Children and Young Persons Bill [HL]

I wish to speak in support of Amendments Nos. 47 and 24, both of which have my name and that of my noble friend Lady Walmsley attached to them, and also in support of Amendments Nos. 25 and 92, to which our names are not attached. The noble Baroness, Lady Meacher, explained the situation very clearly. The White Paper, Care Matters: Time for Change, stated that the Government would undertake to reissue the guidance promoting the health of looked-after children and place it on a statutory footing for health agencies, but we do not see anything to that effect in the Bill. We on these Benches are particularly concerned about the lack of assessment and treatment for mental health problems, which, as has been explained, we feel are particularly prevalent among looked-after children. Regulations are in place which state that the health assessment should have regard to mental and emotional health, but there is no requirement for assessments in these areas to take place; nor is there is a requirement for assessments of emotional well-being or mental health to be conducted by individuals with training and/or expertise in the fields that they are assessing. Furthermore, there are examples where assessments have not occurred as soon as reasonably possible and where therapeutic care has not been provided due to a breakdown in communication between local authorities and the health agencies concerned. One example has been quoted in the briefings that we received of a foster parent who said in interview: "““[The child] destroys everything in his sight. He self-harms, doesn’t sleep, doesn’t get on with other members of the family, isolates himself, needs 24 hours of supervision, he pulls his hair out, pulls his finger nails off … [the child and adolescent mental health services] won’t work with him as he is not in a permanent placement. They see him to monitor his medication but do no one-to-one work””," with him. Some 90,000 children will pass through the care system in any one year, and there are 60,000 children in care at any one time. Approximately 37,000 of these children are in care explicitly for reasons of abuse and neglect. They will have experienced emotional trauma, often over a sustained period, and it is reasonable to assume that a high number will have had experiences which may impact on their emotional well-being. It is essential that PCTs and CAMHS pull their weight alongside other partners in children’s trusts. Evidence to date suggests that that is not happening, which is why in these various amendments we wish to give some statutory backing to the duties placed on them. Specifically in relation to Amendment No. 47, we note that the forthcoming public service agreements for 2008-11 are consistent in setting out the health and well-being of children and young people as a government and public service priority. In particular, PSA 12, whose aim is to improve the health and well-being of children and young people, is a key area for all children’s trust partners to work towards. PSA 12 is supported by other, equally important PSAs. The aim of PSA 10 is to raise the educational achievement of children and young people; PSA 11 aims to narrow the gap in educational achievement between children from lower-income and disadvantaged backgrounds and their peers; and PSA 18 seeks to promote better health and well-being for all. The NHS operating framework is a vital policy statement in guiding local NHS services in determining their priorities, yet the current guidance does not even mention the needs of looked-after children. That framework will be crucial in delivering the PSAs, as well as the National Service Framework for Children, Young People and Maternity Services and the Every Child Matters agenda. It is therefore imperative that it should be shaped to ensure that children in care have better and priority access to the full range of NHS care and support services, so that those children and young people can overcome the many obstacles in their present and past lives and become well rounded members of our communities.