Inequality
Baroness Whitaker Excerpts(5 years, 1 month ago)
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Baroness Williams of Trafford
I think the noble Baroness will know that I am not complacent at all. I take the point she makes about life expectancy. It is not just women; it is the population as a whole. Certainly, in Trafford, people’s life expectancy in its more affluent areas is something like nine years higher than for their neighbours in less affluent areas one mile away. This is due to a variety of reasons, as she will know, but it is not something that the Government are not concerned about. Of course prevention in many areas, such as smoking, is key to some of the outcomes for those people.
Baroness Whitaker (Lab)
My Lords, the report on Travellers and Roma was published some time ago. In the much-regretted absence of the noble Lord, Lord Bourne, from the Front Bench, which Minister is responsible for taking this forward and when will the Government’s detailed plan be published?
Baroness Williams of Trafford
I was the Minister responsible way back when, but I think that role has now been taken by the noble Viscount, Lord Younger.
Immigration Detention
Baroness Whitaker Excerpts(5 years, 7 months ago)
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Baroness Whitaker
To ask Her Majesty’s Government whether they intend to implement the recommendations of the report of the Joint Committee on Human Rights, Immigration Detention (HL Paper 278), published on 7 February, in particular those related to indefinite detention.
The Minister of State, Home Office (Baroness Williams of Trafford) (Con)
My Lords, we are carefully considering the recommendations made in the JCHR report alongside those in the recent Home Affairs Select Committee report, and will respond to both in due course. On indefinite detention specifically, the law simply does not allow this. However, we recognise the importance of these matters in informing how we can have a detention system that is fair, upholds our immigration policies and acts as a deterrent to those who might seek to frustrate those policies.
Baroness Whitaker (Lab)
My Lords, I am almost heartened by the Minister’s response. However, is she aware that, of the over 2,200 people detained without any limit being given and without review, appeal or any consideration of vulnerability—some for over three years—some were released back into the community, after all that? This causes untold damage to family life and they had clearly been wrongly sentenced. The recommended limit of 28 days is surely long enough. Can HMG not undertake to implement at least that?
Baroness Williams of Trafford
In terms of review, we are now trialling immigration bail at two months rather than four, which we did previously. The overall picture is that 92% of people leave immigration detention within four months and 69% within 29 days. We have improved the system by not detaining people for longer than needed and fewer people are now spending time in detention than ever before.
Children: Covert Human Intelligence Sources
Baroness Whitaker Excerpts(6 years, 2 months ago)
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Baroness Williams of Trafford
I cannot answer the latter part of that question, but I will write to the noble Baroness. If a child is aged under 16, an appropriate adult—though not necessarily a guardian, because there may be conflict in that relationship—will be present in every case. Children aged between 16 and 18 are assessed on a case-by-case basis.
Baroness Whitaker (Lab)
My Lords, even with all the safeguards mentioned by the Minister, is this not still exploitation of children?
Baroness Williams of Trafford
The noble Baroness asks a very pertinent question. This is not a comfortable or easy arrangement. She will know, of course, that it was brought in by the Labour Government in 2000. With the safeguards that are in place and the work that needs to be undertaken, all these things are taken into consideration.
Commonwealth Heads of Government Meeting: Human Rights
Baroness Whitaker Excerpts(9 years ago)
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Baroness Whitaker (Lab)
Will the Government take the opportunity to make representations to the Government of Bangladesh about the assassination of humanists and others because they do not profess a religion?
Baroness Verma
The noble Baroness raises some important points. We have to make sure that no space is created where freedom of speech is not allowed. The UK Government raise this issue regularly as a matter of course. Wherever we can, we will make sure that all countries, including Bangladesh, that are closing the space for freedom of speech address these issues so that the Commonwealth meets its commitment to the Commonwealth charter.
Children and Families Bill
Baroness Whitaker Excerpts(11 years ago)
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Baroness Walmsley (LD)
My Lords, I have a few additional comments to make in support of Amendment 113, to which I have added my name. I reassure the noble Baroness, Lady Eaton, that in our amendment we do not seek a one-size-fits-all approach as far as local authorities are concerned. Of course we understand, and hope, that the provision made will vary from area to area, depending on the needs of the local population. We are simply looking for some commonality in the way the offer is expressed. The advantage would be that it would not just be helpful to parents in enabling them to choose between one local authority or another if they were able to move from one to another; there would be two other benefits.
First, it would deter a local authority from publishing a weak offer, because it would be very obvious that it was a weak offer. The “very little indeed”, as expressed by the noble Baroness, Lady Howarth, would jump off the pages if there were some commonality in the way that offer was expressed. Secondly, it would help policymakers because this is a very new system. Undoubtedly the Government will wish to monitor how it is going and assess where it is going well and where it is going badly, and whether the regulations need to be tightened up at some point in the future. It would be very much easier to do that if there were a common way in which the local offer could be expressed; otherwise, I can see civil servants spending months digging into all the different local offers, expressed in different ways, in order to dig out that information.
Baroness Whitaker (Lab)
My Lords, briefly, I would like to record my support for all these amendments, for all the reasons given. It seems to me that the very welcome reforms of the local offer remain quite insubstantial if there are no minimum standards and if there is insufficient transparency and no inspection. I recall the Minister’s letter to those of us who spoke at Second Reading on this point. He said:
“Regulations and the SEN Code of Practice will provide a common framework for local offers”.
I am worried that a common framework is really not specific enough. The draft SEN guidance is silent on the real monitoring of inspections. Without a power in the Act to achieve these, I should like to ask the Minister how the regulations are going to do the job which we have all been asking for. What is going to be in them?
Baroness Morris of Yardley (Lab)
My Lords, I also support the gist of the amendments but I take the point made by the noble Baroness, Lady Eaton. I knew that local authorities would have genuine concerns. However, I really want to support the points made by the noble Baroness, Lady Howarth, because I thought that that was a good way forward.
My instinct is that there needs to be some monitoring or inspection, or some notion of a common format or minimum standards. I say that because, looking back, I find it difficult to think of a new service being introduced that has not had that infrastructure under it, at least to begin with. I am concerned about just plonking it out there in the system with no monitoring, no inspection and no minimum standards. I am not saying that local authorities will deliberately set out not to provide the service, but I think that the noble Baroness, Lady Eaton, would have to admit that in the present circumstances, when local authorities have really tough spending decisions to make, those who have no legal or regulatory protection might end up being at the end of the list when it comes to the decisions that local authorities take on expenditure. Therefore, the amendments would offer that protection.
With this new system, I think that the whole Bill could fall if parents did not quickly have confidence in the offer. That is my concern. This service is central and new. It is a new idea, and it has to retain the confidence of the people who use it. I think that there is an added complication, as has already been mentioned, that these are busy people who are already fighting other bits of the system. It is also not something that affects every citizen. This is a small and particular group of people. It has not got the voice of the nation behind it. It is not like “all our schools”, “all our universities” or “all our elderly care people”, it is a very small group of people who will have to fight the good fight. So my starting point is that I am not entirely confident that there is enough in the system at the moment to guarantee that it will grow into a strong part of special educational needs protection.
Children and Families Bill
Baroness Whitaker Excerpts(11 years ago)
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Baroness Jones of Whitchurch (Lab)
My Lords, our Amendment 73 is in this group, and it has the same intent as that of the noble Lord, Lord Ramsbotham, and the amendment from the noble Baroness, Lady Greengross. We have just gone about it in a slightly different way. The issue is one of what should be classified as special educational provision. As the noble Lord, Lord Ramsbotham, quite rightly pointed out, this is important because, by its nature, this determines what issues parents can take to appeal, and we should make that classification as broad as we possibly can.
We have debated before in Grand Committee how broad a definition we are going to apply to special educational needs, and that we believe that a whole tranche of disabled children are not classified and included in that. This issue touches on that somewhat as well. As we said at the time, it is important to get a standard classification of special educational needs and disability included throughout the Bill. We have not tabled amendments to this clause to take that on board; however, earlier clauses ought to clarify it more clearly.
Clause 21(5) sets out that healthcare provision and social care provision can be classified as special educational needs if they are,
“made wholly or mainly for the purposes of … education or training”.
However, according to many in the sector, backed up by the legal advice that we have received, there is a concern that the new definition of the phrase “wholly or mainly” sets a higher threshold than that which exists. We have heard from, among others, David Wolfe QC, the adviser mentioned by the noble Lord, Lord Ramsbotham. That is why our amendment would remove “wholly or mainly” from the clause.
The initial draft of the Bill did not include a requirement for educational provision to be wholly or mainly for educational purposes. It stated that anything provided by the health authority was health provision and that anything provided by social care was, similarly, social care provision and therefore not enforceable or appealable to the tribunal. The new wording was introduced as a result of opposition to the initial draft but we still do not feel that it deals with this problem. I think the Minister will be aware that there is considerable concern about this issue, particularly around therapies such as those for speech and language, which may be classed simply as health service provision under this clause and therefore, apart from anything else, not appealable.
In addition, we have also received the following legal advice:
“Following case law dating back to 1989 the general position has been that any provision which is directly related to an educational need can be classified as educational or medical and it is for the tribunal to decide. Guidance has been given that speech and language therapy will normally be considered educational because of its importance in communication, whereas other therapies such as occupational therapy vary according to the type of difficulty the child has and how far the therapy relates to an educational objective. Tribunals have consistently held that where a provision has a beneficial educational aspect, and is directly related to the child’s educational needs, it can be described as educational provision and specified in the statement. This aspect needs to be set out in the current bill if parents’ rights are not to be eroded. The current wording set a higher bar and reduces the rights of the child and parent”.
This issue was raised briefly in the Commons by the Conservative MP Robert Buckland. At the time, the Minister there replied that,
“the clause maintains the existing right of appeal to the tribunal for special educational provision so that parents will not lose their current protections”.—[Official Report, Commons, Children and Families Bill Committee, 19/3/13; col. 372.]
However, this is not what the experts are telling us, so it would be extremely helpful if the Minister could clarify this and work with us to find alternative wording which would ensure that we are not raising the bar and eroding parents’ rights. In his letter to us following Second Reading the noble Lord, Lord Nash, wrote that,
“the Government recognises the concerns and is looking for ways to address them”.
I would be really grateful if he could tell us how far he has got in looking at ways to address these concerns, and whether he would now be prepared to find an alternative form of wording to address this issue.
Baroness Whitaker (Lab)
My Lords, I support my noble friend’s amendment very warmly. I think that the wording of the Bill must be changed because, although I understand that the Government consider that they can rely on case law to establish the primacy of the education purpose, their own draft SEN code suggests that more firmness is needed. I quote:
“Health or social care provision made wholly or mainly for the purposes of education or training must be treated as special education provision”.
Noble Lords might say that that is all we are asking, but the fact that they have to put “must” in the code suggests to me that there is an element of doubt. I suggest that certainty is what is required in the law, and the code simply amplifies the law.
Baroness Walmsley (LD)
My Lords, I strongly support the amendments of my noble friend Lady Brinton, and would have added my name if I could have been sure of being here today to speak to them. However, here I am, very strongly supporting them.
Many thousands of children fall into the category of “severely bullied” but are invisible, for two reasons. One is that often the bullying takes place outside school, on the internet. The school does not see it happening. Unless school staff look carefully at the attendance record, or the parent is sufficiently distraught to bring it to the school’s attention, the school may not notice what is going on. The other unfortunate aspect is that often these children are quite shy; they take themselves off, rather than put up with it. They become visible to the rest of us only when they attempt suicide, or actually succeed. Then they land on the front page of the local or national newspaper. That is a tragedy.
When the school becomes aware of this problem, it often suggests to the parent that they educate the child at home. This is not the answer. Many parents are not capable, either professionally or economically, and cannot take the time off work to educate the child at home. They need specialist, professional help. Nor is it an answer to send the children to PRUs, for the reason my noble friend Lady Brinton has mentioned. Indeed, I would say it is cruel to expect these children to attend a PRU with a group of children of whom they are often frightened. They are square pegs in round holes in PRUs, because they are often children of great ability, and the provision offered in PRUs will not address their problem and allow them to achieve their academic potential.
Virtual schools can be an answer, but not the whole answer. These children need therapeutic and restorative help from well trained people. That is why my noble friend has suggested that what is needed is temporary special educational needs provision. As to the cost, yes, the sort of provision these children need is expensive, but it lasts for only a short period. If it is done well, many of these children go back into a mainstream school—perhaps a different one—after a relatively short time, during which their confidence has been built up and their mental health problems have been addressed.
If this does not happen, it is not the school that pays but the state that pays later. These children’s potential has not been realised; they do not have the qualifications that they could have; they do not have the well paid jobs that they could have, so do not pay so much tax; and there may be ongoing mental health problems that have to be addressed later in life by the health service. Although the school saves money by not paying for this provision in the short term, the public purse does pay—and, of course, the person who pays most is the child themselves. We have a duty to give these children back their education and indeed their lives. Provision is available, and it could be expanded if only a more sensible approach were taken to ensuring that the funding became available for these children. It is not a lot to ask and, compared to many children who need special needs provision for the whole of their school life—which of course very often they deserve—these children require it for only a very short period. What they need is very special provision from people who really understand what they have gone through and what needs to be put into place to enable them to face an ordinary education again.
Baroness Whitaker
My Lords, the amendments in this group are particularly important, with respect to one group of children in particular. I declare an interest as chair of the Department for Education’s stakeholder group on the education of Gypsy, Traveller and Roma children. These are the children, particularly Irish Traveller and Gypsy children, who between primary and secondary school experience a 20% drop in attendance; one-fifth of children drop out. From the material that I have seen, a very large part of this is due to bullying, although there are also cases when the parents are so mistrustful of education and unwilling to expose their children to the violence that they experience that they are complicit. Whatever the reason, there is a gap in these children’s education. They are a small number of children so they do not always appear in the aggregates, but if you compare them to the population of Gypsy and Traveller children, the numbers are huger than for any other ethnic group in our country. That is why these amendments are of vital importance.
The noble Baroness, Lady Brinton, mentioned alternative education. I place on record that I cannot speak to the fourth group of amendments in the name of the noble Countess, Lady Mar, the noble Lord, Lord Patel, and others, about suitable alternative education, which in a way is parallel to the group that I ought to be discussing now. That, too, has a particular relevance not only to drop-out children but to children of Traveller parents. I hope that in some way my support for those can be recorded, even though I shall have to be chairing another meeting then.
The Earl of Listowel
My Lords, very briefly, having visited a Red Balloon school, having had the privilege of being invited to visit one and speak to some of the pupils, I should like to reinforce what has been said by other Members of the Committee today, particularly the concerns about whether pupil referral units—I have been to those as well—would be an appropriate environment for many of these young people.
I would also like to bring to the Committee’s attention the latest research from Professor Jackson, the academic who had a very important role in highlighting the deficits in educational outcomes for looked-after children. The latest research has been into children with complex needs across Europe and in this country. She has found that in other countries these children find that their school is a refuge for them; it is a place where they feel safe so that, no matter how disturbed their family is, at least their school is a refuge. She looks particularly at Denmark but also at several other continental countries, and she draws a stark contrast with the experience of children in England, who do not find a refuge in their school. That is very concerning. It is also relevant to this particular group of vulnerable young people whom we are discussing now. Finally, I thank the Minister who was so kind as to meet me when I had concerns about this issue. I am grateful for his close consideration of this matter.
Queen’s Speech
Baroness Whitaker Excerpts(11 years, 6 months ago)
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Baroness Whitaker
My Lords, I am very grateful to the noble Lord, Lord Ramsbotham, for his trailer for my remarks, and for his support.
The gracious Speech promises to,
“ensure the security, good governance and development of the Overseas Territories”.—[Official Report, 8/4/13; col. 3.]
This is sorely needed for the Chagos Islands, the inhabitants of which were exiled from their homeland by the British Government in the late 1960s and early 1970s. I am indebted to our former high commissioner to Mauritius, Mr David Snoxell, for his advice.
It is not as if anyone now thinks this exile was an example of good governance. On 23 April 2009 the then shadow Foreign Minister, Keith Simpson, said:
“There is no doubt that there is a moral imperative”,
and that,
“I suspect … the all-party view”,
is that,
“the rights of the Chagossian people should be recognised, and that there should at the very least be a timetable for the return of those people at least to the outer islands”.—[Official Report, Commons, 23/4/09; col. 176WH.]
In a letter to a member of the public on 23 March 2010 the shortly to be Foreign Secretary William Hague said:
“I can assure you that if elected to serve as the next British government we will work to ensure a fair settlement of this long-standing dispute”.
I will briefly remind noble Lords of how this tragic fate overtook the Chagossians. In 1965 our Government detached the Chagos Archipelago from Mauritius in order to form a separate British Indian Ocean Territory, in defiance of four UN resolutions. They reclassified the inhabitants as contract workers, made the largest, most southerly, island, Diego Garcia, available to the United States for use as a military base, and gradually removed the Chagossians from all the islands, eventually depositing them in Mauritius and the Seychelles during 1971 to 1973. Some came to Britain from 2001.
Now, fewer than 700 of the original islanders remain. The United States base on Diego Garcia is 140 miles away from the outer islands, to which some would like to return. When the Government of the United States were asked by our Foreign Office publicly to affirm, as was reported in a WikiLeaks cable from the United States embassy in London, that they required the whole of the British Indian Ocean Territory for defence purposes, they did not do so. The State Department has indicated informally to a member of the Chagos Islands (British Indian Ocean Territory) All-Party Parliamentary Group, of which I also am a member, that if asked it will review the security implications of a limited return. Our Law Lords described official letters that claimed that there was a defence risk as “fanciful” and “highly imaginative”.
In 2014 the agreement with the United States will come up for renewal. I suggest that this gives an excellent opportunity for exploring whether a small number of Chagossian people could return to the outer islands. It would seem to have no security or defence implications for the base on Diego Garcia. I am assured that many will not want to return, but all want their right to do so restored, and some will want only to visit their homeland and come away.
Would this be a burden to the British taxpayer? The Foreign Office set up a feasibility study in 2001, which claimed that resettlement was not feasible and anyway was very expensive. The infeasibility argument has been discredited by one of its own consultants and by others, most recently in a report by Professor Paul Kench of Auckland University. As for the cost, it would be idle to pretend that justice would not carry some. However, the United Kingdom would not have to bear the whole burden of restoring the tiny infrastructure. The European Union high representative has confirmed to Charles Tannock MEP that funds are available. The UNDP may have capacity and it would surely be right for the United States, Mauritius and the Commonwealth to do their bit.
What of the marine protected area, with its full no-take ban on fishing—except, as it happens, around the waters of Diego Garcia, where recreational fishing can be practised—which was hastily declared by David Miliband, as Foreign Secretary, just before the last election? It is unlike most other MPAs, for instance around the Galapagos Islands, where the people who live there help to maintain it.
There is worldwide support for a marine protected area that takes account of the interests of the Chagossians and Mauritius. However, it should have been properly conceived, with a defined role for inhabitants. As it stands, there is only one vessel to patrol the ban over 640,000 square kilometres, and I have seen photographs of very recent substantial illegal fishing operating within the MPA.
The MPA was proclaimed without taking account of the views of the Chagossians, who applied for judicial review in the high court, or of Mauritius, which has brought a case under the Permanent Court of Arbitration for breach of the Convention on the Law of the Sea. There is much work to be done to make the MPA what it ought to be so that everyone can wholeheartedly support it.
In the time available I have simply tried to pinpoint the chief aspects of a manifest and agreed injustice of a fundamental kind. This hardly matches the human rights standards of the Commonwealth charter, which we signed only last March. However, it is very good news that the Foreign Secretary has shown indications of a positive attitude to righting these wrongs in his statement following the end of the human rights case in Strasbourg, and that he is reviewing the policy on resettlement. I hope that the Minister can say how the Government will now proceed and when Parliament will be consulted about the review of that policy.
Health and Social Care Bill
Baroness Whitaker Excerpts(13 years ago)
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Baroness Armstrong of Hill Top
My Lords, I am sorry that the noble Lord, Lord Northbourne, was not here to move his amendment. However, I think that the general principles that the other amendments in this group address are very much what I want to bring to the attention of the House and the Minister. We now know so much more about the development of children. In the 18th and 19th centuries there was a great amount of dirt and other problems in the streets. This aspect of public health was taken up by municipal authorities, which had to build drains and sewerage. It was seen as critical to the future of this country. It also, of course, had an important effect on people’s health.
We now know much more. In my last job in government, I was the Social Exclusion Minister and had the enormous privilege of introducing to this country the Family Nurse Partnership Programme. In learning about that evidence-based programme, which affects the development of children more advantageously than any other single programme in the world, I discovered a little about what neurologists and others now know about brain development. The truth is, if we do not support parents and children in those early months and years, by the time they are three, they are so far behind it will take the rest of their lives to compensate for what they have not had in those early months.
I listened to the debate on alcohol and wanted to intervene. In family nurse partnerships, mothers learn that if you drink alcohol in pregnancy, it will affect the brain of the foetus and therefore the child. It has been incredibly successful, therefore, in giving young women the determination not to drink, because they want the best for their child when it is born. These are all things that we now have a lot of knowledge about.
Recently, I was at a meeting where a neurologist talked about research into the stress put on children and what elements in the body can be measured to tell whether or not there is stress and what can be done about it. Stress can lead to violence and violent behaviour. We know about these things, but they did not know about them in the 18th century, when they began talking about public health. We did not know about it when I was growing up, but we know about it now. That means we have a responsibility to take it into account and build the early development of children into our understanding of public health. We must make sure that we address it. It should not be until we get to extremes, when suddenly somebody notices that a particular child is developing in a difficult way, such as noble Lords have talked about, when children end up in the criminal justice system. We know what will happen to children if we do not pay attention to this: they will end up in the criminal justice system, and they are more likely to end up with an alcohol or drug dependency. We know these things now and, in my view, we have no option but to take account of them as a matter of public health. Therefore, I believe that we have to write that into the Bill.
Baroness Whitaker
My Lords, I rise to support Amendments 72A, 81A, 91A, 200A, 201ZA, 327B, 327C, 329A, 331C and 333B—all amendments on speech and communication. I think that Amendment 218A should also have been included because it deals with integration—in this case, for the commissioning groups. I hope that when the Minister deals with that later amendment, he will be able to recall this debate.
I support these amendments very warmly for all the reasons that the noble Lord, Lord Ramsbotham, and my noble friend Lady Wilkins have set out so cogently. I should also, in this very brief intervention, like to draw attention to the excellent BBC film “The Kid’s Speech”—not “The King’s Speech”, although that was very good too—which graphically portrayed not only the crippling effects of stammering on children’s development, as well as on their happiness, but also an integrated way to deal with it, employing educational as well as physiological expertise. I commend this short documentary to anyone who wants to understand why it is so important to help these children properly early on.
The assessment and treatment of speech, language and communication problems must come within public health. I asked the Minister about this when I made a few remarks at Second Reading. However, with that vast marathon of questions, I quite understand that he did not have time to reply, although I hope that he will be able to do so at the end of this debate. The information must be accessible to those with low literacy and poor understanding. Finally, there must be integration not only with the health and social care services but also with education and children’s services, or we shall fail that very large number of children with speech, language and communication difficulties.
Lord Clement-Jones
I, too, support the amendments of the noble Lord, Lord Ramsbotham. He clearly has a great deal of support in the Committee for the amendments, on which he spoke so eloquently, as did the noble Baroness, Lady Wilkins.
I come at this as a former chairman, and now the president, of Ambitious about Autism, the autism education charity, and also as a very strong supporter of I CAN, the communications charity for children. I also strongly believe that speech, language and communications needs should be regarded as a public health issue. As both the noble Lord, Lord Ramsbotham, and the noble Baroness, Lady Wilkins, highlighted, speech, language and communication needs are the most common disability experienced by children or adults, and it is now being recognised that communication is indeed the single most significant factor in determining a child’s life chances. Because our economy has become increasingly dependent on communication-based employment, the fitness of a person in this century will be defined ever more in terms of his or her ability to communicate effectively. The economic impact on society of people whose communication disability renders them unemployable is significant and is growing year on year. As a society, we need to recognise this issue and find ways to improve the communication skills of children and adults.
As has been pointed out by the noble Lord, Lord Ramsbotham, a number of primary care trusts and local authorities in England have indeed already recognised the importance of boosting early language and communication development. They have aligned the work of speech and language therapists with the Healthy Child Programme and Sure Start children’s centres to create a powerful public health approach based on primary prevention.
However, in contrast, many commissioners—this was also mentioned by the noble Baroness, Lady Wilkins—as reported by Sir Ian Kennedy last year in Getting it Right for Children and Young People, have a limited understanding of children with speech, language and communication needs. Many of these local areas are still not doing enough to address these needs, and it is clear that the economic and social benefits of early intervention and prevention of speech, language and communication needs must be much better promoted. That is why the approach indicated by these amendments is so important and why I support them.
Earl Howe
My Lords, noble Lords who tabled amendments in this group have drawn attention to the particular needs of children. I am in total sympathy with their wish to highlight the importance of children's health in all its facets. The noble Baroness, Lady Wilkins, mentioned Sir Ian Kennedy's report, Getting it Right for Children and Young People, published last year. Sir Ian emphasised that the NHS does not always get everything right for children. He gave us some hard-hitting messages. I say again what I said in my letter after Second Reading: we are determined to build in children's health explicitly and clearly throughout the new system. The NHS reforms are designed to put firm foundations in place to secure improvements, and the Health and Social Care Bill contains sufficient levers to ensure that the new NHS will work better for children.
I thank the noble Lord, Lord Ramsbotham, for his very compelling contributions today and at Second Reading, when he raised questions on speech and language therapy. I commend his work as chair of the All Party Parliamentary Group on Speech and Language Difficulties. I also thank the noble Baroness, Lady Wilkins, for her extremely constructive remarks. I share the commitment of the noble Baroness and the noble Lord to ensuring the early identification of speech, language and communication needs among pre-school children. What can we do about this? One thing that we can do and are committed to doing is beefing up community health resources targeted at the well-being of children and families. In that context, I reassure noble Lords who spoke to these amendments that we are committed to increasing the health visitor workforce by 4,200 by 2015.
We are equally committed to improved delivery of the healthy child programme, which includes a development review at the age of two to two-and-a-half. That provides a huge opportunity, and we are clear that it has to be seized. Everything that has been said by noble Lords about child development in the early years is absolutely to the point. The noble Baroness, Lady Armstrong, rightly referred to the family nurse partnership programme, which has done a tremendous amount, as she explained to us, to address the needs of what were traditionally considered hard-to-reach families.
In his absence, I would also like to thank the noble Lord, Lord Northbourne, for his earlier remarks. I will take the opportunity to address his specific concerns. The Bill as drafted would already allow the Secretary of State or local authorities to provide services to parents or prospective parents where that was a step whose primary purpose was improving health. We recognise that the health and well-being of women before, during and after pregnancy is a critical factor in giving children a healthy start in life and laying the groundwork for good health and well-being in later life.
How can we do this better? The Health and Social Care Bill will, we believe, provide the basis for better collaboration and partnership working across local government and the NHS at all levels. The drivers of the integration in the NHS will be the CCGs and the NHS Commissioning Board. Both have new duties to promote integrated working by taking specific action where beneficial to patients. In addition, the Bill gives each health and well-being board a duty to encourage integrated working between health and care commissioners to advance the health and well-being of the people in its area. That would include children and young people.
The key NHS and public health contributions to speech, language and communication needs are these: first, early identification of pregnant women who may themselves have had the same kinds of difficulties and who would benefit from enhanced support in preparation for parenthood; secondly, building the capacity of universal services working with young children to provide the support required in the early stages, enabling speech and language therapists to focus their support where it is most needed; thirdly, early identification of children with speech, language and communication needs, where enhanced health visitor capacity and better delivery of early years reviews at the age of two to two-and-a-half will be a focus; fourthly, local planning and commissioning for speech and language therapy services through clinical commissioning groups; and, fifthly, consideration of how high-cost and low-volume provision should be commissioned in the new system.
The Government are also committed to tackling obesity and to the continuation of the national child measurement programme. Now in its seventh year, this is a trusted source of world-class data, providing annual information on levels of overweight and obesity in primary school children in their reception year and in year 6. The government amendments in this group amend the powers of the Secretary of State in paragraph 7B of Schedule 1 to the NHS Act 2006 so that he can make regulations about the processing of the full data set of information relevant to this programme. This would include both information resulting directly from the weighing and measuring activity and other relevant data held by local authorities. The amendments also ensure that he can require persons exercising functions in relation to the programme to have regard to guidance about the processing of that information. Our proposals aim to ensure that this important programme can continue to operate in full effect once it transitions to local authorities, along with other public health functions, from April 2013. I hope that the Committee will support the amendments.
I have discussed the vital importance of a focus on children’s needs throughout the NHS, but in our view it would not be appropriate to anticipate priorities in future mandates by enshrining in legislation the inclusion of objectives relating to particular sections of the population—a point I made earlier to the noble Lord, Lord Northbourne, while he was in his place—nor would it be appropriate to impose requirements on CCGs to exercise their functions with reference to specific patient groups or treatments. What you do not emphasise, you can serve to downplay.
CCGs are already under a duty to exercise their functions with a view to procuring that health services are provided in an integrated way for all patients where they consider this will improve the quality of health services and outcomes and reduce inequalities in outcomes and access. The duty also applies in relation to the integration of health services with the provision of health-related and social care services. Where education and children’s services are health or social care-related, they would therefore already be covered by this duty.
The noble Baroness, Lady Wilkins, and the noble Lord, Lord Ramsbotham, tabled a series of amendments concerning the role of health and well-being boards. I fully support the need to ensure the effective assessment of need and access to professional advice on education and children’s services. However, although extremely well intentioned, the amendments are unnecessary and also run counter to the principle of local areas being best placed to assess local need and to access appropriate local expertise. I hope that noble Lords will not press those amendments.
On Amendment 91A, on our second day in Committee we discussed a group of amendments on the topic of integration. There were numerous extremely valuable contributions from many noble Lords that ensured that we had a very informative debate. However, it may be helpful to the noble Lord, Lord Ramsbotham, and the noble Baroness, Lady Wilkins, if I briefly mention that the requirement the Bill places on the board and the clinical commissioning groups to promote integration when commissioning services is very germane in this context. Clauses 20 and 23 contain new Sections 13M and 14Y which create duties for national and local commissioners to promote integration across health and social care. I am thoroughly supportive of the intention behind this amendment. Better integration of services will undoubtedly lead to high quality and better care for patients, and that is why we have asked the NHS Future Forum to consider in more detail how we can ensure that our reforms lead to better integrated services. I am very much looking forward to receiving its recommendations which will be published before the end of the year. I hope that the noble Lord and the noble Baroness will feel reassured by that.
I think the tenor of the question from the noble Baroness, Lady Thornton, was about whether all children’s public health services should be commissioned at a local level from the outset in 2013 to avoid fragmenting the delivery of programmes and care pathways. We believe that the commitment to secure a 50 per cent increase in the number of health visitors and thereby ensure associated improvements in support for families is best achieved through NHS commissioning, and we have therefore retained our original proposal that the NHS Commissioning Board should lead commissioning in this area in the short term. However, we wish to engage further on the detail of the proposals, particularly in respect of transition arrangements and the best way to begin to involve local authorities in local commissioning of these services in partnership with the NHS.
The noble Baroness also referred to the important issue of safeguarding children. Local authorities will continue to lead on safeguarding children arrangements under the Children Act 2004. The board and CCGs will be members of local safeguarding children boards. I have already spoken about the national child measurement programme, and I hope that I covered the noble Baroness’s questions adequately on that topic.
The noble Baroness asked why the government amendment allowed any other information to be prescribed. The amendment will maintain the Secretary of State’s powers to regulate the processing of child measurement data after local authorities undertake the measurement programme, in the same way that PCTs currently deliver the programme. It would not be appropriate to set out the full national child measurement programme data set in primary legislation, as she will understand. The power also gives flexibility to make changes to the data collection that will be needed going forward, and that will allow the Government to ensure that the national child measurement programme remains fit for purpose. Of course, the introduction of any new data would need to be set out in regulations, subject to public consultation and the negative parliamentary procedure.
I hope that that covers the ground adequately. Once again, I thank noble Lords for their contributions. I can now see that the noble Baroness, Lady Whitaker, wishes to ask me a question.
Baroness Whitaker
It is the same question. In the noble Earl’s very comprehensive answer, did I miss whether speech, language and communication problems were within public health? I do not recall hearing him answer that question.
Baroness Thornton
While the noble Earl is collecting questions that we feel were not answered, I asked specifically about the risk register, whether it is 100 per cent of children and where the weighing and measuring is taking place.
Crown Prosecution Service
Baroness Whitaker Excerpts(13 years, 6 months ago)
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Baroness Whitaker
To ask Her Majesty’s Government whether, given the reported intention of the Home Secretary to transfer decisions about whether to charge a suspect from the Crown Prosecution Service back to the police, the same officers will carry out investigations and take decisions to prosecute.
Baroness Verma
My Lords, the proposals build on existing practice and are designed further to improve charging efficiency. The police already have responsibility for charging decisions in 67 per cent of cases. Custody officers, who play no part in investigations, will continue to make the decisions, in accordance with the provisions in the guidance of the Director of Public Prosecutions, on whether to refer cases to the Crown Prosecution Service.
Baroness Whitaker
My Lords, I thank the Minister for that half-satisfactory reply. However, is she aware that, when I was a magistrate and the decision was made to set up the CPS and give it responsibility for prosecutions, it was universally greeted as a great step forward, not least because it removed the incentive, or perceived incentive, from the prosecutor to tailor the investigation so as to fit it for a charge—I am trying not to use the word “fit”, advisedly? How will HMG guard against that perception?
Baroness Verma
My Lords, the noble Baroness has raised a number of interesting points. However, the point is that, through modernising our charging programme, we are building on the trust that we have with our police forces and also making sure that we build in greater efficiency and reduce bureaucracy.