Children and Families Bill

Adrian Sanders Excerpts

Tuesday 11th June 2013 Commons Chamber

[John Healey]

I backed my hon. Friend’s Bill and I remember it. Essentially, it aimed to set standards of support that all schools should have in place and, as I recall, to require Ofsted to monitor and inspect whether they were being met.

Finally on the question of whether an amendment is necessary, the framework of legislation and guidance already in place—the “Managing medicines in school” guidance, the Equality Act 2010 or even the Children Act 1989—is often said to be sufficient, but these problems are so widespread for so many children that clearly the system as it stands is not working and something else is necessary.

That brings me to my second point: is the proposed change proportionate? It is simply indefensible to argue that parents should have recourse to invoke the 2010 Act or the 1989 Act to get support for their kids at school. That is disproportionate. New clause 8 does not propose a new policy obligation or new standards for national Government, nor would it require local authorities to act. It would not even require health bodies to act, other than to support schools. What new clause 8 proposes is that a school should have

“a duty to produce and implement a medical conditions policy that defines how it plans to support the needs of children with specified health conditions”—

no more, no less. In other words, schools should have well-judged, proportionate policies, pitched at where the challenge is greatest and the potential gain most important—that is, in the culture, understanding, practice and sympathy found in schools. We are talking about a policy developed in schools, for schools and by schools, with the support of health bodies and local authorities behind them.

I have addressed whether the proposed change is necessary and proportionate, but is it beneficial? It would be beneficial if children could go to school confident in the knowledge that those around them understood their conditions. It would be likely to make managing their conditions easier, allow them to play a much fuller part in the life of the school and fulfil more of their potential, reduce the requirement on parents to give up or reduce their work—and, arguably therefore, to step up their dependence on the state to support their kids in school—and reduce the demands on the NHS, so the proposal is beneficial as well.

Is this change necessary? Yes. Is it proportionate? Yes. Is it beneficial? Yes, and if the Minister continues to resist it, he will have to demonstrate that it is unnecessary, disproportionate and either detrimental or not beneficial. I want our children who have special health conditions to be able to enjoy school to the full, to fulfil their potential and to feel confident that those around them know what to do because they understand their conditions.

Finally, I want to leave the House with the words that I always remember Emma Smith saying to me: “I would feel a lot happier if people at school knew what to do if for any reason I was unable to treat myself.” That seems to be the very least that this House and this legislation should provide.

[Mr Adrian Sanders (Torbay) (LD)]

It is a pleasure to follow the right hon. Member for Wentworth and Dearne (John Healey), who summed up what many parents at various lobbies of this place have said over a number of years, not least last week, when children with type 1 diabetes came to Parliament to lobby their Members.

New clause 8 stands in my name and that of other hon. Members and was originally tabled by the hon. Member for Washington and Sunderland West (Mrs Hodgson). It seeks to improve the consideration that schools give to students with long-term conditions, including diabetes, epilepsy, asthma and many less prevalent but equally serious illnesses. We have heard that around 29,000 children in the UK have type 1 diabetes. Through my work as chair of the all-party group on diabetes, I have become painfully aware that, despite great improvements in recent years in care for young people with diabetes, something of a blind spot remains in schools, with staff often unaware of the implications of the disease, let alone able to help children with their condition. This leads to all sorts of problems that are, at root, preventable.

At the centre is the impact on child health. A school environment that does not include basic precautions or simple awareness training can lead to complications arising from diabetes. For example, a child experiencing hyperglycemia is at risk of diabetic ketoacidosis, a potentially fatal complication. More than 3,000 children experience this every year, at significant cost to the health care system and obviously considerable anxiety to parents and families, most tragically in the 2% of cases that result in death. Anything we can do to reduce this prevalence must be imperative.

There are more general problems, however. All too often, schools do not have adequate plans in place to deal with the day-to-day needs of those with long-term conditions. That leads to children being made to feel separate and neglected, leaving them more open to bullying, and can also have a detrimental impact on their education. Diabetes and other long-term conditions should have no impact on a child’s ability to learn—they do not have special educational needs—but if those conditions are not managed appropriately in the classroom, they will impede a child’s education.

Ideally, schools should acknowledge that they are looking after a wide range of pupils with varying needs, and staff should have in place a robust plan that has been agreed with parents and health care professionals to prevent the time-consuming and expensive problems that will be inevitable without this investment in planning. I fully anticipate the Minister saying that it is up to schools to decide how to achieve this, and I agree, but we also have a responsibility at national level to ensure that schools do that, and that parents have the scope to force the reappraisal of a situation if it is found wanting. The plans need to be put in place on an individual basis, however. It is striking that the subject that the public most frequently raise with me, as chairman of the all-party parliamentary group on a condition that affects more than 3 million adults, is the poor level of support offered in schools to the 30,000 children who are also affected by it.

[Mr Jim Cunningham]

I congratulate the hon. Gentleman on tabling the new clause. He will be aware that there are specialist colleges, such as Hereward college in Coventry, that would benefit from his proposals. Further down the road, some of these children will have the confidence to go into further education, and they will particularly benefit from those specialist colleges. In that context, the Government should look again at the cuts to the budgets for those colleges.

[Mr Sanders]

I thank the hon. Gentleman for that helpful intervention. I also congratulate him on the ten-minute rule Bill on this subject that he introduced a little while ago.

Last week, I attended a diabetes event, and I heard an account from a parent from the north of England that succinctly summed up the experience of all too many parents, wherever they live. Her son was just starting primary school and, in the previous July, the diabetic specialist nurse had visited the school to put a necessary care plan in place. It was clear on the first day of school that the plan was inadequate. According to the parent, it was not worth the paper it was written on, and was certainly not suitable for a four-year-old. Importantly, it stated that the child should test his own blood levels—something he had never done before and something that no one would expect a four-year-old to have to do. The plan also had no guidelines for emergencies.

Despite the parents providing a new plan for the school, the child’s first six months of school were filled with phone calls home and teachers holding his hand throughout the day, even taking him out of the classroom frequently as though he were a ticking time bomb. This caused a massive amount of stress and inconvenience to the parents. Schools need to recognise that, beyond the health condition, these are normal children who need to be treated normally but with sensible and reasonable adjustments and awareness to maintain the normality as much as possible.

[Mark Tami]

Does the hon. Gentleman agree that the so-called special treatment that such children get, involving missing lessons and sometimes taking days off school, can sometimes lead other children to believe that they are different, and that that perception of special treatment can lead to bullying?

[Mr Sanders]

Indeed; I referred to the danger of bullying earlier. Diabetic children do not need to be taken out of class; they simply need a hygienic environment in which to test their blood sugar levels during the day, and to be allowed to eat in the classroom, or go outside to eat, in order to boost their blood sugar levels. It helps everyone if the staff understand those needs and explain them to other pupils. In that way, the children can learn that many of us will have a medical condition—not necessarily diabetes—at some time in our life. There is a whole spectrum of medical conditions, and treating children who suffer from them separately is worse than providing for them within the mainstream and within the normal school settings. All that is needed is a willingness for schools to put in the effort and to look at best practice while listening to parents. A reminder in the Bill that that is important would go some way towards reassuring tens of thousands of anxious parents.

[Caroline Nokes (Romsey and Southampton North) (Con)]

Given your previous encouragement for speakers in the debate to be brief, Madam Deputy Speaker, I will try to do so. It is a pleasure to follow the hon. Member for Torbay (Mr Sanders), who has spoken on the specific issue of diabetes in schools. I was contacted only last week by a family in Romsey whose four-year-old son is due to start school in September. They had been told that, should he feel a “hypo” coming on, it would be his responsibility to get himself to the school office, where he could be tested and the appropriate treatment administered.

I commend to the House the work of the Juvenile Diabetes Research Foundation in encouraging local education authorities to put in place protocols and care plans so that schools can be made aware of the appropriate treatment and teachers can be properly informed about addressing the problem. This is particularly important for those dealing with very young children, for whom needles and testing kits might still be a relatively strange and foreign concept. Older teenagers might have become accustomed to them.

--- Later in debate ---

[Mr Timpson]

My hon. Friend makes a point about the importance to the parents and the young person of having a single point of access into any complaints procedure. That is why we are looking at how there can be a single point of interface for them, providing them with the information and navigation they require to find themselves in the right part of that complaints process. Clearly, as my hon. Friend the Member for South Swindon said, there are tribunal rules in place and there are always practical ways in which we can look at trying to enmesh more clearly together the various strands in the complaints mechanisms. We need to develop that through the pathfinders and, as we hopefully reduce the number of cases that end up in the tribunal system, see whether that has had an effect. We will keep that under close review.

New clause 24, tabled by the hon. Member for Washington and Sunderland West, was discussed in Committee, following which I wrote clarifying what information was already published. The effect of the new clause would be that details were published by individual case. It would not be appropriate to publish information that could identify details of private cases. Clearly, we want to reduce contention. Publishing information on individual cases is likely to extend the contention beyond the delivery of the tribunal’s judgment.

Information would have to be published on the tribunal service and authorities’ costs, and that raises the question whether information would also have to be published on the relative complexity of cases to justify what may be a proportionate expense. The wish to publish information on the cost to authorities may be based on the misapprehension that authorities usually engage legal representation. The most recent figures show that authorities were legally represented at only 15% of hearings, and in most cases authorities would just be providing information on officer time costs. Publishing seemingly simple information on costs without proper context may well lead to greater confusion, therefore, but I have no doubt that the hon. Lady will want to return to that area in due course.

New clause 8, tabled by my hon. Friend the Member for Torbay, and amendment 65, tabled by the hon. Member for Walsall South (Valerie Vaz), both concern children with health conditions. It is right that every child with a long-term health need is entitled to a high-quality education. Their needs must be identified and addressed promptly, so that they can achieve their full potential. Imposing further statutory duties on schools to ensure that is not necessarily the answer, however.

The right hon. Member for Wentworth and Dearne (John Healey), in a powerful and passionate speech, demonstrated an acute knowledge of life as a Minister and the response that he was likely receive as to current provision. The Education Act 2002 already places a duty on the governing body of a maintained school to promote the well-being of pupils and, as the right hon. Gentleman said, schools are already under a duty through the Equality Act 2010 not to discriminate against pupils with long-term health problems that have an adverse effect on their ability to carry out their normal day-to-day activities. Nor should we require schools and further education institutions to request an EHC assessment for everyone with epilepsy or a related condition.

In a recent written answer to a parliamentary question, I announced that the “managing medicines” guidance would be issued this year, which will further clarify schools’ responsibilities. I am confident that it will address the right hon. Gentleman’s concerns. However, I take what he said extremely seriously and will look closely at the details of what he and others have proposed. I would be more than happy to discuss these matters with him as we consider how we can improve practice in our schools, some of which is still below the level that we should be seeing. We know from figures cited by my hon. Friend the Member for Torbay that the number of children affected by conditions that require support in school is not small, so every effort needs to be made to improve practice on the ground.

[Mr Sanders]

The statistics seem to show that while there are provisions in previous legislation that are supposed to work, they are not working for large numbers of children with these medical conditions. That is the point of new clause 8.

[Mr Timpson]

I understand the intention behind the new clause, but when the raft of legislation directly or indirectly related to the point that my hon. Friend raises is still not bringing about the required support for children in our schools, one wonders whether additional legislation is necessarily the answer. We are seeking to provide the best possible guidance to schools on managing medicines, set against the current legislative framework; and under the new Ofsted inspection of schools, safety is a key feature.