My Lords, I commend the noble Earl, Lord Listowel, for tabling Amendments 32A and 34A, for the eloquent manner in which he introduced them and for the eloquent examples he gave of some of the existing stresses relating to adoption.
However, I have a question for him. Given the wording of Amendment 32A, which calls on a local authority or an adoption agency designated by a local authority to act, it might be better to tie the National Health Service into this provision because I wonder whether local authorities have the authority or the power to undertake what he is seeking they should do. I would like to see it done but I am not clear in my mind whether this is the best way to do it.
The issue of support once a child is placed in adoption can be crucial as to whether or not that adoption becomes permanent. Often specialist support is needed to care for a child appropriately. This is because, having experienced abuse or neglect, 45% of children in care have a mental health disorder compared with only 10% of the general child population. However, the mental health needs of children in care often go unidentified and there is a subsequent lack of mental health support. The Government urgently need to provide specific measures and greater resources around
mental health assessment and support for the tens of thousands of children entering care, whose welfare must remain a priority concern.
The Department for Education’s document Regionalising Adoption, which I referred to in the debate on the previous group of amendments, stated:
“We still have too few adopters willing and able to adopt harder to place children”.
Harder-to-place children are a particular concern and yet the document does not suggest any solutions for this serious gap in provision. I hope the Minister will be able to say what the Government propose to do in terms of increasing the number of harder-to-place children who find a permanent home. She may well say, “It is out for consultation; let us see”, but this is an urgent matter. The argument advanced by Ministers in terms of the academisation of schools with no day to be lost perhaps applies even more urgently in the case of harder-to-place children.
I am aware that it is only a consultation document but, worryingly, it does not make a single mention of children with mental health problems. In something like—I cannot remember offhand—20 pages there is no mention of that. I wonder whether the Government appreciate the need and fully understand the issue and how it impacts on so many children in care. That is often a significant factor in their being in care in the first place.
The document goes on to say:
“Currently, adoption support services are provided by a mix of local authority provision, the NHS and independent providers”.
But— it was perhaps inevitable that there would be a “but”—
“There are regional gaps, gaps in the types of services on offer, and little evidence of spare capacity”.
We had some gaps a minute ago and here are some more, which are highlighted in the Government’s own document. It is fine to flag them up but we need some suggestion from the Government—the Minister might tell me it is a bit early just now—as to how those gaps are going to be filled because they are pretty glaring and very serious.
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The document’s next section talks about what we want to see and post-adoption resources. That is a point I raised earlier. These are absolutely crucial but the document simply expresses a hope that,
“there would be opportunities to share and develop wider support services, including in partnership with health and independent providers”.
That is just a hope. I am very concerned that there is nothing firmer than that and that the Government even suggest that they are seeking to gain from the consultation something a bit firmer than that. Again, I have to ask whether the department or Ministers actually get the extent of the needs that exist in that area of provision.
Perhaps they should talk to the NSPCC because in its recent research, that organisation highlighted that one-fifth of children referred to local specialist NHS mental health services are rejected for treatment and said that a “time bomb” of serious conditions is being
created by children not getting appropriate early help. Specifically, in six mental health trusts that provided information, it found that one in six children who had problems associated with abuse or neglect were rejected by child and adolescent mental health services.
The NSPCC report, Achieving Emotional Wellbeing for Looked After Children, which I referred to previously, found that spending within numerous local authorities on mental health support for children in care was profoundly disturbing. There was a spending lottery between local authorities in terms of both overall spending and decisions about what to spend on. Some local authorities spent nothing on child and adolescent mental health services specifically for children in care, and one local authority spent nothing at all on those health services, which is shocking.
The mental health of looked-after children was raised in the House of Commons recently and the Government responded with reference to the upcoming guidance promoting the health and well-being of children in care. While welcoming that guidance, the NSPCC takes the view that it falls a long way short of being able to meet the needs of looked-after children. There is currently no entitlement for looked-after children to receive support for their mental health needs once those are identified. That is a major worry.
Of course, resources are an issue. Does the Minister realise that that is an important part of the problem? Does she recognise the implications of stresses—financial and otherwise—on local authorities, which are likely only to get worse as further cuts bite into services? I very much hope that she and the noble Lord, Lord Nash, will be fighting the department’s corner in the spending review to ensure that these children and their families get the support they need.
It is essential that support should be provided as early as possible so that children receive the requisite services that improve their emotional well-being and mental health. If the Government reject the amendment, saying that it is not needed, I will have to ask the Minister why she believes that she knows better than the NSPCC or Barnardo’s, which is also very concerned about this issue. The Government do not have a monopoly on wisdom and they should listen to the experts in the field.
At Second Reading the noble Lord, Lord Nash, referred to concerns raised by noble Lords about mental health issues. But he then referred to the report entitled Future in Mind. I have been doing a bit of reading so I have read that one as well, although I will be honest: I have not read it all; it is 80 pages long. That report does not say anything specific about children in or leaving care. It was published three years ago, in 2012. Chapter six is entitled “Care for the most vulnerable”. It worried me greatly that in five pages there was just one mention of the word “adoption”. Clearly, the adoption of children emerging from care is not being given enough emphasis. I know that a lot of money—more than £1 billion, I think—has been attached to it; I know there is money there for spending, but three years down the line the NSPCC and Barnardo’s are still concerned. They would not be writing to noble Lords—and I am sure Ministers receive those
communications as well—if they felt that things were even moving in the right direction. Those organisations, I regret to say, do not.
As I mentioned in our debate on the previous group—I do not apologise for repeating it—currently, children entering the care system are subject to a routine physical health check but are not automatically given access to a mental health check. I just do not understand how that can be rationalised, far less justified. There is a major gap in post-adoption support for children in care and those emerging from it—and for the families entrusted with their well-being. I invite the Minister to explain what steps she intends to take to ensure that that gap does not remain for much longer.