Education: Children with Diabetes

Baroness Crawley Excerpts

Tuesday 1st February 2011 Grand Committee

[Baroness Crawley]

My Lords, it is a delight to follow my noble friend Lord Harrison, who is such a great ambassador for people living with diabetes. May I add my thanks to my noble friend Lord Kennedy for bringing this complex and important issue before the House with such clarity and commitment? I also welcome the informative and humorous maiden speech of the noble Lord, Lord Lexden. We look forward to hearing many more of them in the House.

In preparing for this afternoon’s debate, I looked at the 2008 report of the UK Children with Diabetes Advocacy Group. I found several case studies of children who have type 1 diabetes but who, beyond that, should be leading happy, fulfilling and productive lives at school. It is to our shame that that is not the experience for a large and significant group of children with diabetes across the country.

In the case studies, Matty’s mum said:

“Matty decided that he wanted school dinners this week. At the end of last term I went in and saw the cook and the dinner lady and explained that he would need to go to the front of the queue. This morning he told me that he didn’t want school dinner because the dinner lady had told him off for walking to the front of the queue and made him wait until last.”

Charlie’s mum said:

“When Charlie started reception we had a major fight on our hands with the headmaster who expected Charlie to do all his own blood testing, choose an appropriate snack and go and get it from the store cupboard – all at the age of 4 and only having been diagnosed 4 months previously!”

In case we form the impression that the fault always lies with the school or with the local authorities, the next case study will put us right. I quote the case of Anthony:

“Unfortunately, when we had a meeting with the school and our DSN, (who we thought was there to support us) made matters worse. The DSN seemed to do her utmost to discourage the school from taking on procedures such as testing, her attitude being that schools should not have to take on such levels of care. We were quite surprised and hurt at her attitude. It made us feel very much on our own in the pursuit of a good standard of care for a young child starting school”.

The obstacles were not just raised for families through PCTs in these case studies. In another study, the health and safety officer told a teenage boy with diabetes at a secondary school that he could not carry his insulin and self-monitoring equipment with him at school. This meant that if he felt unwell he would have to go a considerable distance to the school’s reception area to carry out tests, which would have put him at risk.

Obviously, as my noble friend has said, there are children with diabetes who enjoy a full school life because of the support their school gives them. But the sad little stories from desperate parents that I have quoted tell us that by no means all children have that opportunity in 21st-century Britain. Why does the Minister think that such inconsistency of policy and practice across local authorities exists, despite guidance being offered by the last Government, and what are his Government’s plans for dealing with this inconsistency? I am certainly not making a political point here, because things could not have become so much worse for this group of children during the eight months of the coalition Government. We all have questions to answer as far as these children are concerned. However, I am concerned by the scale of future local authority spending cuts, as well as by the demise of PCTs and the reorganisation of the NHS. Both these coalition Government policy commitments will throw an already complex picture for children with diabetes into sharper relief.

How does the Minister respond to Diabetes UK’s concerns, shared by this side of the House, and mentioned by the noble Baroness, Lady Walmsley, that the changes proposed in the education and children’s Bill, which will remove the duty of schools to co-operate with local planning arrangements, together with the growth of academies with no direct link to a local authority, risk further fragmentation of services for this group of children? It would be helpful to learn from the Minister how schools are expected to fit into the new framework envisaged in the Health and Social Care Bill.

I know that the Minister, who I have a great deal of respect for, will agree with me that it is intolerable for parents and children who have this condition to be treated so differently in so many different schools, different LAs and different PCTs, under different head teachers, by different nurses and different staff. These children and young people do not deserve such a cruel lottery of treatment in their schooling. We know that all schools have a common-law duty of care. They also have a duty to promote pupils’ well-being. What does the Minister feel is the current legal framework for ensuring school support? I know that under the previous Government’s Every Child Matters policy, of which I am immensely proud, all schools were required to have a disability equality scheme. Does the Minister believe that further guidance is required?

What is the Government’s response to Diabetes UK’s recommendations? They are ably set out by the noble Baroness, Lady Young: that there should be multi-agency working across schools; that there should be proper training for staff in schools, to feel confident when dealing with children with diabetes; that there should be an individual healthcare plan for every pupil; and that there should be one full-time qualified school nurse for each secondary school and cluster of primary schools, as noble Lords have said.

I would be happy for the Minister to write to me on some of these points. As I have said, our own record in this area is not so burnished that I demand answers from him. I know that all noble Lords who have taken part in this important debate will want to see an end to the confusion, alienation and misery that too many children with diabetes and their carers are currently experiencing.