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Independent Care Review

– in the Scottish Parliament on 5th February 2020.

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Photo of Christine Grahame Christine Grahame Scottish National Party

The next item of business is a statement by Nicola Sturgeon on the independent care review. The First Minister will take questions at the end of her statement, so there should be no interventions or interruptions.

Photo of Nicola Sturgeon Nicola Sturgeon Scottish National Party

This morning, the independent care review published one of the most significant reports that we will consider in this session of Parliament. Indeed, I consider this to be one of the most important moments so far in my tenure as First Minister.

I am making today’s statement to underline my political and personal commitment to turning the report’s vision of how we must care for our most vulnerable young people into reality as quickly as possible.

I do not mind saying that I felt very emotional when I read the report’s main volume, “The Promise”. There is a really powerful simplicity to what it says that we and, most important, the young people who experience it, should expect from a good care system. It should have love and nurture at its heart. Wherever possible, families must be supported to stay together. When that is not possible, the relationships that matter to young people—particularly those with brothers and sisters—must be protected. When a child needs our care, the priority must be the provision not of a series of placements or arrangements that are driven by the needs of bureaucracy but of stable, safe, secure, loving homes that allow them to experience the joys and the normal challenges of growing up and to fulfil their potential in life.

None of that should be at all controversial. However, it distresses me—as, I am sure, it distresses all of us—that that is not the experience of all young people who are in, or who have passed through, our care. To be blunt, we let too many of them down, and they pay the price of that for the rest of their lives. In too many instances, the price can be a life cut short.

The statistics have always told us that, but in the report we hear it directly from the young people for whom we have responsibility. Further, it is not just true here in Scotland; there is possibly no country in the world in which the care review’s vision of care is yet a living reality. As a result of the report’s publication there is, therefore, an opportunity for Scotland to become the first country that makes it so—and I am determined that we should do so.

I place on record my sincere thanks to Fiona Duncan and all the review group members for all the work that they put into the report. They have done a truly outstanding job. I also pay tribute to Who Cares? Scotland, which has been the driving force behind the review’s creation.

Perhaps the most important achievement of the review—and the reason for its conclusions being so powerful—is that it has the voices of people in care at its heart. People with experience of care made up half of the review’s co-chairs and working group members. The review listened to more than 5,500 people, more than half of whom were children, young people, adults and families with direct experience of care; the others were paid and unpaid carers. All their stories have shaped everything in the report. I take this opportunity to thank each and every one of those 5,500 people. I know that sharing stories about painful and traumatic personal experiences is not easy. However, by doing so, they have all helped to make things better for children and young people in the future.

I know that the care-experienced voice in the report is real. Since 2016, I have met just over 1,000 young people who have experienced care, and I will carry our conversations in my heart for the rest of my life. Indeed, some of the early ones led directly to the creation of the review. As I read the report, from every page I heard the voices and the stories of the people I have met. Let me be very clear: I have met many young people with good experience of care who are doing brilliantly, but I have also met many who are doing so even though their care experience was not good and whose achievement is entirely down to their own talents and resilience. I have also seen at first hand the dedication, commitment and passion of those who work in the care sector, and I thank them for that.

However, I have also heard far too many heartbreaking stories. Despite the best efforts and intentions of everyone involved, the actual experience of too many people in care is not what they have a right to expect. The world that is described in today’s report—of a care system that feels “fractured, bureaucratic, unfeeling”, stigmatising and mired in the use of impersonal language such as “placements”, “contact” and “respite” to describe what should be loving relationships—is one that I have had recounted to me many times. That must change.

It is also why the vision and blueprint for transformational change that are set out in “The Promise” are so vital. At their heart are five foundations of care. The first is voice: children must be heard and listened to in all decisions about their care. The second is family: whenever possible, families should be supported to stay together with their children. Our first priority should be to do all that we can to keep children out of care and with their own families. The third foundation is care: when living with their own families is not possible, children must stay with their brothers and sisters when it is safe for them to do so, and they must belong to a stable, loving home. The fourth foundation is people: those in the workforce and wider community who look after children must be well supported so that they, in turn, can provide compassionate care and decision making. The fifth is scaffolding: the system of help, decision making, support and, crucially, accountability that surrounds all of that must be more supportive and responsive.

The report also makes an important but challenging point about risk. Of course, we must always consider the immediate risk of harm to a child when decisions are made about their care. However, we must also consider the risk that is created when we remove a child from their family or overburden their childhood with bureaucracy. The risk then is that we compound their trauma and make it harder for them to enjoy stable, loving, long-term relationships. Protecting family relationships and, above all, allowing children to enjoy the kind of childhood that others take for granted is often the best way of protecting them from harm.

The report sets out very clearly the direct costs of supporting children in care and also the hidden costs of the failures of care—the long-term human and financial costs that are borne not just by society but, more important, by the individuals whose experience of being let down by care impacts negatively on their life chances.

I hope that all members will take the time to read the report in full. I have tried to summarise its principles and key conclusions as best I can, but, in the short time that I have available, I cannot possibly do justice to the detail of the 80 specific changes that it recommends. What I can and will say unequivocally is that I am determined to get on with implementing it at pace. That will involve practical change at every level but, more fundamentally, it will require a transformation in the culture of care.

The Scottish Government has already made some changes while the review has been doing its work—for example, by introducing the care-experienced bursary—but today’s report leaves no room for doubt that we must do more, and we must do it more fundamentally, more systematically and more quickly. A radical overhaul is what the review demands, and that is what we have a duty to deliver.

I want to be clear, though, that we will continue to listen to care-experienced voices who have additional ideas and suggestions to make. There is not and never will, or should, be a closed door.

We will act straight away to implement the plan section of the report. There are two key immediate elements to that. The first is the establishment of a team to quickly turn the report into a detailed delivery plan. Although the report recognises that full implementation of its vision will take time, the process of change must and will start immediately.

The second is the creation of an independent oversight body. I confirm that both groups will include people with experience of care. In fact, half the members of the oversight body—including the chair, who will be from outside the Scottish Government—will have experience of care.

Those groups will ensure that we keep up the momentum that has been established by the review. The Government aims to make progress in a matter of weeks and will update Parliament regularly thereafter.

Throughout the care review process—as I have been speaking to 1,000 voices—I have been struck by the fact that for ministers, in particular, but actually for all parliamentarians, the responsibility that we owe to young people in care is a very special one. In fact, ensuring that they have an equal chance to succeed and that they benefit from the stable, loving relationships that so many of us took for granted when we were growing up is one of the most important duties that any of us has in public life. It is a duty that I take very seriously and very personally.

Today’s report makes the need for action overwhelmingly clear. It sets out the extent of our obligations. However, it also gives us an opportunity: the opportunity to change thousands of young people’s futures for the better. The Scottish Government is determined to take that opportunity. We will work with local authorities, care providers and all other relevant partners to make the necessary changes to care. We will deliver that change as quickly and as safely as possible—starting now—and we will ensure that people with care experience remain at the heart of the process.

That is the promise that I make today to all those—past, present and future—who need our care. In keeping that promise, as I am determined to do, I look forward to robust challenge but also, I hope, to the cross-party support, interest and engagement of the Parliament.

I commend this statement to the Parliament.

The Deputy Presiding Officer:

The First Minister will now take questions on the issues raised. We have around 20 minutes for questions; I am talking through the applause so that we do not waste any time. I call Alison Harris, to be followed be Iain Gray.

Photo of Liam Kerr Liam Kerr Conservative

Presiding Officer, I will take this—

The Deputy Presiding Officer:

Oh, it is not Alison Harris—you have changed! It is Liam Kerr.

Photo of Liam Kerr Liam Kerr Conservative

Many have said that to me, Presiding Officer.

Photo of Liam Kerr Liam Kerr Conservative

Not for the better, indeed.

The Deputy Presiding Officer:

Well, there is a first.

Photo of Liam Kerr Liam Kerr Conservative

I thank the First Minister for advance sight of her statement. I associate myself and the whole Scottish Conservative Party with the tenor of her remarks. Although we will always offer robust challenge, the First Minister can be assured of our support in delivering the recommendations of this ambitious and vital report.

Above all, I, too, extend our thanks to the more than 5,500 people who contributed—it cannot have been easy.

It is clear that what has emerged can change things positively for children and young people.

For that to happen, I agree with Children 1st, which said that the report

“must not be ‘welcomed’ and then put on a shelf.”

Young people in the care system need a great deal more than simply the best wishes of this chamber. They need concrete action to transform their lives for the better and to live up to the promise that I expect and hope that every party here will rightly make today.

When does the First Minister expect the team that will take the report and turn it into a detailed delivery plan to have completed that work? How soon after that process has finished will the much-needed changes begin?

The First Minister:

I thank Liam Kerr for his expression of support—it is very much appreciated—although, as I said in my statement, part of the process of making sure that we take forward the recommendations will be the robust challenge that Parliament and people outside Parliament bring to the process.

I, too, agree with Children 1st and the others who have said that we must not put the report on the shelf. Believe me—while I am First Minister, there is no shelf that the report will be going on. When we first established the review, we made it clear that we did not want to wait until it reported and do nothing in the interim. While the review has been doing its work, we have taken a number of steps, including the care-experienced bursary, which I mentioned, the council tax exemption and the creation of the presumption that siblings will stay together, and I hope that that is seen as a down payment on our intention to deliver what is in the report.

As I said in my statement, we intend to make progress within weeks on getting in place the team that will turn the report into a delivery plan. My view is that that team will start work immediately. In “The Plan”, the review sets out that the change will take place over a number of years. We are talking about not only a series of practical changes, important though those will be, but a transformation and a culture of change. That process must start to happen now and must continue. When we get the team in place, I undertake to ensure that Parliament is regularly updated so that challenge and support can be provided.

One of the greatest privileges of my life has been meeting the thousand and more care-experienced young people over the past few years. They have told me directly—some of them did so this morning—that they will hold us to account on the progress that we make, and I absolutely welcome and embrace that, because the report is for them.

Some of the people who have told their stories as part of the review process have made the point that although it is too late to change the reality for them, they are motivated by the desire to bring about change for others. I am clear about the fact that the time for young people to have to tell their stories over and over again is over. They have told us their stories, and it is now for us to act and change the reality for children in the future.

Photo of Iain Gray Iain Gray Labour

I thank the First Minister for providing early sight of the statement.

The First Minister was right to say that, over generations, we have let down far too many of the young people in our care. We can hear that in the report in the authentic voice of those care-experienced young Scots, and I think that that is why it carries such power, so I say well done to the review chair, Fiona Duncan, all her co-chairs and everyone involved. It is a remarkable effort. I say well done, too, to the First Minister, whose personal investment in the issue is very clear and very much to her credit.

I welcome the creation of the delivery plan team and the agreement to the creation of an independent oversight body but, to reflect what the First Minister said in her answer to Liam Kerr, it is not the process of change, but change itself, that must start immediately.

We should listen to Who Cares? Scotland, which said today:

“The evidence shows that what the Scottish Government chooses to do next is literally a matter of life and death. We expect to see urgent action, in the next few weeks, that makes a tangible difference to young people’s lives. Any further delay would be unacceptable.”

What action can we expect in the next few weeks that will make a tangible difference? Specifically, what can we expect to see tomorrow in the budget to ensure that we invest in keeping the promise?

The First Minister:

I agree very strongly that the issue is about not simply the process of change but the actual change. I have said to many care-experienced young people that when I was asked by Who Cares? Scotland and others to establish the review, I took a little bit of convincing, because I did not want the review to be seen to be kicking something into the long grass; we could not simply set up a review and then do nothing.

We have taken a range of steps, and we will continue to do so. It is right and proper that, in acting on the recommendations of the report, we get the process right not just in relation to the series of continuing changes but by bringing together a process that will facilitate and support overall cultural change.

We asked for this, but when I read the report, I was struck by how different it is from the reports that Parliament usually considers. It is not just about a series of individual practical and transactional changes, although those will be important; it is about how we take the whole system, and everyone who plays a part in it, and change our approach to the care of young people who are our responsibility. I do not underestimate the challenge of doing that, but I am absolutely determined that we will meet that challenge. Each and every one of us has the responsibility to do that. As we have done over the past few years, we will continue to make the changes as we go.

I will not pre-empt the budget, but delivering what is needed over a number of years will undoubtedly have financial implications and require investment. The report is very clear about that. It is also very clear about the relationship between children who go into care and poverty. One of the key things in tomorrow’s budget will be progress on the new Scottish child payment, which is part of what we are doing to help lift families out of poverty.

One of the most powerful things is “The Money” and “Follow the Money” reports, which outline not only the amount of money that we currently invest to support young people in care but the hidden costs relating to the failures of care. Yes, the issue is about up-front investment but, over time, it is also about ensuring that the money that we already spend and which is already in the system is spent on keeping young people in their own families and on preventing them from going into care. However, when that cannot be avoided, we need to ensure that young people have the support that they need. That will be a feature not only of tomorrow’s budget but of budgets for years to come, while we ensure that we provide the care that young people deserve.

The Deputy Presiding Officer:

Thirteen members want to ask questions and we have 12 minutes—you can do the arithmetic. I need succinct questions and answers. I appreciate that the matter is of huge concern, quite rightly, but let us please try to be succinct.

Photo of Rona Mackay Rona Mackay Scottish National Party

The report is an incredibly moving piece of work, and I join the First Minister in thanking all those who took part. Does she agree that it is now critical that we see a pace of change, systematically and culturally, so that we can all come together to support our most vulnerable children and give them the childhood that they deserve?

The First Minister:

Yes. Pace, here, is everything. Based on a lot of evidence, the report sets out a period of 10 years for systematic cultural change. As I have said, change needs to happen on a continuous basis. I want to prove that we can do that on a quicker timescale than the report sets out, and all of us have a role to play in that. That makes it all the more important that we get early momentum behind what we are trying to do. That is partly about getting the right process in place, but it is also about ensuring that we continue to make the practical changes that add up to the systematic change that the report calls for.

Photo of Elizabeth Smith Elizabeth Smith Conservative

I am sure that the First Minister will agree that success will depend largely on strong collaboration between national Government, local authorities and care providers. Will she ensure that clarity on the roles that each has will be set out when the independent review oversees the work?

The First Minister:

Yes, I give that assurance. That is a valid and important point. Even today, I have been heartened by the response to the report from those in the system—I have come to dislike using the word “system” when describing care, but I often slip into using it for shorthand.

The Government has a leadership role to play, but those who deliver care have a role, too. Most of the carers whom I have met do an absolutely fantastic job but, overall, the system is failing too many people, so we need to understand the roles. We also need to understand how some of those roles will change. If we are successful in preventing more young people from going into care in the first place, the nature of the support that is provided in the system will be different in the future. It is really important that everyone understands their role and that everyone pulls together in the same direction.

Photo of Daniel Johnson Daniel Johnson Labour

As the First Minister acknowledged, the statistics are harrowing: care-experienced people are six times more likely to be excluded from school and 15 times more likely to end up in prison. What measures will the First Minister use to track progress, and how will she report that back to Parliament?

The First Minister:

As I said, we will aim to come back to Parliament in a matter of weeks to set out more detail on how, through the group that will be responsible for the delivery plan and the oversight group, we will set milestones, measure them and report to Parliament. That is an important point that we have to get right at the outset.

As Daniel Johnson rightly says, and as I referred to in my statement, the statistics have been telling us those things for a long time. It was statistics that drove me to set up the review, but I no longer think about the issue in terms of statistics because I have met too many of those statistics—they are real human beings. They are our children and young people—human beings—who deserve more from us, and we all need to think of them in those terms and not as the statistics that, rightly, we often point to as providing the reason for change.

Photo of Alison Johnstone Alison Johnstone Green

The First Minister’s statement is notable for its humanity, compassion and desire to put love and nurture at the heart of how we look after young people in care in Scotland. The Scottish Green Party welcomes the report and thanks all who were involved.

What action will the First Minister urge to ensure that caring relationships and important and essential bonds can be formed without fear of chastisement? “The Promise” tells us that where caring and committed staff are afraid to cross professional boundaries, that can result in children growing up in an environment that can feel cold and comfortless.

The First Minister:

That is both one of the most important messages in the report and, to be frank and candid, one of the most difficult challenges to address and meet. I have lost count of the number of young people who have told me about the burden of bureaucracy in their lives and what that means for their ability to be normal children and young people—the need to have a risk assessment and get permission before they can spend time at a friend’s house at the weekend, for example. One young girl told me about being at a party where she could not go on the trampoline in the garden because it had not been risk assessed.

We must allow children to be children, but that also means having a supportive environment for the people whom we trust to care for children, so that they feel able to provide that compassionate and loving care within boundaries that they understand and feel comfortable with. We need to change the balance of risk. Of course, when a child is in a risky or potentially harmful situation, the instinct is to get them out of it; we all understand that. However, sometimes that may not be the best solution. Putting in the support to keep a child in that situation and allow them to stay may be better. That will have challenging implications as we work our way through the issue, which is why I come back to the point that the report is much more fundamental and cultural than is normal for reports that we receive. They also make it more important, and most important, that we get this right.

Photo of Alex Cole-Hamilton Alex Cole-Hamilton Liberal Democrat

I am grateful to Fiona Duncan for the inclusive way in which she has conducted the review. Right now in Scotland, when people leave care a trap-door shuts and they have no right to return. We all know that when people start out as young adults, things sometimes fall apart and they have to move back in with mum and dad. That option is not currently available to Scotland’s tens of thousands of care leavers. Does the First Minister agree with the insistence on page 92 of the report that:

“Young adults for whom Scotland has taken on a parenting responsibility must have a right to return to care”?

The First Minister:

One of the things that I have heard loudly and clearly as I have listened to young people is about the arbitrary nature of some of the age limits that we apply in the system and how they have no meaning in the real-life experiences of young people. Again, to demonstrate that we have listened as the work has been under way, we have not only introduced the care-experienced bursary but, from listening to what people have said, we have raised and removed the age limit on that.

Age will have different application in different aspects of what we are talking about. I am not going to talk about my age because it is too sensitive a subject, particularly this year, but every one of us knows that, no matter how old we get, the ability to look to our parents and families for support at difficult times in our lives is really important. Care-experienced young people are no different. I dislike the term, but, for “corporate parents”, that same lifelong responsibility must be present. That is one of the key issues that we have to grapple with as we create a system that is right for people, at whatever age or stage of their life they may be.

Photo of Fulton MacGregor Fulton MacGregor Scottish National Party

I, too, fully and whole-heartedly welcome the report. The review made it clear that children must be enabled to build stable and lasting loving relationships. Does the First Minister agree that it is crucial to ensure that, in cases where staying with family is not possible, children and young people are able to build the supportive and loving relationships that everyone needs to grow and thrive?

The First Minister:

Yes, I do. We need to stop thinking about placements for young people. For young people who cannot stay with their family, we need to create stable and loving homes where they are treated the same as other children. If we start the discussion from that premise, we are more likely to head in the right direction, which is crucially important. That is one of the strongest messages that has come through the whole exercise, and I guess that that is what we mean when we talk about putting love into the system.

However, although putting love into the system is important, making sure that we do not take it out unnecessarily is equally important. That is why keeping families together when we can and, crucially, not allowing the bonds between brothers and sisters to be broken, are such vital things, and we must do them much better than we have done in the past.

Photo of Alison Harris Alison Harris Conservative

The review’s findings include that there is an overworked and stressed workforce. Clearly, those people perform an exceptionally challenging and complex task, and they must be properly trained, supported, and protected. What steps will the First Minister take to support them?

The First Minister:

I agree with that point, and not just in theory. I have seen at first hand so many times the fantastic job that social workers, foster carers, people working in our residential homes, and those who work with children more informally do.

The one thing that I want to say to them directly is that our talking about overhauling the system is not a reflection on their commitment and dedication—it is important for them to hear that. We must give practical support to those who work in the care sector by making sure that they are properly resourced and funded, which is why the approach of tomorrow’s budget to public services is so important. We must make sure that more of the resources that we already spend is allowing them to support children in the right way.

Also, to go back to an earlier question, one of the most important things that we must do is change the culture within which those workers operate so that they can do what they desperately want to do, which is to give young people the compassionate care that they need. That will be the harder part of all this, but it is the most important part.

Photo of Annabelle Ewing Annabelle Ewing Scottish National Party

As the First Minister has highlighted, the voices of care-experienced young people have been absolutely key in informing the care review. Does she share my view that the input of care-experienced young people must remain at the heart of designing the next important steps?

The First Minister:

Yes, absolutely. We would fail in this if we did not continue to have the voice of care-experienced young people at the heart of where we go from here. There is no doubt that the report would not have ended up where it did without that.

I would go further, actually. By demonstrating the power of the care-experienced voice in this review, we have shown that we should make sure that that the lived-experience voice is at the heart of everything we do. That is certainly true of the care review, but I am sure that it has much wider application across all areas of our responsibility.

Photo of Jenny Marra Jenny Marra Labour

Many Scots and children in Dundee find themselves in the care system because of a parent dying because of drugs. Indeed, I heard of one such case just before Christmas. Is the national drugs task force looking specifically at what can be done to prevent drugs deaths among parents? What can be done to increase the number of supportive care places in areas with high numbers of drugs deaths?

The First Minister:

That should absolutely be a key focus of the drugs task force, although it has to decide its priority areas. More importantly, we must make sure that there is a proper link between the work that we are doing here and in other areas of work, such as the work that is being done around drugs deaths.

Jenny Marra is right to point to the number of young people who will end up in care because a parent has died from drugs, so the connections between those vital pieces of work are important. One of the key priorities of the work that will be done over the next few weeks in getting the process right is to make sure that those connections are properly understood and happen as we want them to.

Photo of Mark McDonald Mark McDonald Independent

One of the most distressing stories that I heard at the outset of the care review was of a public meeting at which the members of the community were up in arms at the possibility of a residential children’s home opening in their area. Does the First Minister agree that, as well as the legislative changes that are being made, politicians must lead attitudinal change across society to ensure that the stigma that still exists in too many quarters relating to children in care is tackled and eradicated once and for all?

The First Minister:

Yes, and I will be direct here: we all have a leadership role to play. We are all constituency or regional representatives and we have a duty to represent the views of our constituents, but we also have a role to play in changing attitudes and combating stigma.

I have had conversations with constituents in which I had to take a different view from theirs on their understanding of what a care home in a residential area meant and why the children were in that care home. I think that we all have a responsibility to do that.

Having the places where our most vulnerable young people are cared for in the heart of communities is not something that we should oppose, but something that we should welcome, because that is part of making sure that our young people are part of an overall stable, loving environment.

I have been forced to think about a lot of things very differently as part of this process, and I think that we all have to do that in all respects as we move forward.

The Deputy Presiding Officer:

There is no pressure,

Ms Gilruth, but, if you are brief, I can get in your colleague Stuart McMillan, too.

Photo of Jenny Gilruth Jenny Gilruth Scottish National Party

The care review has highlighted the importance of schools in helping children to build relationships that will encourage them to learn and to thrive. Does the First Minister agree that stability and support is vital in improving the educational outcomes of care-experienced young people?

The First Minister:

I agree 100 per cent with that. Many young people have told me that the teacher in their class was the only person who they felt able to turn to and talk to. However, I have to be frank: I have, equally, heard young people say that they felt that they were treated differently at school as a result of their being in care—because people did not have the necessary knowledge, their behaviour was perhaps misunderstood.

A young person spends a great deal of their time in school and it is a key part of the stability that they have in their lives. That is even more true for young people who are in care. In recent weeks, I have heard great examples of schools doing really good work, including setting up groups for care-experienced people, to help other young people understand what they experience. We should see schools as a key part of the solution, not a part of the problem.

Photo of Stuart McMillan Stuart McMillan Scottish National Party

Will the First Minister join me in welcoming the care review’s finding that mental health support must be accessible for vulnerable children and young people and that it should be delivered in their communities?

The First Minister:

Yes. Again, I think that the report is clear and explicit on mental health. A lot of our general work on mental health for young people is important in that regard. For example, establishing the new wellbeing service and getting more counsellors into schools have general benefits, but can bring particular benefits to care-experienced young people.

I mentioned Fiona Duncan in my opening statement. As we have reached the end of questions on this topic, I reiterate my thanks to her—she has absolutely repaid the trust that we put in her as chair of the review by bringing together all the different voices and issues. We have been given a platform for change. On mental health, poverty and all the other issues that are brought to bear, we have a golden opportunity to do something special, so that future generations can look back and not have to constantly talk about the failures of the care system.

The Deputy Presiding Officer:

That concludes questions on the statement. I will move on with very little pause. [

Interruption

.] There should be no applause, please. I understand why some people in the gallery may wish to applaud, but it is not permitted.