Children with Special Educational Needs and Disabilities
Lord Patel Excerpts(2 weeks ago)
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Lord Patel (CB)
My Lords, it is a pleasure to follow the noble Baroness, Lady Fraser of Craigmaddie, and I thank her for leading this debate in such a brilliant way.
My brief comments relate to the educational needs of children born prematurely and the challenges faced by parents and children in getting the system to help them. My comments are based solely on evidence received from many parents by the House of Lords Preterm Birth Committee, which I chaired.
Approximately 45,000 pre-term births occur annually in England. For most children who survive the neonatal period, the outcome is good, but for a significant number, particularly those born between 24 and 31 weeks’ gestation, while the incidence of physical disability is low, the most common outcome is a whole spectrum of cognitive impairment that extends into adulthood. Apart from poor hearing and sight, some children also suffer from epilepsy—and we have already heard of the problems that education has with children with epilepsy. Children born prematurely show problems with memory, attention and problem-solving, and social and emotional problems, withdrawn behaviour and communication difficulties. While some will need long-term healthcare, for most it is their educational needs that need greater attention and therefore consume more resources than healthcare does.
Entering school is a stressful time for children born prematurely and their parents—a flashpoint when the cognitive, social and emotional difficulties experienced by children emerge or become exacerbated. Many parents are worried that their child is not mature enough to enter school according to the cut-off point in age to start school. Children born prematurely are more likely to have special educational needs and learning difficulties than children born at term.
Parents reported a lack of understanding and awareness of the needs of children born prematurely and, therefore, a lack of support in educational settings. While the government guidance recognises the option of deferment to school entry, we heard many parents face bureaucratic hurdles and that there is a lack of understanding on the part of local authorities and schools of the educational needs of children born prematurely. Parents asked for help to make it easier to ask for deferring school entry and for schools to be aware of the birth history of the children, for example, by including the information on the school entry form. Parents who gave evidence were pleading for a way forward that recognises the educational needs of children born pre-term and the need of support from schools to take on board the views and experiences of parents, including options to defer entry.
Our committee was unable to find a way forward, except to support the efforts of voluntary programmes, such as the Prem Aware Award scheme, to raise awareness of prematurity in schools. I hope that the Minister will give some thought to how the children and the parents of children born prematurely can be helped.
Higher Education Sector
Lord Patel Excerpts(2 weeks, 5 days ago)
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Baroness Smith of Malvern (Lab)
Yes, this Minister does recognise that, which is precisely why this Government, unlike the last Government, have taken action to put universities’ finances on a more sustainable basis. It is fundamentally important that we can protect our world-leading universities sector, ensure that the staff doing such an important job there are supported and attract students, both domestic and international, to the benefit of them and of our country.
Lord Patel (CB)
My Lords, following on from the comments made by the noble Lord, Lord Blunkett, which I support, we have something like 113,000 PhD students in the country, of which 43,000 are international students. They are highly talented. They would like to stay here when they complete their studies and, for this to happen, the Government need to introduce more stability in migration policy for both students and post-docs. If they stay here, because they are talented and have completed their PhDs, they will grow our economy and innovate, so I hope the Minister will have some comments to make about how this could happen.
Baroness Smith of Malvern (Lab)
The noble Lord is right that it is important that the graduate route visa has been protected. It allows international students, in the case of PhD graduates, to stay for an additional three years to contribute and look for work. I think that that is appropriate, given the contribution that they make, as the noble Lord says.
Universities
Lord Patel Excerpts(1 month, 1 week ago)
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Lord Patel (CB)
My Lords, I declare an interest as a professor emeritus of the University of Dundee and its previous chancellor. I have also been associated with the University of St Andrews.
I applaud the Government for recognising that a more sustainable approach to the funding of higher education and research is needed. I am pleased to see that the Government have protected the R&D budget and full funding of our association to Horizon Europe. As highlighted by the Universities UK report, brilliantly introduced by the noble Baroness, Lady Warwick, I hope that, going forward, the Government will recognise that more will be needed to ease financial pressures on universities to support emerging blue-skies research and develop infrastructure to do so.
I will briefly mention two areas that deserve further attention—one was briefly mentioned by the noble Lord, Lord Krebs. The bedrock of the UK ambition to remain a leader in science and technology is doctoral education in UK universities. But there are worrying signs. Although talented overseas doctoral students flock to UK universities, which are second only to the USA, domestic demand, particularly from talented students, is falling. This and the reduction in funded PhD studentships are likely the next university crisis.
Of the 113,000 PhD research students, 46,300 are from overseas. A recent report suggesting that there would be fewer funded places in the future is worrying. Engineering and Physical Sciences Research Council training centres will fall from 75 to 40, leading to some 1,750 fewer funded places. The Arts and Humanities Research Council is reducing its numbers of funded PhD students from 475 to 300. The Wellcome Trust, once a major funder of doctoral students, particularly in the life sciences, is to severely reduce its support following its new strategy. Universities currently provide some PhD studentships and considerable other support for doctoral education, but this will be an early casualty if universities face further financial pressures.
Doctoral researchers are a big cost centre, with low cost recovery. Universities have subsidised doctoral research from fees from overseas students, as we have heard, and from other sources, such as the QR funding. In the past, universities have done this training on the cheap, thanks to 30 years of university growth. By the way, talented overseas PhD students are keen to come to the UK and stay, innovate and help grow our economy, as was mentioned. But, for this to happen, the Government need to introduce more stability in student and post-doc migration policy, as was alluded to. We need them to be able to stay and grow our economy, like in other countries. Otherwise, it does not make sense for the UK to grow brains only for other countries to benefit.
My second point is also relevant to universities’ ability to support research. An important part of this is the QR funding, mentioned in some detail by the noble Lord, Lord Krebs, so I will not go over it again. Although there has been a welcome increase in charities funding research, charity research support funding—CRSF—has not seen a commensurate increase or an increase with inflation. The cost recovery of funding related to charity-funded research is now less than 57%. If this continues, it would undermine the important partnership for research between government, charities and universities.
On successful research institutes, I disagree with the noble Lord, Lord Krebs, who said that, for institutes, the return is two to one, as opposed to three to one for universities. I might have said that it is four to one for institutes, such as the Institute of Cancer Research. This not only carries out fundamental research, particularly in cancers, but has been responsible for producing 60 drug molecules, two of which have been on the market for treating breast cancer and prostate cancer. It also trains half the number of UK oncologists. But it benefits from this research support only due to the funding it gets through the CRSF-related funding, which is not enough for it to support its doctoral students. Over the years, it has therefore supported this activity to the tune of £30 million, which it has to raise from other sources.
There is a need to look at the level of QR and CRSF funding with some urgency. With the spending review in mind, there is a need to look at a more sustained model of university research funding. I hope the Government will be sympathetic.
King’s Speech
Lord Patel Excerpts(5 months ago)
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Lord Patel (CB)
My Lords, I join other noble Lords in welcoming the noble Baroness, Lady Smith of Malvern, and congratulate her on her maiden speech. I tease her a little when I say that it was a really apolitical maiden speech. I also extend my congratulations to the noble Baroness, Lady Merron, on her appointment as Minister of State in the Department of Health and Social Care. I wish her well. I have no doubt that in days to come we will have many opportunities to interact and debate health issues.
In the brief time allocated to me today, I will confine my remarks mostly to issues related to health. I find myself much in support of the proposed areas of legislation that relate to health. The Tobacco and Vapes Bill, with powers to implement it, will deliver huge health gains. More than 80,000 people a year die of diseases related to smoking, from 18 different types of cancers to cardiovascular disease, chronic lung disease, pregnancy-related disease, stillbirths and pre-term births. The measures will go a long way to reducing health inequalities. Figures show that there are more than 6 million smokers in the UK today, and more than 100,000 children take up smoking each year. The Government’s aim over the years to make the UK a smoke-free country is ambitious but, in my view, worthy.
The proposals to ban the advertising and promotion of vapes are good as far as they go. We will have to wait for details in the legislation. I hope the Government will be bold enough in time to ban vapes altogether. Scientific evidence already shows their high levels of nicotine, and children are taking up vaping; 5% of children now use vapes and 20% have tried vapes. Vapes should be banned as much as tobacco smoking.
At long last, we will now have a Bill to amend mental health. No doubt the noble Baroness, Lady Hollins, will have much to say about that. For my part I welcome it. I hope that the legislation will have robust measures to protect and help particularly children and people with learning disabilities. Importantly, I hope that the legislation will include measures to monitor the impact of the proposed legislation, possibly through the appointment of a commissioner, without us having to amend the Bill. I also hope that the legislation will address funding issues in mental health.
The Government’s wish to deliver healthcare closer to home is one that I hope they will pursue with determination, but it cannot be done without the reform of primary and community care, including a greater share of funding going to primary care and community care. This, with legislation related to the devolution of powers more locally, has to be the way forward for providing more care closer to home. We can learn much from countries such as Denmark, where locally managed primary and community health centres deliver much of the healthcare, with 99% patient satisfaction. There will be much opposition from vested interests to develop such a model. I hope the Government will be bold.
I welcome the Government’s commitment in the proposed digital and smart data Bill to allow use of data for medical research. As I have mentioned previously, the lack of legislation to allow the use of health data for scientific research has hindered us in improving the delivery of healthcare, driving innovations, conducting clinical trials, developing new treatments and much more. I hope that the Bill will remedy this.
While all that I have mentioned is positive, we do not yet have plans for the provision of social care or, apart from a promise of more GPs and midwives, a health workforce plan—particularly for the nursing workforce—for a service that by 2035 is likely to employ nearly 10% of the working-age population. Nor is there yet a sustainable funding formula for a service that may well end up costing more than £250 billion by 2035. The NHS for far too long has been a political football subjected to ideologically driven reforms not in the best interests of patients. What we need is long-term political consensus, and I hope the Government might work towards that. Securing political consensus is important given the amount of public money spent on health and adult social care, and so is accountability. Periodic reviews, commissions, parliamentary inquiries et cetera are not the answer. What we need is an independent body, such as an independent office of health and care sustainability, that will hold the Government to account for their funding, plans and long-term use of money.