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IICSA published its final Report in October 2022. This website was last updated in January 2023.

6.4 Financial

The financial, funding and resource arrangements for relevant institutions and services.

Summary of key messages

  • Access to the right support at the right time is crucial for victims and survivors of child sexual abuse.
  • Provision for support is complex and ranges from specialist services provided by the voluntary sector through to physical and mental health services provided by the statutory sector.
  • The Inquiry has noted the lack of data gathered by public sector agencies about expenditure on services and treatment for victims and survivors of child sexual abuse, and recommends that this is addressed by the Government.

As earlier sections of this report make clear, the effects of child sexual abuse on victims and survivors can be lifelong and profound. The Inquiry has heard that accessing the right support at the right time is hugely beneficial. Being unable to access or continue support ‒ or receiving poor-quality support ‒ is damaging and can deter victims and survivors from seeking the support or treatment they need in the future.

In particular, the Inquiry has heard consistently about the difficulties faced by victims and survivors seeking to access support or treatment. This has been raised by victims and survivors who have participated in the Truth Project and in the Inquiry’s online consultation. It has also been discussed by Forum members and participants at a seminar on victims and survivors’ experiences. 

The Inquiry has been told that the decision to seek support or treatment is often a difficult one that requires courage. This means that seeking support and treatment must be made as straightforward as possible, yet the barriers involved have the opposite effect and make the process even more difficult. 

Many victims and survivors have told the Inquiry about the long waiting lists for obtaining support and treatment. Providers of sexual violence and abuse support services in the voluntary sector have told the Inquiry that they are unable to cope with the demand for their services, leaving them no option but to ask those seeking support and treatment to wait. 

The voluntary sector provides a wide variety of support services that are accessed by victims and survivors of child sexual abuse and their families. It plays a key role and provides services including counselling and therapeutic support, independent advocacy, helplines and other forms of emotional support. Voluntary services also provide specialised services designed for victims and survivors of child sexual abuse or victims of sexual violence. Victims and survivors have told the Inquiry that they often value the voluntary sector’s independence from statutory services and their flexible approach. The Inquiry has heard about the significant funding challenges faced by those operating these services.  

Sexual assault referral centres (SARCs) provide services to child and adult victims and survivors of sexual assault and rape. They provide healthcare and treatment and, where appropriate, forensic medical examination. SARCs also offer access to ISVAs who provide information, support and advice to victims and survivors, including support to engage with the criminal justice system where appropriate. Where victims and survivors have ongoing needs for support or treatment, SARCs will make referrals to other services, including specialist sexual violence and abuse support services. 

The NHS in England and Wales provides health services that victims and survivors of child sexual abuse access for support. These include counselling and psychotherapy services, child and adolescent mental health services, and other mental health services. These services are available to all patients, on the basis of their clinical need for treatment, and are not provided solely to victims and survivors of child sexual abuse. The Inquiry has heard that NHS provisions can be inflexible and are not tailored to the specific needs of victims and survivors. 

But I was only allowed a certain number of sessions. I think that was about five or six, sort of, meetings with this person. And he wrote a letter at the end of that ... and the letter basically says, it explains the situation, it says that I was a really high risk. It said I had signs of severe PTSD etc. And that letter was sent to my GP and to my social worker, and they never arranged any follow up. And that was it, I never saw anybody – I never saw the police again, after that I never saw the social worker really much after that.

Victim and survivor, the Truth Project

All services are supported through a wide range of commissioning bodies and funding arrangements. Public funding comes from several departments across the UK and Welsh Governments, and responsibility for local service provision rests with a number of public sector agencies. Local authorities, NHS organisations and Police and Crime Commissioners all have a role in the planning and commissioning of services for their local populations. The Inquiry has been told that complex commissioning processes and short funding cycles hinder long-term planning and investment in support services, and pose particular challenges for voluntary sector organisations seeking sustainable funding.

To support its consideration of these matters, the Inquiry engaged the Chartered Institute of Public Finance and Accountancy (CIPFA) to identify current levels of expenditure on support services for victims and survivors of child sexual abuse. CIPFA considered services delivered in both the statutory and voluntary sectors, including mental health services, counselling and therapeutic services, and specialist therapeutic support services for people who have experienced child sexual abuse.

CIPFA was unable to identify the current expenditure levels due to a lack of suitable financial data collected by the public sector agencies involved. It found that the data held by those agencies do not have the level of detail needed to determine how much is spent on support and treatment for victims and survivors of child sexual abuse. The information held by specialist services in the voluntary sector has the required level of detail in some cases, but not all. As a result, it was not possible to accurately assess the total current levels of expenditure on support services for victims and survivors.

The Inquiry has consistently heard about the barriers to support and treatment encountered by victims and survivors of child sexual abuse, including the poor experiences of some due to insufficient or unsuitable support and treatment. The Inquiry is concerned that funding pressures on agencies make it difficult for them to fully meet their other statutory obligations and to increase investment in the prevention of child sexual abuse.

The Inquiry considers that if the Government is to ensure that there is sustainable funding for support services for victims and survivors, it must understand how resources are currently allocated and the effectiveness of the services it funds. The Inquiry recognises that this will be challenging where services are not provided solely to victims and survivors of child sexual abuse (for example, NHS mental health services), but this should stimulate the Government to do more. This work will not be sufficient on its own ‒ an up-to-date and accurate assessment of the level and extent of need for support services is also necessary.

Given the concerns the Inquiry has heard about the sufficiency of existing support, the Inquiry considers that this must be addressed as a matter of urgency.

Recommendations

England

The Chair and Panel recommend that the Department of Health and Social Care, the Department for Education, the Ministry of Justice and the Home Office work together to establish current levels of public expenditure, and the effectiveness of that expenditure on services for child victims and adult survivors of child sexual abuse in England.

Wales

The Chair and Panel recommend that the Welsh Government and the relevant UK Government departments work together to establish current levels of public expenditure, and the effectiveness of that expenditure on services for child victims and adult survivors of child sexual abuse in Wales.

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