HL Deb 06 July 1988 vol 499 cc269-80

4.5 p.m.

The Parliamentary Under-Secretary of State, Department of Health and Social Security (Lord Skelmersdale)

My Lords, with the leave of the House, I shall now repeat a Statement which has been made in another place by my right honourable friend the Minister for Health on the Cleveland Report. The Statement is as follows:

"With permission, Mr. Speaker, I wish to make a statement about the report by Lord Justice Butler-Sloss on the findings of her inquiry into the handling of suspected child abuse cases in Cleveland in the early part of last year. Her report, and her own short version of it, are available in the Vote Office, as is a statement she is making in Middlesbrough this afternoon.

"Mr. Speaker, the whole House will be united in its condemnation of sexual or other abuse of children, and in its support for proper action to protect children from it. But it will be no less united in insisting that this must be achieved in a way which does not trample on the rights of parents and inflict unnecessary distress on the very children we wish to be helped.

"It is clear from the report that this balance was not achieved in Cleveland during the period in question, even though many children received the protection they needed. The House would wish me to express the deep regret of all of us to those who have suffered as a result. It is perhaps hard to imagine the shattering effect on those parents who were innocent and on the children.

"The report contains substantial criticism both of individuals, including the consultant paediatricians, Dr. Higgs and Dr. Wyatt, the police surgeon, Dr. Irvine, and the child abuse consultant, Mrs. Richardson, and of important aspects of the managerial response to the situation as it developed. It confirms that there was an overall failure to achieve essential communication and co-operation between police, health and social services.

"It is for the authorities involved in the first instance to address these criticisms and take the necessary action. The Government expect that action to be thorough, speedy and effective. The help of the Government's own medical advisers, of the Social Services Inspectorate and of Her Majesty's Inspectorate of Constabulary will, of course, be made available to assist those authorities.

"At the same time, Mr. Speaker, the Government are taking immediate action to ensure that the more general lessons of the report are applied not only to prevent a recurrence of similar events but to improve the handling of child abuse throughout the country.

"First, as I have already said, the report confirms the fundamental importance of the professional people and agencies concerned with child abuse working closely together within agreed guidelines. It underlines the need for a balanced assessment of different strands of evidence, and for action to be judged in the light of all the circumstances of the family as a whole. It stresses the need to listen carefully to what the children have to say and to take it seriously. And it re-emphasises the need for parents to be kept informed, consulted, and given reasonable access to their children unless this would be against the best interests of the child itself.

"These lessons, including the report's recommendations for the creation of special assessment teams, are reflected in comprehensive guidance which is being issued today by my department and the Welsh Office. Guidance circulars are also being issued today to the police by my right honourable friend the Home Secretary and to the education service by my right honourable friend the Secretary of State for Education and Science. Detailed professional guidance on social work practice is now being tested in the field and will be issued shortly.

"On the specific point of ensuring effective co-operation between different agencies, I am also publishing today a survey by the Social Services Inspectorate of current arrangements. I am glad to say that it shows a generally satisfactory picture. In the few cases where this cannot be said, we are asking the inspectorate to monitor the position closely and see that it is improved.

"Secondly, the report indicates that medical examination is only one aspect of assessment, and in particular that the test of reflex anal dilatation should not on its own be taken as conclusive evidence of sexual abuse. That view is confirmed by the report of a sub-committee of my right honourable friend's Standing Medical Advisory Committee, which we asked to consider these matters in parallel with the inquiry. Its guidance for doctors on the diagnosis of child sexual abuse is being published today and sent to every practising doctor in the country.

"We are also publishing today and distributing to the nursing profession guidance for senior nurses on the management of child abuse work from my right honourable friend's Standing Nursing and Midwifery Advisory Committee. Copies of all the reports and guidance to which I have referred have been placed in the Library.

"Thirdly, the report shows a clear need for better training for those who handle child abuse work. We have already included in the Health and Medicines Bill new powers to cover specific grants for social work training in this field. I can tell the House now that we intend to make available in 1989–90 a grant of 70 per cent. in support of expenditure of £10 million. We shall ensure that this major new programme means not merely more training but better training which takes account of all the lessons learnt from the report.

"Lastly I am glad to say that the report gives general support to the proposals for reforming the law contained in the Government's White Paper on the law on child care and family services published last year. The aim of the proposals is to make the law simpler and clearer and to strengthen the rights of parents and children. They include the replacement of place of safety orders by a new emergency protection order with stricter criteria and more limited duration. In addition, where an emergency protection order is obtained without the parents being involved, they will have a new opportunity to challenge the order after 72 hours.

"The Government are firmly committed to a Bill to implement the White Paper proposals, modified as may be agreed in the light of the report. The Bill will be brought before Parliament at the earliest practicable opportunity.

"What I have announced covers the great majority of the report's recommendations. Others are being examined urgently. In particular, my noble and learned friend the Lord Chancellor intends to issue a consultation paper before the House rises on the report's suggestion for an Office of Child Protection, with powers which could include scrutiny of local authority applications in care proceedings and calling for additional investigation or reports.

"We are extremely grateful to Lord Justice Butler-Sloss for the thorough and comprehensive work she has done, and to her three assessors—Professor Hull, Mr. Chant and Mr. Soper—who have supported her in her conclusions and recommendations.

"The issues with which they have had to deal are immensely complex, and the report reflects the inescapable fact that there is no single simple answer. In acknowledging that, it is right also to balance the picture which has emerged from Cleveland with recognition of how much valuable and successful work is done in this difficult field by doctors, nurses, social workers and police throughout the country. But the plain fact is that what happened in Cleveland should not have happened, and must not be allowed to happen again. The measures announced today are designed to see that it does not".

That concludes the Statement, my Lords.

4.14 p.m.

Lord Ennals

My Lords, I thank the Minister for repeating the Statement made by his right honourable friend in another place and for its very balanced tone. Perhaps I may also add my warm congratulations to Lord Justice Butler-Sloss on her thorough, sensitive and painstaking report, which carries with it a deep understanding of the appalling damage which is now being done to young children and their families on a previously unrecognised scale.

As a result of this report, we can all face more realistically the appalling challenge to society of child sexual abuse. It took many years and many notable cases from Marie Colwell and Kimberley Carlile before even the professionals, the doctors, nurses, social workers and police, came to accept the level of physical abuse, neglect and emotional stress on a wide scale in modern society. Experts who had become accustomed to seeing physical signs of beating found it difficult to accept sexual abuse where there was no clear physical evidence. It is no surprise that at the heart of this report is the problem of effective diagnosis by doctors and other professionals.

Therefore, I welcome the Minister's announcement about the new guidance note to doctors and no less the guidance note to nurses and midwives. The revised version of the multidisciplinary approach to child sex abuse is also warmly welcomed.

Cleveland has taught us all the degree of pain which is involved in sexual abuse for the child at the time, sometimes over a period of years, and of course in years to come: and, indeed, also for the innocent parents. The events have thrown up the question of which is more damaging: to take a suspected child sex abuse victim from his or her family and then find that there is no abuse but the family is torn apart, or, on the other hand, to leave a suspected victim at home with the family, limiting the possibility that the child will reveal what has happened, and then to find later that further abuse has occurred which could cause permanent damage to the child.

Some judgments will inevitably prove wrong. No one can be sure of what will happen. What is essential—and seems now to be happening in Cleveland—is that the professionals, including the police, should and will co-operate together. That is something which clearly did not happen in the Cleveland situation and is a lesson which the report wisely points out.

There is clearly broad agreement with the conclusion in the report that the most important of all those involved is the child itself, for whom communication is most difficult and who too often is not believed when a statement is made. As in previous inquiries, crucial to the tragedy is a breakdown in communication between those involved. Clearly that has happened in Cleveland.

I should like to put a number of questions to the Minister on his Statement. First, is it not essential that a full study should be set up by the Government, involving professionals and organisations such as the NSPCC, the Children's Society and Dr. Barnado's, to assess the size of the problem that society now faces and to analyse anything that can throw light on the reasons for this happening?

Secondly, in the light of the size and nature of the problem is the Minister satisfied with his right honourable friend's rejection of the case for a three-year training course for social workers proposed by CCETSW? Will he look again at the position? Is he really satisfied with the announcement made in the Statement that £7 million will be made available for training? I quote: a grant of 70 per cent. in support of expenditure of £10 million, will be made available in England for the purpose. Is that not a modest sum? Are we not entitled to expect a larger response in terms of training and is not the figure of £40 million, which is what was rejected by the CCETSW proposal, more reasonable in view of this problem? In his Statement—and perhaps he can clarify this—the Minister did not refer specifically to child abuse in this training grant. Is he satisfied about the provision for the training of doctors and nurses in this respect?

Thirdly, should there not also be an in-depth study of motivation of this form of sexual deviation? Is this something which is linked with the violence which has become a feature of contemporary society? Is it more likely to be found among those who were themselves abused in childhood? To what extent can any part of the blame be placed on social work being inadequately funded in the work of social service departments?

Finally, will the Minister further comment on the contents and timing of the child care legislation'? I welcome his Statement that it will soon be before the House, but when'? It is now 18 months since the Government published their White Paper. It could be argued that if the proposed legislation had been law the events in Cleveland might not have been so tragic. Will he confirm that the law will aim to put the interests of children first, try to keep families together wherever possible, give parents a right of appeal against care orders by local authorities and give more support to those staff working with suspected abuse cases? Can he confirm that this legislation will be presented in the next Session of Parliament? In any case is it not a good idea that we should have an early opportunity to debate this very important report?

Baroness Seear

My Lords, we on these Benches wish also to thank the noble Lord for repeating the Statement on this very important report. We should like to add our congratulations to Lord Justice Butler-Sloss on the work that she has done, which I think will command great admiration everywhere for its skill and thoroughness in an extremely difficult situation. It must have been a very difficult job, both intellectually and emotionally, to tackle the inquiry and report. We should like to pay a tribute to her.

Following the noble Lord, Lord Ennals, I should like to suggest that this is a matter which requires a debate later on in more considered time. A reply to a Statement is not the moment in which to produce all the ideas that we should like to put forward in this connection. I should like merely to raise a very small number of points which I hope can be developed more fully when we have had the opportunity to absorb the report and to think more about the implications.

Clearly, as the Statement says, there is a problem here with training. These are extremely difficult cases. I should like to follow what the noble Lord, Lord Ennals, said, in asking the Government to look again at their rejection of the three-year training programme for social workers, or at least for social workers of the level who will be called upon to tackle these cases. Having myself seen the training of social workers, which was carried out extensively at the London School of Economics, I know how much has to go into the training of social workers for the skilled levels of the work. I think the Government are unwise to turn down the idea that there should be a third year. No doubt it may have to be of a rather different kind from the training that has been given in previous times. But the need for high levels of skill and knowledge in this field cannot be denied; and this report underlines it. There is far too great a tendency for people to continue to think, strange though it may seem, that social work is just a matter of common sense, good will and kindliness. It is no such thing. Anybody studying these cases must realise that, while common sense and kindliness are of great importance, a great deal more is required. The training needs to be of a high order.

I should like to suggest also that there should be training together in some of these areas for all of the professions concerned. Sending out circulars is fine, but it is no substitute for training. Quite clearly one of the problems arising from this report is that there is a lack of understanding, communication and collaborative thinking among the police, social workers and doctors. Surely the best way to do this is to organise some common training. The training of all those groups has grown up from different bases, with different assumptions of what their work is to be. The only way that one can overcome this is to try to organise training on a multi-professional basis so that they can begin to understand the problems which they have in common and those which are different. That will lead to much easier communication among the groups concerned.

With more hope than expectation perhaps I also urge that somehow or other the media should behave in a different way in reporting such cases. I know that it is in no way in the hands of the Minister to deal with this. But the temptation for the media to make headlines out of cases of this kind must be very difficult to resist. However, it does the greatest possible damage. It makes it extremely difficult for social workers to do their job. They are the people who have to go into the houses, as the noble Lord, Lord Ennals, said and we have also said in this House on other occasions. If they take action, they are wrong; if they do not take action, they are wrong. Either way one can make a highly coloured media story out of it. We implore the media to act responsibly in backing up the difficult job that the social workers have to do and not undermine their confidence in attempting to do it.

I gather that there is a suggestion that there should be established an Office for Child Protection. That might well be a very good step to take. At this stage I have no idea. If Lord Justice Butler-Sloss has made the suggestion, it probably is right, but only if the office is well staffed and has the resources to act quickly. I can imagine nothing worse than yet another level of bureaucracy which encourages buck passing and holds up decisions where delay may greatly increase the harm that is being done.

Finally, does this not point again to the need for speedy establishment of the family courts for which we have asked for so long?

Lord Skelmersdale

My Lords, I am extremely grateful to both the noble Lord, Lord Ennals, and the noble Baroness, Lady Seear, for their sympathetic and understanding reception of this report on such a serious matter. I note that they join me in expressing our thanks and admiration to Lord Justice Butler-Sloss and her assessors for the thorough and authoritative report that they have produced. I believe that it is incumbent upon us now to ensure that the lessons to be drawn from the mistakes made in Cleveland are applied urgently.

As the Statement made clear, the Government therefore responded immediately to the report by publishing today guidance on inter-agency co-operation in the handling of child abuse, by issuing authoritative guidance to doctors on diagnosis of child sexual abuse and by making available a new grant of 70 per cent. in support of £10 million of expenditure on training to deal with child abuse.

As the Statement made clear, in addition we intend to reform the law on child care and family services at the earliest practical opportunity. In answer to a point of the noble Lord, Lord Ennals, I regret that I cannot change those words. I am sure that the House will understand that I cannot anticipate what may be in the gracious Speech this year. All these factors show our determination to act quickly and decisively to ensure that what happened in Cleveland is not repeated.

In Cleveland—the noble Lord, Lord Ennals, is quite right—there was appalling damage to children and their families in some cases, but not in all cases. There in lies a difficulty. So far as concerns future and indeed current law, I think the correct approach is to make sure that there is a right and proper balance between the needs of children, the needs of families and—a factor which is sometimes forgotten—the needs of society at large. Although the noble Baroness is quite right, there is absolutely nothing that I can do to control the press—and I do not think the House would want me to even if I could—the media have a great responsibility in this area and neither they nor we should undermine the incredibly difficult role of social services personnel.

I was asked various direct questions to which I can respond. The first was from the noble Lord, Lord Ennals, on the data and analysis of cases of sexual abuse round the country. The noble Lord will know that until now such statistics have not been held centrally. However, my right honourable friend announced on 9th July that we would arrange with local authorities for the collection of national statistics on child abuse drawing on the special experience of the National Society for the Prevention of Cruelty to Children in maintaining child abuse registers in various parts of the country. We have sent questionnaires to all local authorities seeking the information and we expect the results to be finalised in the spring of next year. Based on experience with that survey, we intend to introduce an annual statistical return.

Training is obviously very much an issue. Both the noble Lord and the noble Baroness mentioned my right honourable friend's decision not to agree with CCETSW on three-year training. I would point out that once one has read the report in detail, as I perforce have done, one becomes aware that the training that is needed is not basic training but postgraduate training. So I suggest that whether the training is for two or three years is immaterial.

As to multi-disciplinary training, our guidance to authorities stresses the importance of inter-agency multi-disciplinary training for all those dealing with child abuse. We have under way already a number of central initiatives to promote multi-disciplinary training. The 70 per cent. support for the 10 million is a very significant additional sum for social services training which will be used specifically in the child care field.

I should like to add something about research. We have already identified this as a priority theme for research. My department expects to spend a total of £157,200 in 1988 on research into child abuse generally. Almost £90,500 will be spent on two projects concerned only with child sexual abuse; £ 16,000 on a project concerned with physical abuse, and £50,000 on three projects researching both types of abuse.

Not surprisingly, both the noble Baroness and the noble Lord finally concentrated on the Bill to be produced at the first legislative opportunity. I would suggest very gently that there is an enormous amount of reading in the various papers to which I have referred. Perhaps, when those have been assimilated by noble Lords, that will be the time either to discuss a future Bill or, indeed, to arrange for a debate through the usual channels. I must confess that in my view the prognosis of such a matter before the State Opening of Parliament is extremely unlikely.

4.30 p.m.

Lord Elton

My Lords, is my noble friend aware that the words "failure to achieve essential communication and co-operation" are sickeningly familiar'? Some such words have occurred in every case that I am aware of since that of Maria Colwell right up to the case of the death by starvation of a child which was given publicity a few days ago. The communication is not simply between police, health and social services. There are other agencies—voluntary agencies, teachers and others—who have a locus in this, and such communication is exceedingly difficult to administer. I hope that my noble friend will pay close attention to the view of the noble Baroness, Lady Seear, on training, which he has just accepted, and that he will also hear in mind that where matters are as complicated as this it is perhaps advisable not only to train people jointly but also to make sure that one of the trained persons eventually acts as a clearing house for the information of the others. That may well not have been the intention of the setting up of an office of child protection, but it would perhaps put a focus on where matters could be dealt with by a person who viewed every case as urgent even if it did not immediately appear to be so.

Lord Skelmersdale

My Lords, I certainly agree with my noble friend, but the initial responses of the Government to the report as regards training are to be found in the document Working Together, a Guide to Arrangements for Inter-ageney Co-operation for the Protection of Children from Abuse. That covers the statutory agencies. However, I very much take my noble friend's point that there is also a need, as in other personal and social services areas, to involve the various non-statutory organisations. In this case the NSPCC would be one such, but I hasten to say that it is by no means the only one.

Viscount Tonypandy

My Lords, throughout the House there will be noble Lords who are concerned with various children's organisations. It is my privilege to be linked with the National Children's Home. I have not read the report but having listened to the Minister this afternoon I too should like to express deep gratitude to the learned judge and her colleagues. My heart goes out to the people of Cleveland who, I am sure, are no different from those in the rest of the country. They have been singularly unfortunate to have had a shadow cast over them which no other part of the United Kingdom would wish to have. I hope that after a reasonable period, when we have had a chance to consider the report in detail, we shall have an opportunity for debate in your Lordships' House.

Before I resume my seat, I should like to say that if family life is undermined the damage cannot be measured. This is a complicated issue on which there will be many points of view. It is one which cannot easily be resolved—not even by the learned judge. We can only hope to do our best. I join with the noble Baroness, Lady Seear, in expressing the hope that the media will realise that the family unit is essential if we are to maintain our heritage in this land.

Lord Skelmersdale

My Lords, I would certainly agree with the noble Viscount in everything that he has said. Of course the structure of the family is fundamental to society in this country, and the Government will do all in their power to keep it that way.

Baroness Faithfull

My Lords, my colleague social workers throughout the country will welcome the outstanding report made by an outstanding judge. I appreciate that my noble friend the Minister cannot elaborate too much on the Bill which will have to be in the Queen's Speech; therefore, he is in some difficulty. But having read carefully the White Paper on which we hope the Bill will be based, I should like to say, first, that we welcome the whole question of consolidating the 17 Acts of Parliament relating to families and children which will make for clarity and consistency. We welcome the recommendations in the White Paper on the rights of parents which we hope will figure in the Bill. We would also welcome in the Bill the recommendations with regard to the welfare of children.

I should like to raise a point which my noble friend may be unable to answer. The White Paper recommends an emergency protection order, which is an order of' eight days, instead of the place of safety order. I hope that when the Bill is brought before your Lordships' House it will be realised that resources will be needed. Unless the Government are really going to be able to produce the resources to carry out the provisions of the Bill it is rather pointless to introduce it. The eight-day protection order will need more resources. Indeed in social services departments throughout the country resources are needed which are not there at the moment.

Secondly, I wonder whether I might mention to my noble friend the Minister the question of training. He has given outstanding help in the £10 million that will be allowed for the training of those working in child abuse cases. However, if one thinks about it, I wonder whether this is right and sufficient. To train as a doctor, one has a general training and one specialises afterwards. The doctor's training is five years with specialisms afterwards. To train as a nurse, one has a three-year training. To train as a health visitor, one has a further training after that. If one is a teacher, one trains for three years. If one is to specialise in anything, one has a further training after that.

Social workers throughout the years have had a two-year training only. That is to cover not only child care but five different spheres of work, work with the mentally handicapped and the mentally ill, children, the homeless, the elderly and the handicapped. It simply cannot be done. One cannot train for child abuse only. One would not train a doctor to deal with eyes only if he had not had a general medical training. To be effective social workers must have a general training first on general principles and training on specialisms afterwards.

I therefore very much welcome the £10 million that will be given. However, all social workers will be visiting families and, if they have not had a good basic training and specialist training, they will not recognise the cases to refer to the special unit. I think that such cases must be recognised just as a general practitioner must be able to recognise specialist problems from his general practice.

I hope that the Government will think again about the three-year training to which the noble Lord, Lord Ennals, referred. It is a serious problem. We are in great difficulties because social workers throughout the years have not been properly trained. To be properly trained they must be trained in the law. This was brought out in the case that Mr. Blom-Cooper investigated, that of Kimberley Carlile. In the days when I trained we had one lecture on law every week for two years. The social work courses up to date have had about three lectures in two years, and that is all. I think that the serious disadvantage of social workers in this respect is not recognised in the country.

For my colleagues, I have to say that they do a magnificent job of work. To keep the situation in perspective, considering the number of children in the country, the number reported to be abused is a small proportion. It is a significant and important proportion, but it is small. I pay tribute to the social workers for the work that they do.

Viscount Davidson

My Lords, I regret having to interrupt my noble friend. I know that this is a subject with which your Lordships are very concerned. We have now spent 30 minutes in discussion on the Statement. Under Standing Orders, discussion on Statements should not exceed 20 minutes. When my noble friend has finished, perhaps we may return to our other business.

Baroness Faithfull

My Lords, I have said all that I wish to say. I want to underline that I hope that the Government will understand the whole position with regard to training and not just with regard to training in one area.

Lord Skelmersdale

My Lords, it is clear from the report that the problems in Cleveland were failures in practice. While I acknowledge some weaknesses in correct child care law, I do not believe that this was the cause of the Cleveland events. With the best will in the world, legislation cannot ensure good practice. However, the current legislation and the guidance published today provide a sound framework for good practice. When my noble friend studies the report, she will find that the learned judge makes reference to the limited knowledge of and access to the law. When the Bill comes forward, I understand my noble friend will look critically at the financial and introductory memorandum.

As to the training of social workers, my right honourable friend has stressed the need for a balanced programme of improvements in social work education and training for all personal social services staff. This includes those without basic training qualifications, those needing further post-qualifying studies, which I mentioned earlier, and those who need to bring their training up to date. The training support programme is a measure intended to contribute towards this balance.

Lord Bottomley

My Lords, as the Member of Parliament for Middlesbrough for 21 years, I know from personal experience of the high standards of performance of the National Health Service and of the social services in Cleveland. I could cite many cases of commendation. The same is true of the police. If one bears in mind that over the last five years the National Society for the Prevention of Cruelty to Children has drawn attention to the ever-increasing numbers of child abuse cases, the Government themselves surely cannot be free from criticism for failing to take action earlier.

Lord Skelmersdale

My Lords, I do not think that in the circumstances that is a particularly fair response. The moment that this catastrophic situation came to light my right honourable friend the Secretary of State decided to set up this inquiry. The moment that the report was received, we had arrangements made for it to be printed and presented to both Houses at the earliest possible opportunity. During this time the various publications to which I have referred were prepared, and are being issued today. On this occasion at least. I do not think that comment can be made upon the laxity of government effort.