Medical Examination of Children at Risk (Hansard, 13 January 1988)

§ Mrs. Virginia Bottomley (Surrey, South-West)

I beg to move, That leave be given to bring in a Bill to amend the law relating to child care to enable a social worker or health visitor who believes a child to be at risk to require the parent or guardian to produce the child for medical examination within three days. The intention of the Bill is to fill a gap in the powers available to those charged with the onerous responsibilities of child protection. It is estimated that 150 to 200 children are killed annually by their parents or guardians. There are about 30,000 children on local authority at-risk registers. None of us can fail to experience a strong emotional reaction to such cases. We have seen in recent months many sensational and censorious responses to the reports of physical and sexual child abuse and to cases involving the death of a child.

However, sadly, there is nothing new about child abuse and neglect. We may have updated our way of understanding and describing the syndrome, but descriptions of barbarous treatment are widespread in literature and popular culture, with tales of infanticide, ritual sacrifice, mutilation, flogging and exploitation. Legislation was introduced to protect animals in 1822, but the first children's charter was not introduced until 1889.

Since the 1973 Maria Colwell tragedy, there have been more than 20 similar inquiries into cases of child abuse. Each inquiry is a costly, frequently confrontational and highly charged event in which the social workers are too often treated as whipping boys. We have to find a 'way forward that takes into account the lessons we learn following Mrs. Justice Butler-Sloss's Cleveland inquiry, in which there appears to have been an idiosyncratic, overzealous approach by one group of professionals and parental rights seem to have been disregarded.

We should also learn from the lessons of the harrowing series of tragic individual cases such as Heidi Koseda, Kimberley Carlile, Jasmine Beckford and Tyra Henry, where somehow the child slipped through the net arid where, even in the light of professional or public anxiety, the child was simply not seen and the parents' sensitivities appear to have been given excessive weight and the child's rights disregarded.

Our present child care law, as everyone acknowledges, is untidy and unsatisfactory. The legislation is spread over several Acts and is in need of simplification arid structuring into one new Act. There is widespread support for the simplification and modification set out in the White Paper "The Law on Child Care and Family Services". That major overhaul of child care law is eagerly awaited. It is intended to provide a clearer framework for the provision of child care services to families and for the protection of children at risk. Few hon. Members are aware of the skill required to treat or assess child abuse cases. The task of the social worker, health visitor, general practitioner and others entrusted with child protection is highly skilled and requires careful judgment.

There will have been widespread encouragement obtained from the remarks of my right hon. Friend the Prime Minister yesterday when she referred to such cases which pose sensitive problems to social workers and other people who have to decide when to go into a home because they think that 293 a child is being abused, neglected or ill-treated. It is not an easy question for anyone to answer, but it is supremely important and involves social workers, legislators and neighbours."—[Official Report, 12 January 1988; Vol. 125, c. 142.] Those involved in child protection frequently have to walk a tightrope between building up parental competence and confidence and encouraging parents to succeed in the task of child rearing and, at the same time, not forgetting that their first duty must be the protection of the child rather than the parents.

If there are clear and serious grounds for worry about a child, there are powers available to obtain a place of safety order allowing the child to be removed and detained for 28 days. Section 40 of the Children and Young Persons Act 1933 enables a magistrate to authorise a police constable to enter the premises. What is lacking is a lower order, an order to ensure that a child about whom there is not deep and widespread concern is seen.

It is very easy for parents to say that the child is away or absent. It is not only abusing families who dislike the intervention of health visitors or social workers in their everyday lives. The purpose behind my Bill is to ensure that there is a power to require the parents to produce the child for a medical examination. They escort the child to the medical examination. They are not handing over the parental rights and the child is not removed traumatically from their presence.

In the review of child care law the Government propose a new emergency protection order. This makes up for many of the shortcomings of the place of safety order. The parents have greater say in the procedure and it does not last for such a long time. It is not good enough, however, to argue that this provides the minimal power which would be required to ensure that the child receives a medical assessment with the least possible offence being taken by the parents about interference with what many of us regard as our private business.

I believe that the new minimal power outlined in my Bill will play an integral part, with the many other initiatives and measures that have been developed in recent years. The highly regarded chief inspector of social services at the Department of Health and Social Security, Bill Utting, has tirelessly sought to improve standards of care, emphasising that the first priority must be given to the child, clarifying the powers already available for those involved in child protection. Consideration has been given to better practice guidelines for social workers, nurses and doctors in the clinical diagnosis of sexual abuse and the conduct of child abuse inquiries.

Other Departments are also involved. The Home Office has taken steps to allow children to provide evidence by video link and to remove the need that their evidence should be corroborated. In the education service, there is a greater awareness of the responsibilities of and the contribution that can be made by teachers.

Many of us are looking forward to the implementation of the Bill introduced by my hon. Friend the Member for 294 Westbury (Mr. Walters) to amend the Children and Young Persons Act 1986, which allows greater regulation and control over those who have been sent home on trial from care. Certainly, the Tyra Henry and Jasmine Beckford cases might have benefited from such measures.

In addition, it is important to introduce this new measure. A similar power has been recommended by the commission of inquiry into the death of Kimberley Carlile. The chairman, in his excellent, thoughtful and evenhanded report, argues for a child assessment order. The National Society for the Prevention of Cruelty to Children has endorsed the measure. The National Children's Home has offered its support. The National Children's Bureau, which has given a great deal of thought to the best way of protecting children, welcomes this as a necessary halfway house order.

The fact that the order does not give the local authority the right to remove the child should reassure innocent parents while encouraging social workers to ensure that the child is seen, in the medical sense—the child needs to be seen physically, to be weighed and assessed. Percentile charts need to be consulted to see whether the child is thriving and flourishing.

The Association of Directors of Social Service and the British Association of Social Workers have also welcomed the initiative. Indeed, I have been impressed by what, so far, has been the unanimous support of the groups that I consulted on the Bill in the short time available.

The Bill provides a discreet, specific measure that would improve significantly the powers available to social workers and health visitors, and I believe that it will play an important part in the protection of children at risk while minimising any needless distress for parents, should the concerns about the child's welfare prove groundless. The Bill covers a clear area of need, recognised by last year's White Paper, but not sufficiently met in the proposals for legislation.

If, by some misfortune, the Bill fails to reach the statute book, I hope that my right hon. Friend the Secretary of State for Social Services will find a way to incorporate it in his own proposals for legislation, which I hope will be brought forward at the earliest opportunity.