§ Motion made, and Question proposed,That this House do now adjourn.—[MrLightbown.]
§ The Parliamentary Under-Secretary of State for Health (Mr. John Bowis)
After the overture that we heard this morning from the Church of England and the railways, I should perhaps begin with a quick rendition of "Thomas the Tank Engine", which is the nearest link that I can think of between them and the subject of this debate. After the Thunder and Lightning Polka that you, Madam Speaker, have endured in the past week, perhaps the House can move today to slightly softer music as we consider the children of our nation.
I should like to begin by paying tribute to my predecessor, my hon. Friend the Member for Suffolk, South (Mr. Yeo). As I go round finding my way into the subject of community care and children in particular, I find that he has left behind a reputation for dedication, caring and understanding that will stand me in good stead. We owe him a debt for his work at the Department of Health.
I had two items in my diary last week that, in some ways, sum up this debate. I visited Canterbury, and I took part in a discussion on "Woman's Hour". In their different ways, those two items summed up the good and ugly parameters of this debate on children.
In Canterbury, I visited the Mary Sheridan centre to celebrate 21 years of pioneering partnership between the professions of health and social services and the families of children with multiple disabilities. I heard from parents how alone they had felt when they first realised that their baby was not acting or reacting as other babies—the sadness that comes from the realisation that their child has a debilitating physical, mental, aural or visual condition, and the weariness that they experienced from hours of continuous caring for sometimes messy, unpredictable or unresponsive behaviour.
I saw and heard for myself the progress that those children of 18 months to five years had made, and were making, thanks to the multidisciplinary approach of doctors, nurses, therapists, teachers, social workers and, above all, parents working together with their respective but interdependent skills. That approach is at the heart of our policies. The needs of the individual child were being assessed, barriers between agencies were being broken down, parents were involved at every stage and, whenever possible, children were able to join mainstream schools for at least part of the year ahead.
Children enabled to achieve: that is my ambition, and that, I believe, is the aim of the House and of all those who plan and implement policy in our health service and local government departments.
The "Woman's Hour" discussion was not so happy. We were talking about international adoption rackets. The background was children who are the victims of sordid and squalid organisations and individuals, of pressures on natural parents to give up their child on the false pretences of a semi-legal but immoral trade in young lives. Too often, mothers were being misled into thinking that their children were just being loaned until they could cope better or better afford to have them back. Often, the receiving adoptive parents are not aware of the health background or cultural needs of a child and are unprepared for difficulties, which then become problems.
563 But it is the traders and middle men in these cases who are evil. If the House often shouts about man's inhumanity to man, how much more right it is to cry out against man's inhumanity to a child. That is why the Government have worked so hard to achieve the text of, and signatures to, the Hague convention on inter-country adoption. I hope that, before long, we shall see the nations of the world ratifying and enforcing it.
Justice requires that a child who leaves his parents leaves with their full understanding of the permanent steps that they are taking, and justice requires that such children go with certainty to a good home and adoptive parents who are fit and proper people to take on the responsibility. Children should not be considered for foreign lands unless their own country cannot adequately find a home or a carer. If they are old enough, the child's own wishes must be taken into account.
Those, after all, are two of the key rights of the child in the United Nations convention of 1991. Decisions must be geared, first, to the interests of the child, and the child, whenever possible, must have a right to be heard.
It is on that convention that we base our policies on when and where a child may be locked up, how he or she should be treated in such circumstances, and when a child can or should be separated from his or her parents, which perhaps is the most difficult of all decisions. I shall return to this a little later, but first let me dwell on the health of our children.
There are few better spheres than child health for revealing the progress that the national health service has made in improving the health of the nation. Today, children are living longer, growing taller and catching fewer infectious diseases than ever before. If one is looking for evidence of improved child health, the first and most basic indicator is the figure for infant mortality. For the fifth year running, infant mortality has fallen to a new low for England and Wales.
A century ago, 132 children per 1,000 died before their first birthday. Fifty years ago, the recorded figure was 51, but, during the past 14 years, we have halved the figure, from 13.1 per 1,000 to 6.6 per 1,000. We are well into single figures, which is a tremendous achievement, and to the credit of modern medical science and the teams of doctors, nurses and midwives who make up our health service. Pregnancy, birth and the early months of life are now safer than ever before.
Most recently, we have been able to announce the dramatic success of the Back to Sleep Campaign.
§ Mr. Jeremy Corbyn (Islington, North)
Although everyone is delighted by the rapid reduction in the infant mortality rate figures which, in many cases, meant avoidable deaths, will the Minister reflect on the fact that, in urban constituencies such as mine, the infant mortality rate and the mortality rate before the age of one are considerably higher than in the wealthier suburban or rural parts of the country? Does he think that there is a problem associated with feeding, the health of the parents and the quality of housing, which is reflected in the infant mortality rates?
§ Mr. Bowis
I am sure that the hon. Gentleman is right to say that there are differences between the different parts of the country, and differences in inner-city areas such as those that he and I represent. Some of the differences are the result of people coming to this country from overseas. 564 I am sure that he is right, and we are also right to reflect such concern in the way we allocate resources—whether through the standard spending assessment to deal with a locality's needs or through specific grants that my Department can make. Nevertheless, I think that he will agree that, overall, it is good news that the infant mortality rate is declining.
§ Mr. David Hinchliffe (Wakefield)
One of the things that worry the Opposition is the fact that the decline in the infant mortality rate has been slower in this country than in comparable European countries. Would the Minister care to comment on the fact that Britain now has one of the highest infant mortality rates of any European country?
§ Mr. Bowis
The figures that I am giving show that our success in bringing down the infant mortality rate. As I said, the rate has fallen from 13.1 per 1,000 14 years ago to 6.6 per 1,000. We are not yet satisfied; complacency does not enter our language, but we have nevertheless made remarkable progress, for which we can thank medical science and the people in the health service who care for children.
§ Mr. Peter Bottomley (Eltham)
Analysis will prove that the rate of reduction in this country has been greater than that, in other European countries, and needed to be. The reduction has been greater among the lower socio-economic groups and needs to continue to improve because there is still a discrepancy. We should perhaps concentrate most on the fact that two thirds of the deaths are still among the 10 per cent. of low-birth-weight babies. That reinforces the point made by the hon. Member for Islington, North (Mr. Corbyn)—that we need to go in for various types of pre-conception care.
§ Mr. Bowis
I entirely accept my hon. Friend's point, which serves to reinforce my argument. We are determined to ensure that the progress continues. As I was about to say, one sphere in which progress has been made is that of dealing with the tragedy of cot deaths.
The tragedy of a cot death—the sudden, unexpected, unexplained, death of an infant—has long been a matter of deep concern to us all. Until recently in England and Wales, more than 1,000 infants a year succumbed to cot deaths. In 1991, there was a growing scientific consensus that the sleeping position of an infant was a major risk factor.
An expert group, reporting to the chief medical officer, examined the evidence and advised that infants should not be laid to sleep on their fronts, except in particular circumstances on medical advice, and that the great majority of infants should sleep and be nursed on their backs. A publicity campaign was mounted to put across this advice to families with new babies and, in 1992, there was a reduction of 50 per cent. in the number of sudden infant deaths.
Childhood immunisation and its part in reducing, and sometimes eliminating, a number of terrible diseases, which most of us can remember, is another of the most heartening successes in our preventive health programme. There are now four main programmes. The first deals with diphtheria, tetanus and pertussis—whooping cough—for which the combined vaccine DTP is available. I am pleased to say that cases of whooping cough have decreased by 90 per cent. since the late 1970s.
565 The second programme covers measles, mumps and rubella. The notification of cases of measles has also decreased by more than 90 per cent. since the epidemic years of the mid-1970s. The third deals with polio. For more than a decade, there has been no wild polio virus in the United Kingdom. Fourthly, since October last year, we have had a new vaccine for haemophilus influenzae B, or HIB as it is known, which is the main cause of bacterial meningitis in young children.
The success of our programmes can be attributed in part to the introduction of targets for immunisations in the general practitioners' contract. Childhood diseases have dropped to their lowest ever levels. Indigenous diphteria and neonatal tetanus no longer occur, and measles and whooping cough are now rarities in GPs' surgeries. No child in England and Wales has died from acute measles-related illness in the past four years. We are also close to completing the evidence which will enable the World Health Organisation to declare the United Kingdom free of indigenous polio. They are achievements of which we, our scientists and our practitioners can be proud.
There will, of course, always be children who require hospital treatment. We have sought to ensure that this treatment is of the highest quality and meets the needs of children and their families. In July 1991, we issued a good practice guide entitled "The Welfare of Children and Young People in Hospital", which had been the subject of widespread consultation with the professions and special interest groups. It has been widely welcomed as setting the standards for which health authorities should aim in placing contracts for hospital services for children.
The principles of the guide are that children should be cared for in accommodation separate from that provided for adult patients; that facilities should be provided for parents to remain with their children overnight; and that children have a right to information about their treatment appropriate to their age and understanding.
Health authorities and voluntary organisations have collaborated in implementing these good practices. For example, I recently heard of a patient preparation scheme run at Frimley Park hospital, with the collaboration of the local branch of Action for Sick Children. Children who are to be admitted to hospital are invited to make a preparatory visit with their families on a Saturday morning. They visit the ward to see the beds, lockers and playroom. They are introduced to the medical and nursing staff and are given the opportunity to watch videos and read books on events surrounding the administration of an anaesthetic or an operation.
The staff at the hospital confirm that this reduces the anxiety that the children and parents feel when the admission takes place, and thereby improves the outcome of the treatment. I sincerely hope that other hospitals will follow that fine example.
To put all this into perspective, I am pleased to say that, despite a small decline in the number of children's beds since 1981, the number of child in-patient cases has increased by 60 per cent. This reflects the decreases in the length of time a child needs to remain in hospital, and the increased demand for care created by advances in medical science.
566 Although health is crucial, it is only one dimension. For children to have the overall quality of life we would wish for them, they sometimes need the protection of the law to underpin their rights. In a way, it is sad that the law needs to enter young lives, but over the centuries—it is still true today—evil and injustice, from abuse to exploitation, have been perpetrated against children and, no less true, it has, just as sadly, been perpetrated by them. From legislation, therefore, flow policies and practices that seek to protect, to guide and sometimes to reform, but which always put the interest of the child first.
Since October 1991, we have had, in the shape of the Children Act 1989, the most comprehensive legal framework for the care and upbringing of children in the world. The Act has been hailed as the most significant reform of children's legislation this century, but the mere existence of legislation cannot ensure that children's welfare is promoted and safeguarded. We have therefore fulfilled our promise given during the progress of the Bill that we would monitor closely its day-to-day practice to ensure that Parliament's intentions were being carried out. The first report on the Children Act came to the House in February. It contained a wide-ranging description of how the Act had operated in the first year, and described the progress made by local authorities in implementing the legislation. Practice may not yet have resulted in perfection, but, I am pleased to say, the report shows that practice in the other sense is increasingly reflecting the principles of the Act.
The increased availability of services for children in need is helping families who are experiencing difficulties to stay together. At 31 March 1991, 59,834 children were in the care of local authorities in England. A year later, the number being looked after by local authorities was estimated to have fallen to 55,000, a reduction of about 5,000.
Following the implementation of the Children Act, 2,215 children were subject to emergency protection orders, giving authority for the child to be removed from home. That compares with 4,677 children removed to a place of safety the previous year under the Children and Young Persons Act 1969. Those are clear indications of how new practices and social workers working in co-operation with parents, as the Act intended, can make the system work better.
I am pleased to say that the number of children with a multi-agency child protection plan, and hence on child protection registers, decreased between April 1991 and April 1992 by about 15 per cent. and now stands at 39,000. The tragic cases of children killed or seriously injured by their parents or carers amount to between 50 and 100 a year. Such cases rightly attract our attention and our concern, but they must not be allowed to blot out the enormous amount of good work undertaken successfully day in and day out, and often night in and night out, by professionals who protect and improve the lives of so many vulnerable children.
One problem that we are tackling is that of unallocated cases, which was identified by the second report of the Select Committee on Health. The social services inspectorate has been pursuing that regionally.
§ Mr. Hinchliffe
The Minister will be aware that I was a member of the Select Committee on Health when the inquiry was undertaken. One of the issues that concerned members of the Select Committee of all parties was the 567 major problems faced by certain London boroughs that had difficulties in the allocation of statutory child care cases. They faced discrimination under the standard spending assessment arrangements of the Department of the Environment. That point was made in the report. What action have the Government taken to deal with the problem?
§ Mr. Bowis
The report was studied carefully; that is why the social services inspectorate went in not just to criticise, but to advise. We are seeing progress. As the hon. Gentleman will recall, the inquiry found that there was no problem in 40 per cent. of authorities and that, in the vast majority, fewer than 20 cases were unallocated.
However, I recognise that an unallocated case is a vulnerable case. That is why we are monitoring and advising the very few authorities that appear still to be having problems. I still have concerns, as the hon. Gentleman has, about some cases. However, the number of authorities where there are problems has been falling. Most of the other authorities about which he and the Select Committee were concerned have shown encouraging improvements.
We, of course, recognise the importance of providing adequate financial resources to social services departments for the work that they have to undertake under the Act. In 1993–94, the standard spending on children's services will be 32 per cent. higher than it was 1990–91, which is a real-terms increase of 16 per cent. In addition, we have a specific grant of £5.7 million a year for the guardian ad litem service. We have also set up the family support initiative on which we shall spend up to £1.5 million over three years. Its purpose is to encourge the expansion and development of good practice and policy in the provision of family support services by voluntary organisations.
The voluntary sector work is being supported in a number of ways: the production of training materials, advocacy, advice and counselling, information services and the promotion of inter-agency co-operation. One example is that the National Society for the Prevention of Cruelty to Children is being funded for a prevention of child abuse project in Corwall. It is working with volunteers on a particular estate to promote within the community an awareness of the problem and of the help available.
I hope that that exercise, which could be called childwatch, will spread to other estates where there are perceived to be problems. Everyone, not just the authorities, has a role in the area. The message to people is, "Don't look the other way. Don't pass by on the other side. If you know that there is a problem in your neighbourhood, bring it to the attention of people who can help to sort it out."
I also acknowledge the importance of day care services. We recognise that it is good for pre-school age children to be with other children for some of their waking hours. That enhances the child's development and improves the transition to full-time education. Nine out of 10 children take part in some group activity before they rech compulsory school age. More than 500,000 three and four-year-olds go to play groups. A similar number of children of those ages go to nursery schools or classes, or to the reception class of a primary school.
We have a rich variety of day care services, with important contributions from the private and from the voluntary sectors. That gives parents choice. Since 1988, 568 the number of private and voluntary day nursery cases has doubled. There are now 90,000 places in day nurseries. The number of child minders has grown by 40 per cent., and there are now more than 100,000 child minders with places for 240,000 under-fives.
My Department is building on its experience during the 1980s of running centrally funded initiatives with voluntary organisations to test policy ideas on services for the under-fives. We are spending £1.5 million over three years and in 12 areas for an out-of-school initiative to pump-prime an expansion of day care services for school-age children. In addition, we have a small grants scheme to help existing local schemes to expand and develop. A lot of good work is developing from bringing together the various sectors that look after children under school age and as they get into the school day.
§ Mr. Malcolm Wicks (Croydon, North-West)
The Minister surely does not want to suggest any complacency about the provision for the under-fives. Does he not recognise, as many parents in Croydon recognise, that, when both parents have to work outside the home to pay the mortgage or the rent, it is sometimes impossible to find decent child care for the under-fives? His Department knows of the studies. Does the Minister not recognise that, compared with many progressive European countries, our provision for the under-fives, whether pre-school or child care, is lamentable? It does not match the patterns of how people work and live in Britain in the 1990s.
§ Mr. Bowis
The hon. Gentleman is saying that, increasingly, both partners are choosing to work; that is their choice. If they both choose to work, it is reasonable to expect that they will be able to make a contribution to the support services for their children.
I said that those services are available. The figures show that the voluntary and independent sectors are coming forward with opportunities for such families and I am sure that those opportunities will continue to develop. There will, of course, always be some children in greater need whom the state, and the local authorities in particular, need to support. Overall, the picture is good news and bears comparison with any other progressive country in Europe or elsewhere.
§ Miss Joan Lestor (Eccles)
I am interested in what the Minister says and I do not dispute his claim that there is now a developing variety of voluntary care. Unfortunately, it is very expensive. There is the problem of the women—it is usually a woman, although not always—who is left alone to bring up children for a variety of reasons.
Women on income support find the fees of private day care prohibitive. People can pay £60, £70 or £80 a week for good child care between 8 am and 6 pm, which is what a working mother requires. Those women are forced to stay on income support although they would rather work and would rather that their children had the experience of the pre-school activities that the Minister has rightly highlighted. That is one of the central problems in day care today.
§ Mr. Bowis
The hon. Lady does not need to tell me about the problems of people living in the inner cities. I represent many of those people. I also see the opportunities that are coming for them. As the hon. Lady says, if someone is on income support, it is likely that the 569 facility will be provided. However, the hon. Lady highlights the problem of the jump from being at home on income support to going out to work. One sometimes needs to be able to afford the costs of day care in the interim period. That area is worth looking at. The basics are there, however, and as the hon. Lady generously acknowledges, there is greater choice for parents in general. A safety net exists to help those who really cannot afford provision, and we need to ensure that the ladder from one set of circumstances to the other is adequate.
I am not claiming that all is for the best in the best of all possible worlds. I hope that no one will get that impression just because I have rightly highlighted our successes. None of us can have read the well-documented and publicised stories of revulsion—and, sadly, no one can guarantee that similar events will never happen again. But it is worth reminding the House of the positive steps taken by the Government in the past two years to minimise the possibility of abuse and to enhance the quality and delivery of residential child care.
In his report, "Children in the Public Care", Sir William Utting identified a number of respects in which improvements were necessary. The Government accepted the broad thrust of those recommendations and, with local authorities and other agencies, we have been working hard to implement them.
In December last year, we published the report of the Warner inquiry into the recruitment and selection of staff working in child care. My predecessor, who is now Minister for the Environment and Countryside, took immediate action to ensure that local authorities acted to make necessary improvements in staff selection procedures. From the progress reports we have received, it is clear that most local authorities share our view of the importance of improving procedures.
More recently, we have announced the establishment of a residential child care support force, to be led by Adriane Jones, former director of social services in Birmingham. I announced yesterday the group's terms of reference, on which we are currently consulting the local authorities and others. One of its prime purposes will be to achieve improvements in the quality and delivery of residential child care, as well as ensuring that the necessary personnel procedures are in place.
In considering the problems of residential child care, we must remember that children's homes today care mainly for older, adolescent children, some of whom are disaffected, troubled and troublesome. We must not forget the difficulties that that can cause for the vast majority of committed caring staff. In April, my Department issued new guidance on permissible forms of control in children's residential care.
Any responsible and caring parent would accept that children need the right balance between care and control. That is precisely what the guidance aims to achieve, and we will be monitoring its effectiveness. I emphasise that the guidance is not a charter for excessive and unjustified use of physical restraint. If there is evidence of such restraint, it needs to be stamped out quickly.
The provision of proper care and control as well as education, rehabilitation and training were features of the statement made by my right hon. and learned Friend the 570 then Home Secretary on 2 March, when he announced the Government's proposals for dealing with a small but significant minority of juvenile offenders.
The Government will be announcing further details of those proposal in due course. The House will already have noted one important feature of my right hon. and learned Friend's announcement: the secure training centres for that group of offenders will be subject to inspection by the social services inspectorate.
If we are to deal effectively with that small group of little villains and young thugs and improve the quality of social services generally, we must ensure that social workers receive proper training to equip them for the often difficult tasks that they have to undertake. Both the Utting and the Warner reports made important recommendations about the training of social workers. The report of the review of the Central Council for Education and Training in Social Work was published on Monday.
I yield to no one in my admiration for the vast majority of effective, sensible and dedicated people working in social work up and down the country, but time and again, the message reaches me that we need common sense and not outdated dogma. We need practical, down-to-earth training and not lessons in political correctness. When common sense goes out of the window, something much more dangerous flies in. That must not happen, and I believe that, under the chairmanship of Jeffrey Greenwood, we can be confident that social work will meet the challenge in the best and most effective way possible.
I have highlighted the great progress that we have made. The United Kingdom's record on child care, welfare and health stands comparison with that of any country in the world. I have sought to salute the partnership that has made that possible. However, so long as there is a child in pain or distress, so long as cruelty and crime are done to or by our children, so long as a good record could be a better one, for so long will the Government continue to strive to achieve more for, by, with and from the children of our country and the children of the world.
§ Mr. David Hinchliffe (Wakefield)
I welcome the Minister to his new post. I had intended to do so at Health questions a couple of weeks ago but, unfortunately, he did not answer the question that I expected him to. I wish him well in his work at the Department.
The Labour party welcomes this opportunity to hold a debate on the health and welfare of children. The most telling example of the short-termism—a phrase that we have heard a lot recently—not only of the Government but of Parliament as a whole is the very small amount of time that we devote to discussing the real future of this country, which is dependent on the health and welfare of our children and young people.
Excluding the debates on the Children Act 1989, the number of occasions on which we have debated the welfare of children since I came to this place in 1987 can be counted on the fingers of one hand. That is a disappointing record.
One reason advanced for the lack of debate is that there is a broad political consensus across the parties about child care policy in general. To argue that is to take an extremely narrow view of what is meant by child care. Although there may rightly be some cross-party agreement on the narrow question of legal provision for child protection, 571 there is certainly no consensus on the key political decisions that are urgently needed to bring about a real and fundamental improvement in the health and welfare of our children.
It is simply not good enough to ignore the damage done to millions of children through mass unemployment, homelessness, poor housing and the wider moral bankruptcy of a Government who have presided over Britain's achieving the highest divorce rate in Europe. I am sorry that the Minister made no mention of that deeply worrying factor, which affects many millions of children in our country.
The Labour party believes that one cannot separate the discussion of child protection and children's well-being from an analysis of the wider political issues that have a direct impact on the health and welfare of individual children. During the passage of the Children Act 1989, I pointed out that central to Government policy on child protection was an individual pathology model that largely ignored the wider social and economic context.
The Minister may have emergency protection orders, care and supervision orders and so on coming out of his ears, but until the Government address the social, economic, moral and political issues leading to family breakdown and child abuse, we will not start out on the road to the development of a coherent and meaningful child care policy.
I make those remarks before commenting in detail on the operation of the Children Act, because, far too often in the past five years, debate on child welfare has been bogged down in discussion of the processes of law, and there has been a failure to address the reasons why that legal intervention was necessary in the first place.
When the Minister's predecessor published the first annual review of the Children Act in February, the social work press reported that he was in congratulatory mood. He claimed that the Act had resulted in a marked decline in statutory intervention in child care, which he believed was reason for some satisfaction. Although the main parties both had a strong desire for the Act to work, the implication that the overall well-being of children can be measured by reduced statutory intervention is open to question.
The Opposition certainly hope that the legislation has meant fewer unnecessary placements of children in compulsory care. However, we are seriously concerned that the vital preventive work envisaged in section 17 of the Act has not got off the ground. From talking to a range of agencies concerned with child care, it is apparent that, while local authorities are undertaking their duties under section 47 of the Children Act to investigate concerns about child welfare, the longer-term but crucial preventive steps under section 17 are much less in evidence.
I have no doubt that the crisis orientation of the implementation of the Children Act relates directly to problems of resources at local level rather than to philosophy. The Association of Directors of Social Services, an independent body, told us not long ago that nearly 90 per cent. of social services departments had either standstill budgets or planned cuts in the current financial year.
The Labour party's comprehensive survey earlier this year of local authority social services budgets found clear evidence of the provision for children at local level being raided to fund the implementation of the community care changes that have taken place since 1 April.
§ Mr. Corbyn
My hon. Friend will recalll that, in answer to an earlier intervention, the Minister said that standard spending assessments reflected the needs of inner-urban areas and particularly the deprived state of children's care in many inner-urban areas. Does not my hon. Friend agree that inner-urban areas such as those that we represent have fared extremely badly in relation to SSAs? All our social services departments are being cut, budgets are being raided to fund other things, and the children of the poorest inner-city communities are losing most under this Government.
§ Mr. Hinchliffe
My hon. Friend is absolutely correct. His authority, like mine, has been hammered in relation to SSAs in recent years. Over the past two years in my area, there has been a £3 million discrepancy between SSAs and actual spending needs for meeting statutory obligations. If my authority had decided to go along with the Government's advised level of expenditure, it could not have met its legal obligations under child care legislation.
Although the Minister has not had a great deal of time to master his brief, it annoys me that he repeats the same old nonsense that his predecessor talked about SSAs rising. He should consider the reality of actual spending, because there is a huge difference between SSAs and actual spending.
My point about the inner-London boroughs was not answered. The Select Committee on Health recognised a huge discrepancy between the asessment arrangements for inner-London boroughs and those for other areas. The hon. Member for Chislehurst (Mr. Sims), who is present today, is a member of that Select Committee, and he heard the evidence. Many of the inner-London boroughs were discriminated against quite blatantly by the Department of the Environment.
§ Mr. Bowis
In that case, no doubt the hon. Gentleman studied the differences between the efficient inner-London boroughs and the inefficient ones. It is not simply a question of throwing cash into the local government pot; it is question of the efficient use of resources. That is why some London boroughs, which I do not need name and which receive less money from central Government, manage to provide better-quality services than others which receive twice as much.
Does the hon. Gentleman accept that some local authorities make a sensible use of charging to top up what they can spend on services while some fail to do that? Does he also accept that the money that he refers to as being taken to fund community care changes has been ring-fenced with £565 million—£140 million more than was strictly speaking necessary under the social security arrangements? There should not be the difficulties that the hon. Gentleman has described. He should look into his own backyard.
§ Mr. Hinchliffe
I am very familiar with my own backyard. I happen to have the good fortune of a very well-run social services department in my constituency. I have no doubt whatsoever that it is efficient, and that it is using the local ratepayers' money effectively and well.
As a Yorkshireman, and having read the stories in the media about London boroughs, I sat on the Select Committee inquiry with great interest. I found that, far from it being simple inefficiency, the explanation was much more complex. Problems of unallocated child care cases related to the blatant discrimination, clearly for political 573 reasons, against certain London boroughs. Everyone who sat on that inquiry must have reached that conclusion. That was the conclusion of that Select Committee, which had a Conservative majority.
The Minister should address those issues. We must stop talking about SSAs and talk about actual spending and the resources available to local authorities for child care and community care purposes. As the Minister travels around the country, I hope that he will listen to people from a variety of political backgrounds.
I have spoken to Conservatives who are deeply worried about the under-investment in local authority social services. The Minister should speak to people in his own party, when he will realise that I am making not a partisan point, but an objective one, which is supported by plenty of independent evidence.
From discussions that I have had with people across the country, I am aware that there is great concern about the new duty on social services under section 20 of the Children Act 1989 to house children in need who have reached the age of 16. That duty is simply not being implemented across the country in accordance with the original intention of the legislation.
The Minister will be aware that section 20 has particular relevance to meeting the needs of those leaving care. However, it is apparent from evidence in a range of reports that that particularly vulnerable group is obviously far too often falling through the safety net envisaged by the Act.
Many hon. Members will have had experience of dealing with homeless young people who were often previously in care. They will share my concern that, far too often, those young people are turned away by social services and housing departments, which rightly argue that they have insufficient resources to implement the Children Act and to fulfil their responsibilities.
That group suffers the additional disadvantage of being ineligible for income support. As the Minister is aware, the result is that many youngsters are needlessly at risk and out on the streets.
Several organisations are looking to a judicial interpretation of the Act's provisions. However, the Government must address, as a matter of urgency, the apparent inconsistency in the application of section 20, and must deal with the reasons why many local authorities clearly feel unable to fulfil their duties.
There has also been confusion over the Act's provisions in respect of the control of children in care. Alongside inquiries into the misuse of control in care settings, the intention of the Children Act was to protect youngsters from such abuse. However, although guidance subsequently issued by the Department of Health told residential staff what they could not do in terms of control, it gave them very little advice on possible action that might be taken.
The advice offered more recently by the Department of Health, to which the Minister referred, attempts to respond to concerns arising since the implementation of the Act. However, the real problem lies with residential care provision itself and not simply with control. We have 574 landed under-resourced, often under-trained and under-paid staff with the frankly impossible task of trying to deal with levels of behavioural difficulty which, in the past, would never have been seen in that environment.
The philosophy of the Children Act was right. However, with regard to children in trouble, the confused messages on control issues emanating from the Department of Health have added to the difficulties arising at local level with the implementation of the Criminal Justice Act 1991. I have lost track of the number of social services managers who have asked me whether, in implementing the Children Act and the Criminal Justice Act, the Department of Health and the Home Office are aware of each other's existence.
There is a real concern that the lack of a coherent approach at national level to provision for children in trouble is leading to the introduction of a less than properly thought-out proposal for new-style approved schools—I can find no other phrase to describe what the Government have proposed. I urge the Minister to consider what happened when the Government were panicked into ill-thought-out political gestures as an answer to youth crime.
The Minister is aware that I have a little experience in this area, as I worked for many years directly with young offenders. In addition, one of Lord Whitelaw's experimental short, sharp shock centres, which were such a disaster, was situated in my constituency.
I do not underestimate the scale of the task entailed in drawing together a meaningful policy on children in trouble and on child protection. I have spent much of the past 11 months that I have been on the Opposition Front Bench in dialogue with a series of organisations that are concerned about children and young people. They often offered very differing views on what we should do and on the way ahead.
The Labour party will publish a detailed policy discussion document later in the summer. Central to our thinking on the issue will be the need to establish a coherent national political strategy for children—which, frankly, does not exist at the moment under this Government. Not only do we not have a national strategy at the moment, but it is absolutely clear that there are blatant ideological differences within the Government between those drafting laws for education, criminal justice and asylum arrangements for refugees and those concerned with the Children Act. We recognise that if there are different goals and messages at national level, it will not augur well for the implementation of such measures locally.
§ Mr. Bowis
Does the hon. Gentleman accept that the Children Act is very much a guideline and a policy for children? It is a framework or a structure on which we can build. It is not set in historical concrete: it is something that we can continue to advance and amend to meet the relevant case.
Does he accept also that one of the ways in which we can provide better care of children is the care of offenders? Does he accept that there is a small but significant group of persistent young offenders for whom everything has been tried, and that the only answer to protect society as a whole is to take them out of circulation for a period? What one does with them, we can discuss.
§ Mr. Hinchliffe
The Opposition have made absolutely clear our belief in the need to protect the public. However, having worked for much of my life dealing with youngsters who have offended, I find it very worrying that the Minister bandies about the term "little villains and young thugs". If he cares to look at the backgrounds of many of those youngsters, he will see that there are reasons why we end up with what he terms villains and young thugs.
The sad fact is that the Government seem to be prepared to opt for a philosophy of locking up youngsters rather than remembering that every piece of evidence gained from research on locking up youngsters is that, when they come out, they are far worse than when they went in.
My central point is that we need a coherent national strategy that considers why youngsters become, as the Minister puts it, little villains and young thugs. There are very clear reasons. The Government are not seriously addressing that matter, and it is on that point that our parties differ markedly.
Over the past few years, we have seen markedly different approaches in different Government legislation. It is astonishing, for example, how little thought has been given to the fairly obvious impact of local management of schools and grant-maintained status on child protection arrangements at local level.
It is deeply worrying how little thought has been given to the possible consequences of the advent of the purchaser-provider splits in health and in some aspects of children's provision on child protection. To me, it is a matter of great concern that the Government have done absolutely nothing to monitor the impact of those changes on child protection.
I give notice to the Minister, so that he can prepare his brief, that, in a couple of weeks, we will publish a report on a survey that demonstrates great concern across the nation about just those points.
§ Mr. Hinchliffe
I do not wish to hold a press conference this morning, but the Minister will be welcome to attend our press conference. I assure him that every reply 'to the letter gives our party reason for great anxiety about the manner in which the changes have been brought forward, and in particular about the fact that the Government have done very little at local level to monitor the impact of those changes on child protection. I will certainly ensure that the hon. Gentleman receives a copy of the detailed analysis of our survey when it is published in a couple of weeks.
The Minister will be aware that central to the United Nations convention on the rights of the child was article 12, on the child's right to be heard. Implementation of the 1989 Act, shortly before ratification of the convention by the United Kingdom, set in motion machinery for ensuring that the child's voice is heard in a way that it has not been heard in the past.
It has been particularly interesting to see how certain sections of the media have sought to sensationalise the issue, with bizarre stories of children allegedly divorcing their parents for a variety of spurious reasons. How sad it is that there has been much less media interest in 576 highlighting the permanent damage that has been done to a significant number of individuals within the care system and elsewhere because, in the past, our laws have denied children and young people the right to be heard—the right to speak out against the way in which they were being treated.
It is fairly common knowledge that a significant number of legal actions by individuals who were damaged and abused as children, often within the care system, are currently in the pipeline. It is particularly worrying that many of those people, whose lives have been totally ruined by what has happened to them, fail in their entirely legitimate actions because the Limitation Act 1980 does not take account of their circumstances. I have received several representations on the issue and I hope shortly to introduce a Bill that will amend the limitation legislation to take account of such circumstances, which, when it was drafted, it certainly did not anticipate.
I hope that the Minister—this is a non-political, non-party point—will look seriously at the Government's taking that amendment on board. If it remains in place, vast numbers of young people who have been abused within the system will be disadvantaged as a direct result.
The Minister talked in detail about inter-country adoptions. I look to him to make a breakthrough in respect of the concerns of many thousands of people who were child migrants from this country. I am sure that he will be aware of this very sensitive issue. I knew nothing about this issue; it was a great surprise to me, having worked in social work, but last year, I met a woman who visited this country with the Australian rugby league team, and she told me in detail about her father's experience as a child migrant dispatched from Britain.
I am aware that the Government are being asked to assist many people who have been grossly damaged by the experience. I am not making a party point, because it happened under successive Governments of different parties. However, I hope that the Minister will respond and ensure that resources are made available to counsel some of the people who have suffered from experiences as child migrants.
I hope that the Minister will also address the concerns of people who consider that the Children Act, does little to secure a voice for the child or the young person when he or she is assessed as in need of services, and the local authority concerned cannot provide those services because of reductions in its budget.
I cannot overstate the concern that is expressed to me every week—I have heard the point several times this morning—that local authorities controlled by various political parties are deeply worried about the desperately difficult financial times they presently face in attempting to implement the variety of legislation introduced by the Government.
I remind the Minister that we need to address the inability of some authorities to meet their statutory obligations. Many authorities—for example, the London authorities to which I have referred—consider that their allocation from the Government does not reflect their needs. Objective analysis of the kind that was undertaken by the Health Select Committee clearly proves that point.
It is because of the lack of a voice for the child, despite the Children Act, and the Government's unwillingness to face up to the reasons for the denial of services in some areas that there is understandably such widespread support for the creation of an independent children's 577 rights commissioner to promote the rights and interests of children and young people. I am sorry that the Minister did not refer to that matter in his lengthy speech.
I recall very vividly, when the United Nations convention was ratified by the United Kingdom Government in 1991, the comments of John Rae Price, the director of the National Children's Bureau at the time:unless the underlying causes of poverty, alienation and inequality are tackled, ratification of the Convention will be but a token gesture".No one doubts the contribution of the Children Act in enabling significant improvements in the operation of the law relating to children, but its use often arises directly because of the consequences of that poverty, alienation and inequality that were referred to by Mr. Rae Price.
The Government have not only failed to tackle those problems, but have adopted policies that are clearly worsening them. In the 13 years since the Black report on inequalities in health was published, with key pointers to the improvement of the health of our children, we have had a Government who have chosen not only to disregard that report's widely supported conclusions but positively and deliberately to depart in completely the opposite direction.
For the past 14 years, we have had a Government who have regarded the inequalities identified by Black as not only inevitable but an essential motivating factor towards individual success. Their political philosophy has not only necessitated ignoring Black, but required burying the lessons of history. Even the most dogmatic of free marketeers—one or two are present—cannot deny the crucial role of collectivism and the state at national and local level in the dramatic improvements in child health and welfare over the past 150 years—for example, in the key public health measures of the last century, the development of council housing and a system of income maintenance and social security.
Clearly, rolling back the frontiers of the state and deregulation mean reducing the ability of our society to tackle the blatant inequalities of health that are most definitely still with us 13 years after the Black report.
We know that the decline in infant mortality rates has been much slower over the past decade than in previous ones. It may well be harder to reduce mortality rates beyond a particular level. Earlier, I said that it is especially worrying that the rates have declined more slowly in Britain than in other comparable countries, and we now have one of the highest rates in Europe.
The clear correlation between low birth weight, death in infancy and various measurements of social deprivation has been illustrated frequently, not least by various reports of Select Committees. While infant mortality has decreased, there has been much less of an improvement in the socio-economic related causes of death. The National Audit Office reported on maternity services in 1990 and pointed out:above-average perinatal mortality rates are likely to be associated with above average levels of social, economic and housing deprivation.The conclusions of that report were endorsed by the subsequent maternity services report of the Select Committee on Health, which was initiated largely by my hon. Friend the Member for Preston (Mrs. Wise)—she is in her place today. She will have noted, as I did, that the 578 recent survey by the British Association of Perinatal Medicine, which was published on 9 June, showed that more than 1,000 new-born babies die each year due to a lack of basic equipment and inadequate staffing in NHS neonatal units.
In that maternity inquiry, I recall, as will my hon. Friend, taking evidence on the importance of the school health service and the provision of good-quality school meals not simply for the health of the children concerned directly but for the health of the babies that they would subsequently have. I also recall the unanimous concern of witnesses about the need to take drastic action to reduce smoking among parents, which retards foetal and infant development, and children in later life.
The Government's response to the vitally important conclusions of that report are well know—they removed the Chairman of the Committee. He and other members of the Committee had been faced with the fact that there is an obvious connection between social deprivation and poor health, which the Government are simply refusing to address in various policy documents, including "The Health of the Nation". That connection has arisen through the lack of an adequate and nutritionally balanced diet.
Both the National Children's Home and the Family Welfare Association have shown how so many low-income families simply cannot afford nutritionally healthy diets. The annual NCH fact file, which is a fairly objective view of the status and care of children in our society, said:
We must add to that the misery that is endured by millions of people who are homeless or poorly housed because the Government have abdicated their responsibility to house them adequately. We can see exactly how much Britain's ratification of the United Nations convention has meant.
- "1. Every day in this country, at least 9,000 children in families on income support go hungry.
- 2. At least a further 9,000 parents and families on income support will go hungry to feed their children.
- 3. Every day, the children of 553,000 families living on income support will not eat a good enough diet.
- 4. Every day, more than 3 million children will be living in poor families, unable to afford items that a majority of people regard as a necessity."
The Secretary of State for Social Security talked only this week about poor people making second-rate efforts because of the universality of state benefits, which he intends to cut. Every day, in my constituency and elsewhere, I see poor mothers and fathers struggling to survive and give their children a chance in life. They are kicked in the teeth almost daily by the Government, who treat poorer people with total and utter contempt.
The Secretary of State may well cut even further the pittance that they are allowed on which to exist. Let him not forget that, just as the mass unemployment created by the Government is directly responsible for the increase in public expenditure, so he should not be in the least surprised when his benefit savings have the knock-on effect of requiring additional subsequent expenditure on health care, child protection measures, provisions for young offenders and an expanded prison system.
I have spoken at length—longer than I intended—about my party's concern about the implications for our children and young persons of a lack of any form of political strategy to address their needs. I should like to have said much more on the measures that might be taken in the short term to have an immediate impact on child 579 welfare, especially the reform of our adoption and divorce laws. My party believes that reform of those laws is long overdue.
Some time ago, we had a debate on the adoption law review proposals, when I made clear the views of my party. I know that my legal colleagues on the Opposition Front Bench have set out their thoughts on the Law Commission's proposals for divorce law reform. I endorse the need to take urgent steps to protect the interests of those 150,000 children under the age of 16 who are caught up in divorce every year.
It is absolutely vital that couples are given time to reflect on the breakdown of their relationship and access to the counselling and mediation services that are necessary to help them and their children. Great Britain now has the highest divorce rate in Europe—one in every 2.3 marriages breaks down. Whatever our politics, we should all be deeply worried about that fact. I can point to the economic and social reasons that sometimes contribute to marital breakdown, but there are deep moral questions about the overall direction of our country which also have a direct bearing on family breakdown.
When it comes to partnership—marriage in the family—which is the starting point for all our children, Conservative Members seem to say one thing and frequently do another. They say one thing about personal morality of the individual and often do something different, as we have seen yet again this week.
When the moral direction of the Conservative Government for the past 14 years has been one of active encouragement of personal selfishness, opting out and looking after number one, is it any wonder that we see the values needed to underpin personal relationships and family life disappearing, and family breakdown on an unprecedented scale? Is it any surprise? When will the Minister see a clear connection between the moral direction pursued by the Government and the lead that they have given to the nation, and the social consequences that we see locally in our daily lives?
We need nothing less than a whole new agenda for children. The starting point must be no longer regarding social inequality as a positive virtue. In policy terms, that means positive discrimination towards the poorest in our income tax and benefit systems, and moving in precisely the opposite direction to the present strategy. It means fundamentally reviewing our moral attitudes and values, and moving from the opt-out, look-after-number-one view of life to a renewal of societal concern for the less well-off, beyond the occasional rattling of tins and personal consciences.
It means rejecting the idea that mass unemployment is a price worth paying and an economic regulator to be switched on when required, regardless of the human consequences. It means listening to the message in the Black report on the abolition of child poverty, the provision of school milk and nutritious school meals, investment in day care, ante-natal facilities and local authority housing. It means recognising that society's main tool for the achievement of such ends must be positive and substantial Government intervention.
It means developing a health climate that is aimed at evaluating inequalities and a health service that positively discriminates towards areas of deprivation. Above all, it means recognising the importance and value of our children, in a way that is certainly not happening at present under this Government.
§ Mr. David Evans (Welwyn Hatfield)
I welcome my hon. Friend the Minister to the Dispatch Box and wish him every success in his new job.
This debate goes to the heart of the problem that we have with the most crucial aspect of our lives—the health and welfare of our children. When I was young, I was brought up to fear three things—almighty God, my father and the village policeman. Children need to be guided by a firm but sure hand. Instead, they are confused by a hesitant and soft system that is filled with fairy tale theories and seriously lacking in common sense. By deliberately shedding the vital ingredients of discipline, authority and supervision, we have been left with a system that threatens and damages the health and welfare of our children.
The Government can be proud of their record on health. Infant mortality has fallen by 40 per cent. since 1979. The rate of immunisation of children is at record levels: 95 per cent. of children receive diphtheria, tetanus and polio immunisation; 92 per cent. of children have received whooping cough immunisation; 93 per cent. of children have received measles, mumps and rubella immunisation. Expenditure on vaccines for immunisation of children is estimated at £40 million per annum, with 650,000 children being immunised every year. The number of cot deaths or sudden infant deaths fell in the first nine months of 1992 by more than 55 per cent. compared with 1991. So we Conservatives have more than kept our promises on the health of our children.
Today, I wish to concentrate on the welfare of those who most need our Conservative principles. The focus must be on those whom I call latchkey kids. Unfortunately, many children are allowed to run riot. People scratch their heads in disbelief and ask why that occurs. I am sorry to say that it occurs simply because we have allowed it to occur. We have created little monsters and pint-sized Rambos. To whom should we apportion the heaviest blame for this sickening state of affairs?
I blame the parents who do not give a damn about their kids and let them run wild. I also blame the socialist do-gooders on the Opposition Benches for their politically correct baloney, which tells us that it is wrong for a child to experience discipline and authority.
§ Mr. Corbyn
The hon. Gentleman referred to pint-sized Rambos. Does he believe that there is any connection between violence among young people and the violence that they experience in society through what they see on television, the war games that they are taught and the war toys and video games that are pushed on them? Does he not think for a moment that there is some connection between the continual intake of violent images and the violence that is later exhibited by them as young people?
§ Mr. Evans
It is not often that I agree with the hon. Gentleman, but in this instance I agree with him entirely. [Laughter.] It may come as some surprise to the hon. Gentleman that we agree. I shall deal later in my speech with the point that he raised.
I blame the socialist do-gooders on the Opposition Benches. [Interruption.]I have said that already and I say it again. The hopeless, has-been hippies have created a system in which some children have no rules and responsibilities. It is no wonder that so many children are going off the tracks.
581 Also, society has undermined the authority of the police. I give one example. For a minor offence, a policeman has to fill in 47 forms. For a more serious offence, he has to fill in 119 forms. It takes two hours to fill in 47 forms. So, for four minor offences, a policeman spends the following day in the police station filling in forms rather than outside on the beat where we want him. That is one way in which we have undermined police authority.
The problem is clear. We face a breakdown of discipline in society. It stretches from the home to the school and to the world at large. Too many parents pay too little attention to the upbringing of their children. As a result, my constituents tell me that they are scared to go out at night for fear of being mugged, raped or robbed. They are fightened to leave their homes unguarded. That happens because the parents of little hooligans—that is what they are—could not care less where their children are, what they are doing or who they are mixing with. I am not alone in that view. It is shared by the vast majority of the British people.
A Home Office research paper found that in the past 20 years some 70 to 90 per cent. of respondents in a succession of surveys identified lack of discipline by parents as a major cause of juvenile crime. These negligent parents are completely irresponsible. They allow their children to watch all kinds of filth and violence on the television and on video. The dark influences of the visual media have had a disturbing effect on those youngsters who are not lucky enough to receive firm parental guidance.
§ Mrs. Audrey Wise (Preston)
I agree with the hon. Gentleman's analysis about filth on the television; it is not suitable for people of any age. Does the hon. Gentleman accept that the fundamental purpose of the production of most of that filth is making private profit? Do not his Government deplore any interference with such an objective?
§ Mr. Evans
The Conservative party believes in free enterprise and free choice, but I agree with the hon. Lady that the material that we see on our televisions gives great cause for anxiety. I am sure that hon. Members on both sides of the House feel exactly the same as I do and that the matter will be discussed at some length at another time in this place.
Where else do youngsters get the idea of maiming toddlers? Where do youths get the idea that wielding a gun or knife is glamorous? Too often, violence is depicted without the moral standpoint. Worse still, the homicidal maniac is idolised.
We have also heard recent reports about computer porn. Children spend much of their time in the evenings in their bedroom playing violent computer games or watching computer porn while their parents are downstairs oblivious to the world of their child because they never set foot in the child's bedroom. They never talk to their children. They never take any interest in them, pay any attention to them or exercise any supervision of them.
Children need to be protected from harmful influences. That requires the participation and authority of parents. Sadly, many parents prefer to neglect their responsibilities and leave their children to their own devices for long periods. When those neglected children inevitably go off 582 the rails, their parents feel aggrieved that they are asked to come to the school or police station to pick up their child. They shrug their shoulders and tell the authorities, "He is not my problem. Why don't you do something about him?"
It is a sad world when thousands of married couples would give all their time and money to love and care for a child while many people lucky enough to have children show no love or responsibility for them. The politically correct cuckoo brigade on the Opposition Benches would recommend a jolly good lecture to negligent parents, highlighting the need to show more affection to their children.
§ Mr. Hinchliffe
I am listening carefully. Undoubtedly, the hon. Gentleman will achieve his objective of a line inThe Suntomorrow morning. I make a serious point.
§ Mr. Hinchliffe
It is a cheap speech. Does the hon. Gentleman think that there might just be a connection between the example that we have had from Ministers this very week and the moral direction in which society as a whole is going? This week is not an exception. We seem to get it virtually every week from the very top of the Government. Does the hon. Gentleman see a connection or is he completely oblivious to the common ground between the behaviour of the Government and behaviour at grass-roots level?
§ Mr. Evans
More than that.
Highlighting the need for parents to show more affection to their children does not work and will not work. I recommend a bloody good kick up the backside. If parents will not show a natural interest in their kids, it is up to the Government to make the parents of persistent young offenders more responsible. Perhaps their child benefit should be suspended as and when their child is convicted. Failing that, perhaps those parents should face a custodial sentence. That would give them some future incentive to show some responsibility for their offspring. Children need role models and they need to respect authority. Sadly, the pathetic behaviour of negligent parents leaves many children with no role model and no respect for or deference to authority.
The problem of negligent parents has a knock-on effect in schools. Lord Elton, in his report on discipline for the Department for Education, noted that he wasaware of research findings which link anti-social and aggressive behaviour in school to the quality of the child's upbringing and family relationship".
§ Mrs. Llin Golding (Newcastle-under-Lyme)
Can the hon. Gentleman tell why it is mostly boys and men who commit crimes? Does he believe that that is connected with the role model of the father?
§ Mr. Evans
I would like children to look up to those role models that I respected when I was young—God, my father and the village policeman. They are the role models that I have in mind.
Pathetic parents lead to badly behaved children and that leads to trouble in schools. With the abolition of corporal punishment, however, schools no longer have an effective means of disciplining children. That loss of discipline has led to a loss of respect and a loss of control
The recently deceased novelist, Sir William Golding, shot to fame with his first novel "Lord of the Flies". Little did he know that it would come to reflect the present anarchy in the classroom, where little hooligans are allowed to rule the roost, with brutal consequences. We have heard horrific reports of children being savaged by sadistic forms of physical and mental bullying. The power and authority of teachers, however, has diminished to the point where they are scared even to touch a child for fear of being suspended. We even hear regular reports of teachers being subjected to violent physical and sexual assaults by children who are, quite simply, out of control.
§ Mr. Jonathan Evans
My hon. Friend may be aware that the National Society for the Prevention of Cruelty to Children and other charities have expressed great concern about bullying in schools. One of the difficulties that they face, however, is schools' refusal to recognise that that problem exists. Even when parents raise the issue, they have to fight governors and teachers who say that there is no bullying problem at the school. Does my hon. Friend agree that that is part of the problem to which he has referred?
§ Mr. Evans
One need only recall the head teachers conference to appreciate that they do not recognise what discipline is about. One need only observe the conference of the National Union of Teachers to discover what they think about discipline. Need I say any more?
Naturally, I blame the parents who have failed to give problem children a proper upbringing, but I also blame the succession of Ministers who did not have the guts to re-establish a sensible framework for authority and discipline in schools by reintroducing corporal punishment. Generally speaking, that lot on the Opposition Benches seem to reject corporal punishment on the half-baked notion that they are protecting children. What a lot of rubbish. I believe that the absence of corporal punishment has allowed little thugs to bully and harm pupils and teachers.
Children are not stupid. They know that if they are not going to get punished when they do something wrong, they can go on doing it. That process of permitting delinquency has graduated from the schools to the streets. The Home Office has instructed the police to caution rather than prosecute juvenile offenders. On occasions, juveniles who have been caught four or five times committing offences have merely received four or five cautions. Where is the logic in that? We can caution youths until we are blue in the face, but unless we come up with an effective deterrent, those delinquents will carry on offending.
If anyone is interested in reading horror stories arid has already read the most recent Labour party manifesto, I suggest the 1990 criminal statistics for England and Wales. I was shocked to discover that youths had merely been cautioned for rape, indecent assault on a female and 584 conspiracy to murder. A staggering 2,071 youths aged between 14 and 17 had been cautioned for burglary. What is going on?
Those young offenders should be properly punished for their crimes. We have been told that the borstals for youths will be up and running in three years' time, but my constituents ask me what we are going to do about those youths who are running riot today. Even when those special borstals are established, I doubt whether they will do any good. Those baby borstals will be about as tough as kindergartens. The staff will be instructed to comfort and cosset the offenders. I would not be surprised if the Home Office issued a circular to instruct the staff to provide offenders with a nice hot cup of cocoa before bed time.
Last May, The Sunday Telegraph reported on another Home Office circular, under the headingAre you enjoying your porridge?Apparently, the staff had been instructed to ask offenders whether they were having their underpants changed regularly enough, whether their cells were hot enough, cold enough, too noisy or too quiet. They were asked whether they could sleep at night. That is just what the new borstals will be like, because they will be run by socialist do-gooders.
I suggest that we drop the trendy socialist claptrap philosophy and return to a dose of discipline and authority. We need to urge my right hon. and learned Friend the new Home Secretary to take the bull by the horns and introduce a framework that will being those kids back into line. Let us reintroduce flogging—cat-o'-nine-tails if you like—because that will make those thugs think about crime. That would certainly have a better effect than one pointless caution after another, which lets thugs go out and rob and rape again. That is what is happening every day.
The socialist softies on the Opposition Benches may shake their heads, but they should bow their heads in shame, so should many on the Conservative Benches, at the fact that their soft soap slogans and slushy nonsense have landed us in a mess. By listening to their sort for too long, we have removed responsibility, authority and discipline from our society. The nation is now being held to ransom.
A solution has emerged from an unlikely source—the European Community. My friends know my honest view of Europe: no, thank you. One practice of the Community that I would grasp with open arms, however, is national service, not necessarily in the armed forces, but in the community. Young people, men and women, could then learn the benefits of discipline, team work and a deference to authority.
The Government should be encouraging young people to get out, get active and get stuck in. Children, sadly, no longer seem to have any sense of participation or involvement in events. That is particularly true of sport. Children just lounge around their bedrooms at every opportunity, playing computer games or watching television. When they get fed up with those computer games, they go out in the evening and hang around the streets and estates, where boredom, inevitably, leads to mischief.
Children should be encouraged to play more sport. School teachers have, sadly, become 9 to 3.30 merchants. They should hang their heads in shame when it comes to latchkey kids. In my day, when the school bell went at 585 3.30, we were encouraged to participate in sport, whether it was cricket, hockey, netball, swimming, running or jumping. The teacher took pride in producing a swimming team. The whole school was made to stay back to cheer its side. That created team spirit and pride, rather than the dreadful individualism which seems to be affecting our nation, our youth and, dare I say it, our party.
Sad to say, these days, the most vulnerable go home to an empty house while mum is at work. They have two hours to fill in, which, in itself, produces problems. It may even be necessary to pay teachers overtime to stay on at school, because a concentrated effort to encourage youngsters to participate in sport would be in the long-term interests of everyone.
As a youth, I played football and I was fortunate enough to make football my career. I only wish that more children could enjoy the excitement, sense of achievement and discipline felt when participating in sporting activities. The politically correct crackpots of the Opposition would probably disagree and argue that sport is too rough and too competitive. Perhaps that is why they cannot win a general election. Looking back on the Labour party's record, I think that it makes the English football team look successful. I would not be surprised if it appointed Graham Taylor as its new campaign manager—he could not be worse than the one it has got. Sitting opposite that lot day after day, I have had to conclude that they lacked discipline in their upbringing and are obviously a bunch of political delinquents. I do not wish to spend any more time on that lot because they are losers—there is no hope for them.
Children are different. They have a life of potential and achievement ahead of them. It is up to us to guide them through the path to adulthood with care, attention and supervision—most of all supervision—and provide them with role models in authority and the use of discipline. The Government must free themselves from the clutches of the chattering classes and adopt a commonsense approach to the health and welfare of our children. We do not need to spend vast sums of taxpayers' money. All that is required is an occasional clip around the ear and a cuddle every night before bedtime. For the health care of our children, I give the Government three plus points and a gold star; on the subject of our children's welfare, I would say of the Government that they are trying, but could do better.
§ Miss Joan Lestor (Eccles)
If the views of the hon. Member for Welwyn Hatfield (Mr. Evans) have been formed as a result of his activities on the football field, I recommend that the Government ban the sport immediately. I cannot believe the speech that I have just heard and I do not intend to pick up on it in any way, except to throw out one or two general thoughts.
People call for activities for our young people at a time when youth service facilities are decreasing, many regions do not have recreational facilities and the aspirations that the Government describe as important cannot be met because of cuts in local authority expenditure. Therefore, to talk about activities in that context seems to undermine the philosophy that we should adopt.
Some of us have fostered children or worked with children in need and children who have suffered in a way 586 that it is hard for others to comprehend—where children have been abused, ill treated, violated and moved from home to home never to be rehabilitated. After 12 or 15 years of such existence, many such children end up as delinquents who are antisocial and violent. But unless one traces the history of those children and learns the lessons of how to guard against a repetition of such events, we will end up with more borstals, more secure accommodation and more measures designed to curtail such behaviour. I do not think that most hon. Members would want that.
We must learn the lessons of what has happened in the past. To be fair, I think that the Government have sometimes responded well to the problems. We can all remember the cases of Maria Colwell, Tara Henry, Jasmine Beckford and Kimberley Carlile, and a host of children who died because we let them down. We must always be sure that the structures that we set up as a result of the inquiries we undertake following the deaths and suffering of those children are watertight. We must constantly review the position.
Yesterday I was disappointed by the reply I received when I asked whether there was to be a review of all the structures involving children and young people in residential care. I was told that that would not happen in a major way. We must always review the provision. People slip through the net and we cannot know at all times what is happening in any home or organisation for children.
I was interested in the point made by my hon. Friend the Member for Newcastle-under-Lyme (Mrs. Golding) about boys. Persistent offenders are nearly always—although not always—boys. Why is that? Is it because we expect too much of our boys, who find that they cannot meet those expectations and so become young offenders? Is it because the status of young men in society is measured in terms of owning large cars and becoming providers, breadwinners and heads of families, and many boys believe that they will never achieve that status? We should consider that aspect.
We should also study what is happening to young girls. But we must remember that we are talking about a minority of young people. An increasing number of very young girls are having babies. They do not have babies in order to obtain a house. Perhaps they do so because the only way in which they can achieve status in society is to become a mother. The lack of educational and work opportunities for many young girls results in an increasing number of them seeking refuge in obtaining some form of status by becoming mothers, which worries me. However, it takes two to make a baby and we should ask why the number of teenage pregnancies is increasing. What sort of society produces such a problem?
We all know that unless we intervene at an early stage to help alleviate the problem of young people, the pattern tends to he repeated. I have fostered children for a long time. Happily, I have seen some of them adopoted or rehabilitated, but some were less fortunate. Of the less fortunate, those on whom I have managed to keep tabs over the years have, unfortunately, tended to become part of an ever-repeating pattern.
§ Mr. Jonathan Evans
The hon. Lady mentioned teenage pregnancies as though they might all he intentional. I also have some experience of child care work and I think that she will agree with me that most teenage pregnancies are not intentional.
§ Miss Lestor
I was just about to comment on that. We kid ourselves that young people are well aware of birth control, but they are not. The hon. Gentleman is right when he says that many teenage pregnancies are not intentional. Many young girls who become pregnant decide to go ahead with the pregnancies despite the social difficulties which they know that they will face. We must address that issue. The hon. Gentleman is right to say that we have not tackled the issue of family planning and birth control for boys and girls in our society. We could develop an argument on the subject of why teenage pregnancies are becoming more frequent. They were not so common years ago when less knowledge was available about family planning. The age of teenagers who become pregnant is decreasing.
Parents are blamed for everything in today's society. All hon. Members with children have neglected them in some way or other. Being a Member of Parliament means that we have to neglect our children—we have to leave them to our partners as we are at Westminster most of the week, not with our children. If they are honest, hon. Members from both sides of the House, irrespective of political affiliation, will admit that sometimes they fail to get to a birthday party or some other event.
There are degrees of neglect of children, but the accusation of neglect must not be levelled simply at the poor, which is not fair. The poor care for their children as much as those who are better off; it is someone's circumstances which can lead to neglect. To argue that parents do not care and should be put in prison is ridiculous and shows the lack of understanding about the neglect of children. All hon. Members—the majority of whom are men—are fortunate. The men, if they have children, have wives at home looking after them.
I remember one Conservative Member who asked me who were the lovely little children who were running around me. I said with great pride that they were my grandchildren. He said that my response made him feel terrible as he would not see his children until Friday. When we talk about the neglect of children, we must be careful about what we say. People who are poor or unemployed care for their children just as much as anyone else, but they cannot afford to pay other people to assist them, as many of us can.
We must consider the impact of television, to which probably all children are subjected. People will say that only a minority become violent and behave in an antisocial way as a result.
All our children these days play video games and watch a great deal of television. It is important to find out whether what they see on television is reinforced in the family circle. If children see violence and are told by their parents that violence is terrible and that people should not behave like that, they will begin to question what they have seen. If, on the other hand, they are told that the violence is wonderful and manly, they will react differently. There is a generation gap: we did not play video games, so we do not know about their impact. In any event, how we react to what we see on the screen and how schools and other institutions in charge of young people react to it is all important.
There is not just one cause of antisocial behaviour by this minority of children. Our schools are not collapsing because of indiscipline. I repeat that the problem is confined to a minority. Most youngsters who are 588 cautioned—85 per cent. of them—never offend again. It is unfair to maintain that there is a relentless tide of bad
§ Mrs. Wise
Perhaps my hon. Friend would like to hear about the experience of a member of my union—an elderly lady who took part in a television programme about young people. She listed several instances of good behaviour, but they were not included in the final programme. Only the criticisms were included.
§ Miss Lestor
I am not surprised. We hear about this minority all the time; we concentrate on it. We have all had a great many letters, however, from young people in our constituencies asking how they can raise money for various good causes. They want to be involved. They are increasingly aware of environmental issues. We have all been to functions at which we have seen the good activities carried out by young people. Certainly, there is a problem with a minority, but that problem cannot be divorced from the social circumstances in which many of them find themselves. If we forget that, we sell these young people short.
Young people do not become violent out of the blue. We should remember how many of them become thugs after they themselves have been treated violently. Similarly, many youngsters who suffer sexual abuse go on to become sexually abusing adults—but not all of them do. A majority of the most violent people in this country have been violently treated themselves.
I am also worried about the fact that a large number of young people who end up in penal institutions used to be in local authority care, often taken into care to remove them from unsatisfactory homes. Perhaps the personality damage had already been done before they went into care, but there must be a link. Equally, a disproportionately large number of young people sleeping on the streets have been through the care system. We cannot ignore these factors or claim that social circumstances are irrelevant. There is a thread that runs through all these experiences and we should not just dismiss it and call for the return of the birch.
The National Association of Young People in Care will bear out what I am saying. We need to ensure that our structures for dealing with children and young people are not open to abuse. Children who have suffered at the hands of people in the care system, in which we have placed them for their own protection, will obviously encounter problems and difficulties later on.
My hon. Friend the Member for Wakefield (Mr. Hinchliffe) dealt adequately with many aspects of the Children Act 1989, but I draw attention to the decline in the school nursing service and the problems that that will entail. I recently asked a parliamentary question about the numbers of school nurses in post. In 1979, there were 3,810; in 1985, 3,110; in 1991, there were 3,050. Clearly, there has been a decline. Now, two health districts, Bath and Bristol, have said that they no longer intend to provide a school-based nursing service and that they intend to reduce universal school children health surveillance programmes. Doubtless the Government will say, as they have in the past, that the service is not needed so much—that children are healthier and are going to see their family practitioners. I question that and so does the Royal College of Nursing.
589 Schools nurses in many areas see every child for a health interview at the start of his or her school career. That leads to the early detection of problems, on which advice can be given. It is therefore a great pity that the service is to be allowed to deteriorate. Statistics may show that more of our children are healthy—I am sure that that is true—but what an indictment of 14 years of Conservative Government it would be if there had been no progress on this front. More children are being immunised—we have stamped out many diseases during the past 50 years—but there will always be a minority to whom the overall approach does not apply. They will be the children who will lose out; they are the ones who do not go to family GPs, whose parents may be poor and unable to take advantage of the service in their area. The Government and health authorities are selling children short if they allow the school nursing service to decline.
In this country we are good at concentrating on pre-school health services for children. We have a good health visitor service—long may it last: I hope that it will never be tampered with. After children go to school, however, the service is not so good.
The British Dental Association and other organisations have expressed concern about children's teeth. The number of examinations carried out is declining. It will be said that children's teeth are improving because of fluoridation. That may be so, but too many young children still get caries and there is not enough early detection. That may be partly due to the cost for adults of going to the dentist, which may lead to fewer children accompanying their parents to the surgery. There is a wide variation in the prevalence of dental caries among five-year-olds. The highest incidence is in the northern urban districts and among poorer people with poorer diets. The lowest incidence is in the southern areas where people tend to be better off.
§ Mr. Corbyn
Does my hon. Friend agree that another problem has been the continual cuts in the school meals service, the abolition of nutritional standards in 1980 and the high price of school meals? More and more children are bringing packed lunches to school, often containing far too many sweets and far too little protein and fruit. It is simpler to pack sweets than to prepare sandwiches.
§ Miss Lestor
I was coming to children's diets, and advertising. Most of us have expressed concern about the decline in the school meals service. A recent survey in a school showed that children were bringing white bread sandwiches with jam or paste, chocolate biscuits, packets of crisps and drinks full of sugar. That may be the result of ignorance or of poverty. When we did away with decent school meals, we opened the door to all sorts of problems with our children's health. It is a great pity that the service has declined.
Another related issue is the effect of food advertising on children. The dental health promotion, Community Dental Service, in Hampshire recently sent to me a copy of a letter that it had written to the nutrition section of the Department of Health regarding a chocolate drink, manufactured by Crookes Healthcare Ltd., a subsidiary of Boots, and sold under the brand name of Farley's. That drink is designed to encourage toddlers to sleep.
590 Anyone who has ever had a baby knows that the biggest mythical phrase in the world is "sleeping like a baby", because they rarely do. I am sure that many parents have been attracted to that drink, for it says that it will soothe their toddlers to sleep. The drink is called Bed Timers and is aimed at children between the age of 12 months and four years. Bed Timers contains a total of 43.3g/100g of sugar. Almost half the content of that product is sugar.
Other products that are on the market are just as bad. If hon. Members have ever sat in front of their television sets during half-term or at other times when children are at home and watched the advertisements, they will know that cereal and all sorts of drink advertisements are aimed at children and that children, just like us, are being brainwashed. Those who care about children's health should talk to the promoters of these products and ask them to take out the sugar. They should also ask them not to show these advertisements at a time when children are likely to be watching television.
§ Mr. Roger Knapman (Stroud)
Does the hon. Lady agree that good example and respect for the law are important? Will she therefore ask for another survey to be conducted? Five Opposition Members are in the Chamber, of whom two actively encouraged their constituents not to pay their local taxes. What sort of an example is that to young people in their constituencies?
§ Miss Lestor
We could talk about Chancellors of the Exchequer who have their legal fees paid by the Treasury and the rest of us. If the hon. Gentleman wants to go into this game, there is a whole string of issues that we could raise.
§ Miss Lestor
Yes, watches as well, but do not let us be silly. I began my speech on the assumption that we all care about what happens to children. What the intervention of the hon. Member for Stroud (Mr. Knapman) had to do with the sugar content in drinks I cannot imagine.
In 1990, a Food Commission survey found that half of all advertising during one week of children's television was for food and soft drinks—51 per cent., eight times higher than any other category. In just over 10 hours of viewing, there were 92 advertisements for food and drink, an average of nearly 10 an hour. The vast majority—78 per cent.—were for pre-sweetened cereals, sweets, crisps, fast foods and soft drinks. After the Government White Paper "The Health of the Nation", which includes the health of children, it is nonsense that our children should be subjected to such a barrage of influence on their diet.
We all know abut the dangers of heart disease later in life. I make the same criticism, in a different context, of the promotion of smoking in such a way as to attract young people to begin to smoke. These are issues that we rarely examine. Instead, we congratulate ourselves and say that for many children things are much better. Of course they are. However, for a minority of children—in some instances, a growing minority—things are getting very much worse. The problem is linked to unemployment, bad housing and poverty. The gap between the two is widening. That worries me very much.
§ Mr. Michael Fabricant (Mid-Staffordshire)
I take many of the points that the hon. Lady makes regarding soft drinks, but does she commend the Independent Television Commission for preventing in this country 591 something that happens on a dreadful scale in the United States—the linking of cartoon films with toys that are available, the suggestion being that if a child does not have a particular toy that is shown on a cartoon there is something wrong with the child—that in some way he or she is inadequate?
§ Miss Lestor
A little bit of that is creeping into advertising in this country and it is to be deplored. I mentioned some time ago in the House that Benson and Hedges uses the puffin symbol to advertise cigarettes. The moment we begin to link positive images for children, characters that they love with something else, we are on the road to disaster.
I welcome the debate. All of us who care about children have a duty to them and to all who look after them to make sure that the services that exist are provided to them all. Unhappily, as I have already said, the gap between children is widening. We cannot separate the social circumstances in which many children find themselves from many of the difficulties that they face. We must always be vigilant and ensure that when we pass laws we include all children in the provisions, not just the majority, for it is the minority of children who cause us concern and it is they who are suffering in a disgraceful way.
§ Mr. Roger Sims (Chislehurst)
I join in congratulating my hon. Friend the Member for Battersea (Mr. Bowis) on his appointment, and on the manner in which he has swiftly got to grips with his portfolio. He rightly covered a number of strong points, and he had some good stories to tell about children. He also highlighted problems that continue to have to be faced.
The hon. Member for Wakefield (Mr. Hinchliffe) made a typically robust speech. Although I agreed with some of his criticisms, he would not, I am sure, expect me to agree with some of the others. Stripped of party rhetoric, however, no one doubts his commitment to children, and his sincerity.
Health and welfare is a vast field. It is impossible to cover everything in a brief speech, so I intend to confine my speech to a few issues that interest me, particularly those that stem from my involvement with the National Society for the Prevention of Cruelty to Children, the magistracy and the Children Act. That Act represents one of the two landmarks in child welfare in recent years. There have been a number of admirable initiatives. I refer also to the United Nations convention on the rights of the child, which was agreed and ratified by the United Kingdom.
Both the Children Act and the United Nations convention are admirable in their intentions and philosophy, but we must ensure that they are fully implemented. We must ensure that the philosophies that underpin the Children Act are implemented and that the philosophies that underlie the United Nations convention are implemented in other countries. One could give a list of problems that show that the convention is not being applied throughout the world. We must ensure that it is.
It is accepted here that children represent a distinct section of the national community. They have their distinctive problems and needs. There is a case, to put it no higher, for considering the appointment of an independent 592 children's rights commissioner to act as a watchdog and to view the legislation that emanates from all Government Departments from the angle of the child.
Organisations and individuals are appointed to look after the interests of various sections of our society—women, the disabled and ethnic minorities. Children are just as important, if not more important, a part of the community, and merit particular attention being paid to their needs.
A number of interesting initiatives that affect children have emerged in the past few years. Childline, set up by Esther Rantzen, enables children in trouble to pick up a phone and talk to people who may be able to help them. There is no doubt, from the thousands of calls that Childline has received, that this service has met a very real need.
The NSPCC has developed, alongside that service, its child protection line, which enables people who are concerned about certain children to voice those concerns, make contact with appropriate people and have action initiated. It also enables desperate parents to ask for and get help before problems that are emerging reach a tragic climax. The thousands of calls that both services receive show the extent of the problem and the need for those services.
I believe that the Children Act may prove to be one of the most important measures passed by the last Parliament, and, indeed, by this Government. It is worth reading the words of the chairman of the Children Act advisory committee, the hon. Mrs. Justice Booth, who reported in the foreword to her annual report on the Act:What can be said with confidence is that the enthusiasm and goodwill that greeted the Act have remained unabated.The Government's report on the working of the Act generally supports that view.
Having said that, the report also points to the inevitable problems that have arisen, one of which has already been mentioned—day care. Paragraph 4.35 of the report says:Examination of correspondence from MPs and the general public confirmed that some local authorities were seeking to impose on childminders and daycare providers more stringent or higher standards than those recommended in the national guidance.I must confirm that that certainly seems to be so. An admirable holiday play scheme operates in my constituency. With a few professionals, volunteers help to run schemes in school buildings during the holidays to enable children to occupy their time in a range of worthwhile educational and leisure pursuits. The scheme suddenly faced quite unduly onerous requirements on the qualifications of voluntary helpers, on health checks for every helper and on space, with no account being taken of the playground or playing field, all of which threatened the future of the scheme.
A similar case arose more recently. I learned of a constituent who, for many years, has run an admirable and well-supported nursery group. She was visited by the inspection manager of the local authority children's division, who required a number of quite unreasonable changes to be made before the group, which had run so successfully and satisfactorily for many years, could be registered.
The predecessor of my hon. Friend the Minister issued some guidance on 11 January. Paragraph 4.38 of the Government's report says:The circular … reminds authorities that, in the interests of children and families, they must strike the right balance 593 between ensuring standards and encouraging development of provision. There is a presumption under the legislation that registration should be granted unless the authority has good reason not to register.I invite my hon. Friend the Minister either to issue further guidance or to emphasise that circular in the next annual report. We must ensure that the implementation of the philosophy behind the Act is not strangled by bureaucracy.
The Joseph Rowntree Foundation conducted a survey into respite care for children. It found:The increased bureaucracy undermines the previous flexibility of services and is causing link families to leave.It quoted from a respondent, who said:'I feel that the requirements of the Children Act have placed some unnecessary burdens on carers, workers and users, making arrangements more inflexible. Existing good practice may well be eroded by such formality and form-filling.'It is important to strike a balance between what those who were involved with the Children Act wanted to achieve and what is happening on the ground.
§ Mr. Bowis
I am grateful to my hon. Friend for raising this matter. He is right to say that, in practice, some well-run organisations, day centres, playgroups and so on have suffered from bureaucracy and an intrusive interpretation of quite well-intentioned rules. That is why we issued guidance in January.
I hope that it is working and that the debate may draw it to the attention of people who operate the Act. I hope, equally, that he and any hon. Member who is aware of instances where it is not working will draw them to my attention, because I want to pursue the problem and get the matter back on the rails.
§ Mr. Sims
I am grateful to my hon. Friend for responding so promptly to my point. I invite him to respond similarly, if not immediately, to the next matter that I want to mention—the continuing problem of the number of children who are on the at risk register but who have been unallocated. It is worth reminding the House that a child is put on the at risk register because somebody is concerned about what has happened or because of signs that they saw in the child or the family.
Paragraph 2.59 of the Government's report on the Children Act says:As at 30 June 1992 the total number of unallocated children … was 1,543 or 2.9 per cent. of the total numbers of children looked after.It notes that, in 31 authorities, all the children have been allocated. I am happy to note that my borough is included. That shows that it can be done, but some have a very poor record; indeed, three authorities account for two thirds of the unallocated figure.
We can argue the toss about resources and I have some sympathy with the point that the hon. Member for Wakefield made, but I urge my hon. Friend the Minister to put the strongest possible pressure on authorities that have so many unallocated children to organise their resources and get their priorities right.
The courts seem to be settling down to the new Act and I take this opportunity to pay tribute to magistrates who sit in the family courts. They are not the family courts that some of us would like to see, but we are getting there. Those magistrates had, in effect, to forget all that they had learnt and to be almost retrained.
594 Some evidence shows that not all legal practitioners have become used to the new approach of the Children Act. They must forget the adversarial approach that they have used in the past and probably still continue to practise in other courts. It is not a question now of whose side they are on. There is only one side in family courts—the child's.
I invite my hon. Friend the Minister to investigate the role and workings of guardians ad litem, who play a particularly important part in court procedures. He should consider whether they should be managed centrally rather than by local authorities. He will realise that local authorities often bring cases before the court. If they are also managing the GALs, it must, to some extent, compromise their independence, or at least the perception, if not the fact.
It is interesting to note that some courts have been issuing explanatory leaflets to the parties involved, including solicitors, to assist them with the new procedures of the court. Perhaps there is a case for doing so on a national basis.
If children are likely to appear in court, they now have the advantage of the admirable child witness pack issued by the Department of Health, the Home Office, the NSPCC and Childline with support from the Gulbenkian Foundation. That was exactly what was needed, but not only for children. It would be a great advantage if something similar could be produced for practitioners, parents and others who are to appear in court.
The value of the television link in court, which enables a child to give evidence without physically having to be there, is already being proved. Recent provisions enabling videos to be admissible as evidence are also to be welcomed. There are still circumstances, however, in which a child has to appear in court, which can be extremely intimidating and traumatic.
I hope that the Minister, in conjunction with the Lord Chancellor's Department, will further consider the idea of pre-trial hearings at which a child could give evidence and be cross-examined in chambers—thus as far as possible avoiding the necessity of the child having to appear in court.
While on the subject of court proceedings, I must mention the recent case in which Judge Ian Starforth Hill referred to the eight-year-old victim of attempted unlawful intercourse as "not entirely an angel", As one of my hon. Friends says, that is disgraceful, and it was also the general reaction. Surely, when a child is abused by a adult, the child cannot and should not be blamed for the abuse.
A further dimension to the problem to which I feel I must draw the House's attention is the Attorney-General's sentencing guidelines on incest. The guidelines cite as a mitigating factor the apparentgenuine affection on the part of the defendant rather than any intention to use the girl simply as an outlet for his sexual inclinations.It is well know that the genuine affection shown by the abuser, especially when the relationship between the abuser and the child is a close one, may have a traumatic effect on the child because of the profound betrayal of trust. I hope that the various Departments involved in this sphere will review all the sentencing guidelines on incest and provide more training for the judiciary in child sexual abuse and similar cases.
595 Finally, I refer to the scandal of cases in which children have been abused and, in some instances, have died, but where no criminal proceedings have followed, simply because of the right of silence.
A well known, relatively recent case was that of Kim Griffin, who died from dreadful injuries at the age of only two months. She had been in the care of her parents. The coroner's verdict was death by unlawful killing. No charges were brought. Both parents exercised their right of silence, so it was impossible for the prosecution to proceed. The parents were free to leave the interrogation to which they had not responded and, of course, they are free to have more children, which means that there is a possibility of a repetition of that sad event. The case, alas, is not an isolated one; there have been a number of similar cases in recent years.
Many people believe that the law must be changed. The NSPCC has presented a well-prepared dossier on joint enterprise to the royal commission. I have no doubt that my hon. Friend the Minister will make the valid point that the issue is being considered by the royal commission, but I am worried by press reports suggesting that the commision has already decided against any change in the right of silence rule. Whatever its views on the application of the rule generally, I suggest that there is an overwhelming argument for a change in its application in the cases that I have just described.
We all accept that we have an overwhelming duty to protect the rights of the child. Surely, the younger and more defenceless the child, the stronger our responsibilities. If we fail to protect a child who has been neglected, abused, gravely injured or even killed, we must at least ensure that those responsible are punished, and that justice is done.
§ Mrs. Llin Golding (Newcastle-under-Lyme)
"What sort of person could do that?" Are they the words of disbelief that we use to justify our lack of action in dealing with the unimaginable pain and suffering inflicted on the children who are the victims of physical, mental and sexual abuse? Do we really feel that, when an offender is caught, charged and put behind bars, our expression of revulsion and the detailed coverage in the press and other media are sufficient to enable us to say that another monster has been caught, another child has been saved and that we can now push the problem to the back of our mind until the next shocking headline? Is the banging of prison doors the end of society's responsibilities? Should not we be asking ourselves how it happens, why it continues, what happens to the victims and the offender and, most important, what can we do to stop it happening again?
How does an apparently normal person justify to himself the molestation of children? I say "normal" because it is not identifiable men in dirty raincoats who do these evil things but men—it is mainly men—in all walks of life, men who are often well respected and in responsible jobs. What has happened to them that means that they refuse to see that their behaviour is wrong, wicked and evil?
§ Mr. Jonathan Evans
The hon. Lady is correct in saying that most of the people engaged in child abuse are male, but she will no doubt have seen that there are, sadly, many cases in which women become aware of the abuse but defend the abuser. There was such an instance only last 596 week in Wales. Two brothers committed suicide because of years of continual abuse by an uncle. The mother was aware of it, but turned her gaze from it, believing that her discovery would lead to the abuse stopping. While the hon. Lady is considering the fact that most abusers are men, will she postulate on the issue of why, when women learn of the abuse, they often defend the abuser?
§ Mrs. Golding
The hon. Gentleman is quite right. The reasons are varied: fear of the man, fear of the family splitting up or a failure to recognise what is happening in the house. There are many complex reasons and I am sure that we could have a separate debate on the subject, but, if I may, I shall stick to a narrow brief today. What has been done to change attitudes and to protect children from being further molested by men? Giving offenders fairly short prison sentences and then releasing them back into the community is certainly not the answer. More often than not, prison reinforces their behaviour and fails to make them face up to the damage that they have wreaked on so many children's lives. I am aware of the many efforts to provide treatment for sex offenders in prison, but I believe that such treatment has little hope of success unless it is long term and intensive. Our Prison Service cannot and does not provide such treatment.
I am convinced that the only hope that society has of changing the attitudes and beliefs of sex offenders is attendance at clinics such as Ray Wyre's Gracewell clinic. Ray Wyre has faced up to the ugliness of this world with determination and great courage. He knows that too few sex offenders receive experienced, specialist treatment. Too many are allowed to continue offending.
§ Mr. Michael Stephen (Shoreham)
Is the hon. Lady aware of Dr. Wyre's views on the effect of pornography on sex offenders? From a lifetime's study of the subject, he is convinced that the availability of pornography contributes to sexual offences against children.
§ Mrs. Golding
The hon. Gentleman is right. There are wide-ranging concerns about pornography. We recently had an exhibition in the House and I am certain that it shocked many hon. Members who had no conception of what was going on in the world of pornography.
The funding of clinics needs to be addressed. The Gracewell clinic is a charity which is funded by donations. Ray Wyre has told me that community care funding from the local authority will be the source of additional funding. The Faithfull Foundation has now been established to carry on the work that the Gracewell clinic started. It was established by the determination of Baroness Faithful, that champion of all causes concerning children. She spent days on the telephone to raise money to enable the foundation to be established. In future years, she will have to find the funds to keep it going. Surely it is nonsense that that should happen. These organisations fight vile crimes against children. The Government should see that and should fund them as such so that they do not have to go, year after year, cap in hand, to different Government Departments attempting to get money to continue work that so badly needs to be done.
What happens to accused sexual offenders who never come to court? Many do not because the Crown Prosecution Service says that it would be too great a strain on the child to give evidence. Few parents are as enterprising as a lady who wrote to me in anger because of the release of the man who had molested her small 597 daughter. She cut out details of the case from her local newspaper, photocopied them and delivered them to every street near where the man lived. That relieved her anger, but it did not bring justice. The real crime was that the man was set free into the community to molest other children. In considering the welfare of the child who had been molested, the court failed to address the welfare of children who were put at risk by the decision not to prosecute.
Is not it time that sexual offences against children were dealt with in some other way, outside the formal courts system? Is not it time for a different form of sentence, which recognises that the abuser needs treatment, to be considered for a man who is found guilty of sexual offences? It is obvious that the release of such men into the community or the shutting of a prison door is not the answer when the welfare of children is at stake.
§ Mr. Fabricant
Does the hon. Lady agree that there is a danger that if the miscreant receives treatment, those providing the treatment may believe that he is cured? The danger that then arises is that the miscreant can be let out into society when he has not been cured.
§ Mrs. Golding
The hon. Gentleman may think that there is a cure for these men. People who deal with them say that it is difficult to cure them. All they can do is make the offenders think and look at the reality of what they have done. They can then, perhaps, let the offenders go back into society. If they have saved a number of children from being molested in the short term, that is something and it is better than doing nothing. However, the more work is done, the more we learn about such men. The more we learn, the more we can help.
If we are to protect children, every effort must be made to identify signs of abuse. There has been a highly successful campaign that tells children to say no to strangers. However, it is usually not strangers, but people who are responsible for the care of children—often members of the family, a family friend or baby sitter—who molest them. What thought has been given to advising children, without frightening them, that sexual abuse by adults is not normal, loving behaviour? How can a bridge be built from children to adults to allow them to realise that sexual abuse is occurring? It is difficult because abuse is veiled in secrecy.
A child is coerced by an abuser into believing that the abuse is a secret which must not be revealed because if it is, terrible things will happen. Sometimes, children are made to believe that abuse is normal and a sign of love, so to say no would make them wicked; in any case, it is all their fault. How can that barrier be broken down? Children often hide their hurt and distress because they are afraid of not being believed or are afraid that, if they are believed, they will be taken away. What they most want is for the hurt or the abuse to stop and for everything to be all right. We do not want adults to go rushing in and to destroy the children's small world.
I spoke to one of the officers of the National Society for the Prevention of Cruelty to Children. I asked him what he would do if he were given enough money to do one special thing—I am sure that my hon. Friend the Member for Eccles (Miss Lestor) will be interested in this. He answered unhesitatingly that the one thing would be to have one fully trained person in each school who had time to listen 598 to children and to talk to them in small groups so that he or she could pick up signs of what was worrying them. The children would then know that they had someone whom they could trust and someone who would not tell them to go away because he or she was busy and did not have the time. In the real world, we are unlikely to have that. We have people who care about children, but who have other jobs to do as well. Many of those people have been mentioned in the debate today.
One group, the Professional Association of Nursery Nurses, had a training seminar in Birmingham last Saturday, which I attended. The nursery nurses listened not only to Ray Wyre talking about the sex offender but to the internationally acclaimed Madge Bray, who spoke on healing the child who has been abused. Who knows better than she what an extremely difficult job that is?
The training programme and training packs help to identify the children who need our help, but, having found them, where do we go from there? The process of healing needs to begin quickly. Delays in court hearings put strain on children. To attempt to give a child therapy while being aware that the child may need to go to court to give evidence is difficult. Is not it time that the excellent Pigot report on video evidence was looked at again and that legislation was passed to avoid additional strain being put on children? Parliament has gone a long way in changing the law on children's evidence, but we have not yet gone far enough. Would it also be a good idea for money to be paid from the criminal injuries compensation scheme directly into a trust fund to help to heal children who have been damaged by sexual abuse?
Madge Bray and her colleagues have set up two houses in Shropshire which give a home, care and therapy to children who have been severely damaged by abuse. More funding is needed to enable them and others like them to deal with the children who need their help. The abuse of children is a difficult and complex subject, of which sexual abuse is only a part. I have touched on only one aspect of the work that numerous people in all professions are doing to help children.
Are we in the House the sort of people who say, "What sort of person could do that?", and wait for others to deal with the problem? I do not believe that we are. We, more than most, have the power to alter things. We should look again at our legislation and the need for change. The welfare of children is the responsibility of us all. We should not leave them alone to cry in the night.
§ Mr. Michael Fabricant (Mid-Staffordshire)
It is a rare privilege to follow the hon. Member for Newcastle-under-Lyme (Mrs. Golding), my fellow Staffordshire Member. Before I begin on the serious matter of this debate, I seek the forbearance of the House for the fact that I am wearing what Dame Edna Everage might call her face furniture, due to a minor—I hope—injury to my left eye. I had the choice of looking like Roy Orbison or wearing an eye patch and looking like Moshe Dayan. I opted for the Roy Orbison look. While the Minister is on the Front Bench, I should like to commend to my hon. Friend the Minister for Health Dr. Jeremy Prydel and his colleagues in the medical eye unit of St. Thomas's hospital, who looked after me so well yesterday morning.
I believe that it was Oscar Wilde who said that the best way to make children was to make them happy. I could not 599 agree more. The good health, well-being and happiness of children should not only be the aim of parents everywhere but should be the responsibility of the Government. It is a responsibility which the present Government have taken on with relish; they have recognised the duty of care and are fulfilling their obligation. We are witnessing a marked improvement in the health of children, as many hon. Members have said. The Children Act 1989, on which I shall concentrate today, was one of the most comprehensive and radical reforms of child law enacted by Parliament for many years. That Act has been widely hailed as a great success.
The Opposition—notably the right hon. Member for Islwyn (Mr. Kinnock)—have for many years scorned what they call our obsession with the traditional family or with family values. We make no apology for that so-called obsession. We are not embarrassed by it. I believe that it is family values which maintain the structure of society and protect children in our society. Even Professor Halsey—for so long a Labour party guru and major influence on the Labour party's thinking on social issues—last year extolled the virtues of the traditional family:Children from these families",he said,tend to do better physically, educationally and emotionally.It is a sad fact that more than a third of all families in our society are single-parent families. There are many apologists for that—many people who try to justify it or even defend it. I believe that there can be no substitute for the traditional family.
§ Mr. Hinchliffe
I find the hon. Gentleman's comments on Labour's attitudes to family values somewhat strange. I am not aware of my hon. Friends having made comments of the kind that he suggests. We believe fundamentally in family values. Our comments have been on the Government's performance and on the fact that the wider policies that they pursue do not support family values but lead every day to the break-up of families.
§ Mr. Fabricant
Naturally I cannot agree with what the hon. Gentleman has just said. If he is stating that there has been a change in Labour party policy—or in views that some members of the parliamentary Labour party have previously espoused—I am delighted to hear it.
Families provide the sense of security that is so beneficial to a child's development. They also provide role models from which a child can learn much and without which children may flounder. Baldwin—not the Baldwin who was quoted yesterday but James Baldwin, the 19th century American writer—wrote:Children have never been very good at listening to their elders, but they have never failed to imitate them.For that reason, it is tremendously important that parents—or a single parent—should provide a suitable role model. Our appreciation of the value of family life lies at the heart of the Children Act. The Act provided for intervention in family life by public authorities and courts only where that was absolutely essential in the interests of the child. The aim of the Act was that, wherever practicable, children should be brought up and cared for in their own families and that, when they were needed, social workers should work with parents in partnership.
The Children Act introduced the new legal concept of parental responsibility. Is not it sad that that sense of responsibility—something which we should all innately 600 have—should need to be written into the law? The Act also balanced parents' rights and duties with the powers of local authorities and the child's interests.
Quite rightly, parents are held responsible under the Act for bringing up their children, but local authorities and other agencies are also given a role to play. No court order transferring a parent's responsibility for caring for a child can now be made unless that is better for the child. That tremendously important principle has now been enshrined in English law. The welfare of the child is now the paramount consideration.
The Government have every right to claim a great success with the Children Act. Mrs. Justice Booth, chairman of the Children Act Advisory Committee, has called it "a great Act" with "huge potential". We can already see a new spirit of co-operation developing between the judiciary and our councils and welfare services. I am especially conscious of that—as, I am sure, is the hon. Member for Newcastle-under-Lyme—because we in Staffordshire have experienced our own difficulties with the care of children in recent years.
We should rejoice in the fall in the number of court orders since the Act was introduced and the decline in the number of cases reaching the courts. In my view, the statistics are impressive. There were more than 1,500 applications for emergency protection orders from October 1991 to June 1992. The equivalent figure a year earlier for place of safety orders was more than 3,000.
§ Mr. Jonathan Evans
May I caution my hon. Friend on the subject of the figures? I am sure that he is not suggesting that, in the past year, there has been a dramatic reduction in the amount of child abuse. I put it to him that one reason why there may have been fewer emergency protection orders is that many local authorities are coming to terms with the complexity of the new law. There is another side to the argument: there may be children who are unprotected by the Act at present.
§ Mr. Fabricant
I am grateful for my hon. Friend's intervention. He is right: there will always be unprotected children.
The Children Act 1989 has been criticised for being complicated. However, any such all-embracing Act must be comprehensive and complex. We should be encouraged by the fall in the number of children removed from their parental homes. Local authorities are forming a genuine partnership with parents and they are helping families to stay together. The new emphasis on parental responsibility and on court intervention only when that is to the benefit of the child is worth noting.
Since the Children Act came into force, the Government have monitored carefully the child protection register. The aim has been to concentrate minds in local authorities on the reasons for placing children on the register and for keeping them there. We should be pleased that the numbers fell by 15 per cent. between March 1991 and March 1992. However, we cannot and will not be complacent.
The performance of some local authorities is deeply worrying. Like many hon. Members, I am very concerned about the number of children on protection registers who are not being allocated social workers. Last June, Lambeth sadly had 914 children on its register—twice as many as any other London borough. The legislation to which I have referred has been backed solidly over the past year by 601 additional Government expenditure. Local authorities' standard spending on children's services for 1992–93, the first full year after the Children Act, was more than 20 per cent. higher than for 1990–91.
The Government's campaign to improve the health of our children is being fought on many fronts. The leading cause of death in children over five is accidents. That death rate fell by 27 per cent. in the 1980s, but there is still more to be done and there is no room for complacency. A Department of Health task force is examining accident prevention with a number of agencies, including the Child Accident Prevention Trust, and schemes are being developed to teach road safety to very young children.
Children are being encouraged to adopt a healthy life style through a wide array of projects. I was grateful for the comments of the hon. Member for Eccles (Miss Lestor) about the way in which unhealthy eating habits for children are encouraged on television. It is important that the Health Education Authority counters that.
The HEA can boast the comprehensive "My Body" project which develops health education through physical activity in primary schools. The health in clubs project for youth workers would no doubt encourage my hon. Friend for Welwyn Hatfield (Mr. Evans) who spoke earlier.
Immunisation rates against infectious diseases are at record levels. There is now a 95 per cent. coverage for diphtheria, tetanus and polio and 92 per cent. coverage for measles, mumps and rubella. Over the next five years, £5 million will fund projects aimed at helping children with life-threatening illnesses. That was very welcome news when it was announced last year. Respite care, home support and residential care should benefit. I am confident that that initiative will achieve its goals in due course. It focuses sensitively on a child's home and local community, his family home and friends. It will, without doubt, lead to improved services for seriously ill children.
All that good work is now being bolstered by the Department for Education. That shows that, although we might not talk about "national strategies," there is a co-ordinated strategy on the Conservative Benches, between the Department for Education, the Department of Health and the Home Office. The national curriculum has ensured the provision of essential health education for school children aged between five and 16. The National Curriculum Council has identified the key components for health education and its advice has been issued to all primary and secondary schools. Is not that a national strategy that crosses the boundaries between Government Departments? I applaud the response of our schools in developing health education programmes. That is indeed a national strategy which we are putting forward in deeds and not simply words—as is the case with some Opposition Members.
The drive for higher standards in schools shows how concerned the Government are about the welfare of children. Education, like health, is crucial to a child's healthy development. Alfred Horn said:The first thing that education teaches you to do is to walk alone.Providing the means to walk alone is one of the most serious obligations of a Government. The provision of a national curriculum will he remembered as one of the 602 greatest achievements of this Government because we have a duty of care to all our children for health, legal care and education.
In their radical reform of child law, and through the provision of decent health services and a decent education, the Government have shown how deeply they care for our children. As Douglas Newton said:The worldwide fraternity of children is the greatest of savage tribes, and the only one which shows no sign of dying out.In this country, at least, we can go further: this tribe is all set to thrive and the Conservative Government can claim much of the credit.
§ Ms Liz Lynne (Rochdale)
I welcome the Minister to his new appointment and wish him well. As the Liberal Democrat health spokesperson, I welcome the opportunity for this debate.
It almost goes without saying that the health and welfare of the country's children is one of the most important issues to be addressed by any Government. It may seem a cliché, but it is clearly true to say that children represent the future and if we do not have regard for them now we fail to have proper regard for our own and our country's future. The health and welfare of children must therefore be at the forefront of our minds.
There has recently been a series of major stories in the press about the health problems of individual children, one of which ended up in court. The most recent of those cases was publicised by the National Health Service Support Federation only last weekend. A young boy was born three months premature, suffering from detached retinas in both eyes. Suitable treatment is not available in the United Kingdom, but it is in America. However, because the NHS is unwilling to pay for the treatment in America, the family must raise £60,000 themselves. Some hon. Members may respond to that story by saying that, of course, it is a very deserving case, but there are many such deserving cases and the NHS cannot afford to deal with them all and difficult choices must be made.
Whatever one thinks of that argument, it ignores the fact that the cost to the health service, let alone to the child and his family, of having to support a visually impaired child is much greater than the cost of the operation. Not only is the Government's position uncaring, it is economic nonsense and a reflection, perhaps, of the underfunding of the health service. I know that the Minister will claim that more money has gone into the health service, but I argue that the health service needs yet more money.
Hospital care for children has also been in the limelight in the past week as a result of the publication of the report of the London specialty reviews. The review relating to children recommends, as do the others, a concentration of facilities in fewer and larger hospitals rather than specialist services spread around a large number of specialist hospitals. Obviously, there is much concern among staff and patients at the hospitals affected. People are naturally concerned about the loss of national institutions.
Those fears are not confined, however, to London and the home counties. They can also be found among the people of Greater Manchester and elsewhere. For instance, Booth Hall children's hospital in Manchester—hailed as a centre of excellence by a Minister, no less—is now threatened with closure by the end of the century. Naturally, local people are up in arms. One woman who 603 was interviewed did not even know where the new children's hospital site was and she was desperately worried about that.
If the Government are to press ahead with rationalisation, they must consider providing support to families on low incomes, to enable them to visit a sick child whenever they consider that they are able to do so. I was pleased to note that that point was made by the specialist review team—a reflection, I believe, of the hard work of the Two Dear to Visit Campaign. However, despite the importance of hospital services and the media publicity that they rightly generate, we should give much greater attention to the health and welfare of children. The bare necessities of life, such as a decent home in which to live and a good diet are the basic requirements of good health and welfare.
It is a disgrace, therefore, that in one of the richest countries of the world there are increasing reports that many children do not have their basic rights. A recent report by the National Children's Home states that the number of children placed in temporary accommodation by London councils more than tripled from 14,000 in 1986 to 43,166 in 1992. Furthermore, 18 London boroughs have said that they do not have enough family-sized homes to house all their priority homeless applicants. London is certainly not alone; that is happening throughout the country.
§ Mr. Stephen
Is the hon. Lady aware that, at present, there are about 10 times as many empty houses as there are homeless families in this country? What should we do about that?
§ Ms Lynne
I am aware of that. We have to make sure that those homes come back into the public domain. The Government can help by releasing capital receipts. I know that they will release them in future, but capital receipts are still tied up. Much of that money could he spent on repairing property that is not presently used by homeless families.
Virtually everyone in the National Children's Home sample could provide a catalogue of symptoms and conditions that they and their families had suffered. Many of them were as a result of living in cold and damp conditions. Also, there were illnesses such as rheumatism which are worsened by such conditions. Those health problems are not helped by the absence of health care for many of those families. One couple claimed not to have received a visit from a health visitor, despite having very young children. As a consequence, children are missing out on vaccinations and developmental checks.
Of course, in such conditions, children's development and health are impaired. There is little or no room to play or learn. Frequent moves make it difficult for children to make and keep friends. Children are, often teased for being homeless and some become disruptive at school as a consequence. We have heard many reports of that.
The health and welfare problems of children are not confined to children in those circumstances. I have received information from a consultant paediatrician on the effects of an adequate diet on the health of children in inner cities in particular. The report showed that between 30 and 50 per cent. of children of Asian origin in inner cities suffered from iron deficiency. In one Sheffield practice alone, the figure rose to 55 per cent. of all children tested.
604 The action of iron in the brain is especially important during childhood growth. Iron deficiency might cause a delay in neurological development. Clearly, that is a potentially serious problem which the Government should address and I hope that they will. However, "The Health of the Nation" does not mention it and, in the opinion of the consultant to whom I spoke, the problem has virtually been ignored by health planners.
What is required is appropriate nutritional education by properly trained health professionals and a mass screening programme such as that in the United States, particularly in inner cities. Surprisingly, however, primary health workers who are responsible for nutrition education in Britain do not receive specific training in nutrition. Despite that, many health visitors are eager to screen for iron deficiency, but the modest capital needed for the required equipment is not available. I hope that the Government will look at the problem and take appropriate action as soon as possible.
Just those two issues higlight the health and welfare problems of vast sections of our child population. The problems are made much worse by poverty.
A report in the British Medical Journal in March this year showed that children whose parents were classified as unoccupied had the worst mortality rate of all social groups. The conclusion of the article was that strategies to promote the nation's health must take more account of material and social deprivation. If, as a result of this debate, the Government finally acknowledge that key point, the first step has been made to improve the health and welfare of a vast number of our nation's children.
I hope that the Minister will accept my final point. If children whose parents are just above the income support level are charged for prescriptions, it will be detrimental to the children's health. I hope that the Minister and his colleagues will put pressure on the Treasury to rule out the possibility that children whose parents are just above the income support level might have to pay for prescriptions in the future, because many of those parents will not be able to afford to do so.
§ Mr. David Amess (Basildon)
I congratulate my hon. Friend the Member for Battersea (Mr. Bowis) on his debut at the Dispatch Box. His promotion was entirely on merit. I hope that this will not be the kiss of death, but I wish him a long and successful career.
I have been greatly interested in the speeches of all hon. Members. The House is made up of Members from all sorts of backgrounds and we bring our own experiences here. I intend to do that today. None of us is an expert and none of us has the solution to any of the difficult problems regarding the health and welfare of our children. I certainly intend to draw on my own experiences as a father.
You may, Madam Deputy Speaker, have missed the excellent speech of my hon. Friend the Member for Welwyn Hatfield (Mr. Evans). He greatly entertained the House and made some relevant and pungent points on discipline. I wrote down one of his expressions about cuddling children and giving them a clip around the ear.
The hon. Member for Eccles (Miss Lestor) said that many of us were poor parents. I certainly admit to falling into that category because, when I telephoned my wife earlier today—not having seen her since the weekend—it 605 seemed as though there was a riot going on in my house. I shall have to return this evening to instil some discipline into my children.
In the interests of being politically incorrect on the Conservative side, I am happy to use state services in my constituency of Basildon. I am delighted to say that we have an excellent local hospital. It is a trust hospital and dispenses magnificent services throughout the local community.
I shall draw on an experience I had five weeks ago with our youngest child, who is only 18 months old. I am vain enough to say that at present she looks like Shirley Temple; unfortunately, her behaviour resembles that of the Terminator. I was up late sitting in a chair—I had fallen asleep while reading a book. Suddenly, my wife came down with the 18-month-old in her arms. Clearly, the child was running a temperature and in some distress.
When I woke up, I saw my wife dispensing Calpol. Within a flash, she said, "Phone for an ambulance." The situation then became like a horror movie. I could hardly believe what was happening because, while I was telephoning the ambulance, the child stopped breathing. Unless one has experienced that and has some expertise in how to deal with it, one does not realise what a shock that is. I learnt at first hand what a great shock it can be.
All I can say is that the emergency services were absolutely superb. There is no question that there was any special treatment or favour. This happened in the small hours of the morning. The emergency services came quickly and resuscitated our child. We ended up at the hospital. A few days later, it was explained to us that the child had overheated. Nature is so wonderful that, if that happens, the child then has a fit and everything is restored. After five children, we thought that we had seen it all. Now we know that, no matter how robust a child is, such things can still happen. I pay tribute to the marvellous treatment that our local hospital gave.
I wish to highlight several areas of activity at Basildon hospital since it became a trust. Basildon hospital not only has two wards providing comprehensive medical and surgical care for sick children but a children's centre providing comprehensive assessment and support services for parents of disabled, chronically sick and handicapped children.
The children's centre encompasses physiotherapy, speech therapy, audiology, child psychology, family therapy, social work and clubs for Down's syndrome children. The trust has recently refurbished a distressed parents room which provides privacy and comfort. It is supported by a bereaved parents counselling service which provides help for parents for as long as they need it.
Beds are provided so that every child can have a parent sleeping beside him or her or in more private peaceful facilities away from the ward. Security measures have been implemented to protect children in our care. Stringent security checks are carried out by the director of nursing and the personnel department to ensure that suitable staff are working in our wards and to minimise any risk to children.
The trust is taking a pro-active approach to increasing the number of registered sick children's nurses working on the wards. To assist with that, the trust is seconding nursing staff to attend the relevant English National Board 606 for Nursing, Midwifery and Health Visiting training course for the care of sick children. Three nurses were sent last year and three more will be sent this year. It is expected that the trust will achieve the Department of Health recommendation that, by 1995, two registered sick children's nurses should be on duty at any one time. Professional practice on the children's ward is monitored closely. Any cause for concern is rapidly highlighted. If any nurse gives cause for concern, he or she is immediately removed from the children's ward pending further investigation.
Moving on rapidly to the welfare of our children. I was touched by certain comments by my hon. Friend the Member for Welwyn Hatfield. I am convinced that there is a general lack of discipline in society. On occasions, we experience it in the House. Who are the opinion formers who set the example to our great nation? Sadly, whether or not we are to blame ourselves, it appears that politicians are becoming marginalised or trivialised.
We had a Minister resign only yesterday. I am beginning to wonder whether people will be generally satisfied with resignations. Will they want Ministers to be brought to our market squares and put in the stocks or publicly executed? One wonders where it will all lead eventually. Because I happen to love this place and believe that it is all-important, I believe that we should be listened to and have real contributions to make.
We have a real contribution to make towards the conduct of society.
§ Mr. Amess
The hon. Gentleman has highlighted the reason behind the remarks I am about to make. If we allow our discussions in the House to resort to the subject of individuals' personalities and behaviour, there is no hope for democracy. I am not ducking the point that the hon. Gentleman made, but there is a huge gulf between the socialists and the Conservatives. It concerns me greatly that we seem to make too many excuses. Where are the standards? We seem to accept the lowest common denominator. Someone must say what the right standards are. As for the welfare of our children, it is not the case that the Government—I know that the socialists want a grand plan for everything—can act as parents for our children.
§ Mr. Wicks
I believe that the hon. Gentleman has misunderstood my point. I was not talking about the Government's social policies. I was attempting to help the hon. Gentleman to develop his theme about the importance behind the way in which the Government, or any other institution, conduct their affairs and the example, either good or bad, that they set for young people in terms of honesty and integrity. I was not talking about personalities or the hon. Gentleman's mates in the Government. I was referring to Governments in general. Does the hon. Gentleman believe that Governments set a good example to our young people?
§ Mr. Amess
Oh no, I am not. On 9 April 1992—not that long ago—I was not on my own. I have no doubt that when the next election is called, all the nonsense and trivia will be put aside. The British people are not so daft that they will be taken in by the Opposition and their lack of policies, which is evident day in day out, week in week out, month in month out.
I do not want to be distracted from my argument about the welfare of our children. We need proper standards and discipline. It is appalling that the peak age for offending is 15. What are we going to do about that? Are we always going to make excuses and say that Jonathan's behaviour is bad because his parents were brought up badly and the parents of those parents were brought up badly? When are the excuses ever going to stop? We need to draw a line and say what standards are expected by a civilised society. We set the laws and we should see that they are enacted.
§ Mr. William Cash (Stafford)
Does my hon. Friend agree that children prefer a disciplined environment? Many of the difficulties and psychological problems from which children suffer stem not just from family background but from a lack of discipline. That is evident in our schools as well. The root cause of their difficulties is not only that they are not taught the difference between right and wrong but that they grow up in an atmosphere of imposed insecurity.
§ Mr. Amess
My hon. Friend is entirely right—children respond to discipline. We can see that in terms of Government behaviour—once we show a chink or weakness, the situation quickly gets out of hand. As long as we are certain that what we believe in is worth fighting for, we must he strong and determined. I have no doubt that we must take that approach to the welfare of children.
Young people are responsible for so many good activities in life. I pay a warm tribute to the local organisations in my constituency—scouts, guides, the National Society for the Prevention of Cruelty to Children, boys' clubs and pre-school playgroups—which are doing a magnificent job. The Government support and encourage voluntary organisations, but such groups cannot do it all. The schools cannot do it all—they cannot bring up the children. Opposition Members may not ask for extra money for voluntary organisations, but they ask for extra money for all sorts of things. Ultimately, the voluntary organisations cannot do it all. It is important that we all take on our responsibilities, and set and meet standards.
I have an example to illustrate the core of the problem. In February, I attempted to introduce in the House the Human Fertilisation (Choice) Bill. When it was defeated, it was a sad day for Parliament, which should be eternally ashamed of what happened on that day. I had naively thought that sex selection was undermining the essence of the health and welfare of our children. I was not ready for what happened in the House.
Feminists and others came to the Chamber to speak against and vote against my Bill. It was interesting that when, four or five weeks ago, "The London Programme" telephoned a number of hon. Members who had voted against my Bill to ask them to appear on television and articulate their case for sex selection, those hon. Members said, "Oh no, of course we are against sex selection. We 608 were only voting against the Bill because of Basildon." That lack of discipline in the House undermines the democratic process.
I thought that there would be all-party agreement on my Bill. We know only too well that sex selection runs counter to the feminist position. However, that was not the case when it came to voting on the Bill. It was voted down when a majority of hon. Members decided that life and what we were trying to discuss in the Chamber were so trivial that it was all right for parents to decide whether they wanted a boy or a girl.
I congratulate the Government on their record in the health and welfare of children. I have no doubt that, within a short time, Opposition Members will see the error of their ways and join the Government in recognising that such problems cannot be solved by the state and Government, and that individual responsibility is all-important.
§ Mrs. Audrey Wise (Preston)
I. had intended to congratulate the House on dealing with this subject in a wide context, but, having heard the speech by the hon. Member for Basildon (Mr. Amess), I feel that things have gone too far. Indeed, I begrudge every moment not devoted to the subject of the health and welfare of children.
Nothing contributes more to damaging the health, welfare and happiness of children than bad housing. I will not labour the point, because others have already made it, but I associate myself with what they said.
Every week, many of my hon. Friends and I are faced with the tragedies that are acted out in homes and, in the case of those not fortunate enough to have homes, bed-and-breakfast accommodation. Many children live in the kind of homes which can only give them the message that they are well and truly animals of the lowest order, deserving of no humane consideration. The root cause is the financial pressure on councils and housing associations.
Long ago, when my grandfather stood as a Labour candidate in a local authority election, he referred to the importance of housing. It is a pity that we have to discuss the subject today in the same terms as he used.
I believe that play is for children the equivalent of work. It is certainly of the utmost importance. My hon. Friend the Member for Islington, North (Mr. Corbyn) was mocked when he suggested that it is no use telling children to play football if they have no football ground to play on, but he had a valid point. Not only do we lack sports facilities: we lack the most elementary play facilities, even for the tiniest children. Our children are often made to play in areas where they are a nuisance to older citizens.
For some time, I have looked into the problem of the general neglect of play safety, especially of bouncing castles. The slashing cuts in the Health and Safety Executive budget perpetrated by the Government notwithstanding, it should be pointed out that, had a new machine been introduced to a factory, more care would have been devoted to ensuring the safety of its users than has been devoted to the safety of those who use bouncing castles. I was involved in an intermnable correspondence which was passed from Department to Department—none 609 of them knowing whose responsibility these castles were. Finally, the Health and Safety Executive emerged as the responsible body.
Accidents are supposed to be reported, but nothing is done to collect the statistics without which we cannot compile our knowledge of the subject. We are talking here about serious accidents—not bruises, but broken necks and a toe in an eye. Our neglect of such matters shows how profoundly unfriendly and neglectful society is to children.
I should like to touch briefly on the experience of mothers at birth. Although there has been a gratifying reduction in perinatal and infant mortality, there is no room for complacency. Social inequality is as great as ever; 4,000 babies' lives would be saved every year if the figures for social classes 4 and 5 were brought up to those of social classes 1 and 2. The figures come from a Public Accounts Committee report of about two years ago.
There is unnecessary trauma. An inquiry by the Select Committee on Health revealed that many mothers, when giving birth, experience unnecessary trauma and distress, and their dignity and their wishes are often disregarded in a cavalier fashion, to the great detriment of the beginning of their lives as mothers and the founding of their families. We outlined many splendid recommendations that have been taken up with alacrity by the midwifery profession in particular and by voluntary organisations, such as the Maternity Alliance, the National Childbirth Trust and AIMS—the Association for Improvements in Maternity Services. I hope that the Government will respond positively.
We uncovered an almost total lack of research into the post-natal health of mothers. If the health of new mothers is neglected—everything from depression to backache—the life of the infants in their care will be detrimentally affected. I therefore await energetic action by the Government.
A fairly narrow issue, it may seem, although it affects many people, is the Government's proposal that there should be a limited or selected prescription list. Last Saturday, a mother came to see me and brought with her a petition. She did not know that one has to pray to this honourable House in specific, archaic language. She just wrote down her experiences and fears and collected the signatures of other people.
Although it is not an official petition, I want to share with the House what this mother wrote. She and her husband, who had never done anything like this before, collected 900 signatures. She said:Alexandra is what would appear to be a normal, healthy, happy, six-month old baby, but unfortunately she suffers from a skin condition called atopic eczema. This form of eczema affects her in the most distressing ways, as she is unable to sleep more than two hours at one time and also requires up to eight forms of medication a day and 24-hour care. The Government is considering the removal of all types of skin medication from the NHS medical list. This would mean going without medication due to costs which cannot be met by the ordinary working family, resulting in permanent disability or full-time hospitalisation. Alexandra is one of many who will suffer if the Government is allowed to go ahead with yet another policy aimed at helpless and defence less children. Please show your support for the future of Alexandra and many like her.If hon. Members know anything at all about skin conditions, they should use their imaginations for about 10 seconds and consider the life of that family. My 610 constituent is wrong when she says that all forms of skin medication would be removed from the prescribed list. Those that would still be available on prescription, even under the Government's proposals, would be the fiercest and most potent forms, which have to be used with the greatest discretion and whose use, especially their long-term use, should be minimised.
Those potent forms of medication must be backed up by the constant use of emollients of all kinds. It is important that they should be of all kinds. Skin sensitivities are so precise and so varied that one cannot talk about generic prescribing and thereby meet the needs of these people, many of whom are children. The lives of their families will be rendered utterly miserable, as will the lives of those children.
§ Miss Lestor
When I was lobbied recently by dermatologists in Salford, I discussed this very point with them. In addition to my hon. Friend's point, they referred to the fact that, in the case of children, they have to experiment with a treatment because, as my hon. Friend said, there is no one overall treatment. The Government's proposals will cause havoc and misery to families, and will be very expensive for the parents.
§ Mrs. Wise
My hon. Friend is absolutely right. Furthermore, new sensitivities can appear. The medication often has to be changed. There is scope for further exploration of this condition and the use of alternative therapies. More research should be done into allergies. However, none of that is a substitute for topical preparations to be applied to the skin.
The proposal is concerning professionals as well as parents. I have a letter from a health visitor in Preston, who says that she comesacross many families who have children with Eczema or similar skin complaints. These children often need many months or even in severe cases, years of treatment with Dermatological creams. The area in which I work has a very high unemployment rate and a large number of single parents, as well as people on lower wages. I feel that, if people have to pay for these essential medications, they will not seek treatment if they have not got the money to buy these creams and may try to use other substances which they can buy more cheaply over the counter, but which will not be as effective. If Eczema is left untreated it can cause a lot of ill-health by introduced infection due to scratching, misery for the child keeping it awake at night, and for parents as well as the child".The problem is not confined to my constituency or only to poor families. I received a letter from a mother in Hampshire, who says:My four year old daughter has severe atopic eczema and has to use a large range of emollients together with topical steroids to keep her condition under control. She has to be moisturised regularly at hourly intervals to stop her skin cracking and peeling and I am at present using 500 grams of moisturiser on her a day. He skin is very sensitive and through trial and error we have at last found the creams that suit her. Should these now cease to be available, I know her condition will deteriorate badly. She has already had a spell in hospital and it is only the constant use of these emollients that keep her out of hospital. Surely it is more cost-effective to continue to provide these valuable creams on the NHS than to take up much needed hospital beds, not to mention the extreme suffering which will be caused to the eczema sufferers and their families.I am glad that that mother chose to write to a Labour Member. I do not know what conclusion to draw from that, but I am glad that she chose to share her information with me.
Someone from London says: 611Our four-year-old son Peter has suffered from eczema since he was six weeks old. For the first two years of his life he itched so intensely that he woke scratching several times a night and his physical and mental development was held back. In 1991 he started to see Dr. John Harper, the consultant at Queen Elizabeth Hospital for Children, Hackney"—about which I will have more to say later—and also at Great Ormond Street. Thanks to the sophisticated management provided by QEH, the eczema is now well controlled, and Peter is a happy and lively little boy … Peter regularly uses a combination of seven back oils, emollients and creams. Of these only one is proposed to remain on the Selected List. If the others are removed, we shall have to purchase them via private prescriptions at an average cost of just over £24 per week or over £1,250 per year excluding any dispensing fees charged.Both of us hold reasonably well paid professional jobs. We would manage to find this amount, simply because we could not do otherwise—although there would be sacrifices by the rest of the family. The impact on a low-income family would be horrific. (We point out that £24 a week is three times the amount of Child Benefit Peter receives).I chose to read those letters because sometimes we have to let people speak directly to the House, in their own words and from their own experiences, which often are more immediately relevant than ours.
I think that the Government hope that the general public will think that skin complaints are trivial. Of course they are not life-threatening; they are just profoundly life-damaging. A member of my family once experienced such intensive itching that she wanted to throw herself under a bus, so I can imagine what it must be like if the person affected is a baby.
I urge the Government to think again about the selected list in general, and in relation to skin preparations for allergic conditions in particular. I know that the Government have been fully briefed by the National Eczema Society. Eczema is a chronic problem, but there are other problems relating to children's intensive care needs.
Hon. Members may have seen the television programme about the shortage of intensive care beds for children; I do not intend to labour the points that it made, except to say that it reduced my mother to tears. As a great-grandmother, she imagined her great-grandchildren suffering the deprivation depicted in the programme. I hope that the programme reduced Conservative Members to tears—and, more important, spurred them to action.
One particular case that received publicity involved my own local hospital, the Royal Preston. An 11-year-old girl died of asthma, and my local hospital was one of three which could not give her the intensive care she needed. She died two miles from the Alderhey hospital in Liverpool. She lived in Cumbria; one does not need much knowledge of geography to understand the significance of that.
She was first treated at a hospital in Lancaster, but, through lack of intensive care beds, it could not give her all she needed; nor could Preston or Manchester. If she could have been treated at the Royal Preston, she would have been in intensive care considerably before the final crisis that was reached in the ambulance.
Asthma kills 2,000 people a year. It is a serious and increasing problem, and many of its victims are children. Some suffer relatively mildly, but many suffer a great deal of misery and handicap at school, for example. However, as 2,000 people a year die from asthma, it is imperative that there are sufficient beds for children, and that they are specialist paediatric intensive care beds. I have been 612 appalled by the regrettable complacency in some—although not all—of the speeches made by Conservative Members today.
However, hospital beds for children represent only a relatively small part of the way in which we deal with children's health. We do not want to fall into the trap of providing a national sickness service rather than a national health service—a national health service should be a much wider concept—but, if we cannot even manage to provide a national sickness service, we are falling at the first hurdle. That failure is affecting many children.
I refer briefly to the situation in London. I do not represent a London constituency, which possibly makes it all the more appropriate for me to draw attention to the problems facing highly deprived areas not very far from the House itself. The recent specialty review gave some valuable information and made some interesting, possibly dangerous, and certainly expensive, recommendations. I shall share with the House some of the information.
The report stated:As might be expected there is a correlation between deprivation and high admission rates to hospital for children under 15"—but, in the case of the very highest deprivation, there is a dip in admission rates which suggests that such populationsmight experience difficulty in gaining access to health care.The figures for London show that the two areas with the greatest levels of deprivation—Tower Hamlets and Hackney—have lower hospital admission rates for children up to the age of 14 than less deprived areas. That is not because the reasons for hospital admissions suddenly end. Deprivation and admissions should not follow a curve—a more deprived area having more hospital admissions—that suddenly drops if an area is even more deprived, although those children do not need to go to hospital. The figures show that there is something wrong with hospital provision. Will the specialty review remedy that?
The review recommends the closure of the Queen Elizabeth hospital in Hackney, and its transfer to the Royal London hospital site. The review says, however, that the Queen Elizabethhas a paediatric, accident and emergency service, which provides a major contribution to primary care in this locality. We heard good reports of the service provided at the Queen Elizabeth from local GPs.I cannot understand how the report could then say:We recommend as a matter of priority that the services currently provided at the Queen Elizableth are transferred in their entirety to the Royal London Hospital.The review also says:Since the proportion of children in the population is so high and their needs are so great, it will probably he necessary to reprovide out patient and day care facilities on or close to the Queen Elizabeth site … The site development plans for the Royal London will have to be worked through carefully if children are to receive the maximum benefit from our recommendations. The impressive new unit at the Royal London hospital will not be large enough to meet all requirements.I may be cynical, but I think that we shall get the closures and the transfers. I do not think that we shall get the re-provisions, the extensions and the maintenance of numbers of doctors and nurses which the report also recommends. I may be cynical; there is one way to prove me wrong.
The provision is patently too low at the moment. It is fashionable to say that London is over-provided, but, in 613 Hackney and Tower Hamlets, it is not over-provided but under-provided. Cynics like me should be proved wrong by lifting the provision first, by providing the extra first, and by stopping trying to use hon. Members such as myself, who are from provincial seats, as a stick with which to beat our colleagues in the deprived inner areas of London. Some of us saw through that ploy long ago.
§ Mr. Corbyn
I appreciate very much, as do many London Members, what my hon. Friend is saying about the health service in London. In Professor Tomlinson's proposals, consideration was given endlessly to the financial consequences to this hospital, that hospital or the other hospital. Consideration was given to the market potential of this or that hospital, and to the private sector.
No consideration was given to the problems of poverty, bad housing and homelessness throughout London, and the Government are clearly approaching the health problems of London from the wrong angle.
§ Mrs. Wise
I agree with my hon. Friend. The studies of London health care are inadequate and are endangering London's health service, which could certainly stand a lot of improvement. I think that we shall get the closures, but not the improved primary care. We shall get the closures to the children's sector, but not the extension of provision and the re-provision.
As a mother and grandmother, I would rather keep what I have, even if it is not first-class and de luxe, than have facilities closed and fail to have adequate re-provision.
In the atmosphere of cuts, there will not be adequate re-provision. It is a pity that, in discussing the health and welfare of children, we must focus on those children who may die for want of hospital care, or those who may suffer endless miserly for lack of something as simple as a cream with which to soothe the skin. I would rather have spoken, as some of my hon. Friends did, of the wider issues in society. There are so many respects in which our society—and in particular, the Government—let down our children.
I will conclude by referring to my constituency, and by making a point about adolescents. A few weeks ago, I received a letter from members of staff at the Royal Preston hospital about the adolescent unit of that hospital. The letter said:We have recently been informed that this service is to be transferred to an acute paediatric ward specialising in burns, plastic surgery and orthopaedics which will offer only four adolescent beds instead of current eight beds.The letter says that the adolescent wardoffers adolescent patients the facilities of their own lounge, kitchen, shower and laundry room, together with full-time supervision by trained nurses with dedicated responsibility for adolescent patients.The staff thought that the number of beds was to be cut from eight to four. I have found out today that there is now no specialist adolescent provision at the Royal Preston hospital. Adolescents will either go to the paediatric wards or to the adult wards.
There is now no specialist adolescent accommodation as described in the letter from the hospital staff. That is deplorable. I have no doubt that the decision has been forced on the hospital by the general stringency in the health service. I am making a criticism not of the Royal Preston hospital, but of the situation faced by our 614 hospitals. It is important that children are in children's wards, and that the special requirements of adolescents are met fully.
I hope that, in time, we will be able to say that our society properly looks after the welfare of our children, in sickness and in health and whether they are poor or from a more fortunate background. I deeply regret that that is not the case today. We cannot make that claim, and the situation is getting worse for many children and their parents.
§ Mr. Peter Bottomley (Eltham)
I made my maiden speech in the House in July 1975. In it I referred to how the trade unions represented the interests of those at work and in work, while the rest of us have responsibility mainly for family and domestic interests. Many in the union movement have rightly given attention to matters other than work-related interests.
It is worth noting that in 1975, the then Labour Government proposed a two-year freeze on family allowance, yet wanted to have a pay increase every six months for those in work. The problem was that inflation was running at a rate of 10 per cent. in the first six months of 1975. People were that much worse off in a short time. The control of inflation makes a great difference to those who care for dependants. That is where the issue of health and welfare of children comes in.
I would define health and welfare as trying to improve the chances of well-being and to reduce the incidence of avoidable disadvantage, distress and handicap. There is no point in thinking that either we or our children can go through life in a totally risk-free environment. We know that, even at the time of birth, a significant proportion of children suffer from congenital malformations or disabilities.
It is worth starting where Arthur and Peggy Wynn did in their analysis of pre-conceptual care. People should be aware that for a child born to a non-smoking father the chance of a severe congenital malformation is 0.8 per cent. If the father is a smoker and consumes tubes 20 times a day at lop a time, the chances of a child suffering a severe congenital malformation rise two and a half times to 2 per cent. That is an increase in avoidable risk which people should know about.
I do not argue that everyone can give up smoking straight away. I call smoking tubing to avoid the glamorous word. I prefer to say more accurately that people buy a tube which is three or four inches long, bring it near their faces and light it up. That practice can increase the chances of severe congenital malformation by two and a half times. It should also be known that if a mother has consumed significant amounts of alcohol in the 48 hours before conception, that also has a statistically significant effect on the chances of a child being born with a handicap.
I do not want to pretend that handicap has to be life changing. People can come to terms with handicap and many handicaps are not terribly relevant to people's lives, although some are. However, the smoking and drinking to which I have just referred are, in terms of avoidable disadvantage, distress and handicap, things that people should know about.
I believe that people should be practising what I call "conception control" if they are sexually active at a young age. There would then he a greater span between the 615 generations and people would move from puberty and grow up before taking on the responsibility for children at too early an age.
One of the developments that I have welcomed over the past 10 years since the House began to debate family policy issues is demonstrated by the fact that The Daily Telegraph now has a weekly family supplement. As well as the more jolly things, that supplement refers to some of the more serious things in life.
I have a plea for our radio and television broadcasters. Most of us who watch television or listen to the radio are aware that, every week, there are startlingly obvious programmes about gardening which tell people, for example, "Now is the time to prune your wisteria" or "Now is the time to scratch the thatch from your grass."
When will we have programmes to help the 600,000 or 700,000 people each year who are forming a family or the 200,000 or 300,000 people who are going through family separation, divorce or break-up? What about the 1.4 million people who contribute to a pregnancy which leads to birth or the 1.4 million parents whose children reach primary school age each year? What about the 1.4 million parents whose children reach the troubled teenage period?
In addition to the soap operas, there should be opportunities, in five-minute or 10-minute bursts once a week or half an hour a month, to raise the kind of issues that parents face for the first time because those issues have been faced by generations of people before. Such coverage might help people to develop confidence and competence in the experiences that they face.
Parents are primarily involved in raising children. They determine most of the health and welfare. They improve well-being and help reduce the avoidable risks that children face. Parents are even more important than the medical and social services and teachers. Clearly, when parents can work in partnership with the professions, life becomes much better for the children. That is clearly shown by the remarkable figures produced by the national health service in relation to child immunisations.
There is a difference between the apparent Labour party position and the Government's position in respect of child immunisations. About five years ago, some 40 years after the establishment of the national health service, we woke up to the fact that we had a lower level of childhood protection against avoidable childhood diseases than there was in Zimbabwe or Beirut in the middle of civil war. We had taken our eye off the main aim of the NHS, which is to cut out avoidable or disabling disease.
Taking the figures generally, it was clear that the worst problems were in the inner-city areas. People asked whether it was difficult to set the same immunisation target for inner-city areas as for suburban or countryside areas. Although I do not want to stress this too much, at that time, some Opposition Members thought that we should set a lower target for immunisation in inner-city areas, because the problem there was more difficult.
I believe that the Government were right to say that, as the problem was more difficult in inner-city areas, there should be greater incentives to reward doctors and others. It was clear that the parents would be rewarded by the fact that their children would not fall ill. There was an incentive for doctors and practices to provide good support staff, to involve the parents and to create a culture in which parents were aware that protection was important, knew how to get it and received reminders if they forgot to come forward at the right time.
616 I am not convinced that we were right to allow the school medical service or the school nursing service to die away. What we have managed to achieve in respect of the first six to 18 months of life should be extended throughout the school years. I ask the Government to consult people in the education service, the national health service and the royal colleges to see what can rightly be done at reasonable cost to try to extend the advances that we have re-established for the very young to children of primary and secondary school age as well.
There are some shocking facts in terms of the well-being of children. One is that eight is the peak age for a male child to be hit by a car in a traffic crash—not an accident, a crash. The peak age for a female is 11. That in part answers the question about the difference between boys and girls or men and women in terms of crime and so on. We give more protection to our daughters than to our sons. If we could extend protection of our sons for an extra three years, they might turn out still to have exciting, risk-taking lives but not to the ludicrous extent that so many of them get themselves killed by cars and not to the extent that they get into habits or activities out of school which lead to a life of crime for a period.
It will come as a surprise to many people listening to this debate that, by the age of 30, 30 per cent. of men have been convicted of a serious criminal offence—one for which they could have been sent to gaol for six months or longer. Studies—sadly, they are not up-to-date studies; they are not the result of a sudden crimewave—showed that 10 per cent. of 15-year-old males and 25 per cent. of males by the age of 21 have been convicted of a serious criminal offence. That is a lack of order on which we should focus.
It comes down to care and control. I have always put the emphasis on "order" rather than on "law". We bring in law to define as criminal behaviour that which is seriously anti-social or dangerous. It is the order or structure that matters.
I visited an impressive primary school—Middle Park—in my constituency, where ordinary teachers with ordinary children managed to have control and care in an assembly in which no voice was raised and in which teachers could speak to 200 or 300 people even more quietly than I am speaking now. Children from each class were rewarded for an improvement in their behaviour or for their work. They got recognition for the good things. They were treated by the teachers in a calm, quiet way. I should like that attitude to be extended to secondary schools as well. In my constituency, I recently learnt a good deal about the upbringing of three children, Georgina, Stuart and Stephen. I heard about how they have been taken along to Sunday school classes, how their parents encouraged them at primary school and at secondary school, about their weekend activities, and about Stephen and his father doing things together. I also heard from others such as a police inspector who used to go running with Stephen, who was involved in the London marathon—a very fine thing for someone approaching 18. I also heard how Stephen had worked at school and was going to qualify as an architect. I heard from ministers in the Methodist Church how the family of parents and children attended church together.
That is the kind of upbringing that many others in my constituency would benefit from. If more people had the upbringing that Georgina, Stuart and Stephen received, fewer children would get into serious trouble and we 617 would certainly cut the number of those who wander aimlessly around the streets with knives—one of whom, sadly, murdered Stephen at a bus stop in my constituency about two months ago. That might be an extreme case, but one should look upon Stephen's family as a normal family—people who are capable of doing the things that hon. Members pontificate on.
I ask my hon. Friend the Minister to consider a decent response to this national year of the family. I make two suggestions. First, every three to five years—perhaps starting next year—there should be a publication across Departments on what the family policy targets are. By "family policy", I am not talking about what people should believe or what they should do with their bodies—we can get over-excited about such things; in my 18 years in the House, no one has ever come to my surgery to ask for advice on either matter. They have come to ask for advice on the upbringing of their children and how to overcome some of the barriers which are in front of them. Those barriers are rather more in front of the poor, the underprivileged and those who have bad housing than others.
The targets set in 1986 by the Department of Transport for reducing casualties have led to a reduction in serious injuries of 35 per cent. The number of deaths is down by 25 per cent., although traffic has increased by about 30 per cent. Such targets have worked in child immunisation and casualty reduction and can work in other areas such as education. Targets can be specified in health, the Home Office and housing.
I ask my hon. Friend the Minister to consider setting up across Europe a framework for cohort studies, perhaps with European Community help. The child cohort studies were the ones that gave us the first clue to the impact on child development of mothers smoking.
With a basic framework, all European countries in the Community—and perhaps some outside—could cooperate to set up a new cohort study every seven years and provide framework funding so that we can carry out further analysis as people go forward. That would be a positive approach—it would not require a directive, but could show co-operation.
As a final European point, the House knows that 20 children a year die unnecessarily on our roads because we refuse to move to common European time. Obviously, there is some risk to children going to school in the mornings, but there is a much greater risk to children coming back from school and during the hours when they are playing. There would be the same number of hours of daylight, whether we had common European time—as I call it—or double summer time and we moved to an hour earlier in winter, instead of Greenwich mean time.
The number of deaths and the number of serious and slight injuries are predictable. The work has been done by the Transport Research Laboratory. The gain in Scotland is as great as, if not greater than, the rest of the United Kingdom.
If there is any other field of public policy where we knew that we were condemning 140 people to death because we could not bother to apply common sense as a result of some political failure, we would change smartly and the newspapers would be right to criticise if we did not. I ask the newspapers to start examining the issue of 618 the 20 children and 120 adults who will die unnecessarily this winter because we cannot move to common European time. We should start to have that sort of rational approach which leads to great benefits to our children in terms of their health and welfare.
§ Mr. Malcolm Wicks (Croydon, North-West)
It is a pleasure to follow the hon. Member for Eltham (Mr. Bottomley) because we worked together for a number of years when he chaired the Family Forum and I was at the Family Policy Studies Centre.
I shall outline some of the key trends and issues relating to the themes in this debate on health and welfare as they affect families with children in the United Kingdom. I shall outline some trends that are associated with insecurities and new needs. We always need to balance that with a recognition that some of the new trends and emerging family developments are associated with strengths.
I can remember the hon. Member for Eltham talking about backing the sense of competence and confidence of families. We need to do that. When we discuss family life in Great Britain or read about it in our newspapers, it is as though the trends are pointing in a downward direction and we ignore some of the strengths. We always look back to the golden age of the family—I suspect that the historians among us would say that it never existed. The remarkable capacity of the British to be optimistic only about the past is something which we need to question. I am as interested in the strengths in family life as in its weaknesses.
We need to understand the major changes that now affect societies like our own—I include the European family, because the trends are not restricted to our own shores. Those of us who are interested in family policy and in relating matters about health and welfare to a wider policy agenda affecting employment, law and order, housing and many other matters must understand the force of some of those changes. Some of them are remarkable in terms of their scale and development over a relatively short period.
Let us recognise that more and more of our children are born to people who are not formally married. The increase in the proportion and number of children born outside marriage is demographically significant. It may have social significance, too. We need to understand it. Back in 1981, just 13 per cent. of our children were born outside marriage, most to single mothers. Today, almost one in three children—32 per cent. at the end of 1992—are born outside marriage. The change that has taken place is that, although many of those children are still born to single mothers, about half are born to cohabiting couples. The increase in cohabitation has taken place throughout Europe. The level of cohabitation is high in Scandinavian countries, but it is on the march throughout Europe. It is of social significance. As someone who is interested in analysing such issues and examining data, I worry that we know too little about that trend.
I am pleased that my former research institute, the Family Policy Studies Centre, will soon publish a report funded by the Rowntree Foundation on cohabitation and its significance for social policy. We do not know much about the trend and its significance. If the children born outside marriage—whether to cohabiting couples or to single mothers—were as secure and had the same needs as 619 those born to the more conventional families, cohabitation would be a matter of interest only to theologians, churches and so on. It would have no social policy implications. At present, we do not know the answer to the question whether the life chances of children born to cohabiting couples are any different from those born to conventional married couples.
We rely to a great extent on the official collection of data on matters such as the number of marriages and the number of divorces for our social analysis. Therefore, let us recognise that our official statisticians are not capturing many emerging family patterns. If a couple cohabits and the relationship breaks down, with consequences for the children, by definition that is not captured in statistics on divorce because if the two people were not married in the first place, they do not divorce. We all get excited about the number of divorces every year and whether it has risen a little or fallen a little. Let us remember that that statistic captures a smaller proportion of the picture of family breakdown than it did a generation or even 10 years ago. That is significant.
The importance of cohabitation has increased. More couples choose to have a child before marriage. Most of the couples go on to get married. In older generations, of all the things that one did, one got married first. Certainly in Scandinavia, and to some extent in Britain, marriage is the thing that people do at the end of the process. The Swedish demographers tell me that a couple may have one child and then get married when the second child is on the way or the first child goes to primary school.
Although many pundits deplore the decline in the popularity of marriage, the remarkable thing sociologically is that marriage is still so popular. Most of the material and legal advantages of marriage have disappeared—although not all of them. Yet by the year 2000, seven out of 10 people will probably still get married. That is the interesting factor which has policy implications.
As we all know, marriage is an increasingly risky institution and occupation. Of new marriages taking place in the late 1980s and early 1990s, 37 per cent. will end in divorce. The proportion seems to be increasing. The significance of that to today's debate is clear, because most of the marriages that break down will involve children under the age of 16. That is a worrying factor. Every year, approximately 160,000 children in Britain see their mum and dad divorce. The risk of a child under the age of 16 having divorced parents is about one in four.
I urge the House to examine those trends carefully. In 1969, for England and Wales, and a few years later for Scotland, the House decided to legislate for easier divorce. Personally, I have no quarrel with that decision, but I doubt whether the House was able to think through the social, psychological and economic implications of its decision for so many of our children.
The evidence that is emerging increasingly proves that divorce can be an economic and emotional disaster for adults and children. I am not pleading that the clock should be put back and the law changed—far from it—but we should recognise that the social revolution in family life has not been bloodless. It has had calamitous consequences for women and children in particular, although I know that men, too, have been adversely affected.
Although many one-parent families have been created by divorce, many result from the rise in single parenthood. 620 The economic consequences of that are obvious. Surely it is worrying that as many as seven out of 10 such families are dependent on income support. Of all one-parent families, 85 per cent. will spend some of their lives on income support.
If I were Chief Secretary to the Treasury—I doubt whether that will happen for a while—and I were undertaking a review of public spending, I would not have started at the end of the process. There is no point in asking why we are spending so much now and what we can get away, politically, with cutting. I would start at the beginning of the story and I would try to understand why more and more of our people and families with children are becoming socially insecure. I would ask questions not about social security benefit but about employment, training and child care. I would ask how we can create socially secure families. If I were serious about cutting spending on social security, that is where I would start. Perhaps the Government will prove me wrong in showing that they have had the wisdom to start at the beginning of the story. That is always a useful place to start.
Divorce and the rise in the number of one-parent families have produced more socially insecure children. There was a time when some people wanted to hope that the great social revolution of family change was having no calamitous consequence. However, research from my former institute, the Family Policy Studies Centre, shows that on a range of indicators, based on longitudinal survey data, children in one-parent families do less well than those in intact ones. That is clear whether one is studying data on the numbers who acquire educational qualifications, on those who leave school early at 16, on those who form a cohabiting relationship or on those who have a child while still a teenager.
It would be good to debate the balance of reasons for that disparity, which range from material and economic disadvantages, which I would stress, to the psychological and emotional difficulties of bringing up a child single-handedly. I would certainly lay stress on the sheer difficulty of doing that. I sometimes think that debates between ideologues about one or two-parent family life should give way to a new movement for three or four-parent families; the costs and strains are now so immense that the more parents a child has, the better!
Today, between one in five and one in six of our children are brought up in one-parent families. Life is tough, emotionally and psychologically, for many of them. Those children are more likely to leave home early because of family break-up. Life is also very tough materially and financially. Those difficulties should be one of the major issues on our future social policy agenda.
The political right use the term "dependency culture". As a relatively new Member of the House, however, I am struck by the number of people in one-parent families who come to see me at my advice surgery who, for want of other opportunities, or for want of realising that they exist, are totally dependent on the state. Life is not good in such circumstances. If all that people can look for is more money from the income support system—goodness, they need it—or a slightly better flat in a local authority tower block, life is tough. If we are to offer hope to so many children we need a new agenda on training and employment.
Another significant change that we need to consider is in the pattern of work and family life. We now have almost contradictory trends—the rise of mass unemployment 621 means that many children in this country do not know what it is like to be in a family whose head, whether woman, man or both, gets up early in the morning and goes out to work. Many children do not have experience of that working pattern. By contrast, more of our children are growing up in families where both the mother and father work outside the home. That has important social policy implications for child care.
I know that other hon. Members wish to speak, so I shall curtail my remarks. The policy implications are important as they show the interdepartmental nature of the family policy agenda. The Minister rightly talked about the concerns of the Department of Health from his departmental base. But we are talking about a far wider policy agenda than that.
The 19th century public health reformers found that if one wants to improve the nation's health, one does not necessarily start from doctors and hospitals but should consider housing and general public health measures. In the same way, many of today's key policies on health and welfare involve education, housing, employment child care and training. I hope that we shall adopt that wider agenda in future. The key to the policy is to build a partnership between the family and the state. It is an idle debate to pretend that either the state or the family can do everything in terms of pre-school care and health and welfare. We must ask what partnerships we need to build in future.
One aspect of the moral dimension that we should stress is that the rapidly changing social patterns and the emergence of new family forms—one-parent families and step families—can be associated with stress. We need to debate the subject of step-families more frequently, as 9 per cent. of children are in step-families and many of them face difficulties and stresses, which we seldom debate or recognise.
How should we build the partnership and what balance should we strike between the rights of families to work, child care and training, and family responsibilities? How do we strike the right balance between duties and rights in the future? Such questions should form the cornerstone of future debates on family policy.
§ Mr. Jonathan Evans (Brecon and Radnor)
I thank the hon. Member for Croydon, North-West (Mr. Wicks) for his characteristic generosity in allowing me enough time to contribute to the debate. Having listened to the contributions, I must say that it has been a pleasure to be here, as the quality of speeches from both sides of the House has been high.
I shall refer to only two contributions, but that does not mean that I think that the other speeches were not worthy of comment. My hon. Friend the Member for Chislehurst (Mr. Sims) drew attention to the guidelines on sentencing on incest. I agree with most of what he said, but I shall voice a caveat about his perception that, in dealing with such crimes, we should be interested only in punitive sentencing. I say that knowing of specific cases in which a child has drawn attention to an incident of sexual abuse and a close relative such as a father or uncle has been 622 arrested and charged with the offence. The effect on the offender has been to produce such feelings of guilt that there have been instances of suicide.
I ask the House to consider the effect of such events on the child who has drawn attention to the abuse—probably, dare I say it, with no clear perception of what the abuse amounted to. If the child draws the abuse to the attention of the authorities and loses the relative involved, it can have a crushing effect on the child. When considering the guidelines on incest, it is important to bear that factor in mind.
The hon. Member for Newcastle-under-Lyme (Mrs. Golding) rightly spoke of the importance of listening to children, and I endorse her comments. We need to listen not only to children at home and at school but to children in care. So often when children in care have had something to say about their experiences, they have not been heard. There have been several recent instances of that.
I must declare an interest as president of the National Society for the Prevention of Cruelty to Children in Cardiff, vice-chairman of the Welsh council of the society and honorary consultant on law and policy to the society. I have acted for the society in Wales for many years in many of the cases that it has brought before the courts. I am pleased that the society in Wales is working on two projects with local authorities, creating children's rights officers with the primary aim of encouraging children in the care of local authorities to feel that they have an independent person to whom they can turn.
Over the years, the perception of child care on the part of the legal profession has undergone quite a change. When I first qualified as a lawyer, we were not required to have any training in the subject. A great deal has altered since then, culminating in the 1989 Act. Now, we have panels of specialist child care lawyers. Here I declare another interest as a member of the Law Society's panel of specialist child care lawyers.
Some aspects of the Children Act are worthy of the description of the most radical reforms of child law this century. The emphasis on working together—much debated throughout the 1970s and 1980s—is one. The hon. Member for Eccles (Miss Lestor) mentioned the fact that there have been many inquiries in the past, and one of the key lessons to emerge from them was the necessity for professionals to work together, to share information and to develop a multi-disciplinary approach. That was encapsulated in the legislation, which also emphasised parental responsibility—although how we enforce that effectively is a continuing question. It is all very well to emphasise perental responsibility, but many cases arrive in court because that responsibility has not been exercised or has been exercised wrongly.
Another great advantage of the Act has been the training of magistrates and judges. It is now first class—so much so that it has become rather better than the training given to lawyers. Some aspects of the Act, however, need to be treated with caution. I drew that to the attention of my hon. Friend the Member for Mid-Staffordshire (Mr. Fabricant) when he referred to the fall in the number of emergency protection orders. I simply do not believe that there has been a dramatic reduction in child abuse, and I am not yet persuaded that only the cases that need to be brought before the courts are being brought. Herein lies the fear about the complexity of the legislation. In other respects, it was certainly a great step forward, but had it come to the House three or four years earlier it would have 623 emerged rather differently. It followed the Cleveland inquiry, and it was more parent-centred than child-centred.
The Act involves a great deal of bureaucracy and I fear that that may partly explain the reduction in the number of cases that have been brought under it. We need further to examine the role of the law in respect of children. As the editorial in the current issue of the "Practitioners Child Law Bulletin" asked,Is child law good for children?Have the complexities of the legal system started to override the interests of children? That is a matter perhaps for philosophical debate, but we need to keep it at the forefront of our minds.
The NSPCC, in its justice for children campaign, drew specific attention to the fact that that question was bound to be answered more on the side of the legal system than on the side of the child. The NSPCC view is that when children are caught up in legal proceedings, their needs are not met. It is often the case that the different professionals, working together, pay specific attention to their own needs in the proceedings and sometimes lose sight of the needs of the child. Nowhere is that more clearly illustrated than in the approach adopted by Crown Prosecution Service lawyers in taking cases before the courts.
I have been given specific instances by the NSPCC of young children who have drawn attention to abuse that they have suffered. An eight-year-old child, of perhaps limited intelligence, may manage, through foster parents, to draw attention to an instance of abuse. One case that was drawn to my attention showed that this child was unable to differentiate between reality and fantasy—so much so that the child believed that a pantomime was real and was therefore sick as a result of the fear of being present at that event. Unfortunately, that child was unable to receive therapy. The Crown Prosecution Service felt that evidence of that treatment might be used in court, and that it would he claimed that in some way the child had been coached for the proceedings.
This is an important matter. The way in which professionals deal with cases and the way in which the Crown Prosecution Service takes steps to protect the interests of children will no doubt have to be discussed by the House on a future occasion.
§ 2.2 pm
§ Mr. Jeremy Corbyn (Islington, North)
I am grateful for having 10 minutes in which to speak and to other hon. Members for co-operating on the timetable. I am particularly pleased that the hon. Member for Eltham (Mr. Bottomley) mentioned the appalling case of the murder of Stephen Lawrence and the horrors that followed for that family and so many other people. It is a scourge on the country that young people like Stephen should be murdered in such a vile way. I hope that the media will recognise the horror of racist attacks and racist murders and the increase in the number of those crimes throughout the country.
We are debating the health and welfare of children. I believe that there is a strong link between the welfare of children and the poverty of the family and the area in which they live. There has been a study of children's health needs in London. An independent review of specialist services in London was published this week. By means of a series of tables, it shows the Townsend score of deprivation in inner London districts.
624 The deprivation level for my district, the Bloomsbury and Islington district health authority, is seven, which is quite serious. The highest score is 11, which is for Tower Hamlets. The average figure for inner London is seven and for outer London districts minus 1. Those are much less deprived areas and they are relatively affluent. The score for the other districts in the four Thames regional health authority areas, which extend out into Essex, Kent, Middlesex and Surrey, is given as minus 3, which means that, by comparison, they are very affluent.
It is hardly surprising, therefore, that infant mortality rates and perinatal mortality rates in inner urban areas such as those that I represent are considerably higher than elsewhere. Therefore, I would say with the greatest kindness to the Government that they have got their health strategy for London wrong. London does not need rationalisation and hospital closures. What is needed is a serious examination of the health of Londoners, particularly of London's children and of the associated socio-economic problems, and a rapid improvement in primary care, housing and education facilities. That would be the best possible contribution to the health needs of inner London children.
A serious problem, which has not had much of an airing, is the high level of air pollution in London, as well as environmental concerns. I firmly believe that there is a link between the high levels of bronchial and asthmatic conditions among children and air pollution. One only has to go into any infant of primary school and talk to the school secretary. There one finds a shelf full of Ventolin sprays that are given to children during breaks and at lunchtime. It cannot be right that the solution to air pollution in London is the prescription of more and more Ventolin to children to alleviate their suffering. The problem, surely, is the air quality of the city. I am glad that many hon. Members have signed my early-day motion on the subject, because unless we consider the transport, industrial and waste incineration problems of London, air pollution will only worsen. The Department of Transport follows a policy of encouraging car use in London by increased road building. These problems must be investigated.
The area that I represent is an inner-city community. There is a danger, which other hon. Members have mentioned, in saying that somehow or other if children are more deprived in a poor area it is because their parents or guardians care for them less than parents from more affluent areas care for their children. That is not true. Many parents care dearly, want the best and do the best for their children, but that is a little difficult when both parents are unemployed and live in high-rise blocks with inadequate play space, no single bedrooms for the children and none of the things that many hon. Members simply take for granted.
Like other hon. Members, I hold a constituency surgery every Friday evening, which is always packed. There is a huge queue every time I arrive. I have a fair idea what most of the problems are, because they tend to repeat themselves week after week. The majority of them relate in some way or another to poverty and bad housing.
Children come in with their parents to see me and in order to be able to talk to parents I often say to the children, "Would you like to draw a picture?" and I keep a handy supply of toys and bits of paper for them. I said to one little girl, "Would you like to draw me a picture?" She said, "What of?" I said, "You choose whatever you 625 want and I shall look at it when you have finished." I spoke to her parents about their housing problem and 10 minutes later she gave me her picture. I asked, "What is that?" She said, "It is my dream bedroom." She has to share a bedroom with two older brothers, and there is little chance of their being offered a reasonable-size flat in the near future because my borough council is not allowed to build or buy anything. The only construction is a small number of housing association properties. The number of people who are in bed and breakfast, the number who are street sleeping and the number who are concealed homeless is increasing. The problem is getting worse not better.
If hon. Members talk to teachers in inner-city infant schools and nurseries about the problems that are associated with overcrowding and bad housing they will begin to understand why children under-achieve at school. We want the best for our children. We should like our children to grow up with the ability to play in parks and gardens and have their own bedrooms. That would be heaven for many of the children whom I represent and I ask the Government to look seriously at such social problems and the background to them.
There are connections between the problems of children's lack of achievement and pre-school education. I believe strongly in the need for a wide variety of pre-school education. Socialisation among small children is important. The ability of children to play safely and the ability of parents, particularly single parents, to get a break when the child is at playgroup, nursery, creche or whatever is vital.
The importance of access to good, qualified nursery education cannot be over-emphasised. Life is a complete nightmare for many parents who are both working. It is incredibly expensive for parents to put their children into private nurseries because they cannot get them in local authority nurseries. They then have to arrange other kinds of informal care, which are often very expensive and, in some cases, extremely unsatisfactory.
The provision of nursery education is particularly important. My borough has a fairly good record on attempting to provide pre-school nursery education. We are not thanked, applauded or helped by the Government for doing that. Indeed, quite the opposite. Islington, like other inner-London boroughs, apart from Wandsworth—we should all like parity with Wandsworth's standard spending assessment—has done badly in its SSA. Wandsworth, like Westminster, has been dealt with specially by the Government to return a Tory council—the Minister, the hon. Member for Battersea (Mr. Bowis), knows perfectly well what I am talking about.
In Islington, two nurseries—Springdale and Harvist—are due for closure. The parents and those who work there have occupied them and undertaken to continue to operate them to try to persuade the council to keep them open. At one level, the argument is with the council because the council has decided to close them. There is strong support for what the parents and workers are doing and I hope that the council rescinds its decision and decides to expand nursery provision. All the parents, children, neighbours and the hundreds and thousands of people who have signed petitions supporting the nurseries know that the real problem is central Government's attitude to inner-city local authorities. The victims of that 626 attitude are often children and the very poor of those communities. I hope that we shall not lose sight of those connections.
I have very little time, but it would be remiss of me not to make two further points. First, if children are to be able to develop, they need open space. I like the idea of children playing sports—football, cricket or whatever they want to play—and of their having decent play facilities. It is a bit rich of Conservative Members to say that there should be better sports facilities in inner-city schools when the Conservative Government, through the London Residuary Body, is selling playing fields all around London. Schools in my constituency have to rent playing facilities from private schools on the outskirts of London in order to have a sports day because they have no sports fields of their own. That cannot be the right way to treat many inner-city children.
What about library closures and the reduction in library opening hours? It means that children have few outlets other than to watch endless television programmes, some of which are good, some of which are bad and some of which are appalling. Alternatively, they play video games, some of which are good, some of which are bad and some of which are downright evil.
Secondly, there is an international dimension to today's debate. When I arrived home from the House a few weeks ago, my son Ben, who is six, rushed to meet me at the door and said that he wanted to talk to me about something very important. He had just been watching "Newsround" and wanted to know what the Government were doing about the import from India and elsewhere of carpets made using child labour. Although we want the best for our children, we should also ensure that our trade policies are not leading to the exploitation of child labour in other countries simply so that we can import cheap carpets and crafts.
That leads me to the problem of unaccompanied child refugees. The Government recently fought bitterly against an amendment that would have guaranteed the statutory provision of a supporter for every unaccompanied child refugee. We have a great deal to do to ensure that our children—and all children—grow up in a safer and cleaner environment than we have so far managed to achieve.
§ Mr. Hinchliffe
With the permission of the House, Madam Deputy Speaker, I shall speak for a second time.
This has been a useful debate. I am grateful to my hon. Friend the Member for Islington, North (Mr. Corbyn) for putting it in an international perspective, which had been lacking. Many of us are aware of the need to deal with the issues that he raised.
I listened carefully to and agreed with many Conservative speakers, but it is commendable that the majority of Labour Members who have spoken have been women, whereas no Conservative women have spoken. I believe that women bring a specific perspective to these issues, and it is helpful to have a balanced debate.
Time is limited, but I shall pick up one or two points that have been made. One of the main points made by the hon. Member for Brecon and Radnor (Mr. Evans), with whom I entirely agree, was that we should not rely too heavily on statistics, especially in relation to child welfare. I think that the Minister will probably accept that. I speak with some concern because I was a social worker under the 627 old law, prior to the Children Act 1989. I am absolutely convinced that too many place of safety orders were taken out under the previous legislation, often to protect the social workers who were being attacked by the media for not acting.
I am sorry that the Minister does not take more seriously the daily dilemma facing many social workers. They must decide whether to intervene. From personal experience, I know that, whatever one does in social work, one is wrong in somebody's eyes. We should recognise that and praise the valuable work of many social workers. If we are concerned about unallocated child care cases. we are saying, in a roundabout way, that social workers are doing a reasonable job.
We have had some good speeches and some less serious speeches in the debate. The people who entertained us have departed long ago. I shall not spend too much time responding to some of the rather silly points that have been made in what, overall, has been a useful and constructive debate.
I was sorry to hear the Minister talk about the little villians and young thugs. He needs to analyse the issue deeply. Are these little villains and young thugs born bad? If they are, the task of social policy is to pick up the ones who are born bad and to lock them up from the word go so they will not cause problems. I do not believe that children are born bad. We must address the issue, which has been picked up by Conservative Members as well as by some of my hon. Friends, of why a small minority end up causing society difficulty. I am sorry that the comments of certain hon. Members did not contribute to serious thinking on those issues. It is all very well talking about socialist do-gooders, but we should remember that the Government have been in power for 14 years and must, therefore, have some responsibility for the overall state of British social policy.
Conservative Members talked about blaming the parents. I listened carefully to the serious speech made by the hon. Member for Eltham (Mr. Bottomley). How we prepare parents is an important point. I was in no way prepared to be a parent. I had no preparation whatever for the most important task of my life. One learns as one goes along. I have made mistakes—we all have. There is something that we can do and the hon. Member for Eltham was right to make such points.
My hon. Friend the Member for Eccles (Miss Lestor) spoke with great authority and experience. She talked about the decline in the school health service—a point echoed by the husband of the Secretary of State for Health who talked about the service dying away. We should all be concerned about that. My hon. Friend the Member for Eccles may be aware that a report is due to come out in the next couple of weeks from the British Medical Association, the Health Visitors Association and a number of other organisations. It deals with the issue of attempting to resurrect this crucial children's health service.
The hon. Member for Chislehurst (Mr. Sims) made his usual serious and well-thought-out speech. He and I do not agree on everything, but I believe that he made some important points and I hope that his hon. Friend the Minister will listen to his plea for a children's rights commissioner.
My hon. Friend the Member for Newcastle-under-Lyme (Mrs. Golding) made a brave and sensitive speech on how we deal with child sexual abuse. How is it that only some people abuse children and how do we deal with those 628 people? Is imprisonment the best way? My hon. Friend made an important point by saying that we need to fund the few clinics, such as Gracewell, that have a different approach to the treatment of people who offend in such a way. Are there other forms of dealing with sexual offenders?
The hon. Member of Mid-Staffordshire ( Mr. Fabricant) talked about Labour's attack on family values, but he was not able to substantiate his point, so I could not understand him. I felt that he overdid the argument that the Children Act 1989 introduced the concept of parental responsibility into law. Having worked in child care from the late 1960s, I am aware that there has always been parental responsibility in law. It has been addressed in a different way by the Children Act, but the hon. Gentleman should not go away with the impression that, suddenly, we have something different. We have not.
The hon. Member for Rochdale (Ms Lynne) raised the Two Dear to Visit campaign. It rings a bell because, in my constituency, parents have expressed concern about having to pay to park when they see their children in hospital. We are reaching a bad state of health care when people have to pay to go to see their loved ones in hospital, and it is causing great problems.
My hon. Friend the Member for Preston (Mrs. Wise) made a powerful speech about maternity, the Select Committee report on the selected list and skin complaints and, especially, on the implications of the shortage of intensive care beds for children and the tragedies that arise directly from that. I take note of her comments on the implications of the specialty review in London. We are aware of what the review may mean in terms of retarding health care in London.
I agree with virtually everything that the hon. Member for Eltham said about smoking, about preparation for partnership and parenthood and about the role of males in crime. The socialisation of men must be addressed seriously. I have raised that matter before—and have been laughed at—but we must be concerned at the damage that some men do in society, and to women and children.
My hon. Friend the hon. Member for Croydon, North-West (Mr. Wicks) made the useful point that divorce statistics understate the extent of family breakdown.
My hon. Friend the Member for Islington, North made what is, I believe, the key point in today's debate when he drew attention to the crucial link between child welfare and poverty. If we are to make that link, we must adhere to the United Nations convention on the rights of the child. I suggest that, if he has not yet done so, the Minister should look at what is in the convention. I draw his attention to one article whose conditions the Government have not met. Unless we meet them, we cannot honestly claim to adhere to the convention. Article 24 gives a child the right to clean water. I came across a case recently of a 12-year-old girl who had commenced menstruation whose family had no water for her to bathe in. Buckets of water had to be brought to her house to deal with those circumstances. That is unacceptable in this day and age. The Government have taken from numerous families the right to clean water.
The Minister said that children should be enabled to achieve, and I agree. My concern about Government policy is that, in so many ways, it is not enabling children to succeed.and achieve. That is, to me, the central message of today's debate.
§ Mr. Bowis
With the leave of the House, Madam Deputy Speaker, I shall respond to the debate. First, I thank the hon. Members for Wakefield (Mr. Hinchliffe) and for Rochdale (Ms Lynne) and my hon. Friends for their kind words of welcome. I also thank everyone who has participated in a thoughtful and good debate—the hon. Members for Wakefield, for Eccles (Miss Lestor), for Rochdale, for Preston (Mrs. Wise), for Croydon, North-West (Mr. Wicks), for Islington, North (Mr. Corbyn) and for Newcastle-under-Lyme (Mrs. Golding), as well as my hon. Friends the Members for Mid-Staffordshire (Mr. Fabricant), for Welwyn Hatfield (Mr. Evans), for Chislehurst (Mr. Sims), for Basildon (Mr. Amess), for Eltham (Mr. Bottomley) and for Brecon and Radnor (Mr. Evans). My hon. Friend the Member for Plymouth, Sutton (Mr. Streeter) unfortunately did not succeed in participating, but perhaps he will follow in his predecessor's footsteps and include the occasion in his diaries.
The hon. Member for Wakefield referred to infant mortality. I must correct his comparisons with Europe. We are on a par with the best in the European Community. Our achievements are the same as those of France and Germany. The hon. Gentleman is looking at examples from Scandinavia, where Sweden has reached the figure of four per 1,000, which is our target, too.
The hon. Gentleman said that unemployment was important and I would not disagree with that, but he forgot to mention or to welcome the fact that unemployment has fallen for the past five months. No doubt that was an oversight.
The hon. Gentleman referred to homelessness. He would acknowledge that lead responsibility for the homeless lies with my colleagues at the Department of the Environment. However, as much research has shown that many young people who end up sleeping rough have been in local authority care at some stage in their lives—a point made by the hon. Member for Eccles—I naturally also take a strong interest in that area of policy.
During the past three years, the Government have provided £96 million to help those who are sleeping rough in central London, where the problem has been at its greatest. We have provided 950 extra places in short-term hostels, of which 190 are specifically for young people. However—and this is important—most of the resources are going towards 2,200 places in permanent housing so that people who have been in hostels can move on. That initiative has been particularly effective for homeless young people. A count by voluntary organisations in November found about 420 such people, compared with more than 1,000 three years previously; more important, of those 420, only 20 or so were aged 18 or under. There has been progress and the hon. Gentleman might have acknowledged it.
As the hon. Gentleman said, young homelessness is not exclusively a problem for London. That is why we have provided £3 million over three years under our single homeless young people initiative, which is funding 14 projects outside London. That is the Government's response to a perceived and understood problem and I hope that we can do better in future.
The hon. Member for Wakefield referred to the Limitation Act 1980. I understand the problems and I know that a recent House of Lords judgment in respect of 630 inter-familial abuse decided that the Limitation Act applied in that case. However, it is by no means clear whether it applies in other cases. The law is not straightforward in that regard and the best advice at the moment is that legal advice should always be sought in particular cases. If the hon. Gentleman writes to me I will give him a considered reply on that important point.
The hon. Member for Wakefield also referred to child migration. The Child Migrants Trust provides for children who were taken to Australia before the war. The Government have given the trust a £25,000 grant to allow it to carry out work on behalf of those children. As the hon. Gentleman is aware, the Australian Government have also made a contribution. We are looking for other ways in which we can help.
The hon. Member for Wakefield referred to a moral lead and I accept that challenge. We must set the moral lead for which the hon. Gentleman is looking. I believe that we are setting that lead. We have made it clear that parents are responsible for their children and that is very much in tune with the United Nations convention to which the hon. Gentleman referred.
We believe that an individual is ultimately responsible for his or her behaviour. However, we also believe that society is responsible for helping the vulnerable. We believe that society has a duty to help those in need to achieve and that it is society's duty to enable individuals to become responsible citizens. We do not duck the moral lead which the hon. Gentleman is seeking. However, we believe that there should be a partnership, as hon. Members have said, between individuals, organisations, Governments and agencies to enable people ultimately to be responsible for themselves.
My hon. Friend the Member for Welwyn Hatfield and the hon. Member for Eccles may be surprised to learn that they came together on the question of television. The hon. Lady was of the Martyn Lewis school of thought and believed that we should have more good news on television. There was an interesting meeting of minds in respect of the way in which violence on television poses a threat to, and influences, young viewers.
We all agree that physical and verbal violence can influence young viewers. The way in which women and children are treated by actors playing parts can also cause problems. References to drugs on television can be harmful to young people and may even be a come-on. Too many role models smoke on television—although perhaps fewer than used to be the case. We also see people drinking to excess.
Television companies must strike the right balance between alerting children to the problems that they will have to face and protecting them from bad influences. In that respect, I pay tribute to the Book Trust and its work in providing material that brings difficult problems to the notice of children in a way that they can understand, but which does not frighten them.
The hon. Member for Eccles referred to the circle of television and it is right that we should explore such issues. Circles do exist. We can recall children playing with bows and arrows and then playing cops and robbers. More realistic versions of such games were shown on television and there is now a more dangerous fantasy world of violence and horror. That must be examined.
The hon. Member for Eccles referred to a cycle of care, to crime and rough sleeping. We must also take notice of that. She referred to the parliamentary question which I 631 answered yesterday in which she requested an inquiry into residential care and children. We have probably had enough inquiries for the time being what with Utting, Warner and all the rest. We now need action and that is why we have set up the task force to ensure that we have action on the basis of those inquiries. Let us have action first and then see whether we need to look further.
The hon. Member for Eccles and my hon. Friend the Member for Eltham referred to school nursing services. I note what they say and I will certainly consider the matter, but the important point is that, although there has been a small decline in nursing services, there has been a 20 per cent. increase in the number of GPs. Also, 90 per cent. of GPs are involved in child health surveillance. Of course, that gives the continuity that many families welcome.
My hon. Friend the Member for Chislehurst, in his usual thoughtful way, referred to several issues. He rightly said that I would have to respond to some of those issues by saying that they are matters for the Lord Chancellor's Department—for example, pre-trial hearings, the eight-year-old girl he referred to, and the right to silence. They were matters in which children are involved, so I shall take a very close interest. On guardians ad litem and their independence, I agree on the importance of independence. We have tried to build that requirement into the system, but we will keep the matter under review.
§ It being half-past Two o'clock, the motion for the Adjournment of the House lapsed, without Question put.