Children and Families Bill

Baroness Howarth of Breckland Excerpts

Wednesday 23rd October 2013 Grand Committee

[Baroness Butler-Sloss]

My Lords, I support the noble Baroness in this amendment. At his request, I will also speak to the amendment of the noble and learned Lord, Lord Mackay of Clashfern. Is that separate? It is separate, so I will speak entirely to this amendment.

At the adoption stage, Part 1 of the Bill, a number of us spoke about the importance of sibling contact. I made the point—I make no apology for making it again to a different Minister—that the Select Committee on Adoption Legislation took informal evidence from a considerable number of children. One of the points made both by the group who were adopted and the group in care concerned the enormous sorrow they felt at losing contact with the siblings they knew. Very sensibly, one girl said, “I am not concerned about the siblings born after I left the family but I am very worried about my brothers and sisters”. Another child was almost in tears as he was so worried about his younger brother, not knowing what was happening to him and nobody being able to tell him. He said he woke up at night worrying about his brother. That is not acceptable. Therefore, it is important at each stage that those in charge of children or in charge of making arrangements and connections with children have the siblings in mind. The judge may well say that the social workers have given him all sorts of good reasons why they are not going to meet, but it is important that the judge asks. There is no requirement on the judge, or indeed the magistrates in the family proceedings court, to ask that question unless it is in legislation.

[Baroness Howarth of Breckland (CB)]

My Lords, I know that David Norgrove was very concerned that judges spent quite a considerable time reviewing care plans and that might well delay looking at the future of children. However, I cannot see why this aspect should not be looked at. When the judge is looking at the placement of the child before him, he must look at the whole family, the parental position and what is going to happen to the siblings. Although I understand absolutely why David Norgrove felt that the local authority should be the one looking sensibly at the care plans, I do not at all see why the court should not look at the sibling placement.

[The Minister of State, Ministry of Justice (Lord McNally) (LD)]

My Lords, I am very grateful to all noble Lords who have contributed to this debate. The noble Baroness, in introducing the amendment, referred to the strength of feeling expressed when Part 1 of the Bill was discussed and how important it is that the court is able, where appropriate, to consider the arrangements that the local authority might make for a child to live with his or her siblings. My noble friend and I will consider the points made both today and earlier in the Bill.

As was discussed in the other place, the purpose of Clause 15 is to focus the court, in its consideration of the local authority care plan, on those provisions which set out the long-term planning for the upbringing of the child; for example, whether the child is to live with a parent or other family member, to be placed in foster care or to be adopted—the permanence provisions. The court is not required to consider the remainder of the plan. The clause is based on the findings in the family justice review that, driven partly by concerns over the quality of local authority social work, courts can spend a long time scrutinising the details of local authority care plans for children before making care orders. In many cases, court scrutiny goes beyond what is needed to determine whether a care order is in the best interests of a child. This can lead to unnecessary delays and contribute to the lengthy duration of care cases.

As was also highlighted in the other place, details of care plans are not set in stone and often change over time in response to a child’s changing needs and circumstances. In 62% of cases in a recent study, the care plan scrutinised by the court was not carried out, due to changing circumstances. Given this likelihood of change, the local authority, rather than the court, is better placed to consider the detail of the care plan.

I appreciate the concerns expressed by noble Lords about sibling placement, following the debate in the other place. I want to clarify that if the permanence provisions of a particular plan deal with arrangements relating to a child’s sibling—for example, if the plan is for the child to be adopted along with his sibling—the court will be required to consider those arrangements as part of the permanence provision. I will look at the statistics cited by the noble Baroness, Lady Hughes, about loss of contact and, in addition, I make the point that she anticipated: there is nothing in the clause that prevents the court looking at any other aspect of the plan it considers necessary to make the order.

I understand the point made by the noble and learned Baroness, Lady Butler-Sloss, with her vast experience and from the evidence heard by her committee, about the grief and stress that can be caused to siblings by being parted. It is a matter that needs to be looked at. I re-emphasise that nothing in the clause affects the duty of the local authority, when deciding the most appropriate placement for the child, to ensure, as far as reasonably practicable in each case, that the placement enables the child to live with any sibling who is also being looked after by the local authority.

As has been pointed out, concern has been expressed and some statistics have been advanced for us to ponder. We will look at this again in those terms and in the context in which David Norgrove made these recommendations. There is a danger that if we have too many belts and braces in the process, we will lose the very advantages of speed that we are trying to bring in and which are also in the best interests of the child. I hear what the Committee has said and my colleague and I will consider that between now and Report. In those circumstances, I would be grateful if the noble Lady would withdraw her amendment.

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[Lord Kennedy of Southwark (Lab)]

My Lords, earlier in this debate, I referred the Grand Committee to my declaration in respect of Diabetes UK. I shall speak to my Amendment 223—I am very grateful to the noble Lords who have supported it—and Amendment 241A, which was tabled by the noble Lord, Lord Nash. I am very grateful to him for tabling his amendment. He has clearly listened to representations made to him. The amendment goes a long way to address the issues raised in my amendment.

I reinforce the comments made by the noble Baroness, Lady Howe. The Health Conditions in Schools Alliance supports this amendment. The alliance is made up of 30 organisations representing more than 1 million children. It called for a duty to be placed on schools to support children with health conditions. Children with conditions such as asthma or diabetes are often left on their own or unsupervised and are vulnerable to an attack or a hypo. Some children are prevented from treating their condition as soon as they recognise the symptoms, often meaning that the situation ends up worse than it should be.

A lack of understanding from teachers and staff can make the situation worse by making a child anxious and stressed about their condition, which can make it worse than ever. A lack of understanding and training sometimes means that teachers and staff are not able to recognise that certain conditions or medications can affect learning and behaviour. Poor management of conditions often means that children miss lessons. Sometimes schools do not even have policies for absence and for whether a lesson has been learnt or not.

Good management of conditions means that children are better able to concentrate and get the most out of their time in school. Exclusion from school, whether from a trip, a lesson or for months at a time, is one of the most common problems for children who face long-term health conditions. In the past few days alone, Diabetes UK has had a number of calls to explain the problems of children. I shall not mention the children by name, but one 10 year-old girl who uses a pump has been told that she cannot go on a residential trip unless her mother attends as well. The dad was not considered appropriate. It is an activity holiday, so the girl would exercise far more than usual. A staff member would not be able to look after the child unless the mother attended, so she cannot take part in activities. This is quite common. Unless parents attend residential trips and deal with the medication, children are excluded from them.

The Anaphylaxis Campaign is aware of a 12 year-old girl in year 8 who has not been able to attend school for a single day this term because the school and the local authority have not properly prepared for her arrival.

Cases where parents are left to provide care in school are known. Some parents have to give up their jobs or reduce their working hours to make sure their child attends school.

The GMB, my union, and Unison support this amendment. Their members are often left to deliver the care, such as injecting insulin for children with diabetes or giving children with epilepsy their medication. This is a major issue for trade union members. They often feel they are not properly trained or that the training is never refreshed. They are anxious about responsibility for supporting children with health conditions and are not helped to fulfil that properly. This is deeply worrying for children with health conditions and their families, and is also grossly unfair on members of staff who are required to look after children but are not given the proper training or support to do the job properly.

My amendment places a duty on schools to work with local health services to offer training and refresher training to staff. It would require schools to have a proper policy in place to support children with health conditions. That would mean that schools are prepared for things such as staff leaving or being absent for school trips, and would know what training their staff can expect. All children with a health condition should have individual healthcare plans agreed between the school, the child, the parents and specialist nurses, tailored to meet the needs in various situations. Looking after children with health conditions is not impossible, and many schools do it incredibly well. A combination of good leadership, planning, communication and training shows how it can be done. It is not burdensome. Schools that achieve that in the end spend far less time looking after those children, who manage successfully themselves. Along with healthier children, well managed conditions mean fewer missed lessons, fewer incidents in classes, fewer meetings with worried parents, happier children and more confident staff.

We know that the Department for Education wants to reduce bureaucracy in schools, but at the moment, the only option that parents have if their complaints are ignored is the costly and time-consuming process of going to tribunals. One local authority was found to have discriminated against a boy with diabetes. It is now appealing the decision. It has already cost tens of thousands of pounds. In addition to financial costs, it takes at least six months before a tribunal meets to make a decision. That is six months of meetings, compiling evidence, filling in forms and anxiety and stress for all parties concerned.

A clear duty on schools will mean that staff are given the support and training they need to offer, with confidence, the care that children need and make the lives of parents, children and schools much easier. A duty will end the current outrageous situation whereby some children’s health is made worse or put at risk simply by attending school. All children should be given the best possible opportunity to reach their full potential at school. At the moment, far too many children with health conditions are denied the right. A duty will help them to reach their potential and allow them to play a full part in school life.

As I said at the start of my remarks, I am grateful to the Government and the noble Lord, Lord Nash, but I will probably push a little further on Report. I think that the amendment does not go quite far enough. I hope we can address the whole issue of relevant NHS bodies being fully engaged in the care plans of individual children. The amendment does not quite address that.

[Baroness Howarth of Breckland]

My Lords, I will be brief—I am sure that the Minister will be grateful for that—but I want to say two things at the beginning. First, the Minister needs to know that many organisations think that a great deal in the Bill is extremely welcome. The tone of the debate seems critical. I think that we have the number of amendments that we have simply because people care about the issue and have discussed it at length. I have met several organisations which have said how valuable a great deal of what is in the Bill is taking forward work with disabled children. I thought that we needed to have that on record while we are all complaining bitterly about the things that the Government have not done.

I shall speak to Amendment 220. Most of the points have been made, and I will not make a long, heartfelt tirade about the group that I care about. I just say that I work closely with children with congenital heart disease, children born with half a heart, many of them with hypoplastic left heart syndrome. They usually look like perfectly ordinary children but they are in serious difficulty when they get to school. I am therefore immensely grateful to see the Minister’s amendment but I ask that we see the regulations, because the devil will be in the detail as to whether it really meets the requirements. If we can see the regulations early, it might relieve the pain on Report, when people will otherwise want to speak at length again.

My other question is: once we have the regulation and the detail, how will families be able to complain without taking themselves through massive tribunal cases, as we know has happened? It might be worth the Government looking at how parents raise issues under the regulations when they feel that their needs have not been met, because that would save everybody pain. It is no use saying to ourselves that Ofsted will deal with that, because we know that it visits only every four years. Some children have been right through school and never seen an Ofsted inspection. If we could have some clarity on that, it would certainly speed things up.

[Lord Patel (CB)]

My Lords, I speak in support of Amendment 223, to which my name is attached. I will be brief, because most of what I would have said has already been said well by the noble Lord, Lord Kennedy of Southwark.

I particularly support the emphasis that he put on the need for teachers to have the right training to deal with children with medical conditions. Without that training, it is likely that any guidance issued will be completely defunct. The NHS, local authorities and schools need to work co-operatively to ensure that training is provided and accessible to teachers.

I welcome the government amendment most sincerely. I am glad that the Minister has tabled it at this stage. My only problem is that, without seeing the draft guidance, we have no way to comment on whether its breadth and depth will be adequate to meet the needs of children with medical conditions. I therefore hope that the Minister can make a commitment to bring forward the draft guidance before Report, so that we can improve it—not criticise it, but help to improve it.

I also want to ensure the inclusion of medical conditions not already mentioned—the list is exhaustive— such as diabetes, epilepsy, asthma and allergies, but also cancers. It is often thought that children with cancers have short lives. Some, unfortunately, do, but most childhood cancers are now long-term conditions and should be treated more as chronic diseases, not short-term ones. I hope that the Minister will include dealing with cancers in the guidance.

The guidance must recognise both the social and emotional needs of young people with long-term medical conditions, and the fact that a health condition can impact on a child or young person’s ability to learn. Another important point made by the noble Lord, Lord Kennedy of Southwark, was the need to involve the parents and children to ensure that the school understands their condition and its emergency needs. A child having a hypoglycaemic attack requires immediate treatment. A child having an allergic attack requires immediate treatment. A child with a migraine needs to be treated with compassion, because they may lose their vision and hearing. Putting them in a corner or a quiet room does not solve the problem. Those are some of the things that children with a medical condition suffer on a daily basis in schools. If we cannot get things right for children in the Bill, we fail them.

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[Baroness Howarth of Breckland]

My Lords, I support the noble Baroness, Lady Hughes, and those who have spoken to these amendments about the inclusion of children. I simply hope that it is a mistake, a slip of the pen, and that “children and young people” was intended and can be put in. We now have a great deal of experience of engaging young people. Certainly, CAFCASS has done a huge amount of work in working with very young children and understanding their wishes and feelings. The Children’s Rights Director spent a long time talking to young people and young children about how decisions were made about them. It is amazing how very young children feel very deprived of having a part to play in their own lives when they have not been included.

A lot of research shows that not including children in decisions has harmful effects. We know from similar research into divorce that young children who are taken along and understand what is happening have less trauma later than those who suddenly find out that it is happening. There is similar research into the effect of understanding on children. I hope that this is a slip of the pen and that we will find that both are included.

[Baroness Howe of Idlicote]

I will not keep the Committee for long. As my name is attached to a number of amendments in this group, I want to emphasise what the noble Baroness, Lady Howarth, has said so ably. It is crucial that from the moment at which a child can speak, their views are sought. To an extent, that may depend on how much value can be given to what they say and on their age. Nevertheless, it is important to hear what they have to say. As you get older and have great-grandchildren as well as grandchildren, the more you are aware of exactly what you are learning from their experiences, which can change your views quite considerably. I very much support the noble Baroness, Lady Massey.

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[Baroness Howarth of Breckland]

My Lords, my name is attached to this amendment. Clause 32, “Advice and information for parents and young people”, says that we should give advice and information, but how can we give advice and information if we do not know how many people we are going to give it to, what the needs of the children are and what range we will have to plan for in terms of strategy?

Sometimes I mourn the chronically sick and disabled persons legislation, which may be from before the Minister’s time. As a director of social services, I found myself trying to implement that. We were to collect information about the needs of the disabled and sick in our areas in order to create a strategic plan. That was in the 1960s, but here we are now and during all that time we have never got this together.

I know that we do not want to add a huge bureaucratic layer to anyone’s workload. Collecting statistics is always difficult if you are going to get some commonality between the criteria. As the noble Lord, Lord Storey, has pointed out, they vary at the moment across the country. I did a report a few years ago to try to prepare a strategic plan for a voluntary organisation—John Grooms Association for Disabled People—so that it could plan its services. When we tried to get data from across the country, they simply did not exist; hospitals, local authorities and schools all seem to collect them differently.

I hope that the Government will look at this extremely carefully. It is a crucial issue. You cannot have a strategy without data, and data are not that difficult to collect, particularly as the Government are hoping to ensure that all the parents and children in an area will get advice, so they need to know where they are.

[Lord Lucas]

My Lords, may I ask the noble Lord, Lord Ramsbotham, whether he has addressed Amendment 76, or is it postponed to a later group?