Health and Care Bill

Debate between David Simmonds and Peter Dowd

Report stage
Tuesday 23rd November 2021 Commons Chamber

[Peter Dowd]

I am afraid that I do not have time. Let the Secretary of State report on access to NHS dentistry and give it a seat at the table on integrated care boards and partnerships, along with other health professionals. In conclusion, these proposals are about a comprehensive national care strategy that will help both patients and the NHS, and giving dentistry the attention that it deserves. Those are the areas we need to focus our attention on. They need a bit of tender loving care.

[David Simmonds (Ruislip, Northwood and Pinner) (Con)]

I will be exceptionally brief, Madam Deputy Speaker. I wish to speak on amendments 103 to 105. It seems clear to me that when a House has made a decision to impose statutory obligations on local authorities and other local bodies, we need to ensure that they are effectively consulted, in order to bring their expertise and local insight to bear in improving the quality of services that are offered to our patients. I hope that Ministers will be taking that on board in their response tonight.

Children and Families: Cross-Government Strategy

Debate between David Simmonds and Peter Dowd

Wednesday 14th July 2021 Westminster Hall

[Peter Dowd (in the Chair)]

I remind hon. Members that there have been some changes to normal practice to support the hybrid arrangements. Members attending physically should clean their spaces before they use them and as they leave the room. I also remind Members that Mr Speaker has stated that masks should be worn.

[David Simmonds (Ruislip, Northwood and Pinner) (Con)]

I beg to move,

That this House has considered developing a cross-Government strategy for improving outcomes for children and families.

First, I draw the House’s attention to my entry in the Register of Members’ Financial Interests as a serving councillor and unpaid vice-president of the Local Government Association. I also put on the record my thanks to the LGA and the National Society for the Prevention of Cruelty to Children, whose research I will draw on in my speech.

The NSPCC’s report, “Bringing the global to the local”, suggests that the UK continues to have a child protection system that is among the best in the world. However, a good childhood goes beyond effective protection from harm; we need to consider how we support children to thrive. Child protection is a good example of where cross-Government co-ordination is required. I very much welcome the Home Secretary’s recent comments about corporal punishment and hope that the Minister can press colleagues across Government to consider bringing England into line with Wales, Scotland and most of our international allies with a reasonable chastisement rule—something that is well evidenced in the research for another NSPCC report, “Equally Protected?”

However, the key thing for all Government policy is that it works well in practice. For most children, the key things in their life will be education and healthcare, and on the whole these things work extremely well at giving our children a great start. The challenges arise when we start to address more complex issues in areas such as public health, child poverty, enrichment activity, financial education and preparation for the world of work, and almost every Government Department has an impact on children and their welfare.

I particularly commend the Minister for her work on the programme to support children during school holidays. It has been a great illustration of both how complex but also how effective cross-Government co-ordination can be, with Departments, including the Department for Education, the Ministry for Housing, Communities and Local Government, the Department for Work and Pensions, and the Department for Digital, Culture, Media and Sport, all having a direct stake in both the process and the outcomes for the children involved. This programme, as strong as it has been, has not high- lighted something that is simply a covid issue; it has demonstrated a challenge that has existed for decades, which covid has brought into even sharper focus.

So why is it timely to consider the cross-Government co-ordination of children’s policy now? First, this is an opportunity to consider how we articulate our ambitions—what we as a country want to achieve for our children. Secondly, today I will make the case for the boring but absolutely essential task of sorting out what one might term the plumbing of the system—the complex web of budgets, policies, markets and providers that we need to support our children as effectively and efficiently as possible. Many across the sector argue that we need to think about what our plan looks like for the future.

I will consider first the question of ambition. The purpose of this debate is to press the case for a clear sense of cross-Government ambition for children. All political experience shows that government—manifestations of the state such as local authorities, schools, health authorities and police forces—is very good at fulfilling the specific tasks it is given by legislation. That is why, for example, councils have prioritised their legal obligations under our child protection system in response to the tough choices driven by financial pressure.

However, the downside to that is that by keeping our policies for children in a state of “just about managing” across some parts of government, we forgo the opportunity to make the strategic decisions that bring about the long-term benefits we want to see, which I have heard the Minister and others articulate their desire for. Many of those things have lifetime cost implications for the state, as well as significant human consequences.

It is right, for example, that the Government have set out a cross-departmental strategy on the environment and climate change. The focus brought by COP26 has enabled us to see all parts of government thinking about how our actions contribute to achieving those climate goals and working with all kinds of stakeholders on the action that they need to take. In the same way, I call for a clear, cross-government strategy for children that sets out what we want to achieve for the health, education and wellbeing of our youngest constituents. On the whole, we have a system that supports children well, but it remains inconsistent in some respects. From early years health and nutrition to entry to university, we still have some distance to travel before we can say that our youngest constituents are able to make the best of the opportunities that our country seeks to offer.

I turn briefly to the specifics. Our children would benefit from a clear set of national outcomes—a list, perhaps—starting from consistent, high-quality antenatal support, as argued for by some, such as my right hon. Friend the Member for South Northamptonshire (Dame Andrea Leadsom) in her recent review, through to access to vaccinations, early education, the financial benefits from the Treasury relevant to childhood, accountable education providers with a restless ambition for every child, and a clear national offer on enrichment to engage all young people in the opportunities and responsibilities of our society.

That brings me to the heart of the issue. As the Local Government Association publication “Rewiring Public Services” highlighted, setting out ambitions is all very well, but unless we think through how to fulfil them, we are setting ourselves up to fail. The research base emerging from the network of What Works centres brings together a good deal of evidence in this respect. It highlights how the best value for the taxpayer is often achieved through programmes, such as the troubled families programme, that move away from specific, legislatively mandated actions to locally co-ordinated interventions.

We need to consider that schools are the one place where the state has eyes on almost all children. They have a unique opportunity and responsibility in all aspects of a child’s life. Too often, our system has prioritised institutional performance rather than the outcomes for every child. We need to think, across all life stages, how we maximise the achievement of every participant—something that remains a legally mandated responsibility of local authorities, but which currently relies on a complex web of often conflicting interests across different providers. We need to ensure that regulation supports the delivery of those national priority outcomes. Anecdotal examples of high-performing institutions are clearly not a proxy for the rigorous pursuit of ambition for all.

We need to bolster the power of our local authorities to fulfil their statutory role as champions for children. Public health is a clear example of this. In practice, many councils have been pushed to accept mixed-quality contracts passed on from historic NHS providers. We need to ensure that NHS bodies welcome the scrutiny of accountable local colleagues and welcome the opportunity to reconfigure services so that, for example, child protection and health visiting become a seamless experience from the point of view of a vulnerable child, rather than a process of navigating an internal market.

Finally, we need a clear process across government for driving these ambitions. Ofsted would not accept a local authority’s saying that it cannot fulfil a priority because it is someone else’s department. We must apply the same principle in Whitehall. A Government with a substantial majority, ambition for levelling up, the support of great Ministers with experience in the area—all these things are an opportunity for setting out a new ambition for what it means to grow up in the UK in the coming decades. That cannot simply be about addressing deficits and failings; it needs to be about having that sense of ambition. Too often, deficits and failings are patched up—with great, but often piecemeal initiatives—and long- term challenges still need to be addressed.

Growing pressure on the special educational needs and disability system is pushing education budgets to breaking point in many areas. Department for Education figures suggest that there is more than £1.4 billion in school surpluses, and many schools on the Department’s radar have excessive surpluses. Councils are criticised for spending on child protection rather than early intervention, but the law of the land makes this inevitable. In respect of refugee children, the Home Office owns the national transfer scheme, designed with the Department for Education and local authorities to improve capacity, but market failure in the system sometimes means a lack of placements for willing local authority participants to procure.

In conclusion, we need to apply the excellent research base that has developed—from many organisations, including those funded by the Department—to build on the depth and strength of the experience of our local authorities and our schools. We also need to set out across government that clear vision of our national priorities for our children, so that we have a system that consistently supports all our children to thrive and make the most of the opportunities that our country has to offer.