Youth Treatment Centres

HC Deb 24 June 1991 vol 193 cc687-93

Mr. Dennis Skinner (Bolsover)

On a point of order, Mr. Speaker.

Mr. D. N. Campbell-Savours (Workington)

On a point of order, Mr. Speaker.

Mr. Speaker

Order. Let us hear the statement first; then I will call the hon. Members.

3.33 pm

The Secretary of State for Health (Mr. William Waldegrave)

With permission, Mr. Speaker, I should like to make a statement on the result of an independent inquiry into complaints made by a young person about her treatment at the St. Charles youth treatment centre at Brentwood, and about management changes that I am making there today.

St. Charles is one of two Department of Health youth treatment centres. The other is the Glenthorne centre at Erdington, Birmingham. Between them, they cater for up to 70 young people convicted of very grave criminal offences, or with the most serious behavioural difficulties, whose needs cannot be met elsewhere in the child care system.

In January this year, through the formal complaints procedure available to residents in the centres, a young person made serious allegations about her treatment at St. Charles youth treatment centre, Brentwood. On instructions from my hon. Friend the Minister of Health, my Department immediately commissioned an independent professional inquiry convened by Mrs. Marian Preston, a consultant clinical psychologist. I am grateful to Mrs. Preston and to her colleagues for their scrupulous investigation. They found evidence to substantiate three of the complaints—the injection of sedative drugs without consent, and on some occasions under restraint; prolonged, and on some occasions unjustified, use of separation; and exclusion of the young person from proper participation in reviews held about her case at the centre.

A management review of the St. Charles centre by the social services inspectorate, done at the same time as the independent professional inquiry, suggests that the practices about which the independent inquiry expressed concern were not isolated. It suggests also poor management control at the centre and an inadequate discharge of its reporting obligations to my Department.

I have placed summaries of both reports in the Vote Office. Some details are excluded on grounds of medical and personal confidentiality, but the findings and recommendations are given in full.

To check whether those problems were present in the other centre, Glenthorne, which adopts a different treatment approach, I asked the social services inspectorate to scrutinise the relevant aspects of practice at that centre too. The SSI's scrutiny revealed no comparable weaknesses at Glenthorne.

The complaints inquiry team also expressed concern about the extent to which my Department had followed up the findings of an earlier 1988 SSI inspection, published in May 1989. A great many of the SSI's recommendations have been implemented, but I am arranging an urgent review to make sure that the Department acted with proper vigour and judgment.

Responsibility for the two centres is laid clearly by law on the Secretary of State for Health. I much regret that a young person had grounds for serious complaint about her treatment at one of them. I am therefore taking immediate steps to bring this specialised but important area of my responsibilities under better control, and to introduce more reliable and more open scrutiny—and am making this statement so that the House may know of those measures at once.

The House will understand that I needed to act swiftly. Uncertainty or speculation about management change would have undermined control and care, in a facility where continuity in both is imperative. The steps that I am taking are as follows. First, the director of St. Charles centre, his deputy, and another member of staff have today been suspended from their duties on full pay, pending disciplinary investigation. They have been replaced by a new management team seconded from the Glenthorne centre in Birmingham. Their prime task is to ensure the safety and the welfare of the young people.

Secondly, to ensure properly independent and open scrutiny of the care provided in both centres, I am establishing a special advisory group, which will watch over their care practices with particular regard to children's rights. Mrs. Winifred Tumim, until recently chairman of the Independent Living Fund, has agreed to chair the group, and I shall publish its periodic reports.

Thirdly, the investigations reinforce the Government's view, made public last year, that the two centres would benefit from a new and integrated management structure. That will include the appointment of a sole chief professional manager; better arrangements for advising him or her on relevant developments in the main stream of child care in conditions of security; and more explicit and reliable procedures for accountability to my hon. Friend the Minister for Health and me. That new management structure will be introduced from 1 April next year. I shall consult the new advisory group on its details, and will in due course give them to the House.

My first duty is the care of the young people in the centres, but I must consider also those directly responsible for providing that care. Their work is important and often very difficult. They must be given a stable environment in which to absorb those major changes. My hon. Friend the Minister and I therefore decided not to pursue for the time being the idea of amalgamating the two centres at the Birmingham site, even though from April next they will both be part of a unified youth treatment organisation, and both be subject to scrutiny by Mrs. Tumim's group, as soon as its other members are appointed.

I believe that the steps that I have taken represent a decisive response to problems uncovered initially by our own complaints procedure and by reports that the Department itself commissioned. I hope that they will be welcome to the House.

Mr. Jeff Rooker (Birmingham, Perry Barr)

The Secretary of State's statement is wholly welcome. It is crucial that the young people at the centres and the staff who work there—and the families of the young people concerned—are confident that they are properly and effectively managed, and that that responsibility is scrupulously observed.

The 1988 report to which the Secretary of State referred made many criticisms of the St. Charles centre, and the right hon. Gentleman is right to order an urgent review of each and every one of the report's recommendations, to establish what has and what has not been done—and why. We should like it published. If there has been any interference with the implementation of those recommendations, those responsible should be identified.

Clearly, the Secretary of State has confidence in the operation of Glenthorne and the work carried out there, and that is a welcome reassurance for its staff, the young people and their families.

The young person who made the allegations in January has been named in the press, but as the right hon. Gentleman did not name her, I certainly will not. Did she make the allegations while she was still at St. Charles, or after she had gone to Glenthorne? The House would be interested to know whether she had the confidence to use the compliants procedure while she was still at St. Charles. If she had not made the allegations, would there have been an inquiry? Other young people must be involved. We assume that a director and a deputy director would not be suspended because of one individual case—although that may have been so in this case, because the allegations that have been proved were very serious.

We wholly concur with the action that the Secretary of State has announced today. His first decision was clearly required on the basis of what has been made public. His second decision was crucial, as there must be some independent overview of the management of such centres. I use the word "independent"—although the right hon. Gentleman did not use it—because a special advisory group, whose reports will be published, will provide the necessary element of independence, something that hitherto has been missing.

The Secretary of State's third decision was that those centres—which have a combined total population of only 70 young people—should have the same management approach. It is not right that those two centres should operate from a different philosophical standpoint. To outsiders and lay people, it is almost as though the two bunches of experts have been using young people as guinea pigs to find different ways of treatment, whether success or failure. There should be a commonality of overview.

The Secretary of State was right to make his statement, and even more important was the fact that he made it orally to the House.

Mr. Waldegrave

Not for the first time, the hon. Member for Birmingham, Perry Barr (Mr. Rooker) has hit the nail exactly on the head. I am grateful for his welcome for my statement. As I have said, the further reports on whether or not there were failings within my Department involve the protection of individuals in case there are any disciplinary aspects, but they will be published.

I understand that the hon. Gentleman has some knowledge about the Glenthorne unit, and I can confirm that it has not shown any signs of having the same sort of problems. Indeed, the inspectors' report cited examples of outstanding professional practice.

I cannot say that I would be certain that I would be standing here today if that young person had not made her allegations. However, I believe that, in the end, we would have realised that certain questions needed answers. The case is an example of the complaints procedure working. However, I must tell the hon. Gentleman, who makes a fair point—this is reflected in the report—that the young person made her complaints at Glenthorne, not at St. Charles. That raises further questions that need answering.

The hon. Gentleman was right to say that the independent overview would be well conducted by Mrs. Tumim. Those who know her, know her to be a person of independent judgment. Her reports, and those of her board, will be published.

I agree strongly with what the hon. Gentleman said at the end of his questions. We cannot have closed worlds competing with one another with different philosophies. All that should be open to proper review by my Department and by the House. In the phrase of the hon. Gentleman, it is not a proper area for experiments.

Sir Robert McCrindle (Brentwood and Ongar)

While paying tribute to much of the work that has been done at St. Charles over the past 20 years, may I ask my right hon. Friend to accept that I commend and endorse his attitude, as outlined in his statement, and following the independent inquiry? He will be aware that there are some worrying aspects to the matter. Is he satisfied that, following the report, procedures for that most delicate of matters—the use of sedation against the will of the young person, sometimes under restraint—will not allow any repetition of that most disagreeable case at the St. Charles treatment centre?

Can the Secretary of State further confirm that, in future, all those young persons who will be detained at St. Charles will be made aware of their rights in the light of the fact that, it seems to me, the report implies: that the young person who complained was not made aware of her rights during the stay at St. Charles?

Finally to echo the point made by the hon. Member for Birmingham, Perry Barr (Mr. Rooker) will my right hon. Friend confirm that the complaints procedure, no matter what the differences may have been in the past, is now precisely the same as between St. Charles and Glenthorne? It is significant, is it not, that the young person concerned felt unable, for whatever reason, to make that complaint while at St. Charles and, on the face of it, appears to have had to wait for transfer to Glenthorne before making it? Will my right hon. Friend give the House reassurance that, as of this moment and before the very desirable changes that he announced are implemented, there will be equality in terms of the complaints procedure at both St. Charles and Glenthorne?

Mr. Waldegrave

I am very grateful to my hon. Friend, whose constituency includes St. Charles and who has paid close attention to these matters. Much good work has been done at St. Charles over the years. It is because of the prima facie evidence that things have been going wrong recently that I have taken decisive action swiftly today. The allegations are serious. It is also because my hon. Friend asked the question, and because it is clear from the report that we do not believe that the allegations were confined to this isolated case, that I have taken this action.

I am well aware that at St. Charles—I have the material with me—material was handed to the people going to that centre explaining what their rights were. However, it was for the new management there to make absolutely certain not only that the young people there had a formal right to complain but also that they had the capacity to do so and felt free to do so. Clearly they did at Glenthorne; in one sense, that is why I am standing here today.

Mr. Robin Corbett (Birmingham, Erdington)

I thank the Secretary of State for his statement, and also my hon. Friend the Member for Birmingham, Perry Barr (Mr. Rooker) for his response. Can the Secretary of State tell the House when and why the young person who made the complaint that has led to this report was transferred to Glenthorne? As Glenthorne is in my constituency, may I ask the Secretary of State to assure the House that the practice, now properly condemned at St. Charles, has not formed and does not form any part of the regime at Glenthorne?

Will the right hon. Gentleman also undertake that the review at St. Charles—and, indeed, of his Department—will investigate why the reason for this apparent delay in implementing the recommendations of the social servicesinspectorate's report, published in September 1989? Finally, will the Secretary of State join me in paying tribute to the staff at both Glenthorne and St. Charles for their skill and devotion in dealing with some of the most difficult children that we ask others to handle on our behalf?

Mr. Waldegrave

To start at the end of the hon. Gentleman's questions, I join him in paying that tribute. These children are not comparable to those in a normal children's home. I am happy to say that this is a small number out of a population of 56 million. We are talking of between 50 and 70 children, many of whom have committed appalling crimes, while others have very severe behavioural difficulties. These are the most difficult children of all: that is why considerable resources are made available. We are talking about children's centres that cost about £2,000 per week per child. The staff ratio to child is about 3:1. It was the doctrines and the processes of reporting that went wrong.

To answer the hon. Gentleman's question, the person in question was transferred to Glenthorne because Glenthorne has an open unit as well as a closed unit. After discussion with the host local authority, it was thought right that she should be moved, as the next stage in what it is hoped will be her return to normality. That was in December, but it may have been late November, last year.

The hon. Member for Birmingham, Erdington (Mr. Corbett) mentioned unsatisfactory practices. Everything that I am saying is aimed at showing that we believe that Glenthorne rightly retains the confidence of the House, which is why we are transferring a management team from Glenthorne to St. Charles. The strict rules on sedation under restraint and separation, which existed at St. Charles but may not have been fully carried out—thereby hangs the problem—will be observed in future, and everything that I have said today is designed to produce a structure that will ensure no falling off from those standards.

Aspects of the original social services inspectorate report were not carried through properly. The delay and anxiety and the fact that recommendations were not carried through, despite instructions from the Department, have caused us the most concern. We must therefore ensure that communications were correct at both ends of the chain of command.

Mr. Tom Cox (Tooting)

The House will welcome the frankness with which the Secretary of State has made his statement, but he will be aware that the nature of the offences that these youngsters have committed, and, sadly, their personal problems, sometimes mean that, although they are aware of complaints procedures, they do not always follow them. What independent involvement will there be with such homes to ensure that if, sadly, youngsters do not have the confidence to talk to staff, they can build up that confidence with someone independent of those who run the home?

Mr. Waldegrave

To achieve the legitimate objectives that the hon. Gentleman mentioned, we should first look to the original local authority, which stands in loco parentis and has responsibility; secondly, as the report says, we should take steps to ensure that children have an independent visitor or adviser. That is what the hon. Gentleman is recommending, and I agree with him. We must consider that recommendation to ensure that it is effectively carried through.

Mr. Donald Thompson (Calder Valley)

Children from all our constituencies go to these schools and homes, and their parents will be reassured by the common-sense way in which those on the two Front Benches have approached this awful problem.

The hon. Member for Birmingham, Erdington (Mr. Corbett) mentioned the skill and devotion of the schools' staff. Will my right hon. Friend, and my right hon. Friend the Secretary of State for Education and Science, ensure that, in the next 18 months or two years, staff are not destabilised by the necessary physical alterations that have been made by the latest legislation?

Mr. Waldegrave

My hon. Friend makes a sensible point. I have made the statement on the day when we are making the changes to ensure that there is not a long period of speculation and argument, which would be intensely destabilising not only for those involved in this difficult work but, perhaps more important, for the youngsters in their care. That is why we have acted rather swiftly today.

My hon. Friend rightly referred to my right hon. Friend the Secretary of State for Education and Science. These schools are subject to Her Majesty's inspectorate of schools and many of the staff have professional teaching backgrounds. Everything that I have said today and our work in the forthcoming weeks is aimed at maintaining the best possible continuity of care for the children concerned.

Several hon. Members

rose—

Mr. Speaker

Order. This is a narrow statement. I shall call the Liberal Democrats' health spokesman, and then we must move on.

Mr. Charles Kennedy (Ross, Cromarty and Skye)

In echoing the welcome that has been given to the statement by the Secretary of State and the decisions that will follow from it, may I ask him to confirm that the key issue for the new management and the new structure which he envisages will be the effectiveness of the appeal system. Its effectiveness has been greatly bolstered by his statement, but there is still a small question mark—to which the right hon. Gentleman alluded—over the likelihood that an individual will appeal when he is in an institution which he believes treats him extremely unfavourably.

I wish to underscore the welcome that many others have given to the appointment of Mrs. Winifred Tumim. How long will it be before the right hon. Gentleman can say more about the composition of the advisory committee over which he will preside?

Mr. Waldegrave

I shall give the names of the other members of the advisory committee as soon as we have them—perhaps in a written answer, if that is agreeable to the House. I am grateful to the hon. Gentleman for his welcome to Mrs. Winifred Tumim, who is an independently minded person with relevant experience.

The efficacy of the complaints procedure has been demonstrated at Glenthorne, where this story came to light. I hope to be able to say to the House that I am equally confident that the procedure is operating properly at St. Charles. Requirements have been in place at St. Charles. One of the first requirements on the new management there will be to ensure that it is not just an empty right but that it is properly and practically exerciseable.