HL Deb 10 June 2003 vol 649 cc118-22

2.41 p.m.

Baroness Massey of Darwen

asked Her Majesty's Government:

What progress they have made on developing the National Service Framework for Children.

Baroness Andrews

My Lords, the first set of children's national service framework documents was published on 10th April. It includes the standard for hospital services—the first standard of the NSF—which emphasises the importance of shaping hospital services around the child, and an emerging-findings consultation document setting out the direction of travel for the NSF. A draft standard for child protection was included with the documents for consultation.

Baroness Massey of Darwen

My Lords, I thank the Minister for that encouraging reply. Will she expand on it by saying when the rest of the framework will be published and how it will fit into the overall NHS Plan?

Baroness Andrews

Yes, my Lords. The full NSF will be published in 2004. It is the most complex of the national service frameworks. It includes eight working groups covering health and ill-health of children and all aspects of care. More than 300 different stakeholders are involved, and a great deal of hard work has already gone into producing the first standard.

Essentially, the framework offers a new way of looking at not only services, but children, and will mean that NHS and care staff are looking for new ways of approaching their working, and even for new attitudes towards children. It fits into the NHS Plan—it is central to it—and will benefit from other measures such as emergency care and improving patient access, which will also lift the NHS.

Baroness Sharp of Guildford

My Lords, how do these proposals fit in with the Laming conclusions and the establishment of multi-agency children's trusts at local level?

Baroness Andrews

My Lords, it is important that we get all this together and that it is consistent. The NSF has a working party which is looking at vulnerable children. That includes children in care. As regards the Laming report, certain action has already been taken. I refer, for example, to improved guidance. The response to the report will be published soon. We are waiting for that in relation to the Green Paper on children at risk to help inform the NSF. Therefore, it is extremely important that all this works together.

Baroness Masham of Ilton

My Lords, there has been an increase in the incidence of diabetes in children, especially diabetes number two. Will such children fall under the NSF for children, or that for diabetes, or both?

Baroness Andrews

My Lords, the beauty of the NSF for children is that it covers all conditions in all children, including the wellbeing of children. We are therefore looking at healthy children, too. They will certainly fall under the external working group that is looking at ill health in children and also under the diabetes framework.

Baroness Knight of Collingtree

My Lords, can the Minister be clearer about the parameters of the national service framework? She hinted that it involves not just the NHS but many other issues, too. Does not that cross over into education and so forth? Can she be clearer about that?

Baroness Andrews

My Lords, as the framework deals with wellbeing as well as health, it involves the care of children. Of the eight external working groups, some are looking at vulnerable children. That involves children in care and young carers. Obviously, a good deal of work is being done on ways of improving care services to those young people and that means working closely with the Department for Education and Science as well.

Baroness Walmsley

My Lords, how will the framework address the needs of children with disabilities? Will it be focused on the needs of the children or will there be cost constraints?

Baroness Andrews

My Lords, an external working group is dealing with children with disabilities. It has already made its report and it is on the website. That is informing the standard for improvement which will emerge.

Furthermore, the hospital standard, which was published in April, contains a good section on children with disabilities. The particularly impressive aspect of it is that it uses accessible language to express the importance of treating the child as a human being and of treating the whole child. It is also important to involve the parents in becoming the carers and the experts around the child.

Baroness Carnegy of Lour

My Lords, in case other noble Lords are as ignorant as I am, will the Minister tell the House precisely what is wrong with the National Health Service treatment of children that is making this provision necessary? What will the overall cost be and what is currently happening?

Baroness Andrews

My Lords, I do not believe that there is much wrong with the way we are treating children. We have expert and excellent services for children in the NHS, but the national service frameworks enable us to look across the whole provision of care and see how we can improve joint working, co-ordination and processes and investigate the organisation of staffing and the development of staff roles. They enable us to look at improving and raising standards so that they are more effective and coherent.

The Earl of Listowel

My Lords, will the Minister recognise in what she has said that while there are many good services for children there are huge gaps in provision as regards, for instance, children's mental health and the workforce needed to provide that service? Does she agree that the national service framework is an opportunity for us to think more strategically and carefully in the long term about how to ensure that our children receive the vital input from good quality mental health services?

Will she also explain to the House what progress has been made in mapping mental health services for children? Can she confirm that that mapping will be a continuing process so that we can be well advised on the availability of and access to child and adolescent mental health services?

Baroness Andrews

My Lords, the noble Earl put it very well. Of course we can do much better, and mental health services for children is one such area. It is a relatively neglected area, which is why we are investing £250 million in it over the next three years. The crucial issue in improving the service is to improve the manpower. The noble Earl is right in indicating that we need to develop a new approach to planning the workforce. We are mapping mental health services and will continue to do so as part of our national strategy. But we need also to find new ways for staff to work, earlier identification and more effective services. We have set up a group of experts specifically to look at those issues and the practical measures that can be taken in terms of training and recruitment at all levels.

Baroness David

My Lords, how does this National Framework Service for Children fit in with other initiatives which are already under way? The Minister mentioned the Green Paper on children at risk.

Baroness Andrews

My Lords, April 10th was a good day for children and it shows how much we are doing. Apart from the Green Paper, we have all kinds of separate initiatives; for example, Sure Start, a children's taskforce looking at a great deal across health and the action programme on inequalities in health, which is extremely important in terms of improving services for children. Much is therefore happening and I hope that we shall see it all coming together.

Lord Alton of Liverpool

My Lords, during our recent debate on the trafficking of children, the Minister's noble friend admitted that more than 70 children have disappeared from the care of West Sussex social services. Can she tell us any more about the fate of those children? In the national framework, are the Government looking at this most vulnerable group of children to ensure that the existing inadequate provision is not further weakened?

Baroness Andrews

My Lords, I shall have to write to the noble Lord on the follow-up to the trafficking of children. Unaccompanied asylum seeking children will certainly be covered by the external working group that is looking at vulnerable children and children in special circumstances.

Lord Harrison

My Lords, in the light of my noble friend's antepenultimate answer, will she be good enough to say what additional resources and funding will be provided to implement the NSF?

Baroness Andrews

My Lords, I believe that my noble friend is asking about mental health services. If I am wrong, perhaps he will correct me. Yes, additional money is being put into mental health services; £250 million is being provided for child and adolescent mental health services which will be used to develop, for example, early intervention programmes and improved training. We hope that we shall be able to shorten some of the delays that are problematic in terms of the provision of psychiatric services for adolescents.

Lord Pearson of Rannoch

My Lords, is the Minister aware that what she said about the wishes of parents in regard to the education and future of their children being respected will be very welcome to the parents of many mentally handicapped children who find that their wishes are totally overridden by local social services, local authorities and others? Often when parents want special schools for their children they are directed towards mainstream schooling against the wishes of those parents.

Baroness Andrews

My Lords, throughout the NSF great effort is being made to consult children and parents; for example, the National Children's Bureau has set up 14 consultative opportunities to listen to children.