Health and Care Bill

Baroness Hollins Excerpts

Lords Hansard - Part 1 & Report stage
Thursday 3rd March 2022 Lords Chamber

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)]

My Lords, I thank the House for its continued focus on addressing the needs of babies, children and young people and thank noble Lords for bringing forward amendments on this issue again today. I am also really grateful to noble Lords who have engaged with the me and my officials, and I hope that this has resulted in amendments that your Lordships’ House feels that it can support.

I start with Amendment 36, in my name. This amendment will require an integrated care board to set out any steps that it proposes to take to address the particular needs of children and young people under the age of 25 in the forward plan. In addition, the Government have committed to produce a package of bespoke guidance, which explains how the ICB and the ICP should meet the needs of babies, children, young people and families. This guidance will contain provisions for the integrated care partnership’s integrated care strategy to consider child health and well-being outcomes and the integration of children’s services, as well as providing that the integrated care partnership should consult local children’s leadership and children, young people and families themselves, on the strategy.

NHS England has also agreed that it will issue statutory guidance, expecting that one of the ICB executive leads will act as a children’s lead, with responsibility for championing the needs of babies, children and young people. I hope that noble Lords are supportive of this government amendment and its underpinning commitment to support, improve and enhance services for babies, children and young people.

I turn to Amendments 157, 185 and 186. Safeguarding children is a priority for the Government, and we share the horror and concern provoked by the awful murders of Arthur Labinjo-Hughes and Star Hobson. The Government are committed to addressing barriers to safe, timely and appropriate sharing of information to safeguard children, and we have heard clearly the strength of feeling across the House on the value of a consistent identifier for children. In particular, I pay tribute to the noble Baroness, Lady Tyler of Enfield, and other noble Lords, for pushing us on this issue.

To this end, we are committing in this legislation to publish a report, within one year of the section coming into force, that will describe the Government’s policy on information sharing in relation to children’s health and social care and the safeguarding of children and will include an explanation of the Government’s policy on a consistent identifier for children. It will also include the Government’s approach and actions to implement the policy set out in the report. The Government agree with noble Lords that action is needed. The report will reflect a cross-government position on what actions will be taken to improve safe and appropriate information sharing.

This amendment, of necessity, is limited by reference to health and social care, reflecting the scope of the Bill. However, the report to which this amendment refers will be laid by the Secretary of State for Education, who intends that it will cover improved information sharing between all safeguarding partners, including the NHS, local authorities and the police, as well as education settings. The Department for Education has already started its work, which will look at the feasibility of a common child identifier. I hope these amendments will reassure noble Lords that the Government are committed to safeguarding children and improving services for babies, children and young people. I beg to move.

[Baroness Hollins (CB)]

My Lords, I am grateful to the Royal College of Speech and Language Therapists, the National Children’s Bureau, the Disabled Children’s Partnership and the Royal College of Paediatrics and Child Health for their support with this amendment and for their constructive engagement with the Department of Health and Social Care. I also thank the noble Baroness, Lady Tyler, for adding her name to this amendment.

I welcome the amendments that the Minister has laid relating to the needs of babies, children and young people but, despite the good progress made, this amendment seeks to go further by requiring NHS England to conduct a performance assessment of each ICB in meeting the needs of babies, children and young people in each financial year. This includes its duties concerning the improvement in quality of services and reducing inequalities and the extent of its public involvement and consultation.

There are significant challenges in meeting the health and care needs of children and young people, including their mental health needs, which are different and arguably more complex than for adults. This is particularly the case for disabled children and young people and those with special educational needs. A recent survey by the Disabled Children’s Partnership and the parent campaign group, Let Us Learn Too, found that 40% of families with disabled children have seen their savings wiped out by fighting and paying for support.

I shall give one brief example from the West Midlands. Joanne, whose autistic son also has pathological demand avoidance and communication difficulties, explained that the local authority refused to do an occupational therapy assessment, so she paid for one privately. Eventually, she took the local authority to tribunal at considerable expense in legal fees. Despite winning, it is one year on and still no support is being provided by the local authority.

One in three families with disabled children said they needed publicly unprovided essential therapies for their disabled child, but could not afford them. Some 60% of families with disabled children have sought NHS mental health support for a family member due to the stress of fighting for basic services. The Disabled Children’s Partnership cites individuals feeling a sense of societal resentment toward disabled people, says that carers are persistently undervalued and underrepresented in policy and details the enormous physical, emotional and financial burden they endure in caring for their disabled family member without adequate support from the health and care sectors. Joanne said, furthermore, that the local authority blamed her for her son’s disability and put a child protection plan in place rather than supporting her, although thankfully it was removed shortly afterwards.

Integrated care boards have a crucial role in commissioning primary and community healthcare services directly for babies, children and young people. They will play a key role in the joint commissioning of services for disabled children and those with special educational needs, as well as contributing to education, health and care plans and in the commissioning of joined-up services in the first 1,000 days of life, in which the Government are, importantly, investing. Crucially, ICBs will be jointly responsible for the leadership of local child safeguarding partnerships, together with the police and local authorities.

Yet support for children and young people varies geographically. Local systems find themselves pulled in different directions by different government initiatives and separate pots of funding, which creates a profound risk of destabilising what are relatively new local safeguarding partnerships. The Wood report, published in May 2021, reviewed the new multi-agency safeguarding arrangements put in place by the Children and Social Work Act 2017. It revealed just how stretched the resources are in protecting children, as well as the need for a more effective culture of joined-up working and a more consistent and detailed understanding of the role of the three statutory safeguarding partners—the local authority, the CCG and the chief officer of police. The Wood report also emphasised the importance of accountability regarding the quality of these services and the need for inspectorates and regulators to develop a model to analyse performance against what is deemed to be best practice, something that this amendment goes a long way to trying to achieve.