Schools (Mental Health Professionals) Bill [HL]

Lord Jackson of Peterborough Excerpts

2nd reading
Friday 1st March 2024 Lords Chamber

[Lord Jackson of Peterborough (Con)]

My Lords, it is a pleasure to follow the noble Earl, Lord Russell, who made a sincere and moving speech. I wish him well in his endeavours, and his family for the future.

I welcome the Bill presented by the noble Baroness, Lady Tyler of Enfield, not least because we are both members of the Chartered Institute of Personnel and Development. She obviously has enormous expertise arising from her time with Cafcass and with Relate. However, I take a similar view to that of my noble friend Lady Berridge, in that I am not wholly convinced that new legislation is what we need. We need a holistic, joined-up, integrated and co-ordinated strategy for children and young people’s mental health, and I am not sure that new primary legislation would deliver that.

The noble Baroness was good enough to refer to the great progress the Government have made following the Green Paper, Transforming Children and Young People’s Mental Health Provision, in 2018, which gave rise to the mental health support teams. I accept that there are now 398 teams and that only a third of children are covered, but there is good progress, and we are going in the right direction. Integrated care boards also have a mandate to provide the appropriate commissioned services for children and young people in their areas. Reference is made in the 2019 NHS Long Term Plan for staffing to putting significantly more money into mental health services. That is good.

I am indebted to my noble friend the Minister for her very helpful Answer, which just got in under the wire and came yesterday, to the Question I tabled on 19 February. It talked about

“delivery of the Special Educational Needs and Disabilities (SEND) and Alternative Provision Improvement Plan, which was published in March 2023”,

which is of course a work in progress. It went on to say that the department

“is establishing a single national system that delivers for every child and young person with SEND, so that they enjoy their childhood, achieve good outcomes, and are well prepared for adulthood and employment”.

We have had heavy briefing and lobbying on this Bill. I make the point again that it is a very laudable Bill and I agree with the spirit of it. We would of course support a full national rollout of mental health support teams in all schools and a fully resourced national implementation programme to support every school, college and university. My own daughter has just gone to university, and I know that that is a big mental health challenge in terms of loneliness, homesickness, socialisation and other issues.

However, I am going to concentrate on a particular area of interest of mine. I declare an interest in that my brother, Stephen, is a professor of cognitive neuroscience at Nottingham University and has occupied that position for 20 years. He has done an enormous amount of work on human movement studies, in relation not just to Parkinson’s disease but to Tourette’s. I want to talk about a specific area of concern, children with Tourette’s. It is an acute issue, in that those children and young people fall between the gaps in provision in NHS specialised commissioning services and between mainstream and SEND education. They are often bounced around the system—the term is “service neglect”. Often, they are expelled and removed from schools and then, even if they get to the NHS, they are stuck between paediatric services, neurology services and other mainstream services. Often, they have no diagnosis. When they do have a diagnosis, it is a document that lies unused, in effect, and they do not have any follow-on care. Often, as the noble Earl, Lord Russell, made clear, parents are forced to pay for private provision. Those children often suffer isolation, school refusal and alienation. There is only one clinic in the whole country that specifically looks after children with Tourette’s syndrome and provides out-of-area referral, and that of course is Great Ormond Street Hospital.

Tourettes Action has done what it can over the years, and I am indebted to it for the help and support it has given me. In fact, I led a Westminster Hall debate 14 years ago when I served in the other place—so long ago that we had a coalition Government, and the Health Minister was Paul Burstow. That was in October 2010 and, in all fairness, there has been great improvement since but there is more to be done. Tourettes Action is involving itself in training and support, not just in schools and colleges but workplaces, where it supports employers who have employees with Tourette’s, as well as in youth centres and job centres, disability advisory facilities and prisons.

Just to recap, Tourette’s syndrome is an inherited neurological condition. It is not rare and affects one schoolchild in every 100. This is a similar prevalence to autistic spectrum disorder and paediatric epilepsy. However, unlike with the latter, there are no NICE guidelines in place for its care. Over 300,000 children and adults are living with TS in the UK and, as noble Lords will know, the key features are tics, involuntary sounds and movements. In many areas, there is currently no pathway for children or adults to be accepted into local or even regional services for the diagnosis and treatment of Tourette’s syndrome.

Specific support in schools is vital for children with TS. Children with the condition have to live with the consequences of their education. If they are not given the right support in school, to which all children are entitled, they risk ending up facing unemployment and social exclusion. Special educational needs teachers are currently not given any specific training on Tourette’s syndrome, even though TS prevalence in SEN classes is high. Tourette’s syndrome has hitherto been treated as the subject of risqué jokes and ribaldry, but for the children and young people afflicted with the condition, who are fearful of its effects on themselves—and of the understandable fear and ignorance of strangers—it really is no laughing matter. They too deserve to have a hearing from our policymakers.

I hope that my noble friend the Minister will reassure us that there is at least a commitment to develop a policy on the condition between the Department for Health and Social Care and the Department for Education, because a coherent strategy across government will not only save taxpayers’ money in the long run but help to relieve TS sufferers and their families of a lonely burden that they have carried for many years. I hope that my noble friend can address some of these issues in her response, or at least write to me at her convenience on the issues I have raised. In the meantime, I again thank the noble Baroness, Lady Tyler, for this debate and the opportunity to discuss these very important issues because, at the very least, we are all committed to improving the lives of children in our country.