Debate on the Queen's Speech

Speech by Annette Brooke MP on Tue 13th Nov 2007

Annette Brooke (Mid-Dorset and North Poole) (LD): I am pleased to be able to speak in this debate on health and education because I wish to raise specific issues relating to access to health services that are clearly pertinent to the proposed children and young persons Bill.

The first issue is the provision of therapeutic services for all abused children, including children in care. I have tabled amendments to achieve that provision to a series of Bills, starting with the Bill that became the Sexual Offences Act 2003-sadly, unsuccessfully in all cases. I believe that such provision must be made for looked-after children if we are to make a real difference. As an ambassador for the National Society for the Prevention of Cruelty to Children, I agree with the call for comprehensive post-abuse therapeutic provision for children in care, children in custody, children in refuges and children exhibiting sexually harmful behaviour.

Child abuse remains an unacceptably large problem in the UK. A study undertaken by the NSPCC in 2000 showed that 16 per cent. of children had experienced some form of sexual abuse, which may well have been by a parent or other relative. Other forms of abuse-physical and emotional, or neglect-can also have a traumatic impact on children. In 2006, the Department for Education and Skills said that of 60,000 children in care, 63 per cent. were in care because they had experienced some form of abuse or neglect. Of course, in reality the problems are likely to be much more widespread, because of unreported instances or reporting taking place many years after the abuse occurred.

The long-term consequences of child sexual abuse include anxiety and depression, anger and guilt, difficulties functioning at school, poor self-image, and difficulties with personal relationships and parenting. Adults being treated for mental health problems often identify childhood abuse as an influence. Research shows that 25 to 40 per cent. of all alleged sexual abuse involves young perpetrators. The majority of those children and young people have been or are being sexually, physically or emotionally abused themselves. Therapy at an early stage could therefore help to reduce the scale of the problems over time by breaking the cycle.

Therapy can transform children's lives, but provision is inadequate and patchy across the country. Resources to provide a comprehensive service will be a problem, but I want at least a commitment to a strategy to make such services fully available in time. Camila Batmanghelidjh, the founder of Kids Company, has recently pointed out that the amount of money spent on locking up young people, and the generation of more crime with consequent high reoffending rates, could be reduced dramatically if comprehensive therapeutic services were more widely available. The average cost per child of therapeutic counselling is £5,000; the cost of holding a young offender in custody for a year is £30,000 to £40,000. Surely it makes sense to invest in preventive action such as therapy.

A related issue is funding for residential family therapy and family assessments. In an Adjournment debate earlier this year, my hon. Friend the Member for Richmond Park (Susan Kramer) raised the case of the Cassel residential treatment centre, which is the only NHS residential hospital for families in the UK. Its services comprise psychotherapy for the parent and child, as well as specialist nursing input. Families are referred when concerns are raised about a child's welfare. Most referrals arise from a child being the subject of care proceedings, which are, in turn, legally enforced by section 38(6) of the Children Act 1989.

After a 2005 legal case involving Kent county council, which centred on a dispute over whether the council had a legal obligation to fund the treatment of a child at the centre, there are concerns that there is a legal requirement only to fund assessments rather than treatment. It now appears that instead of an attempt being made to treat the family and enable them to overcome problems and become successful, children are simply being removed from the home and put into foster care or adopted. Surely it would be cost-effective to provide preventive services to support families. We must do our best.

Mr. Burrowes: I commend the hon. Lady for highlighting the lack of residential therapeutic places. Is not the same true of drug and alcohol treatment services, where the provision of residential care is minimal, especially for adolescents? There is only one such statutory service in the whole country-Middlegate Lodge-and family services depend wholly on the voluntary sector, which does a fine job but gets limited support from the Government.

Annette Brooke: The hon. Gentleman makes some very relevant points, and if time permitted I would pursue that line of debate.

It is important we get clarification of the judgment in the case involving Kent county council from the Department of Health as soon as possible. It would be wrong to allow family assessments to end.

Children's services have been further affected by a more recent change affecting access to legal aid. Part contributions from the legal aid budget can no longer be put toward residential assessments for families. It has been argued that the new arrangement will ensure that the limited legal aid budget is spent on the legal aid needs of priority clients, rather than diverted into therapeutic services that should be paid for by other public bodies. Where is the joined-up working and thinking? I can see the legal aid argument, but surely money must be provided for residential assessments for families. It has to be cost-effective in the long run to keep a family together, where that is possible and practical.

The forthcoming children and young persons Bill must require joined-up working of services and a culture of "Every Child Matters" and its five outcomes to be embedded within all professions and workers involved with vulnerable young people. Preventive action that should be taken automatically now will save money and heartbreak in the long run.

A constituency case is pertinent to this debate. Living in my constituency are the parents of a young man who has been in prison for 15 years; there is no indication of when he might be released. When he was 14, he committed a minor sexual offence and was, I think, just given a caution. His parents tried to access treatment for him, but he received none. He went on, at the age of 19, to commit an extremely serious offence, which is why he is now in prison with such a sentence hanging over him. I recently visited the local youth offending team and, without any prompting from me, the team identified one of its current problems, which is that when young people are given a caution for sexual offences, the team finds it extremely difficult to get those young people into programmes to tackle their sexual offending. Before my eyes, history was repeating itself.

We need joined-up thinking. The new Department for Children, Schools and Families covers not only schools and children, but young people's health issues and youth justice. All those areas must be brought together when considering the need for therapeutic treatment.