Children and Young Persons Bill [HL]

My Lords, there are 60,000 looked-after children in this country: 63 per cent of them were placed in care for reasons of abuse or neglect; an equivalent two-thirds had some kind of physical health problem; and, as the noble Baroness, Lady Meacher, pointed out, 45 per cent of them had mental health problems. Section 10 of the Children Act 2004 places a duty on local health bodies—the PCTs—to improve the health and well-being of these children. They are statutory partners within the children’s trusts with a responsibility to co-operate with local authorities. It is clear that that is not working and that the health needs of such children are not being met. Some local authorities have looked-after children nurses, but one gathers that some do not have looked-after children nurses at all and often those nurses cover two or three PCT areas. There is a desperate shortage of such nurses and a desperate need for more. Not only are health needs not met for these children, but they are not even identified. The proposals put forward by the noble Baroness, Lady Meacher, in these amendments seek to strengthen the Children Act in this respect. When we talked about this in Grand Committee, the Minister promised that there would be revised guidance so that there would be a statutory duty for the health commissioning bodies as well as the local authorities to act in this way. Will that be strong enough? We know perfectly well that guidance is something that PCTs only have to have regard to. There is a very strong case for having a piece of legislation that says that they must co-operate. I want to finish by quoting from a transcript of an interview with a consultant psychiatrist from the child and adolescent mental health services. It says: "““Provision is very patchy. One of the difficulties relates to the split in funding streams over the last couple of years—half to the health route and half to the social services route. This was based on the government’s idea of joint thinking which works well in theory but has been atrocious in practice. This has resulted in Health Services and Social Services not discussing the needs of young people and just setting up very ad hoc patchy services””." In other words, each has taken their share of the money and not done what they are supposed to do.