Health and Social Care Bill

My Lords, I support the amendment spoken to by my noble friend, to which my name is attached. I will strive to be as brief as possible at this late hour, but the issue is very important. I will begin with an aside and refer to the short debate on productivity and manufacturing industry instigated at the start of business today by the noble Lord, Lord Bates. I will highlight the point made recently by Education Minister Sarah Teather that what happens in schools is important, but that the most important thing for children's success outcomes is what happens in the home, outside school. As one academic put it, when one considers what makes the difference to a successful outcome for a child, only 10 per cent of it will depend on schools; the rest will depend on what happens in the background, in the family. Of course, whether a parent is successful in their education is the single most important indicator that their child will be successful in their education. Businesses might be more aware, when they push for schools to teach children to read, write and do arithmetic better to get their apprenticeship skills, that they should think also very much about early intervention and getting it right in the family as well. If we are to compete with China in future, we need to think very carefully about the successful integration of services to support families and children. I will speak briefly, on International Women's Day, about another matter raised in an earlier debate today: namely, domestic violence and women fleeing to refuges. A few years ago I spoke to a child and adolescent psychiatrist, Professor Panos Vostanis of the University of Leicester. He had gone into these refuges and worked with the mothers and children over time, providing them with support. He said how important and effective it had been, but how rare the service was. He has now been commissioned by the European Union to conduct EU-wide research into support for families where there has been domestic violence. This theme recurs in children's homes, refuges and other settings. It seems elementary that a mental health professional such as a psychiatrist or clinical psychologist should visit a children's home or refuge once a fortnight, to speak to mothers, work with children and support staff. That is best practice and it happens—but very often the model gets overlooked because, understandably, clinicians are under pressure and there are high thresholds of access for children and adults to these services. Perhaps I may give one further example on the matter of schools. I recently attended an international conference on the mental health of children in schools. It was organised by Dr Rita Harris, head of child and adolescent mental health services at the Tavistock and Portman NHS Foundation Trust. We were given a presentation by two wonderful mental health nurses who had tried to revive a service in the Sunderland area. They found that schools had given up using child and adolescent mental health services because they would write to the service and it would respond by saying: ““I am sorry, your child is not sick enough for us to see. Wait until he gets sicker and then we might see him””. The nurses had tried to mend the relationship with schools, build trust and ensure that every school had a mental health professional allocated to it. However, one school simply did not want any truck with them because it had had such a bad experience in the past of trying to work in this integrated way with child and adolescent mental health services. The record is very poor. Given the concerns that many have raised in the past about the possible fragmentation that might arise from the Bill, and the many clinical commissioning groups that will come into being and the large upheaval that will take place, I am looking to the Minister for reassurance that the Government will improve a situation that has been so disappointing in the past, that we will see a better integrated service that will better meet the needs of children and families, that we will see better outcomes for children and they will be more successful in school in part because health and social care services have been better integrated for them and they have received, early in their lives, the support that they needed. I look forward to the Minister's response.