Health and Social Care Bill

Baroness Massey of Darwen Excerpts

Thursday 15th December 2011 Lords Chamber

Moved by

[Baroness Massey of Darwen]

310: Clause 178, page 176, line 10, after “people” insert “, including children,”

[Baroness Massey of Darwen]

My Lords, I shall speak also to Amendments 311 and 320. This group of amendments seeks to ensure that the voice of the child is heard in health matters. Too often in Bills that do not relate specifically to children and young people, they are marginalised, yet, as has been said before in debates, child health is a vital aspect of healthcare and children are patients, just like adults. They have opinions just like adults and, in my experience, consulting children about what works for them always results in improved services and policies.

These amendments seek to ensure that HealthWatch England’s functions are clear and explicit in relation to children as well as to others and that its functions in providing advice to the Secretary of State, the NHS Commissioning Board and monitoring authorities on the views of patients and members of the public refer to the views of children, who are patients and members of the public.

Local healthwatch functions must also promote and support patient and public involvement in the commissioning, provision and scrutiny of local care services and must obtain the views of patients and the public about people’s needs for and experience of local care services. I submit that those functions must be carried out to include children. HealthWatch England must provide support and assistance to local HealthWatch organisations in relation to this.

Furthermore, as noble Lords may know, Article 12 of the UN Convention on the Rights of the Child makes clear that children have a right to be heard on issues that affect them. Measures to promote patient and public involvement in decisions about their own care and in the development of health services and care services must include children from the start. I believe that this will make for better health services.

The Bill does not make this clear enough. Research commissioned by the NCB has found that local involvement networks or LINks, which the Bill will transform into local healthwatch, are not always clear that children and young people are part of their remit. Local healthwatch and HealthWatch England will need to be able to identify capacity and maintain the skills to reach out to and engage children, including the most vulnerable children and their families.

A recent review of law, policy and practice in relation to children’s participation in the NHS and other public services and settings found that, in their efforts to support user involvement, the health authorities and NHS trusts had not specifically identified children as service users. The review also found that although 41 per cent of GP practices reported to have a patient participation group there was no evidence of children’s active engagement in these forums. The Royal College of Paediatrics and Child Health has argued that reforms have been lacking in providing the structures and frameworks where children and young people are properly represented. And concerns about children’s involvement in patient and public voice mechanisms were also reflected in the report of the NHS Future Forum. In 2009-10 Professor Sir Ian Kennedy carried out a review of how the NHS delivers to children and recommended a local partnership in each local authority that would co-ordinate public services in the best interests of children. His ambition was that,

“the welfare and well-being of children and young people, seen as so important by so many, will be the prevailing cultural approach”.

My amendments here try to make clear that children are within the remit of local HealthWatch and HealthWatch England and that children’s and young people’s views should be heard. I beg to move.

[Baroness Masham of Ilton]

My Lords, I support these very important amendments. One only has to remember the tragedy of Baby P and all those vulnerable children who sometimes fall between the police, the social services and the health departments.

--- Later in debate ---

[Baroness Northover]

I hear what the noble Baroness says. It is interesting that she said “people of all ages”. The purpose of healthwatch and the NHS is to help and try to assist people of all ages, whether they are patients, their families and so on. We need to make it more person-centred—we all agree that that is what we are seeking to do—and I hear what she says in regard to the regulations.

[Baroness Massey of Darwen]

My Lords, I thank the Minister for her words. I have some concerns, to which I shall come in a minute. I am glad that so many noble Lords contributed. I am particularly glad that the noble Baroness, Lady Finlay, mentioned young carers and that the noble Lord, Lord Warner, talked about adolescent health, so long an area which has been very much neglected in relation to health services.

I would also like to thank the Minister for meeting a group of noble Lords to discuss the issue of children’s interests in this Bill. I hope that the Government have got the message about the need to involve children in decisions about their care and treatment. Many have considerable health needs, although the young population is generally considered the healthiest. They have health and care needs, including mental health needs, disability and so on. I worry that when children get lumped in with expressions such as “the community” or “the family”, their needs are ignored. Children have very little redress on this. If we do not make it explicit that we should consult children, they often do not have the ability or contacts to come back at that and make a protest. We have to do that for them, and children must be included in and consulted on all Bills that affect them.

I would like the words “children” and “young people” and consultation with them to be made very explicit in this Bill. I have amendments later, although I cannot remember their numbers, which will also reintroduce the notion of children into this Bill. In the meanwhile, I will withdraw the amendment, but I may well wish to return to the matter on Report with other noble Lords and look at it again.

Amendment 310 withdrawn.