Children’s Wellbeing and Schools Bill

Debate between Baroness Barran and Baroness Finlay of Llandaff

Thursday 22nd May 2025 Lords Chamber

[Baroness Barran (Con)]

My Lords, my remarks on this group have shrunk somewhat, thanks to the Minister’s earlier reply, so this is really an opportunity for her to confirm and clarify some of her earlier comments in relation to the use of the NHS number, which is addressed through my Amendment 51, which I think shares the aims of Amendment 52, which the noble Baroness, Lady Walmsley, presented in the name of the noble Baroness, Lady Tyler of Enfield, earlier.

The context for considering this group of amendments is the long debate that has run for many years about whether there should be a consistent identifier for children and, if so, what that number should be. I know that the noble Baroness, Lady Tyler of Enfield, has campaigned on this very actively over many years, so I am sure she is here with us in spirit.

I was very reassured to hear the Minister say that there would not be a database and therefore that we do not have to worry about some of the concerns surrounding ContactPoint and other similar projects today. As your Lordships’ House knows, the Children’s Commissioner and leading children’s charities all support this move and believe that a consistent identifier

“will enable a child to be identified with more confidence”

across the multiplicity of information management systems that we know exist and therefore allow information

“to be shared more efficiently and securely when consent has been received or a safeguarding decision has been made to do so”.

Rightly, the assumption in their statement is that is that information can be shared only with consent—or, to be fair, if a safeguarding decision has been made to do so, which implies that there is no consent. So obviously, this will apply in both cases.

My amendment would do two things. First, it would put in the Bill that the consistent identifier would be a child’s NHS number. Many commentators on the Bill have said that it is important to do this rather than leaving it to regulations, and we need to be clear that the Government are not tempted by another major IT adventure in this area. Secondly, it would allow the Secretary of State by regulations to make provision relating to the consistent identifier. Our intention is to get clarity in the Bill that it is the NHS number, but then give the Secretary of State the flexibility she needs to keep the approach up to date. I know that the Minister has said—I do not want to put words into her mouth—that the Government are exploring using the NHS number, and it looks like the front-runner. Those are definitely not the words she used. I wonder whether she could elaborate a little, to the extent that she feels able, on whether it is really the NHS number or whether anything else is realistically in contention. Therefore, if that pilot was not successful, how much time and money would this set us back?

In debates on earlier groups, other noble Lords mentioned the limitations of the NHS number. Of course, there are children who do not have one, including unaccompanied asylum-seeking children, but the Minister has already given a constructive way through that, and there are also adoptive children. I know there are real concerns that adoptive children should have a single NHS number that does not change. I felt there was a hopeful hint behind her words, but maybe she can expand on that. I think there have been cases where changing numbers and not having that history of a child’s health has not been in the best interests of the child.

It would also be good to hear the Minister’s reflections on the concerns expressed by my noble friend Lord Jackson about families who might be driven away from registering with a GP because of concerns about how their data might be used, thus preventing access to basic healthcare for their children. How real a risk does she believe that to be? Either way, we think that those risks just pale in comparison with those of another new IT project and a number created purely for these purposes. If I have understood correctly that the NHS number is the front-runner, could she expand a little more on the Wigan pilot? Is it the only pilot that the Government are intending to run? How long will it run for? Will there be others? Will they be evaluated? Can she give us any hint on a timeline? I assume there will be no wider rollout until that work is complete. With that, I beg to move.

[Baroness Finlay of Llandaff (CB)]

My Lords, I support the amendments in this group and strongly congratulate the Government on having picked up the concept of a unique child identifier. I was part of the group, with the noble Baroness, Lady Tyler, when we did not get there on previous legislation, and we were told that one reason was that the Department for Education could not see how it could do that and link with health, so seeing the Department for Education involved is particularly cheering.

I will make a case quite strongly for the NHS number rather than anything else, partly because I think we need to learn lessons from other number systems. If we look just at hospital records, different hospitals have different numbers and then there is the NHS number, and that has resulted in all kinds of clinical muddles and potential errors. The other thing is that children move around. People do not stay in the same area all the time, and the NHS number moves with them. If they have one number and move to a new area and register with a GP, for example, and then go to register with a school, if there have been major concerns then eventually those case notes will come through and people will become aware.

Going back to my previous experience, sometimes we found that the families with the highest risk had multiple addresses, out of town and in different cities. The other advantage is that, although we have devolved healthcare systems, we have a unique NHS number so, if people move between Scotland, Wales, Northern Ireland and England, that number will persist. That is not a central database; it is simply saying that the number is there.

Children’s names change and their “known as” also changes. They may be known as another name but the number, a little like their genetic make-up, is fixed, which is really helpful. It will also avoid problems of lots of children having the same name, which is when muddles happen. I am from Wales, and we have a lot of people called David Jones and David Evans, and quite a few called David Williams, let alone Siân and Ceri. They are great names but, if you are trying to differentiate between them, you have to be really careful.

The final reason why I think this is particularly important is about transition and children who have learning difficulties and neurodiversity. Transition is an extremely difficult time for children. In those late teens, hormones are kicking in all over the place and all kinds of things are happening. Their relationships with the people who have been their carers through childhood change, and they can be at particular risk during those times, particularly during puberty if they have real learning difficulties.

I really hope that the pilot with the NHS number continues. When the Minister responds, it will be very helpful to know what kinds of numbers are being evaluated in those pilot areas—I hope there are more than one—so that the studies are sufficiently powered to be valid. Where have the objections come from? Who has not complied with being engaged? There may be some education needed to remove any sense of threat, because it will make safeguarding easier for people who have responsibility for children.