The Parliamentary Under-Secretary of State for Schools (Lord Hill of Oareford)
My Lords, like other noble Lords, I congratulate the noble Lord, Lord Kennedy of Southwark, on securing a debate on this important issue. We have already heard a significant number of points that the Government will need to reflect on. I pay tribute to the work that he has done, both here in Parliament and as a member of Diabetes UK, to raise awareness of the problems that diabetes sufferers endure. I was glad to have the chance in the small hours of the morning last week to discuss some of the issues that he has raised; it was one of the few benefits that I could see of the Parliamentary Voting System and Constituencies Bill, but we must be grateful for small mercies.
I join other noble Lords in congratulating my noble friend Lord Lexden on his excellent and entertaining maiden speech. I could not work out where I sit on his Lewis Namier scale—probably somewhere near the bottom. It was my noble friend who offered me a job at the Conservative Research Department after I had been turned down by a number of no doubt wiser people in the CRD. So it was he, perhaps inadvertently, who set me on my way, and whom indirectly I should thank—or blame, I sometimes think—for my being here today. I think that I speak for all noble Lords in saying that we look forward to his contributions to debates in the future.
I shall briefly recap on some of the figures that we have already heard and, in doing that, I welcome very much the comments made by the noble Baroness, Lady Crawley, and the tone and way in which she approached this issue. This is not a political issue, and the approach and the legislative framework taken by the Government follows the one taken by the previous Government.
We have heard some of the figures showing the scale of the problem. There was an audit in 2009 which showed that there are an estimated 23,000 children with diabetes, the vast majority with type 1. The peak age for diagnosis is between 10 and 14 years, but type 1 can affect children in their preschool years. No one would want a child with a long-term medical condition such as diabetes to miss out on school life or be treated less favourably because of it. We have heard a number of powerful examples and personal testimony that make that point.
It is also true—and this lay behind some of the remarks made by the noble Lord, Lord Harrison—that there are many examples where schools provide very good support to pupils, especially in primary schools, where they are working closely with parents and the local NHS. There is one example in Nottinghamshire, which other noble Lords may also know, where the county and city councils and the local NHS trusts run training for school staff. They allow heads to apply for reimbursement towards funding staff, and run a network of diabetes specialist nurses to cover primaries and secondaries. So there is good practice, and one issue that we need to reflect on is how we can make that good practice more universal. I accept the point made by a number of noble Lords that provision is currently patchy. We know that there are cases in which parents do not feel—and not only do they not feel it but it is obviously true—that they get the support that they need. We heard today of children with diabetes having to miss classes or be excluded from school trips or being left to inject themselves unsupervised, with parents feeling that they are forced to reduce hours or give up work or move schools because they do not trust staff to carry out blood tests or carry out insulin injections.
I acknowledge the picture that has been painted by Diabetes UK in its report, State of Diabetes Care in the UK 2009. While there is excellent practice out there, in other areas it is patchy. I also understand the strength of feeling behind its Children’s Charter report. It is a view that has been expressed by noble Lords today and by my noble friend Lady Walmsley, in looking at it from an international perspective. There should be equal access to treatment, high-quality medical care and support in schools for children and young people.
I shall briefly summarise the legal framework and then move on to talk about some of the other issues raised and address directly the request put to me by the noble Lord, Lord Kennedy of Southwark, about meeting and how we might take things forward.
Schools are responsible for drawing up their own policies in the light of their statutory responsibilities—for example, health and safety legislation or the Equality Act 2010—and local needs. The department recommends that schools and their employers should have policies in place on the management of pupils’ medicines and on supporting pupils with medical needs. There is no legal duty on school staff to provide medical support, to administer medication or to supervise a pupil taking it. Like the last Government, we do not have plans to change that. However, as has been pointed out, there is a common-law duty on all staff to act in loco parentis when children are at school.
To encourage schools to provide support for children with medical needs, the DCSF, as it then was, jointly with the Department of Health, published guidance on managing medicines in schools and early years settings back in March 2005. The DFE, together with the Department of Health, is currently reviewing that guidance. Perhaps that provides us with an opportunity to reflect on some of the points that have been raised. I invite Diabetes UK, perhaps through the noble Lord or through the noble Baroness, Lady Young—I am spoilt for choice—to speak to my officials about that. We also hope that we can use the review as an opportunity to draw attention to good practice. Again, I hope that Diabetes UK can help us to champion that good practice.
It is sensible for schools to have clear general policies in place to support pupils with medical needs. For pupils with serious medical needs, it is sensible for schools to draw up individual healthcare plans setting out in black and white the level of support that is needed, and clarifying for staff, parents and pupils the help that will be provided. Our guidance makes it clear that any volunteers, usually school support staff, who carry out such duties on a daily basis should be properly supported in doing so.
Staff who volunteer to assist with any form of medical procedure should be given reassurance that they will not be sued for any action they take in providing the vital support that pupils with medical needs may require. We know, once they understand the reasons for the injections and blood tests, and have been adequately trained in practical skills and provided with reassurance that they are acting within the scope of their employment they are generally keen to help individual children.
As has already been discussed, the Government are reforming the way in which the NHS deals with public health—in particular, how it works with local children’s services. The White Paper, Healthy Lives, Healthy People, published last November, has a clear principle at its heart: that prevention is better than cure. It sets out a clear plan to reduce health inequalities and causes of premature death and illness.
That means making sure that there is a major role for the NHS, particularly for school nurses and community healthcare teams as well as paediatric diabetes specialist nurses. School nurses will continue to have a vital role in providing training and support to schools, in developing health reviews at school entry and in managing pupils’ well-being and medical and long-term conditions.
I reassure noble Lords that we are listening to the concerns that have been raised and are working closely with the Department of Health to ensure that no child misses out because of their long-term medical condition. We are also working closely with the department to enable schools to draw on additional expertise from local health professionals and children’s services to meet the needs of their pupils. We seek in particular to develop a new vision for school nurses that reflects their broad public health role in the school community. I would again invite Diabetes UK to talk to the Department of Health about this work.
Perhaps I may respond to some of the specific issues that were raised. I will write to the noble Baroness, Lady Crawley, if I have failed to respond to all her points. I was asked about academies. It is the case that academies have to meet independent schools standards regulations. They require them to have regard to the Department for Education guidance, Health and Safety: Responsibilities and Powers, which sets out the key elements of a health and safety policy, one of which is supporting pupils with medical needs. Having visited a lot of academies, I do not think that there is any intrinsic reason to believe that they will carry this out less well than any other school. Heads of academies who I have met care about their children just as much as the heads of any other school. Academies are free to buy back services from a local authority.
I was asked by my noble friend Lady Walmsley about competitive sport. PE remains compulsory from the age of five to 16. The Government are keen to encourage competitive sport. I agree with her that it can play an important part in dealing with the issues. I am very happy to discuss with her further the slimmed-down Ofsted regime. Of the four categories that we have outlined, one is to do with behaviour and safety.
In response to questions about funding and as noble Lords might expect, there is little specific that I can say, but I was struck by the point made by the noble Lord, Lord Kennedy of Southwark, who said that this not a matter primarily of money and that it is much more to do with finding ways of working sensibly together.
Like, I think, all noble Lords, the Government are committed to ensuring that all children and young people with long-term medical conditions get the help and support that they need while at school. We will work closely with the Department of Health to ensure that. I would be delighted to meet the noble Lord, Lord Kennedy, to discuss this further or perhaps to point him towards my honourable friend Sarah Teather, who has departmental responsibility for these matters. I am grateful to him, as are all other noble Lords, for giving us the opportunity to debate these important issues.