Health and Care Bill

Baroness Whitaker Excerpts

Lords Hansard - Part 1 & Committee stage
Tuesday 18th January 2022 Lords Chamber

Surely it is in everyone’s interests that integrated care systems give due regard to meeting the needs of babies, children and young people, including those with communication needs. These amendments would ensure that that happens and that the significant cost benefits are not only factored in from the outset but realised in the medium to longer term.

[Baroness Whitaker (Lab)]

My Lords, I declare an interest as a patron of the British Stammering Association; indeed, I am a stammerer myself. I regret that I could not join in at Second Reading. I support all the amendments in this group, as does the Royal College of Speech and Language Therapists.

I want briefly to add my support for Amendments 141, 151 and 177. As the noble Lord, Lord Shinkwin, said, Amendment 141 would improve the lot of some 10% of children in the United Kingdom. That is a large proportion. Those are the ones who have identified speech, language and communication needs, which, as has already been said, affect their life chances in many ways. The way to do this, as the right reverend Prelate said, is to have the vital structure of accountability for their needs being identified and met.

There is a big equality issue here. I remind noble Lords that up to 50% of children in areas of social disadvantage start school with delayed language or another identified communication need. The 2010 Marmot review on health inequalities emphasised that

“giving every child the best start in life … is our highest priority recommendation.”

The review identified reducing inequalities in the early development of physical and emotional health and cognitive, linguistic and social skills as a priority objective, noting communication skills as crucial for “school readiness”. Levelling up is for children too; arguably, it is particularly important for them. The national accountability framework in Amendment 141 must include metrics on speech, language and communication development at the population level and outcomes for children and young people with communication needs.

On Amendment 151, I can do no other than echo the words of the noble Lord, Lord Shinkwin, with whom I agree entirely.

I strongly endorse Amendment 177, which would put the guidance on a statutory footing. One advantage of this, which should be done for all sorts of reasons, is that it would enable the postcode lottery to disappear or at least be very much reduced. Of course, it ought to include specific guidance on supporting speech, language and communication development at the population level, explaining how the needs of children and young people with communication needs will be met. I hope that the Government will pay attention to this often rather neglected aspect.

[Lord Scriven (LD)]

My Lords, I support Amendment 20 in the name of the noble Baroness, Lady Meacher, and in so doing declare my interest, as laid out in the register, as a vice-president of the Local Government Association and a non-executive director of Chesterfield Royal Hospital NHS Foundation Trust.

NHS England defines the better care fund as being there to support

“local systems to successfully deliver the integration of health and social care in a way that supports person-centred care, sustainability and better outcomes for people and carers.”

So why is that not the case for 30% of the population, children and young people, who have the same complex needs and the same need for integration as adults do to help and support them on their journeys? The better care fund has been around since 2014. My guess is that this was an oversight rather than a deliberate means to keep children and young people out. Having looked at examples of what the better care fund can achieve in integration and outcomes for adults, I believe that this oversight needs to be addressed. Children and young people need to be on the face of the Bill.

I think that the Government accept that things need to happen, because we have the children’s social care innovation programme, which is particularly about looking at innovation in social care along with healthcare partners. The problem, however, is that it is a bidding system and it is not for all local authorities. If you win the bid, you can do it. Children and young people across the country deserve and should expect the right to have innovation in integration to improve their outcomes regardless of where they live. It should not be conditional on their local authority being successful in a bid.

I can see no reason why, as the noble Baroness, Lady Meacher, said, the Government would not want to do this. It is an oversight in the better care fund. Putting children and young people on the face of the Bill would ensure that they received the integration and better outcomes that adults achieve through the fund.