|Dawn Bowden AC|
|Hefin David AC|
|Janet Finch-Saunders AC|
|Jayne Bryant AC||Yn dirprwyo ar ran Jack Sargeant|
|Substitute for Jack Sargeant|
|Lynne Neagle AC||Cadeirydd y Pwyllgor|
|Sian Gwenllian AC|
|Suzy Davies AC|
|Dr Dave Williams||Cyfarwyddwr yr Is-adran, Gwasanaethau Teulu a Therapi, Bwrdd Iechyd Lleol Prifysgol Aneurin Bevan|
|Divisional Director, Family and Therapy Services, Aneurin Bevan University Local Health Board|
|Dr Lorna Price||Cynrychiolydd Cymru o Bwyllgor Amddiffyn Plant Canolog y Coleg Brenhinol Pediatreg ac Iechyd Plant|
|Wales Representative of the Royal College of Paediatrics and Child Health' Central Child Protection Committee|
|Dr Rowena Christmas||Cynrychiolydd o Goleg Brenhinol y Meddygon Teulu|
|Representative from the Royal College of General Practitioners|
|Jan Pickles||Aelod o Fwrdd Diogelu Annibynnol Cenedlaethol Cymru|
|Member of the National Independent Safeguarding Board Wales|
|Jane Randall||Cadeirydd Bwrdd Diogelu Annibynnol Cenedlaethol Cymru|
|Chair of the National Independent Safeguarding Board Wales|
|Michelle Moseley||Cynrychiolydd o Goleg Brenhinol y Nyrsys|
|Representative from the Royal College of Nursing|
|Nicola Edwards||Pennaeth Diogelu, Bwrdd Iechyd Lleol Prifysgol Bae Abertawe|
|Head of Safeguarding, Swansea Bay University Local Health Board|
|Lisa Salkeld||Cynghorydd Cyfreithiol|
|Sarah Bartlett||Dirprwy Glerc|
|1. Cyflwyniad, Ymddiheuriadau, Dirprwyon a Datgan Buddiannau||1. Introductions, Apologies, Substitutions and Declarations of Interest|
|2. Bil Plant (Diddymu Amddiffyniad Cosb Resymol) (Cymru): Sesiwn Dystiolaeth 8||2. Children (Abolition of Defence of Reasonable Punishment) (Wales) Bill: Evidence Session 8|
|3. Bil Plant (Diddymu Amddiffyniad Cosb Resymol) (Cymru): Sesiwn Dystiolaeth 9||3. Children (Abolition of Defence of Reasonable Punishment) (Wales) Bill: Evidence Session 9|
|4. Bil Plant (Diddymu Amddiffyniad Cosb Resymol) (Cymru): Sesiwn Dystiolaeth 10||4. Children (Abolition of Defence of Reasonable Punishment) (Wales) Bill: Evidence Session 10|
|5. Papur i’w Nodi||5. Paper to Note|
|6. Cynnig o dan Reol Sefydlog 17.42(ix) i Benderfynu Gwahardd y Cyhoedd o Weddill y Cyfarfod||6. Motion under Standing Order 17.42(ix) to Resolve to Exclude the Public from the Remainder of the Meeting|
Cofnodir y trafodion yn yr iaith y llefarwyd hwy ynddi yn y pwyllgor. Yn ogystal, cynhwysir trawsgrifiad o’r cyfieithu ar y pryd. Lle mae cyfranwyr wedi darparu cywiriadau i’w tystiolaeth, nodir y rheini yn y trawsgrifiad.
The proceedings are reported in the language in which they were spoken in the committee. In addition, a transcription of the simultaneous interpretation is included. Where contributors have supplied corrections to their evidence, these are noted in the transcript.
Dechreuodd y cyfarfod am 09:30.
The meeting began at 09:30.
Okay. Good morning, everyone. Welcome to the Children, Young People and Education Committee. We've received apologies for absence from Jack Sargeant, and I'm pleased to welcome Jayne Bryant AM, who is substituting for him today. Can I ask Members whether there are any declarations of interest, please? No. Okay, thank you.
Item 2 this morning, then, is our eighth evidence session on the Children (Abolition of Defence of Reasonable Punishment) (Wales) Bill—an evidence session with NHS representatives. I'm very pleased to welcome Dave Williams, who is divisional director, family and therapy services at Aneurin Bevan University Health Board, and Nicola Edwards, head of safeguarding at Swansea Bay University Health Board. Thank you both for attending this morning. We're looking forward to hearing what you've got to say. We've got a lot of ground to cover, so we'll go straight to questions from Siân Gwenllian.
Bore da. Dwi’n mynd i fynd yn syth i holi pam dŷch chi’n credu bod angen y ddeddfwriaeth yma? Dwi’n gweld o’r dystiolaeth ysgrifenedig bod y cydffederasiwn a’r pum bwrdd iechyd yn cytuno bod angen deddfwriaeth. Pam dŷch chi’n credu bod y gyfraith bresennol yn aneffeithiol, a sut mae hynny’n cyflwyno heriau i weithwyr iechyd proffesiynol yn arbennig? Pwy sydd eisiau cychwyn?
Good morning. I'm going to ask you why we need this legislation. I see from the written evidence that the confederation and the five health boards agree that we need legislation. Why do you think the current law is ineffective and how does that present challenges to health professionals in particular? Who wants to start?
Okay. I think, from the point of view of having the legislation in place, it would remove the confusion, because currently there is some confusion, and it would provide more clarity.
I think—. At the moment, we have a lot of cases in safeguarding and in looked-after children where you have the discussion of how much is too much, if you like. I view it as the equivalent of playing on the edge of the cliff. At the moment, we've got people who are using punishments, maybe, that are (a) not ideal and (b) don't work. And, in certain situations, when emotions get aroused or—things happen that damage the child.
I think sending a clear message that, actually, the line in the sand lies several feet away from the edge of the cliff—that, actually, there isn't the confusion there, that we're clear that, actually, if you wouldn't do it to an adult, you wouldn't do it to your child—makes the situation much clearer for the population, and starts—. You know, behind that, there's obviously a conversation about what are the better methods of shaping your child as they grow up. But I think it's about moving—. At the moment, the legal line and the danger line are too close together; we need to separate them so there's some clear blue water between them.
So, at the moment, how is the present legislation creating challenges for workers, in your view?
Well, particularly in safeguarding, where there'll be the—you'll see somebody who would appear to be using excess force on a child. There'll be a lot of time and effort discussing about whether that amounts to assault, whether that amounts to safeguarding, whether that should do—. The law on assault is obviously quite a high line, so that's not going to happen, but, equally, the law on safeguarding—. And what you then do, even though you might give a message that this family needs additional support or extra things—it's not clear in the gap that this is an unacceptable and not useful behaviour: 'You need to change your ways'. There's a lot of: 'Is it good enough?' Is it—you know, is it good enough? If you're not told off and you don't have to stop doing it—'Why should I change my ways here?', if you like. There's no doubt that smacking is less used than it was 20 years ago, but it still causes a lot of conversation and time and effort as to how close to the edge is too close to the edge.
I don't know, you might be asking it anyway, so if you do, sorry, Siân. How often do you see families where smacking that is currently below the line, if I can put it like that, that's currently covered by the defence—how often do you see families where that is the only behaviour that's being a source of concern? Is it usually part of a bigger package of behaviours?
I would say it's generally part of a bigger part of a picture, but I think, from a historical point of view, for many years, from a health professional's—. Health professionals have advised families that it is inappropriate, that people shouldn't—you know, parents should not smack children. And I think where problems—going on literally from what Dave was saying—have arisen is where health professionals have witnessed an incident, have been unhappy with the incident from a safeguarding perspective, have advised the family, and then referrals have gone into appropriate agencies from a safeguarding point of view, and then families—it's no further action because, from a law perspective, the law is quite clear what it's saying, and then that's giving mixed messages to families. I think, you know, from a health professional's—most definitely, for many years, we have said that there are other ways of managing children from that perspective. So, it is, and I know there have been discrepancies and escalations where other agencies have not agreed with a health professional's stance, but then it's the message that we're giving to families.
Okay. That's fine. It was just to give me a sense of scale as much as anything.
Sori—mae'n ddrwg gen i am gymryd drosodd.
Sorry for taking over.
No, no. So, what you're saying really is that it's for clarity for everybody, really, for the parents, so that the mixed messages—they will disappear, you think, with this new legislation.
Legislation on its own is never able to do that. You always have to have the supporting services around to help people. People end up smacking because they're not happy with the behaviour or there are issues going on. So, how we help families to have different ways that work better and are less damaging to shape their children in ways we want them to become is an important underlying part of it. If you just rely on the law, it's a fairly—you know, it's a bit of a sledgehammer, but it does set out the clear blue water. It's like moving the whole—the normal distribution. If we can move it all across, the number of people who are on the edge of, on a bad day or an emotional day, bad things happening, shift away from that and there's clarity and space—and, as I say, for everybody. And I think it's really important for children and young people. They are—. We have the United Nations rights of the child in this country; they need to hear that you don't do anything to them that you wouldn't do to an adult, essentially.
So, the rights aspect is important as well from that point of view. Just for clarity, which health professionals are we talking about in particular now who have to deal with the challenges that you've noted, and how is it going to actually make life easier for those particular—? Maybe you can specify—midwives and whatever.
Well, I think health visitors and school health nurses are the ones who are most likely to be in families and pick up how things—. In a children and adolescent mental health services service you pick up the sequelae of that. As you said, very often, there are a number of different issues, but physical chastisement might be one of those issues, and in the complex cases families you have to do a lot of different things. There's very rarely a single intervention that is going to make a difference, but a number of interventions that pick off and support some of those problems is how we work. So, we see the reporting and that clarity of how you should raise your child, particularly for health visitors and school nurses, and also in antenatal classes when midwives deliver them as well. But then the consequences of that we see—. Not so much the severe physical consequences, which we see in safeguarding, but the emotional consequences where it's gone across the line—the child has suffered or decided that aggression and violence is an appropriate way or first guess at dealing with discord and things you disagree with—. You see that in children's mental health and psychology services as well.
I think you could even broaden that from a primary care perspective into community nursing, district nursing, because, often, they will visit families—you know, they visit families. They may go—an elderly relative may be on, but they will be in contact with children and witness things from that perspective, so it isn't just individuals who deal with children; it is far, far wider.
Thank you, Chair. In written evidence, the Welsh NHS Confederation says that the explanatory memorandum does not provide sufficient clarity around the definitions of what is considered acceptable behaviour towards children, particularly in the case of vulnerable children and young people. Are you suggesting that these definitions need to be on the face of this Bill?
I think it's very difficult to define the precise definitions of behaviours on the face of a piece of law. I think there needs to be expansion in the codes of practice and the broad principles with which they do that. But if you set the principle that the use of physical means to improve people's behaviour is inappropriate as a starting point—. Where the line then comes as to what's the difference between—. And it's using that as your defence for your physical involvement with a child, so if you're picking them up, you might pick them up from crossing the road, you might push their hand away when they're about to put it in a fire; you're not then saying, 'I'm using physical means to improve their behaviour'—'I'm using physical means to keep them safe or stop them doing it.' It's when you are using physical means to say, 'Stop doing that. Start behaving differently'; that's when it becomes inappropriate. A blow-by-blow or foreseeing [correction: judgment of] every single incident will need to be worked through between professionals, as it is at the moment, actually. But, at the moment, our starting point is really close to the edge of, 'Is it harmful or is it not harmful?' What we need to say is, 'Are you using physical harm to try and change a child's behaviour?' almost irrespective of whether it's harmful or not, because that's the new standard.
Okay. Just on that, then, Cwm Taf Morgannwg University Health Board says there's a lack of clarity on how physical chastisement is defined. Swansea Bay UHB's written evidence also says that
'more clarity in terms of definition of what is considered to be acceptable actions in this area may be needed'.
Do you agree with that?
I do. As I say, I've just given a definition of what I believe physical chastisement means. So, 'physical' being physical and 'chastisement' being that you're doing it for the purpose of punitively trying to change somebody's behaviour.
And from a definition point of view, it's any punishment that causes pain but not injury, and that's the definition. So, if somebody could slap a child and it leaves a mark, well, is that right or is it wrong? Whereas, it's conflicting advice, the messages wouldn't be going on—. It would be far easier, because that's the definition. And, if you look at a slap, your definition of a slap may be a different definition to mine, and it's very much about the—. The conversation that happens now is, 'Has it left a mark?', 'What was the environment?', 'What was the child's reaction?', which is often confusing.
Okay. That leads me nicely to my next question. Does the existence of the current defence of reasonable punishment have a negative impact on children's health?
I believe it does. It's not the biggest impact on child health, but it's something we can do something about. And it's normally, as you say, in families that are doing a lot of things, so there are a number of issues that relate to the child's mental and physical health and well-being. And certainly, when you see—the most vulnerable children we see, the most challenging children we see, it's not unusual for them to have received physical chastisement as part of the overall picture of the children we see.
To the higher grade of physical chastisement or is some of it the lower?
Well, the low as well, because it's part of that message. If you're going to use physical chastisement, the amount of positive reinforcement you're going to have to do over the top of that is enormous. And mostly it's seen as a short-term thing; it's seen as a traditional way of raising children—you know, people have been smacked for a long period of time—but the reality is that it's not very effective and it can cause harm. You see young children who, when they get angry, say, 'I'm going to smack you' and you can see that they are re-enacting the behaviour of their parents when they're dealing with their siblings and their friends. They only get to specialist services because they're doing some other stuff as well, but they've added the tool of physical chastisement as one of their behaviours, and that's not a healthy thing for children to be developing. It doesn't cause the same—. Most physical chastisement doesn't cause long-term physical consequences, but it does cause some psychological consequences and it sets the thermostat about what is an appropriate level of violence and what isn't at a step up from that—it isn't acceptable, essentially.
Yes. Just if you can help us with this one, because you're talking about the introduction of a culture of aggression at least into a family in this way. So, does the frequency of the smack that's currently below the threshold matter?
The frequency below the threshold will matter, particularly if you're not doing anything else, but that's the only way of managing the child.
I think it's the normality of that behaviour and it's the message that's consistently being given to that child. Because I think, from a research point of view—. Research in this area is very difficult, because of ethical issues—
And it is very difficult, because there's a balance, isn't there? But I think most research will agree that it is potentially harmful and we're aware, with adverse childhood experiences, of the impact in later life. And I think research is saying as well that, if a child grows up in an environment where they've been hit, when they parent, they are more likely to hit. It's that cycle.
Okay. Can I just get to my specific point, then, which is: do you think this Bill, in the way it's drafted at the moment, would not just help the families you talked about but protect those families where there's a once-in-a-blue-moon-type of smacking incident, because it catches both at the moment, and one set of behaviour seems far more harmful than the other?
I'm not sure how—. It depends on the extent of the one-offs, obviously, and things like that. I think it will, because actually it won't enter your toolkit of what you're going to do when you're trying to chastise your child. As I said, it's that whole idea of being two steps away from it. So, it will definitely improve those who use chastisement regularly and routinely, but also, because it doesn't become part of the toolkit, if you like, as a culture and as a nation, it's going to be far less likely, the one-offs, too. Because the one-offs, when people are desperate and thinking of one-offs, what they search for is pulled from the culture of what they've seen other people use and those sorts of things as well.
It's a question about whether they then should be liable under this law. But, sorry, that's what I was trying to get to.
But I think, if you do a one-off and you cause physical damage, you're liable under a different—
Yes, obviously. Well that's over the threshold; that's clearly a different kettle of fish. Anyway, thank you, Chair.
The Children’s Commissioner for Wales and others have told this committee that the physical punishment of children is a public health issue. To what extent do you agree? And what is your view on the fact that the Welsh Government decided that a full health impact assessment was not necessary for this Bill?
I agree it's a public health issue, because it's about culturally how we raise our children to be healthy, well-regarded, psychologically and physically well. It's not an intervention issue, it's a health issue.
Thank you. Do you think the Welsh Government should have included a full health assessment on this Bill?
It's very difficult to track—. My understanding is there's been lots of evidence presented on that Bill and research done for the Bill. I'm not sure what you mean. Is it a health assessment just for Wales or for what exists elsewhere in the world, because we've got some good evidence in the countries that have adopted this legislation and the impact that's made? Now, actually, we're saying many of the impacts of this are on the behaviours and psychological well-being of children 10, 15 years down the line. Most of the countries that have introduced it are not that far down the line to be able to see how that's turning things around.
Okay. Thank you. We've got some specific questions now on the development and implementation of the Bill, starting with Jayne Bryant.
Thank you, Chair. Good morning. In the written evidence that we had from the Welsh NHS Confederation, it says that the explanatory memorandum needs to be strengthened to include NHS bodies as one of the public bodies this Bill will have an impact on. Do you know why that hasn't been made explicit at present? No. That's fine.
Are you confident that NHS bodies have been involved enough in the Bill's development?
I believe they have. They've gone through the particular areas of the NHS that are most affected. So, safeguarding areas have been involved, mental health areas have been involved as well, rather than NHS Wales, if you like, to the same extent. But, actually, the people who deal with it day-to-day and have an expert view have been involved in its development.
Okay. Thank you. We've heard from police representatives and they've emphasised the need for multi-agency safeguarding hubs, and we've heard of some good examples from, say, Cwm Taf, and I understand that there have been similar projects in Bridgend and Cardiff. They think that these safeguarding hubs should be in place across Wales to provide a single point of contact for reporting new concerns once this Bill has been enacted. What would you say on that?
I think areas that haven't got the multi-agency safeguarding hubs will, in the main, have single points of contact as well, and I know there is a discussion more widely in relation to regional partnerships from a MASH perspective. I think the research on MASH is, again, much like everything else, mixed in relation to the benefits—the pros and cons from a MASH perspective—but there are lots of areas that have health representatives particularly working in local authorities in a single point of contact that aren't working in the model of a MASH.
Right, okay, so you wouldn't necessarily think that should be rolled out across Wales; you just think there would be different ways of doing it.
The functions of those should be the same across Wales, because safeguarding should be a multi-agency issue that we proactively meet together and discuss around, rather than only reactively at a high threshold.
And you think working through that multi-agency approach would be essential to ensure the Bill doesn't lead to an increase in convictions.
And just from a safeguarding perspective, I would say there are good examples from a—. But I would say, in safeguarding for many years, having worked predominantly in that area, this is where multi-agency working does tend to work, whereas it falls down in other areas. I think in safeguarding we are ahead of the game. It's very, very well developed.
Okay, and just finally, can you quantify the scale of change needed in guidance relevant to health bodies and professionals if the law is enacted?
From a policy perspective within health boards, any legislation, our policies are updated. Hopefully, we're going to move towards the all-Wales procedures. It would be key to have this information related into that. And what we have in safeguarding is we have an e-learning package that is delivered on a level 1 and level 2, which as health boards is what we work to from a safeguarding perspective. So, it's about getting that information into that training, and all health boards within Wales deliver a face-to-face level 3 training. And each time with new legislation with things that are changed, obviously from examples of the violence against women and social services and well-being legislation, training is key and tweaked each time, and updated on a regular basis.
It's not going to be insurmountable, because we already have those things in place in health boards.
The mechanisms exist, it's putting this new—. As I say, defining the new line in the sand in the new training, essentially. But as far as parental training and all those sorts of things, the delivery and support of parents in early childhood, that should stay the same. To a certain extent, it makes that message louder in the models they're trying to promote.
Thank you. Just on the question of training, do you see any particular funding implications for that, or would you just see this being incorporated in basically what you already do?
I would say—
It should be incorporated in all that we do.
—it would be incorporated.
Yes. So, you wouldn't necessarily see a resource implication for any additional training needs around this.
There are conversations outside of this legislation about how we adequately support parents to understand the best ways of raising children, it's in that arena it lies rather than the change in legislation.
Okay, that's fair enough. Okay, if I can just move on then, Nicola, in your health board's written evidence you list a range of potential barriers to the implementation of the Bill. Are those serious concerns? Do you want me to remind you what they are or are you au fait with them? You talked about the potential criminalisation of parents, you talked about the overburden on public bodies, and you talked about it possibly damaging the trust between public bodies and families. Are those particularly serious concerns for you?
Those are concerns that have been raised by—. Obviously, because the consultation was set wider from a health board perspective and the responses were collated by me, I think those are views that would be concerns in relation to when the duty to report under the social services and well-being Act came in, but it's about working through, being clear with parents what are the acceptable norms. And as I said, it will make it less confusing if this was to be successful.
Okay, so you're not saying that necessarily you consider those to be insurmountable barriers; you're just saying that these are things that have been raised and we just need to be aware of them, basically.
Okay, I understand. I don't know whether you've seen the written evidence that we've had from Cwm Taf Morgannwg, but that says that the Bill does not adequately reflect the impact of the consequences of the legislation on parents, public services or communities. It goes on to say that there needs to be greater clarity with regard to enforcement and processes. Is that a concern across all health boards, do you think?
Certainly, in our health board, it is a concern, but I think if we're dependent on enforcing the law, we haven't used the law properly, because it is about sending the message. Because it's a public health message, as you say, so if you're ending up saying, 'How do we manage all the criminal convictions we've got?', clearly the support hasn't worked properly. So, that's the context.
I think it's a preventative measure. It's got to be at its most—. To work, it's got to be preventative, because we shouldn't be putting an Act that is, if you like, using a punitive measure to improve behaviours. And sometimes, law can feel punitive as well, so something punitive to stop something punitive seems a strange way of going about it. What we should be doing is saying, 'This is the line in the sand; we've made it clear that it's well away'—and that we can clarify what we mean by the words 'physical' and 'chastisement.' But then, it's about promoting the positive behaviours to move away from the edge of the cliff, as I said earlier, rather than policing the edge of the cliff so you can catch people.
Yes, I understand. I understand the point you're making. That's fine; thank you. My final question, Chair. Again, it's based on written evidence that we've had, which is from the NHS Confederation, and they talked again about possible unintended consequences of the Bill, in that there could be a significant increase in demand for services that aim to support parents—the kind of thing that you just talked about. Again, is that something that you would anticipate, you've got a concern about, or, again, is it something you just feel you work through in the normal process?
I think there may be concern in relation to using the preventative services—from the positive parenting, the messages—and, ultimately, from a safeguarding perspective, from a team perspective, in relation to the support for staff who possibly would not have made a referral to the local authority, or from a police perspective, and then, the outcome in supporting staff with police statements et cetera. So, that may be, but looking at the evidence that has been given from a police perspective, I don't think they're envisaging a huge increase in relation to reporting. But, obviously, that would be from their information.
And as far as the need to increase our support for children and families in their early years, I don't think this legislation is the main driver behind that. I think there are loads of other reasons why partnership boards need to be investing more in that sort of thing. So, for people who work in children's services, we think that's a good thing to try and develop.
And, just finally, are there any other unintended consequences that you think we ought to perhaps consider, that we haven't looked at yet? It's quite a short Bill; there's not a lot of detail in it.
To my mind, that's why it needs to be a public health message rather than a criminal law message, if you like.
From the committee's point of view, we need to anticipate the fact that there will be an increase in the number of referrals to lower-level preventative services. From your perspective, are those services uniformly available across Wales?
'Uniformly' is the key word. As far as evidence of what works, and in different pockets of good practice, yes. So, we don't have to learn what we need to do; it's about rolling that out and using some of the resources that are coming through from some other different streams, so that we properly address those issues.
Well, I think we've got—. If you look at—. Again, this is another one of my roles, but if you look at how we're growing support services for families and children in terms of prevention, I think you've got at least four or five of the health boards that are now really cracking on with developing, with transformation funds, integrated care funds—to start developing that level of care. One or two of the health boards are a bit further behind. When you speak to the senior people in health boards, however, the ideas and the will to start enacting is there. So, I think, the hearts and minds are there, if you like, and gradually, as new moneys are emerging and change is happening—. We're several steps ahead of where we were three or four years ago, for example. And my reflection is that most of the health boards are on board. There are one or two health boards that need a bit of extra help and encouragement and support to do it.
Okay. Thank you. We've got some questions now on the importance of awareness raising, from Suzy Davies.
Thank you, Chair. Just to go back to unintended consequences for a minute, do you think there's a possibility that, if there's an awareness-raising campaign, some families who are currently perhaps engaging with the health services might decide they don't want to any more, lest they are judged for their behaviour?
I think that that may be possibly be a risk in relation to that, but it would depend then as to what—. Often, this behaviour, as Dave alluded to, is part of a wider picture. So, from a health board perspective, obviously, and from health visiting et cetera, it's a service available to all—there isn't a threshold for a health visitor intervention—so there are means and ways of understanding why families disengage and processes in relation to that.
It's also about how you raise awareness. If you raise awareness by saying, 'If you do that, then you'll be in trouble', then they will. If you say, 'There are better ways of raising your children and we really want a less violent, healthier childhood', then you would hope that fewer people would feel that that is a bad idea and something to be scared of. So, it is about the intent and who's giving the message and how you raise awareness so you take people with us.
And who do you think should be responsible for designing that awareness campaign?
Well, I think families and young people need to be at the heart of designing those campaigns, particularly some of the families who have maybe struggled and have had to learn different ways of parenting, alongside getting it in right at the start. So, we've got curriculum change, we've got antenatal classes and we've got health visiting, where there are three key opportunities for families and young people and people who are considering starting a family to get the message ahead of the game, rather than having to learn—when you've had your first massive temper tantrum and they're hurling the stuff around the supermarket—how you manage those things. It's about putting them in as the early blocks, as part of the normal message and a way of getting tips on how to raise your children.
Okay. So, you’d say that tone is important. The reason I ask is that, naturally, it’s a bit of surprise to me that in the explanatory memorandum, it says that health professionals are the second most sought-after source for parenting advice—disappointingly after the internet, as opposed to families and friends. So, you’re going to be at the vanguard of this, whether that was your intention or not. So, I wanted to know whether or not you thought health services should be helping to design this campaign, really.
The Healthy Child Wales programme, and the public health message of midwifery services, both of which I manage—they’re on board with it and they understand it. How you set your child and your family up from conception is a really important part of their job.
I know that's a universal service, in theory, anyway. But you know that children between the ages of nought and seven aren't getting that universal service at all. I think it's—well, in Aneurin Bevan, it's only about a fifth.
Yes, but we've got the Healthy Child Wales programme that we're investing in, so we'll have everybody in there by the end of the next two years. So, it actually has been taken on board and the health board has invested in it.
I didn't really want to pick on you particularly, but just generally, it's only about half the families that are taking up that entitlement. So, only half are going to be exposed to that opportunity to get the awareness raising.
Yes, but as I say, if you put it in antenatal and in health visiting and in the curriculum as part of parentcraft or whatever—how to be a citizen—you're hitting a variety of different people. There'll always be people who don't accept offers of help for a lot of different reasons.
And I think that it’s key to engage our primary care partners as well in relation to GPs and community staff et cetera. That would be key—not only health visiting and midwifery; I think it’s a wider—.
Before we move on from the Healthy Child Wales programme, can I just ask—? Obviously it's done on the basis of a universal schedule of visits, which we know isn't being complied with at the moment. How can the committee be assured that a parent who needs extra support—so, say, a mother who is struggling and might need more than the universal schedule of visits from their health visitor—would they be able to get that or would it only be in a Flying Start area? How would that work?
Certainly, in our area, it’s blurring the boundaries so that we don’t have postcode lines that say, ‘You’re Flying Start, you can get enhanced, but if you’re two doors down the road, then you don’t'. It is about developing that menu and having less black-and-white boundaries, if you like, so that we are able to have the flexibility for those pockets of families who need the Flying Start-type level of intervention but actually don’t live in a Flying Start area—that they're able to access the bits of the menu they require.
I think most are reviewing that, because they do think it’s a very blunt tool—defining it postcode by postcode.
Just finally: because that postcode lottery exists at the moment, there's a risk here as well, isn't there, that money that's put aside for awareness raising may be targeted into Flying Start areas, when actually parenting is a universal challenge, shall we say. One of the differences between this legislation and that in Scotland is that, in Scotland, they're putting a duty to raise awareness on the face of the Bill. There is some resistance from Welsh Government, and I just wondered if you thought that was justified and that we can rely on good intentions to make sure that the money goes everywhere. Is a duty helpful?
Potentially it is useful, the duty, because, again, the whole thing is about being clear about where the line in the sand lies. If there's a duty, you're clear about where the line in the sand lies and there can't be any discrepancy about it.
Thank you. Moving on now then to some capacity and resource issues—Hefin David.
Do you expect more money from the Welsh Government to deliver this Bill?
Those are two different questions, aren't they? I don't think there should be—. Personally—I might be talking about myself here—I don't think resource just for this Bill is how it should be tackled. I always think there's a whole conversation about how our public bodies target support for children and young families and whether we've got the balance right between our investment into early years as opposed to later years. The evidence is that if you invest in good early years, a whole range of stuff, that's the most cost-effective way to do it. How you turn the current reactive funding model to a more proactive, preventative model is the catch-22 question. But I think it should be done on the back of that. And there are conversations outside of this about how we view Healthy Child Wales, lots of the early years work, some of the stuff from public health as well. I don't think—. That should be the purpose of any extra investment. This Bill gives an extra legitimacy to say, 'Get on and do it'. But actually, money just for this doesn't seem to make much sense, welcome as it would be.
Okay. And with that in mind, Betsi Cadwaladr gave us evidence that said that there are vacancies in health visitor numbers, for example. And if this adds an extra burden to the role of health visitors in awareness raising and explanation and monitoring and all the rest of those things that health visitors do, there just isn't the capacity to do it.
If you just look at health visitors, they're right. But actually, as we've already said, there are a whole number of professionals—
Yes. There are so many roles of, you know, family care support workers, for example—there are a load of assistant roles, if you like, that are easier to recruit to that potentially could do a lot of the awareness raising and the support. We know, for example, that for some interventions you absolutely need the trained staff to design the programme, but actually making sure those programmes get delivered—in areas like constipation management, enuresis, behaviour management—it's the non-trained staffing skill that can keep the family going, keep them on board, more than requiring a whole load of band 6 or band 7 health visitors or whoever to keep on doing all the day-to-day work. So, there are models that can work differently without the reliance on those professionals.
So, can I just understand that as, 'There are always resource pressures, and there are resource pressures, but this won't necessarily add to a hugely burdensome, extra resource pressure'?
There are probably 10,000 or 12,000 professionals within the health board. Yes, health visiting is under pressure, but there are other solutions to deliver those services and support the families in awareness raising and different ways of parenting.
Okay. I appreciate and understand that. One issue, though: the explanatory memorandum notes the fact that there's a lack of evidence from around the world as to the resource implications of introducing a Bill of this kind, and those countries that have done it are unable to report detail about the amount of resource required. Does that not concern you a little bit?
From a safeguarding point of view, I think it's very clear. From a safeguarding activity, it's very clear in relation to that. I honestly don't—. It's difficult to quantify, because we don't know—. Obviously, I've looked at what, from the police perspective, they're looking at in the number of cases. We're very good at being able to quantify, as with our local authority partners, numbers of referrals from a safeguarding perspective and activity, but it is very much an unknown. When I read through it, exactly the same as everyone else, it was disappointing when you looked at it from other countries, because it's unquantifiable.
But on the other hand, if it had caused the services to collapse, I think—
—we'd know about it. So, there might be a requirement, but it's not cataclysmic or sea changing.
And—last question—we live in a world, now, of binary choices. People are presented with, 'If we do this, this will happen,' and we know the world is more complex. How do you respond to the argument that a campaigner may say, 'Look, if you introduce this Bill, we'll be diverting resources from front-line services'?
I'd be interested to see which front-line services they think we're diverting them from, because I honestly can't think of the front-line services we will be doing, and actually, in the long term, to a certain extent, that's the aim. If we were having to pick up the pieces of damaged adults and children where chastisement had played a part, that would be a good thing, wouldn't it?
Are there any other questions from Members? No, okay. Just before you leave, would it be possible for you to provide us with a note on behalf of the health boards on the early intervention services that are available across Wales, so that the committee can get an understanding of the coverage of those? Because, obviously, I'm aware of the work in Aneurin Bevan, but I think we're looking for some sort of assurance that that's happening everywhere, really. That would be really helpful.
Well, can I thank you very much for your attendance this morning and for answering all our questions? You will be sent a transcript to check for accuracy following the meeting. Thank you again for attending, and the committee will break until 10:30. Thank you.
Gohiriwyd y cyfarfod rhwng 10:11 a 10:32.
The meeting adjourned between 10:11 and 10:32.
Okay, welcome back, everyone, to our next evidence session on the Bill, with the National Independent Safeguarding Board. I'm delighted to welcome Jane Randall, who is chair of the National Independent Safeguarding Board, and Jan Pickles, who is a member of the board. We know that this is your first week, so thank you for coming to give us evidence. We're looking forward to hearing what you've got to say, and I've got some questions to kick off from Siân Gwenllian.
Bore da. Pam rydych chi yma, mewn ffordd? Dyna beth dwi eisiau gwybod. Beth yw'r cysylltiad rhwng diogelu plant a chosb gorfforol, ac i ba raddau mae cosb gorfforol yn dod i fyny fel rhan o waith rheolaidd y byrddau diogelu rhanbarthol a chenedlaethol?
Good morning. Why are you here, in a way? That's what I want to know. What is the link between safeguarding children and physical punishment, and to what extent does physical punishment feature as part of the regular work of the regional and national safeguarding boards?
I think the link between safeguarding and physical punishment is about safeguarding children in the widest context from physical harm. In terms of how frequently it comes up within safeguarding practice currently, I think that would be a question that would be very difficult to answer, in that the data is not specific around children on, for example, the child protection register for physical abuse, whether it's around physical chastisement or other elements of physical abuse. So, there is an issue about the data that we hold currently around the prevalence of physical chastisement within the child protection system. What we do know, though, is that children who experience physical punishment are living within a wider context, potentially, of harm, and that's what the child protection process would look at—at the whole family functioning and the family dynamics, the parenting styles and perhaps the punitive nature of that family functioning. So, in safeguarding, we would always be looking at a broad focus, not just on one particular incident. But physical punishment is an area of parenting that would cause safeguarding boards and safeguarding professionals concern in terms of their particular style of parenting.
Can you anecdotally tell us what the prevalence is of physical chastisement within the cases that you deal with?
Although we're in our first week of the new safeguarding board, I am on my second term of the safeguarding board, so between us I think we've got about 70, 80 years of experience in this world.
So, child protection is a very narrow part of safeguarding. So, child protection, which is what this measure is not aimed at—. The child protection system is already in place and working. And we hope we have the right children that we're protecting. It's always a risk because there are children on the edge, where we're not sure if they do need protection, and that's why we need professionals sharing information and making those decisions.
The wider safeguarding arena often comes into parenting. So, what sort of childhood do we want children to have in Wales and how do we equip parents to be good parents is an issue that is of interest to safeguarding bodies, not just looking at child protection data. That wider safeguarding area encompasses all of us. We all, as parents, have been stressed and under pressure. We all, as parents, have not known how to manage a situation with a child. How we in Wales equip parents to do that is part of the role of the safeguarding board.
So, that could be early intervention in some of the work that's done by health visitors in universal services, telling people what a bedtime routine looks like so that you don't end up with a tantrum at bedtime and the child knows what's going to happen. There's a teatime, there's a bath, there's a story, and then there's bed. That gentle process then helps the child go to sleep and be ready for nursery or play or school the next day. For many families, they don't have those skills. The deficit of those skills, which are taught by our own families and our own communities and wider families, is one where safeguarding begins to step in. When we see people who have those deficits and can't provide that safe and secure environment for attachment to grow and develop between a parent and child, then at some point the state has to decide to step in. But, most of that is outside of the realm of safeguarding boards. It's in that grey area on the edge. It's only when things escalate. Clearly, before a case becomes a child protection case, there will have been opportunities to intervene early.
I know that you've heard from people who've been talking about our safeguarding children reviews and the reviews that we've done for many years. But I did a review of those reviews in the 1950s and 1960s, and the lessons that we learn today from those reviews are exactly the same: that being a parent can be stressful and demanding and challenging and we need to give people skills universally. But there are some people who need more intervention and, at that point, the safeguarding boards and what they oversee would become involved in those children's lives.
From my personal experience in the child protection world and dealing with cases where physical abuse is the primary concern, abuse that was regarded as chastisement by the parents would be small in number. That isn't primarily the kind of physical abuse issues that we were addressing within the multi-agency child protection arena. In fairness, I would say those cases that I can recall would have tended to be with parents and adolescents rather than parents and small children, where it was deemed as an over-chastisement situation.
Yn eich tystiolaeth ysgrifenedig chi, dŷch chi'n dweud bod y bwrdd diogelu cenedlaethol yn cefnogi'r Bil yma. Wnewch chi egluro pam nad ydy'r gyfraith fel mae hi ar hyn o bryd yn effeithiol?
In your written evidence, you do say that the national safeguarding board supports this Bill. Can you explain why the law as it currently stands isn't effective?
The board has a very strong view that this is a children's rights issue, and that is a statement that needs to be fundamentally made. Children should have and are entitled to the same right of protection under the law as adults, and we don't believe that there should be a lesser degree of protection for a child than there is for adults in similar scenarios. So, I think that fundamentally is our position, that they should have equal—. It's not even about giving them extra protection; it's just about having the same protections as everybody else. We have accepted the United Nations Convention on the Rights of the Child in Wales. We've accepted that it will be fundamentally part of our legislation. We think this is a clear statement that we actually believe that.
Ocê. So, dŷch chi'n dod ato fo o safbwynt hawliau plant. Ond, hefyd yn eich tystiolaeth, dŷch chi'n sôn nad yw hi'n eglur iawn yn y gyfraith fel mae hi ar hyn o bryd. Ac ydy ceisio cael rhywbeth sydd yn fwy eglur yn rhan o'ch cefnogaeth chi hefyd?
Okay. So, you're coming to this from the perspective of children's rights. But, also in your written evidence, you say that it isn't very clear in the law as it currently stands. And does trying to get something that's more clear form part of your support also?
Yes, definitely. I think the fact that it's not a defence for more serious criminal crimes—the threshold—and that you can't use the defence of reasonable chastisement but you can for a lesser offence is confusing. It either is, or it isn't, and I think when you're asking not only families to understand what is acceptable behaviour, but professionals, in trying to make decisions about whether it's reasonable or unreasonable, if you've got different standards for different levels of crime, I think that is very confusing.
Oes gennych chi enghreifftiau i ddangos sut mae'r ffaith bod pethau'n aneglur yn gwneud pethau'n anodd?
Do you have examples to show how the fact that things are unclear make things difficult?
No, I can't think of specific cases, but I think you've got—. If it's a clear principle that physical punishment of children is not acceptable, I think that will help the public in how they respond to what they see and witness, and whether they should be intervening, because it's clear it's not acceptable full stop. I think professionals already make those judgments together. They have to weigh up if they're in a situation, in the child protection conference, for example, and people are saying, 'It was reasonable chastisement', those multidisciplinary professionals will weigh up all the information and make that judgment now. I think what you've got currently is you may have a group of professionals in one area coming to a different conclusion, because it's a professional judgment, to professionals in another area. Whereas if it's absolutely clear it's not acceptable, that helps people be consistent in their decision making and, therefore it's fairer, I believe, in families, because you're likely to get the same decision wherever you're living, or more likely to.
I'd like to add to that that I think the clarity for the public is important. If we were in a supermarket and we saw an elderly person in a wheelchair having their hand smacked for grabbing something off the shelf, most people would feel an obligation to do something, and with austerity and shrinking services, we're increasingly dependent on communities coming forward. If that was a child in a pushchair grabbing things, people would see that necessarily as acceptable if that child was being smacked, because of this lack of clarity, because of this defence. And Jen's point about affording the same protection to children as we would to adults—vulnerable adults particularly—I think is well made on that.
But is it acceptable because there is this opt-out in law or is it culturally acceptable?
I think it's because people believe parents have the right to do it, and, therefore, we know that the public find it very difficult to intervene in those kinds of scenarios that Jan's described. They're very anxious about doing it, but if you're going to intervene because you're concerned and the response is, 'Mind your own business. I can do what I like', people are far less likely to intervene than if they know it's not acceptable and it's right for me to do something about it.
And this is about cultural change, isn't it? The law plays a part in that process of change, and we know from the research that Welsh Government has already commissioned that the attitudes of people are moving anyway. I think it's a nudge. I don't think it's a huge change, but actually, in 10 years' time, I think we will look back and think, 'We're surprised we didn't do that sooner'.
I think you've been dealing with this—[Inaudible.]—it's that point about the community taking more responsibility, taking a step to do something, and I just want to test that, because, perhaps, if you're living next door to a family where the children are routinely smacked, you might feel there comes a point when you intervene. But in your supermarket example, where actually it might not be entirely clear what it is you have seen—it might look like a smack, but it may not be and it may not be an act of punishment—do you think members of the public are going to intervene? Or are we actually creating a lack of clarity in a different place—that the line has just moved?
I think it provides that confusion about not wanting to make things worse is often what stops people from acting. What we know is that we don't get the level of referrals from the public.
If we look at more extreme cases—and there is a Cardiff serious case review, a child practice review, that's quite recent, where a neighbour had concerns about a child, and it was a neighbour who worked in a professional capacity, and in that professional capacity would have had no qualms about making a referral—they worked for the health service—but because they were a neighbour, they felt unable to do that because they felt it was the parents' right to do that. So, stepping into a family is harder. It depends; it might be a random person in a random supermarket who's come from miles away, or it might be somebody you see every day. And, really, what we're aiming to do is access people who have just fallen off the edge of coping. So, maybe they were coping as a family and now they're not, and that might be be because of a bereavement, it might be redundancy, it could be a million and one reasons, but they've just fallen off the edge of coping. People in that community will know. When I took my children to the local playgroups, we knew who were the mums who were having a hard time, and we would try to support them. And that's what we want to encourage in our communities, isn't it? But, actually, there's a point at which, for everybody, there's a line at which you think, 'I can't go over this', and maybe part of that is, 'I can't tolerate this any more', and maybe what will help people decide where their line is, and what they're prepared to tolerate, is clarity in the law, so without this defence.
Just the difference, really, between an elderly person in a wheelchair having a smack for perhaps reaching out—I would find that pretty difficult to witness without thinking that there's something far deeper in that, because it may well be that that person has lost capacity. I see the difference in a child, whereas a child—if somebody grabs something, it could be dangerous or something, so you gave a child a tap just because they're learning; they have got full capacity of mind.
But, more importantly, are you saying you're expecting members of the community to enforce or police this? That if there's a greater awareness that children can't be just tapped, that somebody sees that in a supermarket—you're relying on those, really, to intervene or, indeed, to report.
No, I'm not saying that.
We're not relying on the community, but what we want is clarity so that people for themselves know what is acceptable and what isn't acceptable. But it's more about raising—. We're not expecting people to call the police or do anything like that. What we're hoping is that, within communities, we can build stronger communities by us all being able to reach out to people. And if that is an elderly person being smacked because they haven't got capacity, that's an issue that somebody, the carer, isn't coping and that maybe we need, as a state, to offer more services.
In Europe, what we see with child protection is that people come forward and ask services for help. Culturally, in the UK, we have a culture where children's services are seen as intervening as opposed to being invited in. The cultural change, I think, that we need to achieve is where people, when they're having a hard time, can say, 'I need a bit of help', and I think this can help towards that.
And you believe we have the capacity—if these families start to come forward, there is capacity in the safeguarding across Wales to cope with that.
Well, those people will already have a health visitor, on the whole, with a small child. They may already have a school nurse if the child is older. They may already have some support services within a comprehensive school. Those services are already there. I think the earlier we can intervene, the quicker we can resolve issues.
The difficulty that happens where services spend a lot of time, energy and money is when things have gone too far and if only—. I write domestic homicide reviews and serious case reviews in England, and if only people had intervened earlier—a little bit of help early on is worth so much more than allowing things to fester and become more complicated.
Before Janet goes on to her substantive questions, can I just clarify? The Association of Directors of Social Services Cymru told us very clearly that if a member of the public saw a child being smacked they should contact social services. So, can I just clarify: is that your view as well?
So, if you've got concerns about a child—[Inaudible.]—social services. We're not suggesting a police response. A police response comes later down the line if it's seen that a child is at risk.
I think the public's role in safeguarding is one of the issues that the new board has been asked to address and knows is a big issue for us to try and address, where it's not just about this particular issue but broader safeguarding issues, and what the public's role is within that. And I would just reinforce, in the reviews that we all undertake, whether they're child practice reviews, domestic homicide reviews, adult practice reviews, a very common repeating theme is, after the event, members of the public saying they knew about things that were going in the family, but they hadn't shared that with professionals. So, there's something about why the public do not feel able—what is it that stops people from feeling comfortable about sharing concerns that they've had with the professionals who could make the assessment? Because a member of the public observing something is just seeing that one incident; they can't make any sort of assessment. Clearly, that's the professional role.
Yes. I'm a constituency Assembly Member, and I have families coming to me saying, 'Help, I can't cope', but I find it's months, then, getting—
Janet, we're going to go into capacity. Can you look at your questions, please?
Okay. Is there evidence from a safeguarding perspective that physical punishment harms children?
The research is quite ambiguous in terms of if there's a direct link between physical punishment and immediate harm. Clearly, it's about degree, it's about level of force, it's about age and vulnerability of a child. The younger a child is, the lighter tough force is more significant. The older an individual, the more force. It's relative. We also know that children model behaviour that they've witnessed and experienced, so for a child who's experienced physical punishment to then be told it's not right to be physical, you know, with your peers, or it's not right between parents—it's inconsistent. And, developmentally, very young children cannot make associations between a smack or the tap and the behaviour. That is something that comes much later in the child's development. So, physical punishment of a small child actually doesn't achieve anything, because they don't have the cognitive abilities to make those connections.
Developmental psychology and parenting programmes would all back up that.
Okay. Some evidence we've heard suggests that other non-physical punishment, such as isolation—sending a child to a room for an hour or two—can be damaging to a child. To what extent, therefore, are you confident the academic evidence supports removing the defence of reasonable punishment?
Without doubt, being cold shouldered and not spoken to is harmful to all of us, particularly for children where the attachment is the key element, the building block for them as a person to go through life; their self-esteem is rooted in that. What we aim to do is access families early, so if they are under pressure and having difficulties, we are offering them very simple and straightforward ways about how you manage a child. I'm the mother of four children. My eldest child got the textbook approach to managing children. The poor child, the Penelope—I can't remember—
The Penelope Leach approach to children. By the time I had my fourth child—that child is probably the better adjusted. This isn't going out in public. [Laughter.] But because I was confident about the skills that I needed, and we all need help in learning those. You either learn them by watching other people, by watching your family, but if you only ever see conflict being resolved by a smack, then that gives you a very limited repertoire as an adult to resolve conflict. I worked for 20 years in the probation service on anger control programmes, and worked for a further five years running domestic abuse programmes for perpetrators of domestic abuse, and one of the things that was consistent across all of those people was that they'd never been taught that you could get a little bit upset, and you could get angry, and that there's a massive spectrum between those things. And, actually, that's what we need to be teaching people, that maybe anger is a healthy response at certain points, but it has to be an extreme set of circumstances—where life is at risk maybe. But, actually, teaching people the simple ways of resolving conflict—.
So, sending a child to a room and isolating them for several hours would be a very, very harmful thing to do. What we aim to do, and I think the removal of this defence could actually open up this conversation about, 'What are the good ways in order—?' Whether it be a naughty step, or 'You can't play with your favourite toy for half an hour'—what's proportionate and what's responsible, to give people some tools to manage the everyday ups and downs and conflict that occur when you're parenting.
Okay, thank you. And, finally, we've received written evidence from the British Association of Social Workers that refers to serious and significant case reviews in the UK in which physical punishment was referenced. To what extent would you suggest that physical punishment is part of a continuum towards more extreme physical assault?
That it is a continuum is clear. It isn't always the case, clearly, but I think, once you allow a physical response to frustrations or challenge, what you know is, when you're managing behaviours, often, you have to increase, if you like, the stimulus, to get the desired response. So, when one smack doesn't work, do you then go to two or three or four to get the response that you're looking for? So, I think there is clear evidence that it can lead to an escalation. It's also, as I said before, about the modelling of behaviour. It becomes normal to deal with conflict with a physical response, and that is worrying. I think if you were—. I don't know if you've spoken to children or had any evidence from children and young people who've had experience of physical chastisement, but there are groups of children—. And Jan's worked with young people in a prison setting, where they talk about their experience and what it's meant for them. So, yes, I think there is a body of evidence that would support that.
Okay. And a teeny one: do you believe that the threat of the thought of having a smack is a deterrent to help a child improve their behaviour?
I don't think there's any evidence on deterrents. We certainly see it—the longer sentences we give people as an act of deterrent, there is no evidence that that changes behaviour. The threat of something is quite a complicated and sophisticated cognitive thing to process, and, often, we're dealing with people who wouldn't be able to—
It's difficult for us. We all know that there's a risk that we'll get caught and we still do things. It's jumping a red light maybe. We're all—. [Laughter.]
Thank you, Chair. I just want to ask a couple of questions about developing the board. I think, obviously, you've only both been in posts a week, so you may not be able to answer this. I was going to ask you what level of involvement the national safeguarding board has—
Only Jan could answer that.
Okay. I was going to ask you what level of involvement you've had in the development of the Bill. Now, you may not have done because you've only recently been involved. But, anyway, have you? That's the first thing.
As a board, the inaugural board of the national independent safeguarding board, we've had discussions around it, but at the time—. We completed our term of office on 31 January this year, and there's been an—[Inaudible.]—and it's during that period that a lot of this work has gone on. However, I can say with confidence that all members of the previous board, which was under the chairing of Dr Margaret Flynn, were completely supportive of this.
And I guess you would expect to be involved in the development of the Bill going forward, in terms of its implications, its implementation, and all the kind of consequences around that. You would expect an involvement in that, presumably.
I think so, particularly in our relationship with the regional safeguarding boards, who would actually be managing and delivering the implementation of the Bill in their local areas. Our role is to support them in doing their statutory duties but also to be able to help facilitate national issues where they’re wider than just their local agendas.
Okay, that’s fine—I understand that. In terms of the all-Wales child protection procedures, do you see the need for that to be hugely revised and added to or—?
I don’t think so, in that, obviously the procedures will deal with all forms of safeguarding or abuse across the whole spectrum in terms of the processes that professionals will follow. Whereas they don’t currently make any specific reference, I don’t believe, to physical chastisement, there’s nothing to say that they can’t, as they go forward, if it was felt necessary to make specific reference in relation to the requirements of the legislation. They are going to be app based, so they will be able to be updated quickly. The project board—we were talking to them yesterday—for the procedures will continue to meet very regularly after their first year of publication in order to make any changes that are necessary.
I’m assuming that this is a very specific piece of legislation and that it might be quite a simple process just to add that into—
Currently, the all-Wales child protection procedures are massive and the move into them being digital will mean that they’re very quick to alter and the project board expects to be doing quite a lot of snagging in that first year, because it’s not just the social services and well-being Act that has changed things, but the digitalisation—if that’s a word—process will mean that how the material is presented to that front-line worker or that middle manager or to that principal social worker—
So, do the guidelines actually cross-reference pieces of legislation? So, it might be in that context that you might just cross-reference to this as a—
And there are good practice hints and guidance as well.
There are questions now about implementation, starting with Jayne Bryant.
Thank you, Chair. Just to take us back a little bit. You’ve touched on much of this around what you’d expect or think members of the public's role is, but do you think that reporting rates will increase if this Bill becomes law?
I think the expectation is that they won’t increase dramatically. That is based, I think, on the experience of other countries that have introduced similar legislation and it is a bit of a stab in the dark. I think professionals who already have a duty to report any concerns would be reporting now. So, it would be about whether we expect a huge increase in public referrals. I think that is unlikely. We know we need to do more work about raising the profile of safeguarding per se with the public, but whether that would generate an increase in referrals, it’s very difficult to say. But I think we can only rely on the experience of the other countries that have done it—that they haven’t been inundated with referrals as a result.
The aim will be to provide a tiered response, as we do to many other social issues where we've got victims and people—. I know Matt Jukes referred to the tiered response of policing around prostitution. In one of my previous roles, I was assistant police and crime commissioner for south Wales, and we looked very closely at prostitution without wanting to criminalise very vulnerable people—that was not the way to do that. And I think our response will be on a similar level. There are people who are malicious and intent on hurting children and the process is aimed at sifting those people out and making sure that those children are protected. There are other children where, as I say, people have just stopped coping. And there are other people who never knew the skills in the first place. So there'll be a range of responses and I believe that it won't increase the numbers of people coming through in terms of child protection, but it will be that safeguarding—. The public don't understand the word 'safeguarding'. In Scotland, they don't use the word 'safeguarding'; they just use 'child protection'—they don't talk about safeguarding. In fact, you give yourself away that you're not Scottish if you use that word. So, you have to be very careful if you're speaking up there. The cultural change that we need is that we need people to begin to understand safeguarding, and all it is really is about being a good neighbour and offering some support, offering to make somebody a cup of coffee sometimes. It can be as simple as that.
Okay. Thank you. A campaign opposing the law suggests it might mean that more children could be taken into care, but we heard the Association of Directors of Social Services disagreeing, saying that thresholds for social services interventions will not change if the Bill becomes law. Do you agree with that?
Brilliant. Okay. And just finally, to what extent are you confident that there's universal availability of support for families who might need it as a result of the legislation?
I think in terms of young children, the resources are definitely there. Jan's already referred to the fact that all families have health visitors. We've got Flying Start programmes for the under-threes in many areas in Wales. So, I think there's a lot of support there, particularly for young families. I think that support gets less the older a child gets, and I think particularly families struggling to deal with adolescents would find that there are fewer services available to support them. We've seen a contraction in the provision of youth services that would've traditionally been able to support young people, particularly in their communities. But parenting support groups for that age group, I'd say, are few and far between.
But generally, it's not just linked to this particular issue, I would say.
But if an adolescent is on the receiving end of violence from a parent, it's likely that this will be showing up in other areas. It's likely we'll be picking up mental health concerns or anti-social behaviour concerns. They will be demonstrating their distress in a different way: girls often through mental health, and boys often—undoubtedly there's a gender split—boys more presenting anti-social behaviour. We have models around them, but as Jane says, that's where austerity has probably hit the hardest.
Because the committee has had a lot of concerns raised with us about early intervention services, and what you've said, Jan, sounds great, having this kind of tiered approach, helping people more, but the committee has heard that, actually, those services aren't really available, even for very young children. We know that more than half the children living in poverty don't live in Flying Start areas. So, are you telling us that you are confident, Jane, that all families who need that early intervention and support will get it at the earlier years level?
I think I'd be very brave to be able to say I would be confident that every child would get it. We know that there are gaps in service provision. So, no, I couldn't, in all honesty, say 'Yes, every child would get it.' What we can say is there are many more services for the younger age group to support parents than there are for even school-age and adolescent children and young people.
Well, I think that's the big question, isn't it? Certainly, from a safeguarding point of view, you look at the investment in early years, perhaps in Flying Start programmes, and if you were to ask me, 'Is that turning the tide in terms of safeguarding?', we would say, 'Well, we're not actually seeing that yet'. But it can be a generational thing; that's the problem. These are long-term interventions. Our numbers of children on the child protection register and coming into care are continuing to increase year on year, which is an indication of the distress that families and children are experiencing. The causation of that is what has challenged us for years and will continue to do so. It's not a clear, black and white, linear cause and effect.
Some of these things are lagging indicators for austerity. If you look at domestic abuse, which is probably why a third of our children are on child protection registers—it's relating to domestic abuse. Domestic abuse increases during austerity and it takes a few years for it to come through, and it will take a few years for it to be resolved. However, services are there; they do need support, though. They need support locally. We have many services that are funded through charitable donations, as opposed to through the state, and in many services you hear of fantastic projects where groups of volunteers—. The Women's Institute provide 'How to make a cooked dinner'—teaching people how to make a cooked dinner. It's not about making the dinner. It's about the interaction that goes on whilst you're doing that: 'Well, I have these difficulties with my children', 'Have you tried this?' So, people who don't have that within their families receiving that. So, it's not all about the state intervening in this and providing those services. It's about us choosing the kind of world we want to live in and how we contribute.
But it's not all about austerity either, is it? It's about using the money we have in an effective way and moving away from the hard end, if you like, into the early intervention and prevention, and that is the huge challenge.
And I think moving away from short-term funding cycles, which really present challenges to groups, particularly in the voluntary sector, who are trying to work to support their communities when there is this constant short-term cycling of funding—it's very, very difficult to sustain those services over long periods of time.
I ran a domestic abuse service for 10 years in this city, for high-risk domestic abuse cases, and that short-term funding cycle—. We moved from one year into three years from Welsh Government, but all our other sources of funding, whether it would be Home Office, or there'd be a range of trusts and funds, were all on one year. And actually, having that three-year security from the Welsh Government helped us no end, really, to deliver that consistent service, to keep staff so that people weren't always at the point of—. Otherwise you were spending your time handing out redundancy notices to really good staff who you were going to lose. So, keeping good staff, providing a consistent service, allows the public to then identify—. Because, 10 years on when we were receiving referrals, most of those referrals were because they'd spoken to a friend or neighbour who'd told them about us. It wasn't any of the other publicity we did, it wasn't a police officer telling them; it was their friend or neighbour saying, 'These people will be able to help you'. So we need services to be around for quite a long while to provide that.
Thank you. That was really interesting. Before I go on to my main questions, it's led me to this question, which is: the kind of families that you're talking about now; how are they going to be helped by this particular change in the law? Because it seems to me that you talked earlier about people being at tipping point, and something had happened in their lives that was unexpected, but when you've got these long-term built-in challenges, I don't see how a change in the law's going to make any difference either way, actually. The argument is that culturally it will, but if you're under that much strain, your behaviours are going to happen anyway, regardless of this change in the law.
But the culture in which you live will be different, and I think the removal of this defence allows clarity, which allows the culture to change. It's often the two things happening at the same time—public education and a little bit of legislation. I think it's that process that this is part of. In itself, it's not going to be a magic wand.
That's what I wanted to ask you about, actually. The comment—and we've heard it from other witnesses—is that a little bit of legislation and a lot of public awareness is the bit that changes the culture, if you like. Do you think it would be possible for an awareness campaign on its own to achieve the aims of this legislation? This is an open question here. Which bit of this actually makes the difference?
It's one part of it, isn't it? It can't do it all. And it's going to need constantly reinforcing. So, as you're educating that this is what we want as acceptable parenting styles and behaviours in Wales, that's reinforced by professionals in the way that they interact with families. That has to go on continuously. We do it in all sorts of other public health messages, so for me this is an additional one that we would embrace. The effectiveness of that needs to be constantly reinforced. If you take for example things like immunisation, you can have one piece of negative publicity that can totally undermine a campaign, and we're dealing with the fall-out from that years after the event, so you're constantly having to do that reinforcement. But it's not just about, 'you must not smack your child'; it will have to be about, 'there are positive ways of parenting', which we need to promote instead of using physical punishment.
If I compare this with domestic abuse and the change in attitude over the last 10 years, before it was accepted, to a certain extent, that it was a private matter, but now it's very much a public matter. And that's been some public education, some of which has come from Government; it's been about changes to law; it's also been about us embedding storylines in soaps, whether it be EastEnders or Pobol y Cwm or whatever, we've embedded those storylines, as we have done around child sexual exploitation and, increasingly, child economic exploitation. County lines is in nearly every police drama I see on tv now. It's become the flavour of the month. And actually that's what brings about the change. Sometimes, people would come to us as a domestic abuse service saying, 'I saw a storyline in EastEnders where he'd bought her a dress two sizes too small, and I knew that's what my partner was doing to me, telling me I could slim into everything.' And we all know that that's a way of controlling somebody. So, sometimes it's not just the responsibility of Government, it's for all of our civil partners within Wales to contribute to this debate, because it's about what sort of childhood we want children in Wales to have, what sort of confidence—to grow up to be a confident person and to have that self-esteem.
Okay. With the implementation board and the people who are on that, is there enough of a mix to represent the voice of children in particular in this one, to make sure that any awareness campaign is going to hit the right target?
There's nothing worse than a campaign aimed at young people that's designed by adults, in my experience. However, this is aimed at parents—most of this campaign will be aimed at parents. But it's important to hear that voice, that children associate being smacked with anger. For most parents, that's not what they want to demonstrate to their child.
Okay. We talked about the importance of an awareness campaign, and I've got a concern that there's so little money going to be around to support the principles of this Bill that any awareness campaign might just be over-targeted. It's not going to be universal. In which case, do you think there is merit in having a duty to introduce an awareness campaign on the face of the Bill, so that there's no 'get out of jail free' card for Government to say, 'Well we're only going to do it through health visitors', or whatever?
I suppose if you're going to put the duty on the Bill, it's how long does that duty last for and how often do you have to rerun your awareness campaign. I think there absolutely has to be an awareness campaign, at least with the launch of the Bill, but in terms of sustaining that long term, I think you've got to incorporate it into, perhaps, our other public health messages that we give day in, day out, to parents. So those professionals who are working with parents, both in universal and in targeted services, are going to be key in fostering that message over the next years.
But without a formal duty on the face of the Bill, it's open to all those agencies that we're talking about to think, 'Well, actually, we can't afford to do this anymore. We're losing a member of staff, we've got other pressures on us.' Are there other areas of training that might just squeeze this out? Is there any harm in putting a duty on the face of the Bill?
No. I wouldn't have thought so.
No, but maybe with some kind of sunset clause, because if we look at domestic abuse, the messages have changed over the last 10 years. So, 10 years ago, we were talking about physical violence; we're now talking about coercive control, which is a little of what was in your question. So I do think there needs to be—. The messages have to fit with the culture at the time to resonate.
Yes, I wouldn't disagree with that. What you don't want—. I would actually challenge your assertion that this is something we do at the beginning, because 10 years down the line, smacking is still likely to be happening, but the way you raise awareness about it will change. Okay. Thank you.
Just finally, I want to talk about some unintended consequences here. You suggested that there were unlikely to be any new, or a big spike in, referrals. We've spoken with previous witnesses about malicious complaints. I tend to think if you want to make a malicious complaint about your neighbour, you're going to make it anyway, regardless of the material you've got to rely on.
They're happening already.
But there are going to be those cases where, when they come to your attention, they're dismissed pretty early on, but that family will have gone through the process of getting the knock on the door. Have you got any views on the balance between families who are going to go through that experience, possibly because a teacher said something, compared to the families that we've been talking about a bit more in this session, who actually probably need good parenting advice more mainstreamed in their family, the way that they look at the family? It's trying to get round what will this law do to the individual who does the isolated smack that happens to get spotted by somebody who feels they have to report it, and the potential breakdown of trust with some of the professionals who might be doing the reporting.
I think that's a scenario that professionals face now; we deal with it. That is common to deal with that on a virtually daily basis in a social services duty team, or in a multi-agency safeguarding hub if you have an area that has that. Health visitors and midwives receive reports from the community about things they've seen. Teachers report things. So, I don't think that's different from what is happening now—that is normal practice, in my experience—and the professionals are considering together what is a proportionate response to the information they've received, alongside the information that they already have—the context that they already have about a particular family and the scenario. So, for me, that isn't different from what happens now.
Okay, that's useful to hear, actually. I'm presuming you think—. Let's use teachers as an example again. They'll probably need additional training in order to manage this, with advice on how to exercise discretion and things.
Yes, and any sort of developments in our thinking in safeguarding always come with additional training, which, ideally and usually, is multiprofessional; that's what the regional boards do. So, you have those conversations in your training together, as well as in single agency groups.
Yes, and how to work with families.
And it wouldn't be isolated training; it would be integrated into the messages that people are already receiving. Training, if you look at how the prevent duty is being provided to teachers, it's been integrated into the existing training package, so that it raises your awareness when you go through training, so that you become a little bit more alive to looking at those issues. But the process that you would follow would be the same process. So, it's not asking people to do something that is vastly different to what they're already doing. Safeguarding is changing all the time as new threats emerge and new risks emerge.
So, it would just be part of normal continuous professional development, then.
Thank you, Chair. I think you've probably answered the questions. I was going to ask you a little bit about the cost of updating guidance and procedures and training, and so on. And I think in the answer to Suzy, what you're saying is that that would be part of what you're doing anyway. So, do you see—? Because the explanatory memorandum talks about that there are unknown costs around the review of training, and around the updating of guidance and processes, and so on. You don't necessarily see that, do you?
Well, the updating of guidance is already part of a snagging process which is planned from November for a year. So, it will be already covered in that. In terms of training, training is changing all the time, as is learning as we learn more.
So, you see that as part of the—. Yes, okay. So, no significant costs in those areas from what you've been able to identify.
I don't think anyone's going to create a training package that has to be delivered in isolation around this.
Okay. And in terms of additional resources, you don't see that there's necessarily going to be a demand for additional staffing to deal with this. This is something that you feel confident you would deal with within existing resources, or would be dealt with within existing resources.
In relation to safeguarding—
Because there's no expectation that there's going to be a huge increase in the number of referrals coming through to local authority social services, I think it would be dealt with within their existing resources.
This ties in with the adverse childhood experiences work that most services now across Wales have adopted as a model of our approach, including in policing. So, we're expecting that initial contact, making every contact count that you have with a member of the public. So, you might have gone to see them about x, but actually you're talking about the full range of what you as a family can do to reduce those adverse childhood experiences. We're expecting our front-line professionals to be providing quite a wraparound service, and I'm really impressed by the way that people do that.
In your area, there is the multiple intervention assistance project, and I did the original training for the MIA project, and people came—some came from housing and had been housing support workers, some were health visitors, some had come because they were providing financial advice, and after a relatively brief training programme and lots of support, they were going out into families and identifying the elderly person who was at risk, the young person who appeared at odds with their family, the depression and anxiety. So, we were asking people who had only ever focused on a tenancy to look wider, and that's been achieved. The MIA service, I think, is a real tribute to our front-line staff's ability to partly use their common sense, but also to see families as a whole and not to just fragment and segment family life.
Yes, see the bigger picture. Yes, I take that point. My final question, Chair, just relates to the use of the Welsh language in particular around registered intermediaries. Now, again, that may not necessarily be something specific to this piece of legislation, but the explanatory memorandum does refer to it. This is really in the context of police interviews, isn't it? We heard the Deputy Minister say that she had concerns about there not being enough Welsh speakers involved in that. Is that an area of concern for you? I know that there are moves to try to recruit more, but is that an area of concern that you have?
I think there are deficiencies in all areas of advocacy provision in terms of the limitations of those, for whatever purpose. My particular experience is within things like the deprivation of liberty safeguards, but in adult safeguarding where every adult going through that process has to have an active offer for advocacy, it's actually the availability of that service that is the challenge in any language, English or Welsh, rather than just in this particular context. So, I think there is an issue about recruiting sufficient people into mediation and advocacy services—
It's a policing issue, yes.
Because it's not a devolved service, this is something that probably hadn't been thought of in quite the same way. It would be something that we'd give serious consideration to, but a non-devolved service hasn't given it quite the same importance.
The police have a Welsh language policy, and their aim is to offer, particularly among people who are vulnerable, the service in their preferred language, because when we're vulnerable and under threat, we often—our comprehension declines, and if it can be given in your first language, it's superior.
Can I just have one? I've listened really closely to the evidence in both the sessions we've had today. I'm just wondering: do you think there's a fundamental difficulty in trying to get across the purposes of what this legislation is, which is about changing culture and maybe helping professionals like yourselves horizon scan a little bit for problems? Is the fundamental problem that we are having to discuss all this within the arena of criminal law, which is nobody's fault around this table, and that that, in and of itself, kind of puts a pall across all the positive messages that, presumably, we'd all like to see out there? Does the fact that we're talking about criminal law make it much more difficult?
Yes. For me, the comparison I have is the defence that allowed men who had killed their partners to say, 'She nagged me.' And that only—when did that go? It's probably 15 years since that went. So, when we're taking something away, I think it's harder for us to comprehend, and I do believe that we need to swing this onto the vision of what we want childhood to look like, feel like. It's not just about the UNCRC; it's about making sure that we have vision across all of the public services around what childhood should give children.
Okay. Well, we've come to the end of our time. So, can I thank you both for attending? It's been a really useful session for the committee. We will send you a transcript so that you can check that we've recorded what you've said accurately following the meeting, but thank you both for attending, and the committee's going to have to break until 11:40.
Gohiriwyd y cyfarfod rhwng 11:30 ac 11:40.
The meeting adjourned between 11:30 and 11:40.
Okay, welcome back everyone. For our final evidence session of the morning, I'm very pleased to welcome Dr Lorna Price, who is Wales's representative on the Royal College of Paediatrics and Child Health central child protection committee; Dr Rowena Christmas, who represents the Royal College of General Practitioners, and Michelle Moseley, who is here on behalf of the Royal College of Nursing.
Thank you all for attending. We're looking forward to hearing your answers and we'll go straight to questions from Members, with Siân Gwenllian first.
Yn eich tystiolaeth ysgrifenedig, dŷch chi i gyd yn cefnogi’r ddeddfwriaeth yma. Fedrwch chi egluro pam dŷch chi’n credu nad ydy’r gyfraith bresennol yn gweithio neu pam ei bod yn aneffeithiol a wedyn rhoi enghreifftiau hefyd o sut mae pethau, fel maen nhw ar hyn o bryd, yn cyflwyno heriau i’r gweithwyr iechyd proffesiynol rŷch chi yn eu cynrychioli? So, allwn ni gael ateb gan y tri ohonoch chi ar hwn efallai?
In your written evidence, you all support this legislation. Could you explain why you think the current law is ineffective or why it doesn’t work and then could you give us examples of how things at present do present challenges to health professionals who you represent? So, if we could have an answer from the three of you on that, please.
Do you want me to go first? Okay, so I think the legislation is quite grey at present. I’m a health visitor by background, so I’ve worked very closely with children nought to 5. Again, from an education background, if I speak to my students: ‘What does the law say about smacking?’ They’ll say, ‘We can smack children as long as we don’t leave a mark’. So, I think that’s an issue. I think it’s very grey and I think the new Bill would give some structure—not structure, some boundary, I guess—as to what is right and what is wrong in relation to smacking children, would very much enhance a children’s-rights approach and positive parenting approach—attachment and parenting from a very young age. So, I think at the moment, the legislation is too vague and people are getting away with hitting their children. A smack is a hit. Even the term ‘smack’ minimises what a hit is. I feel quite strongly about that. So, I think it’s a grey area at the moment, and this Bill will just give some clear boundary for us, as health professionals, to advise and support parents of children and young people.
I agree. I think the ambiguity is really unhelpful. I’m a GP—busy morning surgery, we’ve got 10-minute slots for each patient and, if a parent comes in and tells me that they’ve smacked their child, I’ve got 10 minutes to work out why they did it, whether it was a smack that left a mark and was a problem in terms of the law or whether, at the moment, it was acceptable, although I’ve got great concerns, and whether I need to be focusing on that parent’s mental health and their own presentation or whether this is a safeguarding referral. That is very unhelpful for busy GPs. So, I think clarity is what we need in this situation and, at the moment, the waters are quite muddied, so the law would be—a change would be helpful.
How often would you come across the situation that you’ve described there now?
Difficult to say. I’m full-time. I probably would perhaps have 35 patient contacts a day. I would say probably two or three times a week I’ll talk to a parent who’s having issues with managing their children—quite frequently. I’m safeguarding lead in my practice, so possibly that’s a greater number than would be normal, because they might come to me as a female GP as well.
Yes, depending on the age of the child. If the child is not at school, then that would be the health visitor and the nursery nurses who come into our practice. If the child’s at school, I might contact the headteacher or the child’s school and have a chat to see whether there are concerns there. Quite often, I'd ask them to come back in with dad and see whether there's anything that could be done there. But it's all focused quite on the parent who's presenting with the problem, unless I feel there's a safeguarding issue, in which case I'll be focusing more on the child. But I do feel the ambiguity is difficult at the moment, and this would give me clearer lines that I could advise parents how they should be parenting.
Yes. Absolutely on this point, about whether what you do in your surgery will change at all as a result of this, because you're still going to be exercising discretion, even knowing where the law is, to decide whether you actually do report or not.
Yes. I don't know that in terms of management it would change hugely, but the advice I'd give to parents is much easier to give and I'd appreciate that. I agree, in terms of referrals, it's probably not going to change a great deal, but in terms of parenting advice—. To be fair, I find that parents are much less likely to smack their children now than even 10 years ago. Certainly, when I was a child, it was commonplace. It really isn't now. But, at the moment, if a parent came to see me and described smacking their children as part of their normal way of managing their children's behaviour, I can't—. Although I strongly believe that the evidence is fairly compelling that this isn't the best way for their long-term development, it's difficult for me to say, 'You really shouldn't do that', though I would talk about all the reasons why it might not be helpful at the moment. If the law was changed, I would have a much stronger case to make and then could be talking about time out and withdrawal of privileges and all those good things that parents can do. I'd have greater strength in that argument.
So, just to be clear, in the first place, the parents would come to you because they felt that their child was being disruptive or whatever, didn't know how to handle it, and you picked up then on the fact that they were using physical means—
That's definitely one form of presentation. Parents might come, for instance, worrying that their child's got ADHD or autistic spectrum disorder, and, actually, when you have a more detailed discussion, it doesn't sound like that at all, it sounds more like just behavioural problems that need managing with good parenting and strong boundaries. So, that might be one reason parents would come in.
But also smacking often happens out—. I think 85 per cent of people, when they smack their children, say that they're experiencing moderate or high levels of anger. So, in actual fact, quite often, mums in particular will come and see me very remorseful, very racked with guilt and upset that they've smacked their child, they wish they hadn't, and that's quite a common presentation to come in. They'd come to see me because they feel stressed and anxious and perhaps depressed, so they come to the GP about that, rather than saying, 'Could you help me parent my child?' That's not—that's just part of what comes out of the consultation, but the presentation is: 'I'm worried about myself; I'm not behaving in the way I want to be behaving.'
Yes. And I think that's why a line in the sand from this Bill would be really useful, because some of those parents who smack perhaps in anger or desperation or exhaustion, or all sort of parental reasons that aren't actually to do with their child's behaviour, they would then have a line drawn where they know that's actually illegal—'I could be reported to social services, I could be reported to the police for that.' I'm not saying in every situation when they've lost their temper that that would hold them back, but I think there's a really powerful argument that it would make a difference to parents' behaviour, just knowing that it's actually illegal.
And, from a health visitors' point of view, the same kind of scenario.
Absolutely. Parents would come to us with similar issues. We deal with very vulnerable families with a whole range of issues—parental substance misuse, mental health issues, domestic abuse—and, when parents are in these situations, sometimes they lose control and they smack or hit their children. So, it's a way of supporting them through that issue, and I think this would give us a firm legislative evidence base to enhance the advice that we're giving. It would draw the line, as you said. So, I think it would be essential to have this to enable us to inform and support parents in these difficult situations.
I'd just say that paediatricians are seeing children in in-patient and out-patient settings, very similar to a GP. I think the clarity that the Bill would lend would be really helpful. I have had parents say, particularly in a child protection, safeguarding, medical-type situation, 'But smacking's not illegal. I can smack my child, it's not against the law', and we have to agree with that, because that is the situation at the moment, and it is a bit of an anomaly that this defence of reasonable punishment exists, especially when you look at the other laws and policy context in Wales—you know, where we uphold children's rights, apart from this aspect.
I don't think there will be a huge increase in work for paediatricians having to undertake further child protection medicals, because the situation in which the defence of reasonable punishment is going to be used, where a smack has only resulted in slight reddening of the skin that's very transient, there's not going to be an injury for a paediatrician to examine and document hours later. It may well be, if there's an allegation or a smacking incident witnessed, that social services or police would make initial inquiries, but, if there's no visible injury, they're not going to bring that child for a medical, and it would be a case of probably signposting to advice and support, rather than going down the route of section 47 and potentially going to court and criminalising a parent. I don't see that happening unless it was a parent that didn't engage with that advice and support and was to continue to smack the child. For a first incident, that's not going to be the route that we would go. So, I don't see a big increase in requests for child protection medicals coming to paediatricians.
Good afternoon—good morning, just. Does the existence of the current defence of reasonable punishment have a negative impact on children's health? You seem to be sort of erring on the side—.
Is that to me? Yes, I feel—. I mean, I've read—. There are lots and lots of studies looking at the long-term effects of physical punishment by parents on their children, and I couldn't find any replicated, peer-reviewed study that shows any positive long-term outcomes for children—not anything at all—whereas there seems to be a compelling, broad range of possible negative outcomes. Children whose parents use physical punishment are at risk of a less good relationship with their parents. They're at risk of more mental health problems as children, and that can follow them into adolescence and into adulthood. They're more likely to be bullied. They're more likely to be bullies and engage in delinquent behaviour or antisocial behaviour. They're less able to verbally respond to challenge; they're more likely to resort to violence. As adults, they're more likely to be involved in criminality. And then, to close the circle, as adults they're more likely to physically abuse their children and their spouse themselves. So, I think the current law is not strong enough and doesn't give us the strength to explain to parents they shouldn't be doing this.
Is it possible that we could perhaps see some of the studies, because—
Yes. I submitted the evidence with a big list of references on the bottom. So, I haven't got them with me, but I have submitted all the references.
Can I commend the Public Policy Institute for Wales study, or report, called 'Parental Physical Punishment: Child Outcomes and Attitudes', published in July 2018, which was actually commissioned by Welsh Government? It's a very well written, well-balanced academic approach.
Yes, it's all in there, isn't it?
It's all there.
And it's quite reserved, isn't it? I—
And it doesn't—. Yes. So, it's not biased at all, and I think it's really—of all the things that I have read, it's the best summary of the evidence. Do you agree?
To be clear, that's not the evidence document that Government are using—
Yes, but there are various other studies, and academics have said that it doesn't go far enough, the PPIW one. Yes.
Well, it's very balanced and it makes it clear where there's just correlation rather than causality.
Because I felt it was quite reserved. I read that first and then I read the actual studies, and I felt, if I'd been writing the paper, I might have been a little bit stronger saying that, actually, the evidence from the studies is quite strong that there are adverse outcomes from parental physical punishment, whereas this is a bit more sitting on the fence, isn't it?
Yes, just on this particular point. Because I hear what you're saying—we've heard from other witnesses as well—but it's not going to be the case in every case of smacking, is it? We’re talking about families where there are repeat patterns, if you like, but possibly as part of other banned poor behaviours as well. My concern is that the law may catch those families where that’s not what’s happening, where there’s been an individual incident or whatever—we’ve heard it: those parents come to you shocked about what they’ve done—and about this law not distinguishing between the area where this recidivism actually could be a problem and those incidents where, actually, everybody’s going to have forgotten about it the following week.
But I don’t think those parents will be criminalised. It’s a different example, but I’d refer, perhaps, a family to social services where there’s been one incident of domestic violence—the child’s asleep upstairs but I was concerned enough that that child might have been affected. Social services come into that home, they see the family, they talk to the mum and dad, they talk to the child, they do the work, they feel, actually, this was a one-off situation, that child is safe, they put safety measures in place and they don’t take it any further at all. That sounds quite a threatening thing for that family but, in actual fact, it’s quite a positive thing that the dad felt, ‘I can’t do this again. I can’t get away with this again’, and the mum felt empowered that people believed her—
Okay. We’re going to come to some unintended consequence questions. Perhaps we can develop that then. Thank you. I don’t want to eat into Janet’s time.
What is your view on the fact that the Welsh Government decided that a full health impact assessment was not necessary for this Bill?
As I think Lorna’s already said, I don’t feel this is going to have a huge impact on primary care. I think it will be helpful, but I don’t think it’s going to increase our workload in any way, really. I don’t think that is needed. I don’t know how you feel about that.
I just think it’s going to add weight, as we said earlier, to what we already do in relation to positive parenting and behaviour management techniques for families that we care for. So, the new Bill will just add weight to what we're already delivering.
Healthcare professionals already have regular safeguarding training. There is a document, the intercollegiate document, which sets out what knowledge, skills and competency they need to have, and they have regular updates, and I feel that this could be just an update, delivered as part of training that is ongoing anyway. And health visitors and GPs and paediatricians all have the knowledge around positive ways of managing children’s behaviour. So, I don’t think there’d need to be any update as part of that.
We get information all the time, so I can imagine this coming in as an e-mail, a single A4 page document, which is what GPs love, just explaining the change in the law, and that’s it, job done, it’ll be part of our usual safeguarding process.
Okay. And in written evidence, the Royal College of General Practitioners says:
‘The balance of evidence seems sufficiently clear and compelling to inform us that parental use of physical punishment of children plays no useful role in their upbringing and poses only risks to their development.’
However, we’ve also heard concerns from witnesses opposing this Bill that other types of punishment, such as isolation, can be equally damaging to children. And we heard that only this morning from previous witnesses. What are your views on that?
By isolation, do you mean time out sitting on the naughty step or—?
Well, yes, being sent up to their room for an hour or two or taking them out of the environment—
I quite agree that we need to make sure that all punishments are reasonable and proportionate. For example, verbal chastisement can be damaging as well. If you really aggressively shout at a child, I don’t condone that either. I think sending a child to their room for an hour or so—that sounds excessive, certainly for a young child. I think you sit on the naughty step, for instance, for a minute of your age. So, a three-year-old child will be put on the naughty step for three minutes, with a clear explanation that they are going to be put on the naughty step, why they are and what the outcomes are. So, no, I don’t think we can bring this Bill in and then allow all sorts of other non-physical punishments to be approved of. We need to carry on carefully parenting, advising parents how to parent appropriately.
On that note, then, do you think the Bill should or could have incorporated emotional abuse and coercive control as part of this measure going forward?
I hadn't thought about that. I'd be concerned that that would make the Bill overly complicated. This is a currently ambiguous area, and no physical punishment is a really straightforward line to take. Like you say, we're all highly trained in safeguarding and we understand about coercive control and emotional abuse and neglect. I don't think anything from there will change. We already know that it's wrong to scream in a child's face or call them stupid or say, 'You've always been a naughty boy.' All of that's wrong and we know that, but I don't know that we need to bring it into this Bill; I think that might complicate it further or make it even harder to pass, and I think this would be a good Bill to pass.
Thank you, Chair. Are you confident that the health sector has been involved enough in the Bill's development to date?
I believe so—we have all been given the opportunity to respond to the consultations. And, speaking personally, I attended the strategic implementation group meeting last week and will be involved, going forward, during the introduction of the legislation, hopefully. So, I feel that we have been consulted and given the opportunity to contribute.
Great, thank you. And I think, Michelle, you mentioned that the Bill will give clear boundaries for health professionals. Can you quantify the scale of change needed in guidance relevant to health bodies and professionals if the law is enacted? I think you touched on about an A4 piece of paper. [Laughter.]
In relation to health visiting, we have a very strong line of communication with our GPs, so partnership working and sharing information that way. But it can be incorporated into the Healthy Child Wales programme. There are a number of mandated contacts that health visitors deliver between the ages of nought to five. So, it could be incorporated, perhaps in a leaflet form, or opportunities, perhaps at 10 to 14 days, you know, or an antenatal contact—starting a drip effect, I guess, throughout all contact with parents and families, providing some educational leaflets or discussion around that, just raising that awareness, which is done, but, again, the Bill would give us some more impetus in stressing the importance of not smacking.
So, you think some of these changes could be simple or quite easy to do.
Okay. Are there training systems already in place within the health boards and other NHS bodies to deliver training to front-line staff to make sure that the change in the law is implemented properly?
Yes. There are safeguarding children boards throughout Wales, there's inter-agency training and there's health board training. So, there is a whole range of levels of training as well, and if you look at the intercollegiate document, that's all set out in there, so that health professionals are exposed to the most up-to-date, evidence-based legislation changes, and to implement that, then, in practice.
All GPs have to have level 3 child protection accreditation, and they have an annual appraisal and there's a box that they have to tick on their appraisal website to say that they've achieved that. I'm an appraiser, so I know that that's a question, so regardless of whatever else I ask, I always ask about how they got their level 3 safeguarding accreditation. So, this would be a very easy thing to fit into that within the year.
The same applies to paediatricians, and, in fact, all doctors in Wales have to show at appraisal that they are up to date with their safeguarding training to the appropriate level.
And do you think that there's enough funding and capacity to deliver this?
Yes, it's happening already. It really just would be an update.
For us, it's just strengthening our case, really. It's a win-win, really.
Thank you, Chair. My question is initially to Lorna, I think, because I think this was in your evidence, or the Royal College of Paediatrics and Child Health's evidence, which said that support for parents should be built into the Welsh Government's early years programmes and policies. So, I just wonder to what extent you're confident that there is universality of support available now, and whether we need to be addressing that to improve and enhance that—within the context of this Bill, I guess.
Yes, well, I think, as Michelle has said, health visiting is a universal service and the Healthy Child Wales programme is delivered across Wales, and there are more targeted services as well that would work with families where it was felt that they needed additional support. So, I think that the health service would be well prepared if this Bill were introduced.
And you'd be satisfied that you can deal with this within existing capacity in terms of what you do now.
Yes, definitely. There are two elements to health visiting: there's the Flying Start service, which Lorna's mentioned, which deals with families in more deprived areas, and the generic health visitor service. They have bigger case loads, and this is something else for them to take on board. So, there might be some resource implications in relation to perhaps the generic service, but it is still part of the health visitor role to educate around positive behaviour management. So, they still will do that.
And that would be universal, because I take your point about Flying Start, but, of course, the issues are around poor parenting—I know they're prevalent in areas of deprivation, but it's not exclusive, is it?
So, there would need to be those levels of support across the piece, really.
Yes, so it could be incorporated into the components of the Healthy Child Wales programme.
Thank you, Chair. I just want to challenge your confidence on this, because we've had evidence given to this committee that, while there's a universal right to contact for nought to 7-year-olds, by the time these children are three and a half, only half of them, in fact just over half of them, are getting contact with their health visitor. In certain health boards it's down to a fifth.
That's what I wanted to say: I agree that this Bill doesn't bring about the need for more resources specifically, but Wales really wants to be a preventative nation, and we know that the more input we put into children, especially in the early years, especially vulnerable children or families who are struggling, the better they will do. So, while I wouldn't say that this Bill says that we need more funding, I think the more we can invest in health visiting and Flying Start and these programmes for vulnerable families, the better Wales will be as a nation, and the stronger it will be. But I don't think this Bill on its own requires more resources.
No, but on that wider point of, 'Yes, it's all going to be fine', are you being just a little bit rose-coloured glasses on this?
No, I don't think this Bill will change things other than to strengthen the people who are already doing the job.
Just before you move on, Dawn, can I just ask Michelle—? So, if a parent in Wales was really struggling and she didn't live in a Flying Start area, and she'd had her requisite number of visits, but she wanted more input from a health visitor, would that be possible across Wales for any parent?
Yes, it would. They make that risk assessment and they work with other agencies, so they might draw and signpost, perhaps, to early intervention and prevention services, and work in partnership with our social services colleagues, but also perhaps lead on that and be the key worker, I guess, within that situation. So, yes, they do signpost, but if families need more visits, they will give more visits. So, yes, they would, if that was needed. We work very much around our principles of health visiting and the search for health needs, and if families need extra visits, then that would be delivered.
Okay, thank you, Chair. The police, when they gave evidence to us, were emphasising the need for a multi-agency safeguarding hub as a single point of contact. I just wonder what your views and thoughts on that are. Do you agree with that? To what extent would that help, having a single point of contact? These would be people specifically that are referred to the police through any kind of referrals from any of your services, I guess. I just wondered what your thoughts were on that.
I think the more we can work together, the more we've got a specific place to take concerns to, so I'm thinking of women who are at risk of domestic violence—we've got a really good set-up for that now. So, the more we work together, the easier all of our lives are, and the better job we'll do working in this multidisciplinary way.
Because I think part of the process, and what the police were saying as to why they felt this was important, was to ensure that we didn't have too many parents becoming criminalised and being subject to convictions. There needed to be a process whereby that support would be the first point of help rather than immediately referring to—
And this is already happening. There are multi-agency safeguarding hubs across Wales. For example—to use a domestic abuse example, a low-risk incident might come in, but being within that multi-agency hub, you've got that level of communication and perhaps, then, signposting to the health visiting service to go out and do a visit with that victim of domestic abuse at a low level before it escalates into anything else. So, it's the same sort of process, I guess—if a smack or a hit was brought to the multi-agency safeguarding hub's attention, the same sort of process could—
Yes, the level of risk, and other risk factors, which we've spoken of, within these families, because that escalation of risk has a major impact on the potential health of the child.
Yes. We've heard from police evidence that these hubs aren't operative across Wales, I think. Is that your experience?
I'm only familiar with the ones in south-east Wales. I know the ones in this area. I think they are starting to be developed. I'm not quite sure. I couldn't tell you exactly where they are. I can only talk about the ones—
They're not everywhere, and they are useful as a single point of contact and for risk assessment, but, whereas they're desirable, I don't think they're essential for the implementation of this Bill.
We're picking up on a lot of the wider issues through this session, I think.
Thank you. Do you mind if I just start with one question, and maybe the clerks can help me with this: you've all, more or less, said that the training that you as health professionals will get, or could get, can be dealt with by a bit of A4 paper—I know you generalised slightly. But I think we had slightly different—. Was it the police who told us that, actually, they didn't think that just an e-mail update or a round robin, or the quarterly continuing professional development newsletter, would work? So I just want to check how confident you are that that probably will be enough for you.
It could be incorporated into multi-agency training.
I didn't mean that's all you'd have.
There are different modes of communication, but it also could be introduced into curricula within the universities, perhaps, throughout Wales. I teach on a health visitor programme, and medics as well, and any health professionals, could be exposed.
It could be incorporated into the curriculum, and all health professionals have safeguarding training within curricula, so it can be a widespread education programme, I guess.
Okay. It’s just to help me get a sense of the different ways that could be achieved.
We talked a little bit earlier on that health visitors don’t necessarily see the number of individuals that the general population might expect they were seeing. With awareness raising, the health professionals are seen as the second-most go-to place for advice on parenting. Do you have any worries that you might be expected to be carrying the awareness-raising load, when, actually, with the ‘every contact counts’ principle, it may literally not be possible?
It’s just inbred in us, as health visitors, to make every contact count, and we use every opportunity of any new initiative, I guess, to raise awareness among parents. And it’s helping them—it’s helping them develop their children. So, I just think it’s the norm within our profession. I’m sure it’s the same, perhaps, within the GP setting and with paediatricians as well. They are making every contact count.
Well, I think we will be, through the implementation group and the sub-groups.
Sorry, the task and finish groups that they’re going to have.
Okay. That’s quite helpful to know as well.
Do you have any concerns at all that, once you as professionals are identified as being the people who give advice on this change in the law, it might discourage some families from coming to you for advice, because they don’t want to be judged, lectured, or any of these things that, actually, they maybe hadn’t thought about before—that there might be a big public awareness-raising campaign that’ll put them off coming to you?
It’s the same with any issue, really.
It’s the same with drinking, smoking—it’s all of those things.
Look, patients will come and see us, and some will say, ‘There’s no point hiding anything from you, doc. What’s the point of that?’, and with others you may have to tease the information out a little bit more carefully. I think if a parent smacks their child and doesn’t want to tell us, we’re probably not going to know. If it’s a light smack that doesn’t leave a mark, we’re not really going to know and we can’t change that. But even in that situation, we can bring it up and talk about good parenting and what’s the right way. And so this law’s still useful, even if we’ve got parents who are smacking their children but aren’t presenting that information to us.
And would a public awareness campaign work without the legislation, because if this is about social unacceptability and culture change—?
I think it adds weight to that.
I've asked so many parents about this, and it's shocking the polarity of people's views, and that's from a broad range of backgrounds. People feel very, very strongly about this one way or the other, and I think, without the law, the people who feel that it's their right to smack their children and that it's doing their children good are not going to change their behaviour
I think the evidence has shown in countries that have either introduced legislation without the public awareness campaign, or had a public awareness campaign without the legislation, it doesn't effect change—you need the two together.
Oh, right, okay. So, would you be arguing then that this very short piece of legislation could at least incorporate a duty on Welsh Government to conduct an awareness campaign?
The Royal College of Paediatrics and Child Health doesn't have a particular stand on that but, personally, I like the legislation as it stands because it's simple, it's clear and, hopefully, will pass, which is the most important thing. That's the most important thing to us. And I think that the implementation group will be developing an awareness campaign, and that should have the desired effect without the need for it to be statutory.
The downside with not having a duty is that it means that Assembly Members don't get a chance to scrutinise it. You can see there's possibly a bit of vested interest in my questioning. Do you have any views that it really shouldn't be included on the face of the Bill, then?
I hadn't really planned for this question.
Because in Scotland they do. There was a very similar Bill. They have a duty on the face of the Bill in Scotland.
I think my priority is passing the Bill. I really passionately think this will make children safer in their own homes, I really do. And anything that makes it less likely to pass, I’d be wary of putting myself behind. The Bill will be better if we have a public awareness campaign to go with it. The violence against women and sexual health legislation, that had a very strong campaign that had good outcomes. So, I’d imagine something similar to that for this Bill would be effective. But my priority is, ‘Let’s get this Bill through’.
I think if you could be confident that it wouldn’t be an impediment to the Bill passing, that’s fine.
I’d be surprised if it were, actually. Can I just finish with this last question, then? If it’s not mandatory, maybe the risks of not having a public awareness campaign wouldn’t be great, but there would be no longevity to it. You could do your big hurrah at the beginning of this when the legislation is introduced, but 10 years down the line when, actually, a different type of awareness may be necessary, there’ would be no statutory pressure on Government to introduce a top-up campaign with a slightly different way of messaging to accommodate the culture change that’s taken place in-between, particularly when there’s money involved. Any reason not to do things when there’s finance involved, it’ll be snapped up.
But if this were a law, wouldn’t there be a duty to ensure that the law is happening?
But the purpose, as so many witnesses have said about this, is not about criminalising anyone; it’s about changing culture. So, 10 years down the line, when the culture’s changed to a degree but there is still smacking taking place, surely we don’t want to be left with the criminalisation option; there’d be a new way of messaging. So, it would mean that the Government 10 years down the line will have to think, ‘Oh, we need a new awareness campaign now', whereas if they weren't obliged to do that, there would be many, many, many other calls on the public purse.
I suppose thresholds change, don’t they?
Because the incidence of smacking is falling already, and I do think that this law would just push us that little bit further towards parents who think, ‘No, I shouldn’t do that, I should do something else’. I think that’s the big gain we’ve got. We’ve already got a momentum towards parents not smacking children. I think this line from Welsh Government and all of the professionals backing it is a strong message, which will bring about change on its own.
Thank you, Chair. I think, to a large extent, you’ve answered this in response to Suzy in terms of the awareness campaign but, obviously, you will all, as health professionals, particularly community staff, be responsible for the giving of advice and support to parents in this situation. Are you confident that there isn’t going to be a significant impact on your resources to be able to deliver that additional support that some parents might need in these circumstances?
I just think these conversations are part of our day-to-day role—they really are. We might offer some more information if this is passed. It’s just going to enhance what we’re already talking about. We talk about positive parenting and disciplining your children in a way where physical chastisement isn’t involved. So, I think it’s just going to enhance what we’re already delivering, as we said earlier.
I can’t see it’s going to lengthen consultations. I can’t see that it’s going to increase the number of consultations, and I don’t think it’s going to increase the number of referrals I make to the health visitor or to social services, because if I was worried, I’d make those referrals now regardless of the Bill.