Health: HIV

Debate between Lord Ramsbotham and Baroness Northover
Monday 17th November 2014

(10 years, 1 month ago)

Lords Chamber
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Baroness Northover Portrait Baroness Northover
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The noble Baroness is right in her analysis of what happened in the first instance. Because HIV was such a major catastrophe, it was targeted separately from the health systems. However, the lesson was quickly learned that these needed to be integrated. Our emphasis now is absolutely that this needs to be integrated with the health systems in the relevant countries, and this has benefits across the board.

Lord Ramsbotham Portrait Lord Ramsbotham (CB)
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The Minister mentioned the giving of money overseas. I ask the Government not to forget the need to provide funding to look after the treatment of those people with HIV in our prisons.

Baroness Northover Portrait Baroness Northover
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Indeed, we are acutely aware of that. The information that I have is that we are very effective in dealing with that.

Children and Families Bill

Debate between Lord Ramsbotham and Baroness Northover
Wednesday 5th February 2014

(10 years, 10 months ago)

Lords Chamber
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Baroness Northover Portrait Baroness Northover
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My Lords, this group of amendments builds upon those that we brought forward on Report and, we hope, address some of the important points raised by noble Lords during that debate. We are grateful to those noble Lords who have continued to raise the important issue of support for young offenders with EHC plans in custody. I particularly thank the noble Lord, Lord Ramsbotham, for his expert and, as ever, very determined contributions throughout and for his continued determination to ensure this small but highly vulnerable group of children and young people get the support that they need.

I am pleased that noble Lords accepted the Government’s amendments on Report. That means that today’s debate is, I hope, starting from a strong position. The Bill already ensures that: young offenders, their parents and professionals working with them can request an assessment for an EHC plan and those assessments can now start in custody; EHC plans will provide up-to-date, current information on entry to custody, owing to the requirement for local authorities to maintain the EHC plans of those under 18 who are not in education, employment or training for any reason; both home local authorities and relevant NHS health service commissioners are under a duty to use their best endeavours to arrange the education and health provision set out in an EHC plan for children and young people in custody; EHC plans must be kept by the home local authority while a young offender is detained and must be reviewed and maintained again immediately on release; and both youth offending teams and relevant custodial institutions are required to co-operate with the local authority.

This is a significant set of improvements over the current system. However, now we want to go even further to address the remaining concerns expressed by noble Lords during our previous debate on this subject—namely, that “best endeavours” seemed, certainly in the mind of the noble Lord, Lord Ramsbotham, not to create a strong enough obligation on local authorities and health commissioners, and that youth custodial institutions should be required to have regard to the code of practice.

Following productive discussions between our officials, the Special Educational Consortium and the Standing Committee for Youth Justice, we are delighted to be able to say that through Amendments 28 and 29 we are strengthening the “best endeavours” duty so that it now says that local authorities and relevant health commissioners must arrange appropriate special educational and appropriate health provision.

Not only that, but Amendments 30 and 31 amend the definition of “appropriate provision” so that it is clear that local authorities and health service commissioners must first seek to arrange the provision that is in an EHC plan. Where that is not practicable, they will arrange provision that corresponds as closely as possible to the EHC plan. Where what is in the EHC plan is no longer appropriate, the local authority or NHS health commissioner must arrange an alternative that is appropriate.

Amendments 22 and 32 also require both relevant youth accommodation and youth offending teams to have regard to the code of practice. This means that we can set out in statutory guidance how we expect them to fulfil their duties to co-operate with the local authority in ensuring that children and young people with EHC plans receive the support they need while in custody.

These changes will be further strengthened in future by commitments in the Ministry of Justice’s response to the Transforming Youth Custody consultation published in January. I know that my noble friend Lady Walmsley—I see that she is not in her place, but I hope she will hear this—will be pleased to hear that, in response to an e-mail from her, this document makes it clear that the arrangements for the new providers of education in young offender institutions, due to be in place by November this year, will require them to co-operate with local authorities in regard to young offenders with EHC plans. They will also retain the existing responsibilities that the current providers have for identifying and supporting young offenders with SEN. The document also makes it clear that identification and support for those with SEN will be part of the new secure colleges that the Government will set up through forthcoming legislation.

Finally, Amendment 34 will remove Clause 76, previously Clause 70. Due to an oversight, the amendment to delete this clause was inadvertently not moved following the debate on Report. I am sure that that was entirely my fault.

Taken together, these amendments will strengthen the changes that noble Lords agreed on Report and will ensure that children and young people with EHC plans in custody will receive the support that they need. I hope that noble Lords will be happy to support them.

Lord Ramsbotham Portrait Lord Ramsbotham (CB)
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My Lords, I am extremely grateful to the Minister for what she has just said, and also for the many discussions and debates that we have had with both Ministers and officials during the Bill’s passage. I am extremely grateful for what has been done. Not only is it a great advance on what was there before but it has the benefit of building on the experience of many years ago regarding what could and should be possible in young offender institutions for people with problems that have otherwise gone unaddressed. I am particularly grateful for the movement that has been made since Report and for the strengthening of the requirement on local authorities to make certain that the change has happened.

I am also extremely grateful for two other things. The first was the Minister’s assurance that those of us who are interested in this subject, including people who are far more expert in it than I am, will be involved in the preparation of a code of practice which will be such an extremely important document in the future. The second was her assurance that the Ministry of Justice will be involved in those discussions as well. As I have explained before, there have been many good initiatives around the country but the Ministry of Justice’s response to them has not been all that was desired and they have been dropped.

Finally, I am grateful for the platform that has been provided for youth offending teams. A disturbing fact is that few commissioning groups in the country appear to realise that they have a responsibility for things such as mental health treatment of people who are undergoing community sentences. The fact that that is on the statute book with a clear “must” will provide just the stimulus that is needed to pull people together and make things better. I really am grateful for all the work that Ministers and officials have done on this part of the Bill.

Children and Families Bill

Debate between Lord Ramsbotham and Baroness Northover
Wednesday 30th October 2013

(11 years, 1 month ago)

Grand Committee
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Baroness Northover Portrait Baroness Northover
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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.

Lord Ramsbotham Portrait Lord Ramsbotham
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Perhaps I should explain to the Minister that there has indeed been a reply from the noble Lord, Lord Nash. I was saying that I am not wholly reassured by what he said. In the letter, he talks about assessments and judgments, but there is no confirmation that child development is on the syllabus of every teacher training course. That is what I want to discover.

Baroness Northover Portrait Baroness Northover
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I will refer that to the department for it to look at further. The department will know, as do I, how determined the noble Lord is, so I am sure that it will look at that very seriously.

I remember the noble Lord, Lord Ramsbotham, dealing with Amendment 117. I assure him that Clause 27 already requires the local authority to keep its education and social care provision under review. I believe that we talked about that in earlier groups, but if I have not addressed the noble Lord’s questions adequately, or he wants more information, I am very happy to add to that. I am sure that we will be coming back to that in due course, by the looks of the groupings.

I hope that I have addressed most of the issues that noble Lords raised and that the noble Baroness will be happy to withdraw her amendment.

Children and Families Bill

Debate between Lord Ramsbotham and Baroness Northover
Monday 28th October 2013

(11 years, 1 month ago)

Grand Committee
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Lord Ramsbotham Portrait Lord Ramsbotham
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I just say to the noble Baroness and the noble Lord, Lord Storey, that I was referring to the assessment required now in the early years foundation stage, which must be carried out by health visitors. I was saying that that is a compulsory healthcare test. I was mentioning that the healthcare visitor to whom we spoke in Northern Ireland mentioned the value that she had had from being trained by the speech and language therapist to identify the particular triggers for speech and language difficulties, which I believe ought to be common practice everywhere.

Baroness Northover Portrait Baroness Northover (LD)
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My Lords, this debate has covered the important issue of SEN in early years settings, and noble Lords have been probing a perceived gap in the legislation in that regard. Clearly, as noble Lords have said, many of the duties in Part 3 apply only to maintained nursery schools, not to other early years providers, which has led to concerns that children in playgroups and independent nurseries or with childminders might not have their special educational needs met. We reassure noble Lords that that is not the case. Duties are in place throughout the Bill and through the Childcare Act 2006 which should ensure that special educational needs are identified and addressed in early years, wherever a child is.

I point the noble Baroness, Lady Jones, who I realise leapt in having not realised that she was about to deal with this amendment, to page 70 of the draft guidance, which is on the role of the SENCO in early years provision, so that she can have a look through that.

Amendments 116 and 108 seek to include early years provision within the local offer. We absolutely agree that this should be the case. Perhaps when I have explained some of these areas the noble Lord, Lord Ramsbotham, will be reassured and will want to see whether that meets most of the concerns of those who were advising him.

Schedule 1 to the draft Special Educational Needs (Local Offer) Regulations 2014 already makes clear that the local offer must include special educational provision from,

“providers of relevant early years education”.

These providers are explicitly referred to in paragraph 1(a) of that schedule. The regulations also require the local offer to include the arrangements that such providers have for “identifying … special educational needs”, in paragraph 4(a), and for,

“securing the services, provision and equipment required by children”,

with SEN, in paragraph 4(c).

Relevant early years education is defined as that childcare which is provided to meet the duties under Section 7 of the Childcare Act 2006. Noble Lords may be reassured that this would include all local authority-funded early education for two, three or four year-olds, whatever the status of the provider. It is not limited to maintained nurseries and 96% of three and four year-olds access such early education through local authority funding, so I hope the noble Lord, Lord Ramsbotham, is reassured that non-maintained early years providers are already included. We share his concern that children are identified as early as possible. This is particularly important in areas of disadvantage, where the current two year-old offer of 15 hours’ free childcare per week is targeted.

Amendment 128 would require the local authority to use its best endeavours to identify children with SEN in early years provision, and then to secure the relevant services for them. In relation to the concerns of my noble friend Lady Perry, I know from the Department of Health that this issue has been picked up there. I assure her that there is cross-government working in this regard. We recognise the importance of health service involvement in identifying very young children who may have SEN as soon as possible. That is why Clause 24, which my noble friend may want to look at, provides for health bodies to tell local authorities about young children under compulsory school age who may have SEN. It is also why we are training an additional 4,200 health visitors by 2015 to help improve early identification. I hope that my noble friend finds that reassuring.

The Government want to reassure noble Lords that local authorities must ensure that all providers that they fund in the maintained, private, voluntary and independent sectors effectively meet the needs of children with SEN and disabilities. Local authorities should remove barriers in access to early education and work with parents to give each child support to fulfil its potential. All early years providers, regardless of how they are funded, must follow the welfare requirements set out in the EYFS framework to have and to implement a policy and procedures for children with SEN and disabilities. This should include how the needs of these children will be met and how reasonable adjustments will be made. Providers are also required to assess children regularly and to keep parents informed. They must consider whether a child has a special educational need or disability which requires specialist support. They should link with families and help them to access relevant services from other agencies as appropriate. These requirements are reflected in the draft SEN code of practice, which also gives practical guidance to early years providers on responding to special educational needs. I hope that the noble Lord, Lord Ramsbotham, will look carefully at that.

Amendment 238, again tabled by the noble Lord, seeks to place requirements on childminder agencies, including a requirement to appoint a SENCO with the prescribed qualifications, and a regulation-making power to set out requirements on how childminders registered with an agency should support children with SEN. I heard the reason he gave for taking that route, and I hope that to some extent what I have already said has reassured him that there is not quite the gap he is seeking to plug here. I also note what my noble friend Lord Storey said about this. The provision to create childminder agencies in Part 4 is an enabling one. We do not think it would be helpful to try to tie these providers into agencies. I am sure we will hear arguments to the contrary when we get to Part 4.

Returning to the key issue of early years childminders, we agree that childminders need also to look out for children in their care. Clearly, they need to be subject to the same duties and expectations whether they are registered with an agency or independently registered with Ofsted. The Government’s intention is that the agency-registered childminders should follow the same guidance on SEN as other types of early years providers, as part of that jigsaw of involvement with young children.

Page 70 of the draft code of practice, which I have just referred to, sets out guidance on the role of the SENCO in early years. It makes clear that the SENCO role may be shared between childminders in the network and suggests a similar approach be applied to agencies. For most early years settings, the SENCO is not required to have a particular qualification. Currently, and in the draft code, only SENCOs in schools and maintained nurseries must hold specific qualifications, including qualified teacher status. We feel that it would not be appropriate to impose additional burdens on childminder agencies over and above those in place for other early years settings. The framework provided by the early years foundation stage and the SEN code of practice makes this unnecessary.

Amendment 75, tabled by the noble Baroness, Lady Jones, seeks to require local authorities to appoint sufficient area SENCOs to support early years providers, drawing attention to an important role. As my noble friend the Minister mentioned in a debate last week, page 70 of the draft SEN code of practice states that,

“local authorities should ensure that there is sufficient expertise and experience amongst local early years providers to support children with SEN”.

It goes on to outline the role of area SENCOs in the early years. By including the role in statutory guidance for the first time, we are recognising its importance and creating a clear expectation about the support that local authorities should provide for children in early education.

Turning to Amendment 79, we fully endorse the importance of early identification of SEN, which this amendment seeks to secure. One of the main aims of the reforms we are debating is to seek to ensure that children and young people have their needs identified earlier—whether through district nurses, as my noble friend Lady Perry indicated, or through others involved with young children—so that the right support is put in place quickly.

The education providers listed in Clause 29(2) have a duty under Clause 62 to use their,

“best endeavours to secure that the special educational provision called for by the pupil’s or student’s special educational needs is made”.

Actively identifying special educational needs is an integral part of this duty. The draft SEN code of practice makes this absolutely clear. Chapter 6 of the code requires schools to assess pupils on entry, make regular assessments of pupils progress and ensure that teachers are equipped to spot potential special educational needs quickly.

I have perhaps been too comprehensive. However, I hope that I have been sufficiently comprehensive to address the questions and needs of all those who are rightly concerned about this area. I hope that my response reassures noble Lords that effective duties are in place because we agree with what noble Lords say they are seeking to achieve. We will continue to work with the Communication Trust and other expert organisations to ensure that the SEN code of practice provides effective guidance on all these issues. I therefore hope that the noble Baroness will be happy to withdraw her amendment.

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Lord Ramsbotham Portrait Lord Ramsbotham
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My Lords, I shall speak to my Amendments, 89 and 92 to 97, and add my support to Amendment 100, mainly because it becomes very relevant when we come to Clause 70, dealing with people in detention.

My other amendments are to do with something I find odd about Clause 26. Although on the face of it local authorities and partner health bodies are required to make, have regard to and keep under review joint commissioning arrangements, there is no obligation on them to operate any of those arrangements, let alone to reach agreement. That seems very peculiar. Even when they operate the arrangements and reach agreement, the resulting provision is limited to what they agree to be reasonably required.

I go back to my amendment to Clause 21(5), because, as I mentioned then, health bodies may well argue that their position is constrained by what they consider necessary. Given how many such bodies apparently give very low priority to speech, language and communication needs and the provision of speech and language therapists, that might mean that little or no speech language therapy would be provided for children or young people other than those who are on EHC plans. This brings us back to the problem of the vast majority of children with these needs who are not on those plans.

Clause 26 does not allow the assumption that children without plans will get what they require; nor does it mention any requirement to publicise what arrangements and agreements are available for parents or the people affected; and it does nothing to ensure that there is consultation on the joint commissioning arrangements. My amendments are designed to strengthen Clause 26 by making its tone “must” rather than “discuss”.

Baroness Northover Portrait Baroness Northover
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My Lords, this group of amendments relates to Clauses 25 and 26, which deal with promoting integration and joint commissioning. These provisions are at the centre of our reforms and I am grateful to noble Lords for their careful consideration of these issues. Children and young people with special educational needs need integrated services. Too often they have to tell their story over and again, and too often they or their parents struggle to navigate a system that makes no sense either to them or to the professionals who are supposed to be helping them. In this mini-debate we have had an echo of the discussions we had on both the Health Bill and the Care Bill, where noble Lords were very keen, as were the Government, to take forward better integration and working together across these areas. Noble Lords who have just come from the Care Bill will be extremely well aware of how the Government have sought to take this forward, addressing how people have so often fallen between the cracks. This, too, is part of the attempt to ensure that those with special educational needs are better supported and that the authorities responsible for them work more closely together.

These clauses seek to tackle those issues head on. The integration duty sits alongside duties for a local authority and its local partners to co-operate with each other. I remember extremely clearly, as other noble Lords no doubt will, how integration, as debated in the Health Bill, had to be part of the new arrangements for the health service. This echoes much of that. It links closely to the joint commissioning clause that provides the statutory framework to enable partners to work together effectively to deliver a better experience for the child or young person and their families, and support improved outcomes. Joint commissioning sets out the framework for key elements, such as the local offer, education, health and care plan assessments, and personal budgets. It seeks to improve both the working relationships between local authorities and health bodies, and the provision to children and young people with special educational needs. It requires the local authority and health bodies to establish clear procedures for making decisions and, in particular, to agree what support is needed locally and which agency will deliver it. Crucially, they must agree how they will resolve disputes between partners, as well as how they will deal collectively with complaints concerning education, health and care provision.

The new draft SEN code of practice’s chapter on joint commissioning has developed a great deal, and I hope it may help to reassure noble Lords to know that it puts great store on the importance of making decisions in joint commissioning arrangements—an issue to which the noble Lord, Lord Ramsbotham, has just referred. It specifies that the arrangements should be robust enough to ensure that all partners are clear about who is responsible for what, who the decision-makers are across education, health and care and how partners will hold each other to account where there is a dispute. It recognises the importance of getting elected members and chief executives across education, health and social care on board, and recommends that the arrangements for children and young people with SEN should be specifically accountable to councillors and senior commissioners. It recognises that local accountability can take the form of a programme board, acting as a bridge between the local authority’s education and social care leadership and health partners.

It also reflects that health bodies must work with the local authority in commissioning integrated, personalised services and designing the local offer, including ensuring that relevant contracts with providers reflect the needs of the local population. Local authorities, clinical commissioning groups and NHS England should develop effective ways of harnessing the views of their local communities so that commissioning decisions on services for those with SEN are shaped by people’s experiences and aspirations. The dovetailing of the SEN reform clauses with the NHS reforms is central. The NHS mandate requires clinical commissioning groups to consider the needs of children and young people with SEN and disabilities, so we see immediately the crossover. The Health and Social Care Act reforms require local authorities and clinical commissioning groups to participate in the health and well-being board and to produce a joint strategic needs assessment and a joint health and well-being strategy that sets out how local needs will be met. So the needs are to be identified, and plans have to be put in place as to how they are met.

The health and well-being board has a duty—and I well remember it—to encourage integrated working. For the purpose of advancing the health and well-being of the people in its area, it must encourage people who arrange for the provision of health or social care services in the area to work in an integrated manner. As I said, the Care Bill has been taking that further forward and making it a reality. I hope that that context helps when looking at how we are trying to tackle the needs of these particularly vulnerable children.

I heard what my noble friend Lady Sharp said about the probing nature of her amendment. As ever, she probes extremely effectively. She is seeking to explore how these new arrangements will work in practice, and obviously she is absolutely right to do that.

My noble friend wondered whether SENCOs would have too much on their plate. Since 2009, the Government have funded more than 10,000 new SENCOs to study for the National Award for SEN Coordination. We will support a further 800 places in 2013-14 and this will help them in their important role in linking with other agencies, such as health and social care. I hope that that helps to take this matter forward.

Many of the amendments in this group reflect an apparent desire to puts lots of detail in the Bill. This is an argument with which everyone here will be very familiar—whether it is necessary to specify certain things in the Bill in order to make sure that certain things happen. I am sure that we are all seeking to go in the same direction, which is to achieve what the Bill sets out to do. From noble Lords’ probing as to whether it is going to be delivered by the Bill as it is, I certainly sense that there is agreement on that.

However, noble Lords will also be familiar with the fact that if you specify in great detail in a Bill, you can inadvertently exclude things that you have not included. That is why there is always discussion about what happens in guidance and secondary legislation and so on, and that is why I am so pleased that we have the SEN guidance. It is comprehensive and, I hope, addresses a number of issues that noble Lords are concerned about. From that guidance, your Lordships can see how the Bill translates into what we intend in practice.

As noble Lords will appreciate, we feel that there is a danger that if too much is specified in the Bill, that will then hinder the kind of flexibility that may also be required at a local level. Noble Lords who heard the pathfinder organisations, which came to address us the other day, probably share my feeling that the often very imaginative and creative ways in which they were going about their work and the way they were working with other organisations in their local areas to address the needs of the children were very impressive. One would not wish to do anything that stifled that. One would wish to support them in taking that forward. The aims of what one is seeking to achieve and the details being spelt out in the guidance—

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Baroness Northover Portrait Baroness Northover
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I hear what the noble Baroness says, and she speaks from a great deal of experience. That is the kind of challenge that has led to us trying to move forward across the board on SEN to ensure that what is provided for children is more uniform and more joined up. If need be, I will write with more detail in response to her but, as I said, what the pathfinders were saying was encouraging. They said that they would link up with those who came after to try to spread best practice. As noble Lords have said, it is often what happens in practice on the ground that may be wanting.

That links up with an issue raised by the noble Baroness, Lady Jones, about how families might hold their local authority and CCGs to account for having arrangements for joint commissioning in place. Ultimately, families could take out a judicial review, but we believe that there are other, more effective ways to hold local bodies to account through local complaints procedures and through NHS England, which will review how CCGs are fulfilling their duties under the NHS mandate. I remind noble Lords that the NHS mandate refers specifically to children and young people with SEN. Therefore, there are those novel routes. That is a new lever.

As the services that result from joint commissioning arrangements will be reflected in the local offer through direct involvement in developing and reviewing it, we hope that that will bring about the opportunity to improve things in the way that both noble Baronesses seek.

Returning to my script, as opposed to my thoughts, Clause 26 requires local authorities and CCGs to keep the arrangements under review, so that service provision will evolve over time and continue to meet the needs of the community that it serves. I have spoken about the pluses and minuses of putting duties in the Bill.

I also note that service providers must take responsibility themselves for how they best use their resources to provide services for children and young people with SEN. I was struck by what the pathfinders said about how often that meant finding a cost-effective way to do that. It was not necessarily the case that working together was more costly. That was interesting to hear.

The final paragraph in Amendment 86 highlights the importance of key workers, which is something that we support and have specifically included in the code of practice. Chapter 3 makes clear that the kind of support that local authorities should offer children, their parents and young people should include key work and support, such as individual casework and informal advocacy, support in attending meetings or contributing to assessment and reviews, and participating in decisions about outcomes.

There was reference to how the NHS provides services and how that might mesh. The fundamental principle of the NHS is that provision should meet reasonably required needs. We have to be careful. There is a wide understanding, certainly among noble Lords, as to why that is the case and why, for example, the previous Government set up NICE to assess treatments and to work out what was effective. An NHS that was free at point of need, universal and comprehensive had to make sure that what it was providing to the population made sense and that clinicians would agree as to what was an effective treatment and so on. All of that is built into the way the NHS has always operated. We therefore have to be careful that we do not inadvertently seek to change that fundamental principle of provision to meet the reasonably required need.

The CCG has a statutory duty to provide services to meet the reasonable needs of those for whom it is responsible. We have a good understanding of that. We may challenge it around the edges, but we do have an understanding of it. It must act consistently with the NHS mandate—

Lord Ramsbotham Portrait Lord Ramsbotham
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My Lords, I am sorry to intervene but the point of raising my concern is that, in many areas, speech and language therapy has not traditionally been accorded the impetus that has been required by the NHS. I welcome the talk about health and well-being boards. Indeed, as I mentioned earlier in the debate, because they are the bodies that are in touch with all people from nought to 25, I hope that they will have a role and that it will evolve. Accepting the way in which the NHS operates, I hope that in future it will take account of speech and language therapy needs because of its increasing importance for our children today.

Baroness Northover Portrait Baroness Northover
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The noble Lord made a very cogent case before and my noble friend was sympathetic to what he said. It will always be the case that, at any one time, there will be debate as to what is essential, what ought to be provided and what will best help children or any member of the population, and, therefore, debate about what the NHS or any other provision ought to cover. As I said, the noble Lord made a cogent case and my noble friend responded sympathetically, so it is a matter of let us watch this space. As I have mentioned, the NHS mandate includes a specific objective that children and young people with SEN have access to the services set out in their care plans. I hope that is reassuring.

I have referred to pathfinders and the wording in the clause reflects the fact that the parties involved are expected to follow the arrangements made unless there is good reason to depart from them. Allowing that flexibility will enable partnerships to adapt to accommodate unique circumstances or changing priorities locally which the arrangements may not have anticipated.

Noble Lords may be anxious that this flexibility could mean that partners have to have only some of the arrangements in place before achieving any agreement. I hope I can reassure noble Lords that this is not the case and is certainly not the legal effect of these provisions. Clause 26(4) makes it clear that these partnerships have the clear function of securing the care that children with SEN need. Therefore they must be able to agree a clear course of action in every case. This point is backed up by the new draft SEN code of practice.

There may be other elements that I need to address. I turn to the point that the noble Baroness, Lady Jones, made about transparency. We certainly agree with her point about needing transparency for parents but we do not think that we should replicate other legislation in the Bill. I am sure she will be disappointed about that. The place to bring this together, we feel, is in the code of practice, and that is what we have sought to do. Again, that is something that comes up in legislation all the time: should we make reference to previous Acts or should we include it in the new Bill? We feel that the draft code of practice helps to bring everything together very clearly, and I hope that she will accept that.

Children and Families Bill

Debate between Lord Ramsbotham and Baroness Northover
Wednesday 23rd October 2013

(11 years, 1 month ago)

Grand Committee
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Lord Ramsbotham Portrait Lord Ramsbotham
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My Lords, looking at the clock, I am a little alarmed. Will we rise at 7.45 pm or will we go on until this group is finished? I am already on borrowed time.

Baroness Northover Portrait Baroness Northover
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We plan to rise as close as we can to 7.45 pm, having completed the group. I trust that acts as a focus for what we may be able to cover. We have to bear in mind the various rules and Hansard.

Lord Ramsbotham Portrait Lord Ramsbotham
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I am very grateful to the Minister, but I am extremely concerned about that because this group introduces very serious issues to do with speech, language and communication needs. I cannot promise to be short over this because there is a number of things to say, and I know that a number of noble Lords wish to speak. I am concerned that we should rise and continue when we resume because, as I say, I have serious timing problems.

Legal Aid, Sentencing and Punishment of Offenders Bill

Debate between Lord Ramsbotham and Baroness Northover
Tuesday 20th March 2012

(12 years, 8 months ago)

Lords Chamber
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Lord Ramsbotham Portrait Lord Ramsbotham
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My Lords, I speak in support of government Amendment 152ZA and also speak on behalf of my noble friend Lord Rix who unfortunately is unable to be present because of his wife’s ill health. I thank the Minister for the extremely productive meeting that we had, which has been mentioned. The points that my noble friend has asked me to raise arise out of the amendment which came after that discussion in support of what was said.

The context of this is the duty of the court to explain sentences in ordinary language, which we raised in Committee. The Minister admitted that the phrase would ensure only that most people could understand an explanation. While we welcome the amendment and believe that it has the ability to extend comprehension of the effect of a sentence on all parties concerned, which is an important development, we are still not certain that it covers the point about ordinary language. On that, we would like some clarification. We believe that the Criminal Procedure Rule Committee could offer a similar safeguard, but we are not sure about where that safeguard extends and how wide it is. Will the Minister clarify how confident she is that the committee will make rules regarding the need to go beyond ordinary language in certain circumstances? Will it actually make these rules? To what extent are the rules made by that committee binding on the court? The concern is that if the rules are merely guidance, they might not be put into practice, despite the best intentions of the Government and the committee.

Will the Minister tell us about the time scales? When will the committee be empowered to make such rules and when might they be enforced? Are we looking at something imminent? Will it depend on when the Bill is passed? Finally, what opportunities will there be for Members of both Houses to scrutinise the implementation of these measures in the future? If they are rules of the committee rather than something in the Bill, it is more difficult for us to monitor them. They have an enormous effect on the people whom we mentioned in Committee and their ability to understand the process of law.

Baroness Northover Portrait Baroness Northover
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My Lords, this has been another useful debate. I welcome the support of the noble Lord, Lord Ramsbotham, for the Government’s changes to the duty to explain. I encourage him to feed in his concerns to the committee. I have no doubt whatever that noble Lords will scrutinise how the duty is being implemented. The fact that this may not be part of legislation will not stop people reporting, debating and asking whether this is working as it should. The Government clearly cannot dictate to the committee what it should make its rules on and what it should say, but I have no doubt that when and if noble Lords find that this is not being implemented as they feel it should be, that will have its effect.

On distress warrants, I am very grateful to the noble Baroness, Lady Lister, for her guarded welcome of the Government’s amendment. She questioned whether the amendment goes far enough and was kind enough to send an e-mail with a number of questions. She has referred to our response, which gives me an opportunity to expand on or clarify a number of those points. She was concerned, among other things, about whether it allowed for the withdrawal of a distress warrant where there had been a change in the offender’s circumstances or where the offender was deemed to be vulnerable. I will do my best to reassure her on a few points.

It is clear that the government amendment allows for the withdrawal of a warrant where there is a mistake in the decision to issue the warrant in the first place. The amendment covers the case where an offender is not in court when the warrant is issued, which results in the court not having the full information before it. This, in effect, amounts to a mistake. I hope that that also helps to reassure my noble friend Lord Thomas. If there has been a change of circumstances that, had it been known to the court, would have had an impact on the decision to issue a warrant, it is open to the debtor to argue that the warrant had been issued by mistake.

The noble Baroness also raised the question of bailiffs dealing with debtors who find themselves in hardship or appear to be vulnerable. It is important that we strike the right balance between protecting the vulnerable—she is right about that—and ensuring that fines, where appropriate, are paid. Noble Lords will have seen recent criticisms of fine payment rates. The fine is by far the most used sentence of the criminal courts.

In practice, however, when bailiffs come across hardship as defined in the guidance they should not execute the warrant and return it to the court. In response to the noble Baroness, Lady Lister, I must say that we would welcome any further information on this matter and on the effectiveness, which she has queried, of the guidance. It is very important that that is monitored. The Government do not think that it would be appropriate for a bailiff simply to withdraw a warrant in regard to a fine issued by a court. This could undermine the decision made by the court, which is why such a power is not included in the amendment, although I realise that that will disappoint the noble Baroness. If, however, the fine was imposed because the full facts were not made clear to the court, or they had changed, the provision in the Bill could apply.

In the case of changed circumstances since the fine was imposed, the debtor can contact the court at any time to speak to a fines officer to have the matter reviewed. The Government would encourage any debtor to contact the fines officer or court about a change of circumstance, which is clearly a better approach than waiting until a bailiff seeks to execute a warrant, but it is important that we separate the two parts in that respect.

As I said in Committee, the Government think it is important that bailiffs are dealt with via effective guidance, national standards and contractual obligations. As the noble Baroness knows, the Government are consulting on the operation of bailiffs, and we will carefully consider responses to that consultation. I hope that the noble Baroness and the organisations with which she is associated will feed into that consultation.

I hope that the noble Baroness can be reassured that the government amendment addresses the key legal issue with distress warrants and places the decision on them properly with the courts. How bailiffs operate is a matter for consultation in order to make sure that they operate properly and as we would wish. I hope therefore that the noble Baroness is reassured and content with what the Government have brought forward.

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Baroness Northover Portrait Baroness Northover
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My Lords, I, too, thank the noble Lord, Lord Ramsbotham, for continuing to examine the practical difficulties that some ex-prisoners face. We appreciate the difficulties that they may face when trying to resettle in the community and we have taken a number of steps to address these problems.

When the noble Lord, Lord Ramsbotham, withdrew his amendment in Committee, he expressed the hope that the Ministry of Justice and the Department for Work and Pensions would communicate more effectively on this issue. My noble friend Lord McNally wrote to my noble friend Lord Freud and I can give the noble Lord an absolute reassurance that our departments are working very closely to address the gap between release and receipt of benefits.

Prisoners’ needs are already often assessed on reception as part of the sentence plan. New prisoners are specifically asked about benefits by staff at induction and are referred to one of the 140 Jobcentre Plus employment and benefit advisers currently working in prisons. In addition, all prison leavers have their rehabilitation needs reviewed as part of the discharge process only weeks before release. It is this period close to release that is key to meeting resettlement needs, and that is where the Government have invested resources.

The Government are doing a great deal to overcome resettlement barriers and are currently implementing a strong package of measures. The key strategy to take this forward is the data-linking project which is being undertaken by the Ministry of Justice and the DWP. The project shows that more than half of offenders sentenced to custody are claiming benefits immediately prior to their incarceration, and two years after release from prison almost half are claiming out-of-work benefits. This is the scale of the task we face as we seek to make improvements to the process.

However, improvements are there. From 1 March, offenders leaving custody have their jobseeker’s allowance claims processed before they leave. We expect to reach some 30,000 prisoners a year. Jobcentre Plus advisers are rightly in the lead on providing advice and administering benefit claims, but they are working closely with prison staff to facilitate this process, including advice on financial support available prior to release. We believe that this is the right point at which to make assessments for eligibility.

We are also aiming to address the finance gap through our plans for universal credit payments. Under our proposals, an applicant, on leaving prison with a valid claim, can be paid his claim immediately through payment on account in the same way as any other benefit claimant. All of this is intended to help prison leavers get their benefits quickly and help increase their chances of finding work, which is also a key part of the Government’s agenda on reducing reoffending.

The noble Lord’s Amendment 156A would have prisons potentially duplicating the work of Jobcentre Plus. In addition, the process proposed by the amendment would require the Prison Service to conduct sometimes wasted work. A mandatory assessment of all offenders on entering into custody would either be premature—as the work done on entering prison is highly likely to need updating as the sentence continues—or not needed at all, if the personal circumstances of that person do not justify it.

The Government are fully committed to ensuring that ex-prisoners have the support they need to make a successful and productive return to society. The noble Lord, Lord Ramsbotham, is quite right in his aim in this respect. Our proposals on ex-prisoners’ access to welfare benefits are part of that commitment. I hope that what I have said today reassures the noble Lord and that he will withdraw his amendment.

Lord Ramsbotham Portrait Lord Ramsbotham
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My Lords, I am grateful to the Minister for that reply. Just to correct her, I had no intention of duplicating any work; I was hoping that the Jobcentre Plus representative in prison would do the work while in prison so that it did not have to be done in the jobcentre outside prison. So it was early work by the jobcentre—nothing more by the Prison Service. I am very glad to hear that this has happened, and it is useful that, at last, the Department for Work and Pensions and the Ministry of Justice have come together, because this is a piece of joint working that could have been done years ago and would have saved a great deal of misery among released prisoners. Rather like the previous amendment, this is something on which the Government can expect to be questioned at fairly regular intervals in the future. Again, in that spirit, I beg leave to withdraw my amendment.

Legal Aid, Sentencing and Punishment of Offenders Bill

Debate between Lord Ramsbotham and Baroness Northover
Thursday 9th February 2012

(12 years, 10 months ago)

Lords Chamber
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Baroness Northover Portrait Baroness Northover
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I am very happy to write to the noble Lord on that point.

Lord Ramsbotham Portrait Lord Ramsbotham
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I am grateful to the Minister for her reply and grateful too for the intervention from the noble Baroness, Lady Whitaker, and the noble Lord, Lord Beecham. I said at the beginning that I am glad to see the reforms that are implicit already in Clauses 91 to 94 but, as I am sure the noble Baroness realises, there is disquiet over the use of electronic monitoring for extended periods, particularly for young people. I suspect that this will return on Report, if not with my amendment then in connection with Clause 75, which was discussed on Tuesday. I am grateful that obviously work has been done to produce the answers to these probing amendments. In that spirit and with gratitude to the Minister I beg leave to withdraw the amendment.

Legal Aid, Sentencing and Punishment of Offenders Bill

Debate between Lord Ramsbotham and Baroness Northover
Tuesday 7th February 2012

(12 years, 10 months ago)

Lords Chamber
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Baroness Northover Portrait Baroness Northover
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In answer to my noble friend, I expect that it will be necessary that this is in legislation, whereas the implementing would not require further legislation. This is therefore a time to tidy up something which was left untidy.

Lord Ramsbotham Portrait Lord Ramsbotham
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My Lords, I am grateful to the Minister for that response and intrigued with the points made by the noble Lord, Lord Bach. I am grateful to him for those and for the intervention of the noble Lord, Lord Carlile. As I rather suspected, this simple amendment has disclosed that there is a need to examine the clarity of the legislation regarding breach, while absolutely accepting the problems faced by magistrates. I very deliberately did not include “wilfully and persistently” regarding a breach, because that was not what I was after. Wilful and persistent was covered deliberately by the noble Baroness, Lady Linklater, in her contribution.

There is merit in doing this, though; as I said, we are talking about the sentences but we must also consider what is going to happen to the person who has committed the breach and what the impact will be on the prison service. In our overcrowded prisons, there are currently vast numbers of people serving sentences for a breach since the 2003 Act. It was a small number before but it has become large, and there is nothing meaningful that can be done with them. That really is a waste of time and money, accepting that the magistrates have to do something. This should be thought through, which I hope is what the Minister will take away from this short debate. I beg leave to withdraw the amendment.