Lord Russell of Liverpool (CB)
My Lords, I thank the usual channels and Cross-Bench colleagues for allowing me and the noble and learned Lord, Lord Hope, to have a third bite of the cherry with our debates, having fallen foul of the non-Prorogation and the general election. I declare my interests as a governor of Coram and as an officer of the All-Party Parliamentary Group on Adoption and Permanence, whose report we are discussing this afternoon.
The adoption support fund, usually abbreviated to the ASF, was introduced in England in May 2015, championed by the then Minister for Children, Edward Timpson—happily re-elected to the House of Commons in December. His personal experience informed his belief in what the fund could achieve. He was brought up in a family with two adopted siblings and his extraordinary parents fostered an additional 90 children. Edward grew up with a deep understanding of trauma because he saw it unfolding all around him. The fund was specifically designed to find alternative and creative—I emphasise that—ways to enable families to deal with the effects of trauma on the behaviour and well-being of adopted children. It was set up with a five-year term, due to end this year.
As our report says, the fund has been, and is, a great success. I congratulate the Government and the Department for Education on making such a positive difference to families and children who were at, or near, breaking point. The Government have invested over £150 million, providing therapeutic support for more than 38,000 families. Since the cost of each child in the care of the state is around £34,000 per annum, one can do the maths: £1.3 billion for children in care, as opposed to eight and a half times less when children benefit from the therapies provided by the adoption support fund. How cost effective is that?
I was fortunate to be present at Coram for the launch of National Adoption Week last October, when the Secretary of State for Education, Gavin Williamson—whom I see has retained his job—announced the extension of the fund to 2021, while also revealing his own personal commitment, having grown up in a family with a foster sibling,
So, the Government have a success on their hands. They have extended the fund for a further year and the department has been resolutely consistent in saying no more than that its future will be considered in the upcoming spending review. I shall try to articulate the case for its long-term continuation and measured expansion, and suggest how it can be even more successful in helping to mitigate the effects of trauma, and in so doing transform and improve the lives of adoptees and their families, saving the state a huge amount of money. To borrow from the words of Mark Antony: I come here to praise the Department for Education, not to bury it.
There are six key recommendations in the report. I assume that the department has studied these carefully so I shall not bore the Minister or the House by repeating them in detail. Instead, I will flag up some specific points for the Minister and the department. The first is prevention versus cure, or how to prevent trauma happening in the first place. Harriet Ward was one of the authors of the 2012 book, Safeguarding Babies and Very Young Children from Abuse and Neglect, which detailed the results from following the lives of a sample group of children at risk from birth to three years old. Of that sample, 66% were identified as being at risk before they had even been born. Of the two-thirds of the sample still with their families at age three, 43% were judged to be at significant risk of harm from their own parents. By age three, 50% of the children in this study displayed serious behavioural problems or developmental delay.
This is partly where trauma starts. I urge the Department for Education and the Department of Health to assess and potentially extend initiatives such as the Oxford Parents Under Pressure pathway, the London and Glasgow Infant and Family Team and the Norfolk Parent-Infant Mental Health Attachment Project, and to build the learnings from these into discussions during the spending review about how to present and/or mitigate the onset of trauma.
Secondly, it is time to reassess the target audience. Initially the fund focused on adoptive families, which subsequently extended to special guardianship families. A third group is kinship carers. One size does not fit all, but I urge the Government to develop their understanding of the needs of each group and to target those specific needs as much as possible. This could be achieved partly by providing more effective publicity and information about the availability of the fund, but one might consider renaming the fund so that it can reflect better its target audiences.
Thirdly, it would be good to understand the consequences of the fund’s success. It was designed to find alternative and creative ways of enabling adoptive families to deal with trauma, and its success has, in effect, created a substitute mental health service without normal governance and scrutiny. An unintended consequence is that some NHS child and adolescent mental health services—CAMHS—use the existence of the fund as a means of excluding adoptees from accessing those services. Can the department, with the Department of Health, please consider the best means of co-ordinating and clarifying services, so that children do not unintentionally suffer?
Fourthly, how do we ensure adequate and appropriate clinical input? How can we resource and embed this better to enable optimal evaluation of need and effective delivery of services? Can the department study best-practice organisations such as the Birmingham Children’s Trust, ably led by Andrew Christie, the chair of the Adoption and Special Guardianship Leadership Board? The trust provides a comprehensive and holistic process which analyses need, develops an individual plan for each client and then acts as the advocate for the family in its interactions with the fund.
Please could the department consider hiring and embedding in-house clinical experts within its own ASF team? Please could the department specify a requirement for Mott MacDonald, which does an excellent job of administering the fund on its behalf, to hire and embed clinical expertise within its application processing teams? Please consider recommending that every local authority should have a qualified, designated trauma lead who colleagues can refer to for advice.
Please review why voluntary adoption agencies are unable to apply to the fund directly, or at least consider the practical solution of allowing social workers to delegate applications to those agencies but with the final sign-off remaining with the designated social worker. The current lack of sufficient clinical experts to help social workers evaluate applications is placing an unfair and unreasonable burden on them. They are not clinical experts, so give them access to the real experts to ensure the children and young people get the appropriate assessment and therapeutic help.
Fourthly, how could we future-proof the fund? The fund was always intended to tap into, and to help stimulate, a market in therapeutic support outside the clinical mental health suite of services. As the fund has grown and broadened, assessing and focusing on what works best and what is worth experimenting with has become more challenging. The fund is currently assisted by the aforementioned Adoption and Special Guardianship Leadership Board and by the DfE, local authority and regional adoption authority user group.
Please could the department consider creating a specialist ASF advisory board which would be able to assess, advise and recommend on improvements and adjustments to the fund in real time? This could include creating a formal evaluation process for measuring effectiveness.
The organisations that provide and develop the therapies that the fund enables children and their families and guardians to access crave the degree of certainty that will encourage them to invest, innovate and expand. This can come only from confidence that the fund has long-term support.
The Minister will be pleased that I am the end of my wish list of questions. I thank Edward Timpson and his DfE team at the time of the fund’s launch for having had the courage and insight to create the fund. I thank Rachael Maskell, the chair of the APPG, for her passion, humanity and gentle but effective leadership; and give a big thank you to the team which supports the group and makes our work possible.
Above all, I thank the individuals and organisations which gave evidence to our inquiry. We received 1,600 responses, hearing from 247 children and young people, 1,212 parents and guardians, 115 therapists and 74 social workers. We are particularly grateful that the Department for Education participated in the inquiry and it was extremely helpful to hear directly from Christina Bankes, the deputy director of children in care and permanence.
Finally, I thank those who will speak in this afternoon’s debate. We are speaking on behalf of children and young people who have had, through absolutely no fault of their own, early life experiences which can blight their lives and the lives of those who love and care for them. Please listen to their voices and to their heartfelt thanks for what the fund is achieving. They are unanimous in asking for its continuation. I beg to move.