Archived decisions

Annexe B2

Report of findings for the Children Looked After Health Policy Review Committee

It appears that there are a number of CLA who are not aware of how the medical assessment procedure works (and hence didn't really understand what I was talking about). They did, however, know that they were compelled to go and see doctors every year, even if they felt there was no need.

The key message that all of the CLA to whom I spoke was that one of the worst aspects of being in care is being `singled out', which is certainly the case when CLA are told to have a medical assessment. This is, in fact, why many CLA regularly refuse to attend their medical assessments. The view of many CLA is `why can't we be like most other young people and just see a doctor when we need to?'

Young people have also said that the medical assessments are `boring' and `too complicated.' The procedure is made even more complicated by the fact that several medical professionals have to be involved, and CLA don't feel comfortable in talking about personal issues with someone whom they have never met before. Hence this often prevents CLA from speaking openly with the doctors and nurses, since they cannot feel that they trust and confide in the people carrying out the medical assessment. Hence there definitely needs to be some change regarding this system.

It is also evident that, because CLA are often made to move several times during their time in care, they are obliged to change GPs several times. (They usually re-register with their foster carers' medical practice) CLA have said that once they have a doctor, whom they feel they can trust and confide in, they would prefer to be able to stay with that GP, even if they change placements. Of course, in a county as big as Hampshire, this may not always be practical. However, if a CLA only moves a few miles away, then CLA should be offered the opportunity to stay registered with their previous medical practice.

Another huge problem regarding the health of CLA is that many CLA feel that no-one is concerned about their welfare and well-being. Several young people, with whom I have spoken, say that there is no-one they feel comfortable to talk to regarding personal worries and concerns. I believe that this gives rise to some of the untreated mental health difficulties which many CLA face. I would hope that the independent advocacy service, when it is implemented, will help with this issue.

Something which is of grave concern is that many CLA are not able to speak to anyone about sexual health issues. Due to having to change schools, or not being in education for a significant period of time, many CLA miss out of sex education. Combined with the fact that they don't feel comfortable talking to their carers, the only way in which they find out about issues such as contraception and what happens during puberty is through talking to their friends. Statistically, people with are care background are much more likely to have sex at a younger age, and women with a care background are also get pregnant at a much younger age, with limited skills in parenting, and no-one to support them.

A suggestion would be to involve the youth service in giving sexual health and parenting advice to CLA.

It is also very worrying to hear that CLA do not feel that they are offered a balanced diet. It seems that many children in children's homes have little choice in what they eat, and this is something that must change. Of course, carers should be ensuring that CLA aren't just eating food that they like, such that they are not getting all the necessary nutrients, but CLA should have more choice in what they eat, particularly in which low-fat foods they want. If a supposed `balanced diet' is offered, but children don't like the particular foods, then they are not being offered a healthy diet.

Overall, from speaking to CLA in Hampshire, the health service offered to them by their corporate parents is well below satisfactory. The key issues which must be addressed are:

(i) Make the medical assessment procedure less stigmatising. Maybe change the name to something much less off-putting than a `medical', and allow GPs to carry them out, and allow designated nurses to take on a bigger role.

(ii) Ensure that CLA in children's homes have some influence over the menu, while still ensuring that they are given the opportunity to have a balanced diet.

(iii) Ensure that CLA always have someone to whom they can turn for guidance. They need consistency, and should ideally be able to speak to someone outside the authority, who is not bound by the professional etiquette of social services. This also involves creating a much more user-friendly complaints procedure.

(iv) Involve the youth service more in offering advice on sexual health issues. It is essential that all young people, even as young as eleven or twelve, have a basic understanding of important issues such as contraception and safe sex.

Mark Houston Emily Joslin

Co-chairs of the Care Action Team

Social Services Department