Children and Young People: Restrictive Intervention Debate

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Department: Department for Education

Children and Young People: Restrictive Intervention

Chris Law Excerpts
Thursday 25th April 2019

(2 years ago)

Commons Chamber

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Department for Education
Jim Shannon Portrait Jim Shannon (Strangford) (DUP)
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25 Apr 2019, 4:32 p.m.

I congratulate the right hon. Member for North Norfolk (Norman Lamb) on securing this debate. We have heard some truly excellent speeches from right hon. and hon. Members.

Like other Members, since I was first elected, I have been inundated with schooling issues. Those include parents trying to secure special educational needs assessments, or those whose children have been diagnosed with special educational needs but are not getting the help they need. There are schools that cannot afford to provide the help that is needed, and teachers who struggle to cope with the number of children who need more from them. I must have dealt with thousands of such cases over the years. The reason why is that education for children matters. It matters that children get the support they need to achieve a rounded education and that schools receive the funding they need to provide it. It matters that parents know that their children will get the best chance at life in the future, and that is critical to this debate.

With that in mind, it is little wonder that there are times when restrictive intervention is needed—an overworked teacher might be attempting to deal with a child who is misunderstood, frustrated and unable to bond with the teacher or classroom assistant as there are too many in the class. That frustration turns to violence, and the child is in danger of hurting themselves or someone nearby. In such cases, action is needed. However, there are limits on restraint, which must always be the last available option and fully considered.

Everyone who has spoken so far has referred to the need for training and resources and to the capability of the schooling system to respond to this issue. Teachers must have the knowledge and training on how and when other methods can be employed and, if there is no option, how to restrain safely. It is my belief that, due to a lack of guidance, there is a lot of confusion about the best and appropriate use. I join with colleagues in asking for that guidance to be released, as the guidance for restrictive intervention for adults has also been released.

Before the debate, I mentioned to the right hon. Member for North Norfolk that I was at a school before Christmas where a young fellow was “difficult”, shall we say? It took two teachers to supervise and restrain him, and a degree of violence did take place. I mention that to illustrate the need for schools to have the necessary teachers, training and resources. They did have that in that school and that was good to have.

I read a briefing supplied to me by one concerned body called the Challenging Behaviour Foundation, whose research has thrown up a few surprising statistics that are certainly worth quoting today. The main source of data is a “5 Live Investigates” freedom of information request to local authorities in England, Scotland and Wales that revealed 13,000 physical restraints over the previous three years, resulting in 731 injuries. Only a fifth of authorities replied, so the information presented might not be the whole picture. Another source of data was a survey conducted by the Challenging Behaviour Foundation. Some 88% of the 204 respondents said their disabled child had experienced physical restraint, with 35% reporting that it happened regularly. Some 71% of families who completed the survey said their child had experienced seclusion, with 21% reporting that it was taking place on a daily basis.

Those figures are challenging and they tell us the real story. I believe there is a better way to prevent these kinds of issues. Issuing guidance is certainly one step, but it is not the whole answer. Classrooms must have sufficiently trained staff members to deal with these scenarios without disrupting the other 29 children in a class. Children who need additional help need assessments, and those assessments must result in extra help and support. Parents must understand what is happening and be able to provide a helpful insight into the best ways to understand a child. There are so many factors, but the guidance that has been on the cards since 2014 must instead be off the cards and taken into schools urgently as the first step to ensuring that the education of every child is the best that it can be.

Chris Law Portrait Chris Law (Dundee West) (SNP)
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25 Apr 2019, 4:37 p.m.

Children and young people are one of the most vulnerable groups in our society. Wherever they live, wherever they go to school, wherever they spend their free time, they require care and protection. Children and young people with learning difficulties, disabilities and those in care are particularly vulnerable. Yet, as we have heard in this debate today, these are the people most likely to be subjected to restrictive interventions. Sadly, this often results in injury, trauma and other long-lasting consequences.

As we have heard, recent research has highlighted the potential damaging impacts of restrictive intervention. A Challenging Behaviour Foundation survey demonstrates the negative effects it has on children and their families. As we have heard, 88% of respondents said that their disabled child had experienced physical restraint, with 35% reporting that it happened regularly. The truly shocking bit for me, Madam Deputy Speaker, was that 58% of respondents said that the physical restraint had led to injury. In other words, it is doing more harm than good. Research has shown that there is a marked increase in the diagnosis of anxiety in children where restrictive interventions were used, and adverse life experiences during someone’s formative years drastically increase their chances of developing mental health problems.

Concerns about restraint have been raised by the UN, civil society and parents and carers of those affected. Beth Morrison was mentioned earlier. She is a constituent of mine from my city of Dundee. She has campaigned for over five years on this issue, after her son Calum was subjected to harsh restraint. Beth gave evidence at the Scottish Parliament’s Public Petitions Committee and has subsequently worked with the Scottish Government to develop their guidelines on restraint. Today, I would like to thank her personally.

The Scottish Government have taken action to strengthen their guidance on restrictive intervention. They make it clear that the use of physical intervention should only ever be used as a last resort. It should only be considered in the best interests of ensuring the safety of a child, as part of a de-escalation approach, and never for disciplinary purposes.

We all appreciate and understand the hard work and sacrifice of teachers and carers, and the duty of care they have for all those they look after. We know the pressures they are put under every day. We also have no doubt experienced an unruly child in the classroom—I am sure some of us in this room will understand that very well. We have met people who are unable to follow instructions, sometimes through no fault of their own, and we have met those whose fuse is that slight bit shorter than everyone else’s. In most cases, these situations are resolvable, but in others individuals can become a danger to themselves, to other children and to staff. Therefore, at the heart of the Scottish Government’s guidance is a clear framework on how to avoid challenging behaviour arising in the first place, how to de-escalate and avoid restraint, and how physical restraint should be used only if it is necessary and as a last resort. Staff use their knowledge and assessment of a child or young person to predict and plan for situations that can lead to challenging or distressed behaviour. They also seek to provide ongoing support for the individual, paying particular attention to any additional needs.

The guidance sets out the Scottish Government’s clear expectation that every local authority should have a policy on physical intervention, along with a process for how decisions on physical intervention should be made. All decisions to intervene physically are recorded to demonstrate that children’s rights have been taken into account in the reaching of those decisions. The guidance refers specifically to the United Nations convention on the rights of the child. The Scottish Government have committed themselves to incorporating the convention’s principles in domestic law. Their aim is to make Scotland the best place in the world for a child to grow up in, and recognising, respecting and promoting the rights of children is essential to achieving it. The core values in the UK Government’s draft guidance largely mirror those in the Scottish Government’s guidance, and we welcome that. However, the guidance must be published at long last: five years is far too long for anyone to wait, particularly those young children.

As we all know, human decisions have to be made at a particular time, in a particular place and in a particular set of circumstances. However, as I have said, physical restraint must be required only as a last resort, and it is vital that it is proportionate, measured and understood by all participants. As someone who spent time as a child in care, I have witnessed personally what restraining does to young people, and I therefore fully understand how important it is for it to take place only as a last resort. I also have a personal understanding of how difficult it is for those who have to use physical restraint as a last resort to make the right decision. It is imperative that children and young people know their rights, and that the actions of teachers and carers are always guided by the need to protect them.

Ultimately, clear guidance and good policy will lead to better decisions on more occasions. With the appropriate guidance and policy in place, we will hopefully see an end to the troubling stories and statistics that we have heard today and ‘ensure that all young people, children and staff are kept safe.

Mike Kane Portrait Mike Kane (Wythenshawe and Sale East) (Lab)
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25 Apr 2019, 4:42 p.m.

I thank the Backbench Business Committee for granting this important debate. It was secured by the right hon. Member for North Norfolk (Norman Lamb)—who made an excellent speech—along with my hon. Friend the Member for Dulwich and West Norwood (Helen Hayes) and the hon. Member for Berwick-upon-Tweed (Anne-Marie Trevelyan), who gave some powerful personal testimony, as did the hon. Member for Dundee West (Chris Law).

This is a difficult and, for some, very personal issue to talk about. I congratulate all the Members who have spoken, including my hon. Friend the Member for Hornsey and Wood Green (Catherine West) and the hon. Member for Strangford (Jim Shannon). I also pay tribute to my hon. Friend the Member for Croydon North (Mr Reed). Members will know that his private Member’s Bill, known as Seni’s law, was predicated on the devastating and inexcusable death of his constituent Seni Lewis in 2010. Seni had been restrained so excessively, so unreasonably, that he died. Seni’s law addressed the issue of prone restraint—the act of forcing someone’s face into the ground—and, as we know, Seni was not the first person to die in such circumstances. In 2014, during his time as a Minister in the Department of Health, the right hon. Member for North Norfolk issued guidance on the restraining of adults, with the intention that it should be followed by guidance on the restraining of children.

The national inquiry into child sexual abuse recently concluded that “pain compliance” was child abuse and should be outlawed, and the Equalities and Human Rights Commission has also argued that such methods should not be used on children. Article 19 of the United Nations convention on the rights of the child, which has already been mentioned today, states that Governments must do all they can to ensure that children are protected from all forms of violence, abuse, neglect and bad treatment by their parents or anyone else who looks after them. According to the BBC, these painful techniques were designed for prison riots, with the aim of forcing individuals to comply through the use of pain. I should not even need to say this, but we should not be using prison riot techniques on children.

What is also concerning, and constitutes the essence of the debate, is the continued absence of clear guidance from the Government. Although their consultation on draft guidance to reduce the need for the restraint of children took place between November 2017 and January 2018, we have still not received the results. Will the Minister tell us when they will be published?

Parents have argued that, in the absence of guidance and with the prevailing uncertainty, schools are using so-called restraint techniques against children with special educational needs and disabilities. That has occurred in an environment of austerity; one that has seen a crisis in funding for children with special educational needs. As we discussed in the previous debate, local authority children’s services are currently overspending by £800 million. It was reported last November, for instance, that council overspending on children’s special educational needs and disabilities has trebled in just three years.

The Minister might be aware that the Challenging Behaviour Foundation and Positive and Active Behaviour Support Scotland released a report in January on the use of restrictive intervention. The report found that 88% of parents surveyed said that their disabled child had experienced physical restraint, and 35% said that it happened regularly. Over half the cases of physical intervention or seclusion were of children between the ages of five and 10, with one case involving a two-year-old child. It should come as no surprise that this has had a negative effect on the children’s health. Over 90% of those surveyed said that restraint had emotionally impacted their child. That physical intervention was for cases of incontinence, meltdowns and shutdowns—situations that leave children unable to communicate as they are so overloaded with emotions.

I will return quickly to the Government’s own delayed guidance. When Ministers launched the consultation, they stated that any guidelines would not apply to mainstream schools. This is clearly illogical. Guidance must apply across the board, not just in specific settings. Otherwise, this suggests that mainstream schools are not safe spaces for children with special educational needs and disabilities. Will the forthcoming guidance be universal, so that all children are protected?

I would now like to move on to the treatment of young people who are autistic or have learning disabilities or mental health conditions. Across mental health, autism and learning disability services, over 1,000 young people were subject to a restrictive intervention in 2017-18. That accounted for 26,000 separate restrictive interventions. What is shocking is that the under-20s in these services who are subject to any restrictive intervention are, on average, subject to more than twice as many as those in any other age group. There are also hundreds of young people who are subjected to seclusion, segregation and—perhaps most worryingly—chemical restraint. We are drugging these young people because their behaviour is deemed to be too challenging. That is not acceptable. I know that the Care Quality Commission is currently carrying out a review of the use of restraint in these services, but it will not report until next year.

Currently 250 young people who are autistic or have learning disabilities are being detained in inappropriate care settings that were covered by the Transforming Care programme. That programme was intended to move people out of inappropriate settings and back into the community. Since 2015, however, the number of young people in such institutions has more than doubled. Some of these children have been sent more than 100 km from home. Ministers have recognised that this is wrong, but they have not yet done anything to stop it. Moreover, the programme expired last Sunday. Can the Minister therefore tell us what plans there are either to continue the work or to introduce a new programme to close inappropriate care settings? What funding will be made available in the next five years, given that the Government have committed to funding only an additional year of the programme?

What happens in early childhood has a defining impact on human development, affecting everything from educational achievement to economic security and health. Violence towards children can leave a long, irrevocable shadow over their lives. There can be no place for it anywhere. I therefore hope that the Minister will take the contributions made to heart.