Case No. FD21P00367

1. Name, date of birth, sex, weight and height.2. A neo-natal report on the child, including—(a) details of his birth and any complications;(b) the results of a physical examination and screening tests;(c) details of any treatment given;(d) details of any problem in management and feeding;(e) any other relevant information which may assist the adoption panel and the adoption agency; and(f) the name and address of any registered medical practitioner who may be able to provide further information about any of the above matters.3. A full health history of the child, including—(a) details of any serious illness, disability, accident, hospital admission or attendance at an out-patient department, and in each case any treatment given;(b) details and dates of immunisations;(c) a physical and developmental assessment according to age, including an assessment of vision and hearing and of neurological, speech and language development and any evidence of emotional disorder;(d) for a child over five years of age, the school health history (if available);(e) how his physical and mental health and medical history have affected his physical, intellectual, emotional, social or behavioural development; and(f) any other relevant information which may assist the adoption panel and the adoption agency.”13.The adoption agency must then prepare a written ‘child’s permanence report’, which must include the wide range of matters listed at AAR 2005, reg 17 and, in particular, ‘a summary, written by the agency’s medical adviser, of the state of the child’s health, his health history and any need for health care which might arise in the future’ [reg 17(1)(b)].14.Where the adoption agency is a local authority, the decision whether a child ought to be placed for adoption is taken by an ‘agency decision maker’, and is not referred to the agency’s adoption panel if the child is the subject of care proceedings [reg 17(2)].. When making a decision as to placement for adoption, reg 17(2D) requires the decision maker to take account of the following reports:i)the child’s permanence report;ii)the child’s health report and any other reports referred to in reg 15; and iii)information concerning the health of each of the child’s natural parents.15.Reference to an adoption agency’s ‘medical adviser’ means the person appointed as the medical adviser by the agency in accordance with reg 8; that person must be a ‘registered medical practitioner’.16.The decision of the agency decision maker that a child should be placed for adoption is an important step. It will, in cases where the statutory threshold criteria for making a care or supervision order under Children Act 1989, s 31 are met, or there is a pending application for a care order, trigger a requirement on the local authority to issue an application for a placement order [ACA 2002, s 22].17.To put the general assertion that there have been breaches of the medical requirements of AAR 2005 into some context, this court has been told that the specific breaches that have been discovered in the work of SCC are not necessarily replicated elsewhere, and that in other local authorities different breaches may have occurred. In SCC the primary error has been for the adoption agency to rely upon the Initial Health Assessment, which is a standard report that is completed for all looked after children. It is not a report commissioned by the adoption agency for the purposes of AAR 2005, reg 15. In breach of the regulations, no further advice was sought from the agency medical adviser and that adviser was not required to sign off that a further report was unnecessary. In addition there is concern that the agency medical adviser may not have been validly appointed although there is nothing in the regulatory scheme to require a formal appointments process. In other local authorities, other errors have been reported, for example reliance upon reports prepared by a specialist nurse, rather than a doctor.18.The conditions that a court must find to be established before a placement order is made are set out in ACA 2002, s 21(1)-(3):