Hakeem Hussain: 'Horrendous' lack of help for asthma death boy

The body of Hakeem Hussain was found in a freezing garden in November 2017

Authorities' lack of help for a boy who was found dead in a freezing garden after an asthma attack was "horrendous", a children's safety chief has said.

A serious case review has been probing the care of Hakeem Hussain, who was known to professionals, and died aged seven in November 2017.

The council, police, health workers and his school in Birmingham "could and should have done better".

Improvements had been made, they said.

In April, Hakeem's mother Laura Heath was convicted of his manslaughter by gross negligence.

Investigators prior to the criminal proceedings had found one of Hakeem's inhalers repurposed as a crack pipe.

Drugs paraphernalia alongside inhalers were found inside the property where Hakeem lived

On the night Hakeem died, 40-year-old Heath, a known drug addict, had smoked heroin before passing out in the same bed as her son, the trial at Coventry Crown Court was told.

She also admitted four counts of child cruelty and was jailed for 20 years.

The court heard how the boy had been living in squalid and chaotic conditions with Heath at a flat on Cook Street in the Nechells area of the city. The garden where his body was found was part of the property.

Just months before his death, Hakeem had "made clear" to school staff how unhappy and scared he was of his life at home, saying he did not wash regularly as there was no money for gas and electricity.

"My mum sleeps all day, and no one takes me to school. I take care of myself while mum is asleep," he had said.

"I am 5% happy, 100% angry and 1,000% scared," he told his school.

He had been made the subject of three Child Protection Plans (CPP) for neglect due to concerns about his mother's substance abuse.

The last CPP was implemented just two days prior to his death.

But the extent of Hakeem's neglect was there to be seen "well before" that decision was made, said Penny Thompson, independent chair of the Birmingham Safeguarding Children Partnership, which published the review.

Hakeem told his school he was "1,000% scared" of life at home

Ms Thompson said of authorities' engagement: "It is horrendous that Hakeem's unhappiness and fear of repeated asthma attacks, some of which required hospital admissions, and the marked reduction in his attendance and performance at school, did not trigger more effective intervention."

She also highlighted how his school - Nechells E-ACT Academy - was "ineffective in escalating concern", and said there was also a "lack of join-up" across health service organisations which failed to plan for his asthma.

"The drugs agency didn't sufficiently focus on the impact on Hakeem of his mother's drug addiction," Ms Thompson explained, and added a GP had failed to recognise a need to share important information.

According to Ms Thompson, a council social worker had also prioritised some of the family's needs "to the detriment of Hakeem", while police had missed opportunities to "properly consider the safety of children" when responding to incidents within the home.

"All those organisations and individuals who came into professional contact with Hakeem could and should have done better," Ms Thompson said.

"Once again, we have a tragedy of a child dying from asthma. This is not inevitable or acceptable."

Asthma sufferers should have an individual management plan which is reviewed annually by an experienced clinician and shared with relevant professionals, Ms Thompson added.

• The needless death of a neglected boy

• Mum jailed over son's fatal asthma attack

• Images released of home of 'neglected' boy

Laura Heath was jailed for 20 years in April

The review, completed in 2019 but held due to Heath's criminal proceedings, identified key issues in Hakeem's experience, including:

• Confusion by professionals around the significant harm thresholds for neglect where a child has a chronic medical condition that is being poorly managed by a parent

• Lack of communication between those responsible for Hakeem's non-school attendance and children's social care, resulting in the extent of his neglect not being appreciated

• Little professional understanding of his daily, lived experience

• Failure by all agencies to consult and inform his birth father of the growing concerns for his son's welfare

• Lack of professional awareness around the appropriate use of medication for children with asthma that can result in a failure to identify patterns of over-prescribing of inhalers

• Shortfalls in liaison across all health providers

"Significant developments and improvements in services for children and families in Birmingham" had been made in the five years since Hakeem's death, said Ms Thompson.

"We cannot guarantee that no child will suffer neglect nor die from asthma; we can assure everyone that learning from Hakeem's death has contributed to positive and lasting improvements in partnership working for the protection of children.

"It is our ambition that Birmingham should be a child-friendly city where all children flourish," she added.

Investigators found one of Hakeem's inhalers had been repurposed as a crack pipe

Hakeem's father had played a "positive role" in the boy's life before he was arrested in 2015 and imprisoned for an unrelated matter.

He contributed to the report along with Hakeem's mother who reflected from prison: "Hakeem should never have been left with me".

Birmingham City Council and Birmingham Children's Trust, appointed to run services six months after Hakeem's death, said they had completed all of the actions identified in the report.

Partnership arrangements had also "significantly improved at both a strategic and operational level," the joint statement said.

Senior leaders at Hakeem's school had fully addressed the learning around the understanding and application of the local escalation procedure, the statement added.

West Midlands Police said since Hakeem's death safeguarding practices around vulnerable children had "improved significantly".

A statement from the force said: "He was a young boy who should have been enjoying a carefree and happy childhood. He died in desperately unfortunate circumstances as his mother had a duty of care to manage the administration of his asthma medication.

"Our thoughts remain with all who knew Hakeem and were saddened by his loss."