Children and Families Bill

Lord Addington Excerpts

Monday 28th October 2013 Grand Committee

[Baroness Howarth of Breckland (CB)]

My Lords, I declare an interest as the president of Livability, which is an organisation that cares for people with complex needs. I am very concerned about this issue because we have two colleges for young people aged 16-plus where their social and educational needs are met together. Sometimes it is quite difficult to differentiate between the two, as we found during Ofsted inspections. If young people have extremely serious difficulties that need perpetual health provision and you are trying to help those young people to learn skills—the sort of skills whereby they can sit and pick up a cup instead of screaming all day, which is how they are when they arrive—it can sometimes be difficult to differentiate between education, social care and health provision. I am simply asking that nothing in the Bill should make that even more difficult. Usually we have difficulty getting payment for the social element of these colleges, but recently we have found ourselves being given the social element without the educational element of the colleges. Some really difficult issues are emerging and I should like to stop them before they develop. I should be delighted if the noble Lord, Lord Nash, would one day visit Nash College.

[Lord Addington (LD)]

My Lords, can my noble friend give us some idea about how the Government will remove those things that are not for educational purposes in the case of a young person with complex needs or a problem that prevents them accessing the process of education? That seems to be what the noble Lord, Lord Ramsbotham, started with. Getting some clarification now about how that process will take place will be of help. If we have a system in place that gives some degree of confidence, I think that we can probably move on from this. If not, it will be a real problem.

[The Parliamentary Under-Secretary of State for Schools (Lord Nash) (Con)]

My Lords, I shall be brief, as we are keen to clarify this point. I shall speak to Amendments 71, 72 and 73 about the circumstances in which provision that would otherwise be health or social care provision should be treated as special educational provision. In doing so, I would like to comment on a couple of the points that the noble Lord, Lord Ramsbotham, made. If I understood him correctly, he said that we needed a child development strategy for every child. I would say that we have such a strategy in the massive reform programme that this Government have put in place for schools.

I will try to get my facts right because I know that the noble Baroness, Lady Jones, will write to me if I do not. We have just been told by the OECD that we came bottom—joint 21st with Italy and Spain, out of 24 countries—for our school leavers, and we have just been told by Alan Milburn that we are the most socially immobile country in Europe. That is why we have a schools strategy and a massive reform programme in place. However, this Bill is about SEN. I will write to the noble Lord, Lord Ramsbotham, about the four pathways that he mentioned. On training, which he also mentioned, I just signed a letter to him today on this point about initial teacher training and other professional development for teachers, which is founded on the teacher standards that were introduced in September 2012. Child development is an important part of those standards.

I turn to the amendments. During the pre-legislative scrutiny of the SEN provisions of the Bill, the Minister for Children and Families gave an undertaking to maintain the existing protections for parents in the new system. Clause 21(5) was added to the Bill before introduction in the other place as part of that undertaking. It seeks to replicate as far as possible the case law established under the present SEN legislation, which, in our view, makes clear that health provision such as therapies can be educational, non-educational or both, depending on the individual child and the nature of the provision. Case law has established in particular that since communication is so fundamental in education and in addressing speech and language impairment, it should normally be treated as educational provision unless there are exceptional reasons for doing otherwise. We have reflected this in section 7.9 on page 109 of the draft SEN code of practice.

I think we all share the aim of carrying the current established position through into the new system. I understand the concerns that have been expressed in this debate that the current drafting does not get this quite right. This is complicated legal territory and it has not been straightforward to find the right formulation, as evidenced by the different approaches taken by each of these three amendments. I know that various parts of the sector have sought legal advice on this issue; I understand that the amendment of the noble Lord, Lord Ramsbotham, follows the advice that the Royal College of Speech and Language Therapists received, and we are currently looking at that advice. The noble Baroness, Lady Jones, said that she also had received advice, and we would be delighted to look at that as well. I would welcome the opportunity to discuss this further and see what progress can be made with noble Lords outside the Committee. With that reassurance, therefore, I hope that the noble Lord will feel able to withdraw his amendment.

Children: Developmental Care and Autism

Lord Addington Excerpts

Tuesday 19th March 2013 Grand Committee

[Lord Addington]

My Lords, the noble Lord, Lord Maginnis, returns to a subject different facets of which I have heard him talk about before. Primarily, it is based on the self-evident fact that if you identify a problem early you stand a better chance of reaching a better outcome. So much for the rocket science involved in this, but it is quite obvious when you are doing that.

How do we do this? There is an assessment at about the age of two. The briefing I received referred to classical autism: those with certain patterns and conditions such as low IQ and behaviour that occurs. You are able to spot that by about the age of two. That probably fits more neatly into what the noble Lord was saying than anything else we will get across. Then, as the noble Lord again pointed out—he can feel free to shoot my foxes as there will always be another one coming along—that will not apply to everyone throughout the process, so assessing until the age of eight is another good idea. If somebody does not fit neatly into that classical band, it is not very obvious that they have a problem. For instance, if that person does not get much pre-school training, education et cetera, their problems may only manifest to a noticeable degree later on. Also, the level of training of the person observing them has to be fairly exact. As you go through the educational process, many people in the higher-functioning part of the autism or Asperger’s spectrum have problems that a teacher will observe not in the classroom but in the playground because that person will not socialise normally.

There has recently been a little splurge of information about autism in the papers. Some of it was accurate and some of it was not. Even a little test in the Times asked how far on the spectrum you were. If you got to 15 on this test, it said “Don’t worry, you are still quite normal”. I, in a dark moment on a train, took the test thinking, “I wonder how strange I will come out”. I only got 12, thought that was a bit low, went back and discovered that I should have marked myself at 10: it is one problem I do not have. But if we are going to do this, we need a way of assessing at various points where that intervention comes in. One of the classic ways for adults to be discovered on the Asperger’s spectrum is when they develop mental health problems: people who cannot cope with a normal environment.

Effectively, there are huge savings here for government. I thought all Governments were interested in savings, or should be. Let us face it, this Government will be more interested than most. That is not a position I particularly relish but it is the fact of the matter. If you get in reasonably early, you stand a better chance of being able to maintain the person throughout their education and working life. Indeed, there is a better chance of them being able to handle the bumps and bangs of relationships later on. Will my noble friend give us a rough guide as to what the level of intervention will be beyond that initial assessment at age two? If we just concentrate on autism, because other conditions will come in, exactly how much training will be required at the various stages of the education process? How much assessment is going on?

The National Autistic Society suggests that at least the SENCO in every school should have specific training in how to spot autism. Autism may not be the highest-occurring hidden condition, but it will certainly be there regularly throughout a teacher’s career. There should be better basic training so they are able to spot a condition and refer on—we do not want to create experts. They must also understand when they are given advice. Parliament is one of those places where occasionally, from a standing start, we are told, “Go and make yourself an expert”. Every person who has stood on their hind legs in this Palace has had that experience with something they had not come across. We all know that it takes time to get your head around a new problem or way of thinking. Unless that is instilled throughout the education and health services, with a basic level of understanding where one knows where to refer back to and where to refer on, you will not be able to do this. It would help if my noble friend could give us an idea of where we are on this and where we are going. This should not be a party political point or football. It should be a point of basic principle because unless you have just enough knowledge to be able to access and call in the help, you will miss this and do it late, causing secondary damage to that person’s life and costs to society.

--- Later in debate ---

[Baroness Northover]

It is planned that every two year-old will have that kind of assessment. It is extremely important not only in terms of autism, but for picking up other problems.

The noble Lord, Lord Maginnis, asked about the availability of health visitors. To support the delivery of the Healthy Child programme, we are committed to expanding the number of health visitors—he is quite right about their importance—by a further 4,200 full-time equivalents by 2015 and to develop health visiting services in order to improve health outcomes and reduce inequalities.

We recognise the pressing need for a new system of commissioning special educational needs provision, so I hope that noble Lords will be pleased to hear that the Children and Families Bill will introduce this. The provisions of the Bill will build on the new approach to commissioning introduced by the Health and Social Care Act 2012. They will introduce an integrated approach to meeting the needs of children and young people with special educational needs, requiring CCGs and local authorities to make joint commissioning arrangements and focusing on a single, co-ordinated assessment involving a range of professionals. Moreover, these arrangements can include people up to the age of 25. It is extremely important that they should go beyond the transition points that others have found to be problematic. The assessment process will result in an individual education, health and care plan. I hope that noble Lords are pleased to hear about this because it will bring together the health and education sides. The process will be focused on improving outcomes for the child. The commissioners, working together, must agree their relevant contributions to delivering the plan, and they will have to work out who is going to be responsible for the different elements.

These plans will not be developed in isolation, of course. The boards and the CCGs will co-operate with relevant local authorities and participate in their health and well-being boards. Each board will provide a forum for the effective assessment of local need, and special educational needs will be part of that so as to ensure the translation of those commissioning plans and arrangements into something that is effective. Health and well-being boards will undertake a joint strategic needs assessment and a joint health and well-being strategy for the local authority area. The CCG will draw on this in developing its annual commissioning plans. Moreover, health and well-being boards will help to ensure the accountability of CCGs by giving their opinion on the extent to which the commissioning plans take account of the local strategy and how the CCG has contributed to its delivery. Noble Lords need to bear in mind that special educational needs are in there, and they have to assess what is being provided against that.

The new arrangements will be introduced in 2014, depending on the passage of the Bill, but a number of pathfinder local authorities are working with local children and their families in piloting new approaches. As the noble Lord, Lord Hunt, will be aware, the mandate for the NHS for the next two years has indicated the particular need for improvement, working in partnership across different services in supporting children and young people with special educational needs and disabilities. In particular, it gives the NHS Commissioning Board the objective of ensuring that children have access to the services identified in the agreed care plan. I hope that that will reassure the noble Lords, Lord Maginnis and Lord Hunt.

We are also amending the Children and Families Bill to place a duty on CCGs to secure the necessary health services in an education, health and care plan. This is a significant step, and highlights how much importance we attach to ensuring that the NHS delivers the right service for children with special educational needs.

We want to ensure that CCGs and local authorities, as commissioners, and the health and care professionals who provide assessments and diagnoses are supported, particularly in relation to their education and training. The noble Lord, Lord Maginnis, is absolutely right to stress the need to link up health and education.

For the past two years, the Department for Education has been funding the Autism Education Trust to develop tiered training materials for schools, as well as national standards for provision for children with autism and a competency framework for those who work with children with autism. These are relevant points for the noble Lord, Lord Maginnis, and my noble friend Lord Addington.

The new qualified teacher standards came into effect in September 2012. These have sharpened the focus on meeting the needs of children with SEN and disabilities. The Government have also strengthened initial teacher training and continuing professional development provision through the publication of additional online training materials for teachers of pupils with the most common and complex special educational needs, including autism.

We have also highlighted the importance of having good quality data that measure the outcomes which are most important to children and young people and their families. The work of the Children and Young People’s Health Outcomes Forum has informed actions across the health and care sectors to identify the best indicators of outcomes for this group, particularly in relation to the time taken from first presentation to diagnosis. The noble Lord, Lord Maginnis, highlighted this as being a problem, particularly in the past, which we certainly do not want to have repeated; we want to address that. One element of this is ensuring the effectiveness of transition at different life stages, particularly from children’s to adults’ services.

The recent University of York report into transitions for young people with autism highlighted that we need to do much more to support young people in planning for leaving school, gaining employment and living independently, while maintaining good health. The NHS Outcomes Framework for 2013-14 includes the forum’s proposal that all data should be presented in five-year bands up to the age of 25 to enable the effective monitoring of that transition. That is quite a significant change. Here, too, I want to reassure my noble friend Lord Addington in relation to those children whose need for support does not become apparent until they are well established in school. The Government’s approach is to strengthen awareness in schools through staff training; for example, extended placements in special schools for trainee teachers. We want to ensure that needs are detected as early as possible, but I emphasise that at any point the school can request an assessment by the local authority. The education, health and care plan approach provides a basis for taking an all-round view of the children’s needs across different sectors. Of course, schools are providing additional support for many children through teaching assistants.

[Lord Addington]

My Lords, teaching assistants have rather a patchy record when it comes to implementing the current statementing system. For instance, there is a nasty tendency for them to become a babysitter for a child who is having trouble within the class. I suggest the Government should look at this because it is something that has been going on for years. Unless you get that person trained to at least implement the strategy across all disabilities, it will not deliver the required outcome but may simply keep the child out of the way of the teacher.

[Baroness Northover]

The teaching assistant may be assisting with other children while the main teacher focuses on those with particular needs. My noble friend is absolutely right that it is extremely important that the right and appropriate support is given according to what a child needs, which is why those plans I mentioned are so important.

Partnership working will be the key to making a difference. We want to work closely with partner organisations, such as the Council for Disabled Children and the National Autistic Society. However, the most significant partners, if you can call them such, will be the patients and their families. The joint arrangements for assessment will be built around the individual; it is a bespoke plan tailored to the needs of the individual and agreed with them and their family.

I am afraid I am running out of time and I will write on any points that I have not picked up. I want to emphasise, however, that clinical commissioning is built upon patient involvement particularly for this group, whose needs have not always been well met in the past. This will perhaps be the most important factor in ensuring they get the care and support that makes the difference to them.

Care Services: Abuse of Learning Disabled

Lord Addington Excerpts

Thursday 13th December 2012 Lords Chamber

[Lord Addington]

My Lords, this is one of those debates where I think that the general element of agreement is going to be overwhelming: we should never have got anywhere near this situation; there were structural problems which were not addressed; and, as has clearly been pointed out, there was also criminal activity. The real question that we face is: how can we minimise the chances of anything like this happening again?

Having said that there is a considerable degree of consensus, looking at exactly what happened at Winterbourne View, we probably had a perfect storm for abuse, as I think it was described in some of the briefing that I received. There was bad management and a disinterested owner, who made no investment, which meant that care workers, who were badly recruited and badly trained, were left to deal with people with what has been called challenging behaviour. To play devil’s advocate for a second, if you meet challenging behaviour—for instance, people who self-harm, are unable to communicate and occasionally lash out through frustration—and you have been trained only in basic restraint, that is what you will use. There is an almost iron inevitability about what will happen unless there is somebody alongside you telling you that there is another way. In this case, such a person was not there. Therefore, it was almost inevitable from the word go that something like this would happen. We should remember that it took less than five years for this culture to be put in place. It was not a slip; it was a fall into very bad practice, and there is no way that we can ever allow it to happen again.

I want to take up a point which my noble friend raised earlier, on the training of staff. The care and support workers at Winterbourne View should have been given better training and—something that is incredibly easy to say but apparently incredibly difficult to do—they should have been told when to call for support. As anyone who has dealt with front-line support in public service will know, getting that message across at any level is difficult.

I have had a discussion with numerous Ministers from numerous parties over many years about many issues relating to people with disabilities. I have pointed out that the people in charge need to be told that the tick-box method does not work. They will need support, and that support will differ as circumstances change. Often, the Minister or senior official has said, “Yes, we’ll do it”, but it does not happen. I have had meetings with Ministers of all Governments and have asked when they are going to implement this. The response has been, “But we said we’ll do it in legislation or in guidance”. However, it does not happen on the ground. That is clearly the situation that we have here. Therefore, we created something that was bound to go wrong—perhaps not as wrong as it did but it was bound to go wrong.

We have to bring about worker registration and make sure that these people have a responsible job where they can develop a career so that they have some stake in it, as well as a stake in making sure that their co-workers are correctly registered. We could talk about whistleblowing here. If we make sure that people have a job where they have a future and a clear duty, the chances of this happening again will go down. We can never totally remove it. Indeed, the idea for better inspections, et cetera, by those higher up are, of course, needed. We can start to take away a part of this cocktail of disaster; we can start to remove it. We can have a group of people who have a stake and who will go back in again.

I do not envy my noble friend her job, but I hope that when she replies she can give us a clear idea of exactly what process we are talking about and where it will be implemented. We must have people who are trained well enough to recognise that they need support and who are willing to ask questions. We must start to work with the situation for those with autism. The noble Baroness, Lady Browning, has been an important part of my secondary education on autism. Once we start working in that field, we need a different approach. There is always a danger that those of us dealing with a disability will think that it is like the disability we have. Probably our problems with bureaucracy are more similar than our actual on-the-ground experience. Unless our front-line workers are better trained and told that it is okay to ask for help and support, such problems will occur again. I hope that my noble friend will say that steps are being taken. We are trying to ensure not that it does not happen again but that the next time it happens we are better able to deal with it because these problems will not go away.

Olympic and Paralympic Games 2012

Lord Addington Excerpts

Thursday 8th November 2012 Lords Chamber

[Lord Addington]

My Lords, I thank my noble friend Lady Doocey for giving us this opportunity to discuss the legacy of the Olympics. We will not cover all aspects of the subject today as it is too multifaceted for us to do it justice in a single debate. We shall have to look at it again and again.

The Olympics were the biggest project Britain has had to bring together and co-ordinate in peacetime, certainly in my lifetime and probably for all time. They were very successful but the idea of taking forward the legacy is new not only for the Olympic movement but for the way we look at big projects. The big sporting projects and championships that are coming up are all trying to learn lessons from the Olympics. Next year the rugby league world championship will take place here. The Commonwealth Games are coming up in Glasgow and also an event for my own sport of rugby union. When I asked representatives of those sports what they considered was the biggest lesson to be learnt from the Olympics, they replied “You should plan ahead. Once your planning is in place, other things are possible”. We should remember the amount of work that was undertaken for the Olympics.

A whole Act of Parliament was devoted to the Olympics. I remember sitting through debates on it in the Moses Room attended by the then Minister, the noble Lord, Lord Davies. Many of the subsequent points of discussion were first opened up there. Work had already been done but we looked at it again. That was the first time Parliament got involved in that. Disability access was one of the largest areas under discussion. The noble Lord, Lord Davies, is not present but I remember saying to him, “Listen, it is not about disability; it is about the Olympics. We have the disability stuff in place”. Those discussions probably helped to make the Paralympic Games such a success. We undertook the relevant work at an early stage.

Have we undertaken the same preparation as regards all aspects of the Olympic legacy? That question will be answered over the next few years. I would disagree a little with my noble friend. I probably would have spent £9 billion on the six weeks of sport but I understand that that view may not be universally held. If we are to ensure that the Olympic legacy is taken forward, we will have to embrace everything that comes from that legacy. Will all the major projects involved, inside and outside the world of sport, take this legacy forward? Do they relate to everything else that goes on?

We must remember that a legacy of involvement and participation in sport needs to apply at all levels. We have the resources to plan and prepare for the needs of the elite, to allow things to happen and to create the space for the experts to get at their subject. However, when you go slightly further down the food chain, things get more difficult. This morning I spent an hour or so with people from the All-Party Parliamentary Group on Boxing who are trying to carry out a survey on the benefits of boxing. That sport has suffered from a bad reputation. However, engaging in boxing seems to discourage people from becoming involved in anti-social behaviour. There is very good anecdotal evidence on that. One of the first questions that was asked concerned how we attract funding and support for boxing. We came to the conclusion that neither the people who run boxing clubs nor the people who attend them like filling out forms. How do you attract investment in boxing? How do you encourage private philanthropists to invest in boxing and persuade them that they will get something out of it? How do you persuade government to invest in it and interact with a schools boxing programme? This is not revolutionary thinking. There is agreement on this matter. We disagree only about how it should be done. We need to involve people in boxing at the junior level and make mass participation easier. I am talking about those who do not participate in elite youth programmes.

The discussion continued on the easiest way to reach people, whether information technology was the answer and whether the Government should enable audits to be undertaken. We also discussed what people expected to get back and what it was realistic to expect in terms of a legacy. For example, you will not always get £5 back for every £1 you put in and you will not stop all anti-social behaviour straight away. Will you make it slightly better? Will you make something that grows? Will you enhance community involvement and the concept that people can do something positive? If that legacy applies to sport it will apply to just about everything else that requires participation—drama groups, arts groups and dance groups. Everybody can learn lessons here if we can only sit down and talk.

The entire Olympic experience was one where lots of different facets were brought together. Planning met sport, which met the Cultural Olympiad. We all had to talk together and be involved together. Unless we can start to take the lessons here and apply them across the board, and learn where we need to do more learning, we are going to miss some of the benefits. The Olympic experience has been a great success. Let us make sure that it continues to be so.

Equality Act 2010 (Consequential Amendments, Saving and Supplementary Provisions) Order 2010

Lord Addington Excerpts

Monday 26th July 2010 Grand Committee

[Baroness Gale]

My Lords, I thank the Minister for her remarks and welcome her to her position as Minister with responsibility for equalities and women’s issues in your Lordships’ House, although obviously this is not the first time that the noble Baroness has spoken on these matters, as only last week she replied to our excellent debate on women. I am aware of her excellent record and long experience of working for the enhancement of women, and especially her record of service to women in her own party, so it is good to see her in what I regard as a very important post.

I am pleased to say that we on these Benches agree with the order. It is largely a technical instrument to ensure that existing legislation continues to work well when the Equality Act commences. As the noble Baroness said, it makes minor amendments and repeals other primary legislation relating to the Act, which brings together nine separate pieces of legislation into one single Act. That simplifies the law and reduces the burden on business by making it easier for firms to comply with discrimination legislation. It will also help many individuals to deal with difficulties that they may experience relating to any form of discrimination.

The core provisions of the Act are due to come into force in October, so it is important that we deal with these matters now. I am pleased to say that I followed the Equality Bill as it made its way through your Lordships’ House and saw it become law. We now have a strong and robust piece of legislation that will allow people to lead their daily lives in a way that shows tolerance and fairness to all. The whole of our society should welcome that. Also, I am proud that the previous Labour Government were able to produce such an Act, but of course with the co-operation of all the parties in the House.

Although this is a comprehensive Act, much guidance will need to be given by the Government Equalities Office and the Equality and Human Rights Commission. I am sure that the Minister will be able to confirm that these guidance notes will be available so that everyone can ensure that the Act is fully understood and that the publications will be there to assist all to appreciate the workings and the intentions of the Act.

A press release issued by the GEO in recent days stated:

“The first wave of implementation of the Equality Act will go ahead to the planned October timetable following the publication of the first commencement order in Parliament …. This will pave the way for the implementation of landmark provisions to protect disabled people from discrimination and tackle the gender … gap”.

That sums up the Act perfectly and is what the order is about. We on these Benches welcome the order as it is another step along the road to the full implementation of the Equality Act in the coming months. I thank the Minister again and I wish her well in her new role.

[Lord Addington]

My Lords, this is one of those times when there is not much to say, and I shall be quick about saying what little there is to say.

Basically, there is nothing to disagree with here. As the noble Baroness, Lady Gale, said, it carries on the previous Government’s good work in many fields. It brings everything together in one Act, or tries to. The law here, good and well intentioned though it was, was a bit like a cat’s cradle and thus occasionally became a dog’s dinner, if I am allowed to double my metaphors; there was so much legislation that crossed over. Everyone who is involved in any part of this area of the law should welcome this approach. Not only is there nothing to disagree with here, but hopefully we shall carry on in this way.

[Baroness Verma]

I thank the Committee for this short but quality debate. I am grateful to the noble Baroness, Lady Gale for her kind welcoming remarks. I also pay tribute to the wonderful work that she has done in this area. I assure her that there will be several pieces of guidance. Five summary guides were published on 5 July, and a further set of quick-start guides will be released over the summer.

I welcome my noble friend’s comments. We all want to ensure that we can make society as equal as possible. Wherever we find discrimination against any group that we are able to eradicate, we will do so. This piece of legislation is a tool to help us achieve that.

On that note, I hope that we shall have no problems in passing the order. The Equality Act 2010, which went through this House just a few months ago, has momentum, and I hope that with your Lordships’ approval, we will see the benefits of it soon.