(10 years, 4 months ago)
Grand CommitteeMy Lords, I start by thanking my noble friend Lord Addington for securing this important debate and for his, as ever, knowledgeable and passionate speech. I also thank the noble Baronesses, Lady Uddin and Lady Jones, for their contributions. I especially thank the noble Baroness, Lady Jones, for her kind words about the potentially transformative effect of the Children and Families Act, on which we both worked.
Our reforms for children and young people with SEN and disabilities are aimed to create a new system to support young people through school, further education and training and focus much more strongly on independent living and helping them to find paid employment. My noble friend Lord Addington is absolutely right to focus on that. The reforms are aimed to create a more streamlined and transparent system at school, which provides support tailored to individual needs and does not require endless reassessment—which noble Lords mentioned.
I am personally grateful to my noble friend Lord Addington, whose help with my own then teenage dyslexic son opened his eyes to what was possible through assistive technology. I have to say that I was a form of assistive technology, finding myself reading my son’s economics textbook to him. I would read a chunk; he explained it to me; and I trust that we both benefited—I certainly did. I did object that economists were taking for granted the way that people acted. I certainly identify with the noble Baroness, Lady Uddin, about the battles that one used to have—I hope, now, less so—to gain support for children with particular needs.
I interrupt my noble friend merely to say that I had forgotten to declare my interests. I hope that my noble friend will forgive me if I do that now.
(11 years ago)
Grand CommitteeI thank my noble friend for that offer. However, before we do that, will she consider how the whole chain needs to be put together, including the examining bodies, providers, teachers and so on? This comes from experience of a breakdown in this area.
I am very happy for us to look right across the board. We need to focus on the individual child or young person and their experience throughout the system.
Coming to Amendment 109, we can assure the noble Baroness, Lady Hughes, and the noble Lord, Lord Touhig, that the term, “finding employment” in the Bill goes wider than providing support for young people in looking for jobs—important though that obviously is. As the noble Baroness, Lady Hughes, noted, the draft code of practice refers to the local offer including information about support available for job coaches, for example, who can support young people when they are working, and the financial support available, including accessing any benefits from the Department of Work and Pensions, both when looking for work and when employed.
Noble Lords pressed harder about support to stay in employment, which is extremely important. I assure them that we are well aware of that. Preparing for adulthood is an important element in the SEN reforms. Clause 30(2) requires local authorities to include in the local offer,
“provision to assist in preparing children and young people for adulthood and independent living”.
That term is defined in subsection (3) as,
“finding employment … obtaining accommodation … participation in society”.
Support for preparing for adulthood would include the kind of support that young people can expect when they are in employment. I hope that noble Lords find that reassuring as a very important point is being made there.
The noble Lord, Lord Ramsbotham, said that he was pressing the case again, rightly, on speech and language communication, and the provision for children and young people. No doubt we will continue to discuss this as it is a very important area. We recognise the importance of this, and the Government are supporting the work of the Communication Trust—I expect he knows that—including through a grant of £550,000 over two years to pilot an online speech, language and communication qualification for early years practitioners. That shows our commitment. We are also providing £1.5 million to the trust to identify gaps in provision and services, which will no doubt spark more amendments from the noble Lord, to promote and extend the What Works database of evidence-based interventions and to implement the reforms in Part 3. I hope that that is an indication of the seriousness with which we treat this.
Regulation 10 of Schedule 1 to the draft local offer regulations sets out the requirement to include:
“Speech and language and other therapies, including any criteria that must be satisfied before this provision can be provided”.
The noble Lord makes a very important point about how practitioners, from health visitors to those supporting children in school, need to work together. That is one of the reasons for the local offer: to try to bring all this together so that support for these children is delivered in a much more effective way.
The noble Lord, Lord Ramsbotham, asked about child development and is expecting a letter from my noble friend Lord Nash. I think that that is in train, if it has not already come out. If it has not come out, I am sure that it will speed along.
(11 years, 8 months ago)
Grand CommitteeIt 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.
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.
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.
It is extremely important that the kind of provision that best suits an individual is the route that we go down. We must look at what the individual most needs, what they wish to have and what their carers and family feel is most appropriate for them. A lot can be done in different environments. It is very interesting to see how new technology may assist people who wish to stay at home, by ensuring that they can do that safely. There are all sorts of possibilities for people and it is important that provision is led by the individuals concerned.
My Lords, does my noble friend agree that one of the most important things that can be done is to make sure that when people ask for support and help, they get the right information? Government at all levels has a patchy record at best on this. What resources are being put in to make sure that when you ask a question, you get the right answer; and that the person who is asked the question is confident enough to go away and find someone who knows the answer if they themselves do not?
I could not agree more, from personal experience. It is extremely important that the right information is available. Certainly, the previous Government made progress in this regard, and we intend to take this further. It is extremely important that this is looked at from the point of view not of the provider but of the individual. Looking at it from their point of view will help to change the way in which these services are provided.