other areas of the UK, and of course the devolved nations can look to examples of good practice in England. But, as I said at the beginning of my speech, we should not say that one part of the UK—in this case England—would be the best place to grow up. Let all the nations in the UK work together, on devolved and non-devolved matters, to learn from each other and to take best practice from wherever it comes. It is achievable, and, in the end, it is all about doing what is best for all our children.
12.50 pm
The Earl of Listowel: My Lords, I, too, warmly welcome the Government’s strategy for children. I am grateful to the noble Baroness, Lady Massey of Darwen, for giving us the opportunity to debate the plan and for all the work that she does for children. Most recently, of course, she reminded us of the importance of the Government’s education maintenance allowance and the difference that that is making to the engagement of looked-after children.
I was delighted to see that the strategy makes a commitment on play, with an investment of £225 million over three years. Many years ago I worked as a children’s play supervisor and I therefore recognise the importance of play. I particularly welcome the emphasis on the children’s workforce and the need to further develop
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In another case, the child’s parent was a milkman. Although I was delighted to take the child ice-skating for the first time, to help him and see him develop, it would have been much better if the father could have been there with his son to see that happen. Again, the more skilled the workforce, the more innovative it can be. Perhaps that milkman would have had time one afternoon to go and enjoy that experience with his son. Those are the sorts of things that I welcome in the proposals.
The proposal on respite care for families with children who have disabilities is extremely welcome. Having spoken to such families I know, and I think we all recognise, how important and welcome this step is. The respite provided to these families will prevent some children having to enter care. The proposal is most warmly welcome.
We must not forget the importance of play in school. The Government will eventually oblige 17 year-olds to stay on in school or training. These children will be far more likely to wish to do so if they are enjoying school. The Nuffield Foundation research to which my noble friend referred has found that the most important issue for children attending school is their relationships with other children. Children value play times because they can be with their friends and develop relationships. It is an important factor, but the length of time allowed for play has been slipping. I hope the Minister will use his influence to encourage schools to protect play times during the school day.
I wish to concentrate on children in care, on a document related to the children’s plan entitled Care Matters: Time to Deliver for Children in Care and on the impact on outcomes for children and young people in public care and on leaving care. The Government are absolutely right to wish to raise our aspirations for these children, to be concerned about our failure to ensure that they do better at school and to be frustrated at the welcome but limited improvement in outcomes for looked-after children despite substantially increased investment. I pay tribute to the Ministers who have taken forward this portfolio while I have been a Member of this House: the noble Lords, Lord Hunt of Kings Heath and Lord Filkin, the noble Baroness, Lady Ashton of Upholland, and now the noble Lord, Lord Adonis. It is a difficult brief—these are challenging children—and the Government deserve commendation for wrestling with the problems, sustaining improvements and seeking better outcomes for them.
I applaud the prioritisation of admissions for looked-after children so that they can enrol in the school best suited to them and not in the least popular school with the only remaining school places. The position of a designated teacher for looked-after children has been placed on a statutory basis. I applaud that as it should help to ensure that this important role is given proper priority and that teachers are equipped to deliver it.
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The new duty on local authorities in the Children and Young Persons Bill to place children locally where that is in the child’s best interests should assist in preventing the disruption of a child’s education, and the new duty on local authorities to provide a range of appropriate placements should help to ensure that that becomes a reality.
However, we must not overlook the trauma that most of these children have experienced. To do so would seriously put at risk the chances of success in these children’s schooling. Sixty per cent of these children arrive in care as a result of abuse and another 10 per cent because of family breakdown. We are right to have the same aspirations for these children as for our own children, but we must not forget—thank heaven—that our children have not experienced the trauma, loss, rejection, broken relationships, abuse of trust, and often violence that many of these children have experienced. For many of these children a close relationship with an adult is a fearful thing. Paradoxically, they will automatically seek to avoid, undermine or destroy such a relationship as much as a part of them is desirous for it. Feelings arising from their past may well turn them inwards, possibly resulting in depression, self-harm and drug or alcohol abuse; or turn them outwards, possibly resulting in verbal or physical attacks on others or on their physical environment.
On Monday, 28 April 2008, evidence was given to the Children, Schools and Families Select Committee in the House of Commons. I should like to quote from the uncorrected transcript of the oral evidence of Dr Rita Harris, clinical director of the child and family department at the Tavistock and Portman NHS Foundation Trust, who said:
“Emotional understanding is central to care, and opportunity alone is not enough. From a mental health point of view, the profound impact of early trauma on children—such as the trauma arising from separation and loss—just cannot be overestimated. We know that people have a built-in propensity to react to new experiences as if they were like previous experiences, and they do not necessarily interpret good intentions in the way in which they were intended. A child may react to very good care by experiencing it as quite damaging and rejecting.
“The profound effect of trauma and loss on children also profoundly affects adults and those who care for them. Children will often identify with their abusers and be physically and verbally abusive to their carers. They can communicate feelings of inadequacy and worthlessness. Carers often end up wondering why they have lost all the confidence that they had gained with their own child to parent a child. Placements often break down because of carers’ feelings of inadequacy and impotence ...
“The last point that I want to make is that the needs of such children are long term. Short and quick measures do not work with these kids; they have needs that last a lifetime ... parenting is a lifelong exercise. Quite often, looked-after children are the most damaged in society. They need long-term services and have long-term needs. They probably do not need to leave home at the age of 18 and have nowhere to go back to”.
We should take from that that there is a need for long-term commitment and the involvement of sophisticated health support agencies, particularly in the area of mental health. It is therefore no surprise that the Office for National Statistics found that 45 per cent of children in foster care and approximately 68 per cent of children in residential care had a mental disorder. Conduct disorder ranked highly among those disorders and can include fire-setting, theft and attacks
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Like those who gave evidence to the Select Committee I pay tribute to the work of the specialist nurses who deal specifically with looked-after children, particularly Miss Kathy Dunnett, whom I have known for some time. She was for seven years a specialist nurse in Hertfordshire and has edited a helpful book entitled Health of Looked After Children and Young People, which I commend to the House.
The Government recognise these children’s need for stability. It is most welcome that they are piloting programmes that allow looked-after children to continue in care to the age of 21 if they so wish. It was encouraging to hear the Minister, Kevin Brennan, at a recent meeting and to learn that he is increasingly of the opinion that all children and young people in foster care should have the choice of staying to the age of 21. That is most welcome. Stable relationships of this kind are exactly what is required to enable a young person to recover from earlier trauma and re-engage with the world, to study, to make loving relationships, and to have the possibility of not repeating the cycle of abuse and the recurrence of that abuse in their relationships with their own children.
However, continuing patchy access to child and adolescent mental health services jeopardises the outcomes that the Minister wishes to deliver. Mental health services are overstretched and CAMHS is a small fish in a large pond as far as mental health is concerned. Looked-after children are a small part of CAMHS’ concerns; they can be at the bottom of the pecking order. Looked-after children have been prioritised in schools by local authorities and this is very welcome. Similar prioritisation needs to be given to them in health. The Government propose to introduce statutory guidance for health authorities. I regret that this is unlikely to be sufficient. A stronger duty is necessary and more effective means of monitoring its implementation need to be made available. Does the Minister recognise these concerns? There need to be more specialised child and adolescent mental health service teams focusing on looked-after children and there needs to be research into their efficacy. Specialist CAMHS are very expensive and need to be evidenced if they are to survive in the long term. Will the Minister consider this particular area?
In the Children and Young Persons Bill my noble friend Lady Meacher has emphasised the need of looked-after children, when they enter care, for improved assessments which look far more effectively at their psychological and mental health needs. I hope the Minister will think further about what she has proposed. On Tuesday I was introduced to four people by the Children’s Bereavement Network.
I think I should stop now—but I look forward to the Minister’s response.
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1.02 pm
Lord Ramsbotham: My Lords, I join those who have congratulated the noble Baroness, Lady Massey, on obtaining this important debate. I also pay tribute to her indefatigable chairmanship of the All-Party Group on Children. She arranges for a remarkable series of subjects to be discussed. They are all relevant and pertinent, and all meetings are chaired with a splendid lightness, as well as seriousness, which is a model of its kind. Like my noble friend Lord Listowel, I pay tribute to the Minister, not least for the courteous and speedy way that he has commented on and responded to all the various points made during proceedings on the recent Children and Young Persons Bill. It is a model of how it might happen and I wish that some of the Minister’s colleagues would learn from him. That remark is, perhaps, not appropriate.
The noble Baroness said in her speech that she was two and three-quarters in favour of the plan. I join her in that. There are tremendous things in the plan as far as intentions are concerned. Like the noble Baroness, it is the implementation that concerns me most. Obviously, the group of children who concern me most are those who end up in the hands of the criminal justice system, not least those in custody. I draw attention to four particular aspects, all of which appear in the plan, and all of which are currently being picked up by good practice somewhere in the system, but none of which are being turned into common practice everywhere. If there is a theme in the implementation of this plan, I hope that it is one of picking up good practice—because all over the place there is good practice by the devoted practitioners to whom attention has already been drawn—and turning it into common practice, from which all can benefit. The “all” is the children of this country and there is no more important group to which we owe a duty of care.
I will refer to the four aspects by the paragraphs in the plan and speak to each in the order in which they appear, not the order of priority. I pick up the first in paragraph 3.61, which says:
“The pilot is aimed at improving ongoing assessment and tracking by teachers, with an offer of one-to-one tuition for pupils”.
It is remarkable, going into young offender institutions and looking at the education achievement or non-achievement of these people, that many of them have dropped out of school and, when you talk to them, are unsure whether the reason was boredom before drugs, or drugs before boredom. The word “boredom” worries me because it suggests that the teachers are not engaging them. You do not engage them by repeating the blackboard-type instruction from which they have walked away.
There is, in Feltham, a remarkable piece of work called the Volunteer Supported Education Scheme, which began in 1992 and has been praised consistently by both prison and education inspectors ever since. The volunteers go in, one-to-one, to these young offenders and achieve remarkable results. For the life of me, I cannot understand why that has not been picked up in every young offender institution in the country. It works, it is cheap and it involves the local community in looking after their own. I have written to Ministers
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Secondly, I come to the problem of communication skills. The failure and inability to communicate is one of the scourges of the 21st century. Children simply cannot do it. In this House I have already drawn attention to this problem, and to a trial funded by the Helen Hamlyn Trust, where speech and language therapists were put into young offender establishments, and which had a remarkable effect. The assessments produced by those speech and language therapists highlighted problems that could be picked up by healthcare, education and behavioural discipline staff. Indeed, one of the hard-bitten disciplinary staff told me that they had been damaging young children in there until they were told that there was another way by the speech and language therapist. The trial finished in 2005, since when there have been three years of inertia. I am glad that John Bercow MP is now conducting an inquiry, and that the work of that trial is being included. I hope he will come out with confirmation of the fact that you find, in young offender establishments, children aged 15 and upwards who are unable to communicate with each other, and tend to conduct relationships with the fist rather than the mouth because they know no other way. Had those children been assessed before they went to primary school, their communication difficulties could have been alerted and resolved, enabling them to communicate with their teachers, and possibly then avoiding their ultimately opting out of school and becoming the truants that cause the problem.
Thirdly, I draw attention to paragraph 3.133, which talks about the achievements of gifted and talented learners. Unsurprisingly, in many young offender establishments you find some very gifted young people who have turned to crime out of frustration because nobody has picked up their talents and run with them. For the past 10 years, Gabbitas has been running a programme called “Tomorrow’s Achievers”. The idea is to identify the talented young and give them master classes that will enable them to maximise their talents. That was put to the Prison Service in 1997, since when absolutely nothing has happened. We are not talking about huge numbers, but if the Prison Service is not prepared to look at the talented and do something for them, that says to me that it is not looking at all the young people in its hands and all their needs and possibilities. This would cost the Government nothing, and it is an example of good practice that needs to be picked up.
Finally, I come to paragraph 6.68, which says:
“The new cross-government responsibilities for youth justice present an opportunity to look at how we might strengthen the approach we are taking to offending”.
I agree. One of the biggest bars to any form of progress with young people at the moment is the institutionalisation conducted in the young offender establishments up and down the country that do not do the job as effectively as possible. One of the reasons for that is that far too many people are being moved around
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There is an opportunity in the pipeline to change all that, by picking up the ideas that have come from an organisation called East Potential in the East End of London, which suggests that a ring could be drawn around an area with about a one-hour radius from the centre, and all children who become involved in the criminal justice system within that radius should all be based on an establishment that would include within its perimeter a foyer, a place for homeless youngsters; a high-level security centre for the small few; and the facilities—the classrooms, the drug treatment centres, the workshops and other places for activity—related to that local area. The ownership of what went on with people in an area would therefore be delegated to the people in that area, which would provide a chance for consistency and continuity so that relationships between the damaged young, the young who are turning down the crime road, could be consistently looked after. They would get to know the people and could build up a relationship that might be the vital thing that kept them on the right road.
That is a splendid development because it has come up from below, from the housing associations in the East End. It has been supported by industries that can see the opportunity for training people to be employed by them. It has come from those involved in education and in drug treatment, who can see that there is continuity in the plan. It has come from social workers, who feel that it is another way of getting over the problems of inconsistency of the treatment of people in care. Here is an opportunity for the new consortium to pick up and pilot something that is designed to eliminate the problems that are created by the current situation.
As I said, I am grateful to the noble Baroness, Lady Massey, for introducing this debate, because it is an opportunity to put before your Lordships the marvellous work behind the things I have talked about, with the hope that they will be picked up and run with.
1.14 pm
Baroness Howe of Idlicote: My Lords, it is a great pleasure—indeed, almost an honour these days—to follow my noble friend Lord Ramsbotham, who is always inspiring in what he has to say on this subject. I add my thanks to the noble Baroness, Lady Massey of Darwen, both for giving us the opportunity to discuss the Children’s Plan and for her brilliant chairmanship of the All-Party Group on Children.
The report outlines a considerable number of changes, some currently subject to legislation but all of which will profoundly affect the childhood of the UK’s rising generation of young children. Like many noble Lords who have spoken, I welcome the report but share their concerns about timing, resources and areas that have not been mentioned, such as the arts—my noble friend Lady Young made an important speech on that—and, perhaps most vital of all, the need to know that the voices of children themselves have been heard on all the proposals in the plan.
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