My Lords, I declare my interests as chair of University College London Hospitals NHS Foundation Trust and of Whittington Health NHS Trust, and as chair of the Schwab & Westheimer Trust, charitable trusts set up to provide education for young asylum seekers.
I am speaking to Amendment 64A. When we last debated age assessments for young asylum seekers, in Committee, it was in the small hours of the morning, and the issues to which we should have given real attention did not get enough scrutiny. The issue had had precious little scrutiny in another place, because these provisions were brought in so late by the Government in the passage of the Bill. I am very grateful to the Government for the amount of information which they have provided recently, but there is still more to tease out. I hope, therefore, that noble Lords will understand why I and my colleagues—the noble Baronesses, Lady Lister and Lady Hamwee, and the right reverend Prelate the Bishop of Durham—are putting forward this detailed amendment at Report. I am grateful to the Refugee and Migrant Children’s Consortium, the Royal College of Paediatrics and Child Health, the British Dental Association, the British Red Cross, the UNHCR, the ADSS, the British Association of Social Workers and many others for their briefings and help.
There is widespread concern about age assessments among all the various voluntary and statutory agencies concerned with young asylum seekers, and among many medical, dental and scientific bodies. Because of the small family charity which I chair, I spend time with asylum-seeking young people who are desperate to get their lives back on track by getting an education. Most of those I meet are older than the children and young people presently under discussion and whose age might be disputed, but by no means all. From what they tell us, I know how traumatised they can be, and have been, not only by their experiences in their home countries and on their incredibly difficult journeys but by the processes they have been forced to go through once they have arrived in the UK, and the way in which they are often not believed—almost as if there is an assumption that they will not be telling the truth.
The fact that they might be asked for consent before they undergo an age- assessment process is neither here nor there. Refusing consent would undoubtedly be a black mark against them in a system which they already perceive as doubting their word. Many of them will not have paper evidence of their date of birth, precisely because of what they have been through. The idea that the Home Office will control these procedures, and insist on them, fills many of us with distinct unease as it almost certainly means that already traumatised young people who have been through terrible experiences to reach the UK will be forced to endure yet more traumatising experiences, possibly including intimate examinations which are hard, if not impossible, to justify.
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The way that Part 4 is framed means that there will be a considerable increase in the numbers of children who undergo traumatic age assessments. It will also undermine the role of local authority social workers as child protection experts, many of whom will already know these children and young people, and give the Government power to force children to undergo these so-called scientific processes that may be inaccurate or harmful, or both.
These amendments attempt to set out what an expert and fair age-assessment process would look like. The principles are clear: age assessments must be undertaken only if there is significant reason to doubt the age of the age-disputed person, unlike what is proposed in Amendment 64. The bar must be set high. It must not be used to intimidate and traumatise already-traumatised young people, and my colleagues will say more about that. Furthermore, the person conducting such age assessments under Clauses 49 or 50 must be a local authority social worker, following the guidance set out by the Association of Directors of Adult Social Services, and not someone appointed by the Home Office, who might seem frightening to the young person. All age assessments must follow that ADASS guidance, or its equivalent in the devolved jurisdictions.
When an age assessment is conducted, the process must allow for an impartial multiagency approach drawing on a range of expertise, including from health professionals, psychologists, teachers, foster parents,
youth workers, advocates, guardians and social workers. These are the people who might reasonably be expected to have some knowledge of the young person and whom that young person will trust, or at least find less intimidating then a stranger appointed by the Home Office—to add to which, these people come from the right groups and professions. Independent professionalism in this area is essential, because only that independence and sense of reasonable trust will remove what young people feel is hostility and doubt towards them, an atmosphere hardly conducive to making them feel welcome in this country.
Most important of all, when making regulations under Clause 51, the Secretary of State must not specify the scientific methods unless she receives written approval from the relevant medical, dental and scientific professional bodies that the method is both ethical and accurate, beyond reasonable doubt, for assessing a person’s age. Clause 51 allows the Government to introduce regulations specifying the scientific methods to be used to assess age, including
“examining or measuring parts of a person’s body”
and
“the analysis of saliva, cell or other samples”
and the DNA within them. These so-called scientific methods to assess age have been the subject of debate for many years; professional medical bodies have been unequivocal in their rejection of the use of dental X-rays, bone age and genital examination, describing them as “extremely imprecise”. The British Dental Association has voiced its opposition to the use of dental X-rays, as they are inaccurate and unethical. Research has shown epigenetics to have the same inaccuracies.
The Royal College of Paediatrics and Child Health does not support its members taking part in such age assessments precisely because the methods are imprecise and can, at best, provide only an estimated range for age. To add to which, as the royal college states, present methods used for bone age X-ray assessments use X-rays taken from average Caucasian children, while many of these young asylum seekers will not be Caucasian in background and may differ considerably in size and development. We need to ensure that any methods used stand up scientifically and have some serious basis of support among the relevant professional bodies. The Council of Europe has highlighted that
“physical and medical age assessment methods are not backed up by empirically sound medical science and that they cannot be assumed to result in a reliable determination of chronological age … several methods have been evidenced to have a harmful impact on … physical and mental health”.
Almost everyone agrees that using radiation for non-clinical purposes is unethical. Indeed, the Care Quality Commission, which regulates everything that goes on in our NHS in this country, argues for justifying each exposure to ensure that the benefit outweighs the risks. I could go on—but we absolutely need to ensure that this is done properly, and we must see this safeguard in the Bill, so that it is clear in primary legislation that any new methods must be formally approved by the relevant professional medical body before being introduced.
We really should not be introducing methods that may add to the pressures on children and young people’s already often fragile mental and physical health.
We already know that the age-assessment process could cause a lot of anxiety to vulnerable children and young people, and have a negative impact. It could prevent them from accessing school or college while the age is disputed, and it could isolate them from peers, preventing them from integrating and accessing educational opportunities.
The consequences of getting this wrong are severe. Recent media reports have highlighted hundreds of children being placed in hotels and forced to share rooms and even beds with adult men they do not know—and this is children we are talking about. Between July and September last year, the Refugee Council assisted more than 150 young people into local authority care who previously had been sent to adult accommodation following a decision by an immigration officer. This is a disgrace. We can do better than this, and we must do so, and this amendment attempts to do just that.