Children and Families Bill

Lord Ramsbotham Excerpts

Monday 28th October 2013 Grand Committee

Moved by

[Lord Ramsbotham]

71: Clause 21, page 19, line 24, leave out subsection (5) and insert—
“(5) Health care provision or social care provision which is provided for the purposes of education or training of a child or young person in addition to provisions included in subsections (3) and (4), if any, is to be treated as special educational provision.”

[Lord Ramsbotham (CB)]

My Lords, I shall speak to Amendment 72, the wording of which, as the Committee will note, is similar to that used by my noble friend Lady Greengross in her Amendment 71. I apologise to the Committee if it, quite rightly, thinks that I am being a bit military in my approach to Part 3 of the Bill. I am doing so because, in my experience, things work much better if they are corralled into an overall strategy.

As I mentioned earlier in our proceedings, the Bill is, or ought to be, all about child development, the heart of that being Clause 19(d), which refers to, “the need to support” every child or young person,

“and his or her parent … in order to facilitate the development … and to help him or her achieve the best possible educational and other outcomes”.

The key word in this is “development”. The current absence of a Minister for child development was the reason for my earlier question to the Minister about who was responsible, and therefore accountable, for overseeing the development of every child in the country. This concern arises from my view that the only raw material that every nation has in common is its people, so woe betide it if it does not do everything that it can to identify, nurture and develop the talents of all its people. If it does not, it has only itself to blame if it fails.

The absence of any apparent child development strategy is doubly disappointing. A number of recent initiatives seemed to suggest that the development of every child was becoming the Government’s default aim. For example, the introduction of an early years foundation stage in every child’s life, concluding with an assessment, appears to be a sensible way to enable entry to a 0 to 25 pathway. During our work on the link between social disadvantage and speech, language and communication needs, the All-Party Group on Speech and Language Difficulties, which I chair, was shown four other sub-pathways that were being worked on by the Department for Education, the Department of Health and others. One covered pre-birth and the first few months of life, the second up to and including primary school, the third roughly secondary school and transition into adulthood, and the fourth was for those at risk of becoming involved with the criminal justice system. Those seemed entirely sensible and appropriate because they pulled in all the players in those processes. I should therefore be very grateful if the Minister would let me know what the current status of these four pathways is and their relationship to the 0 to 25 pathway proposed for those with special educational needs.

Logic suggests that the early years foundation stage assessments should be turned into individual health, education and care plans and 0 to 25 pathways for everyone. Default education, health and care plans for the 81.2% of children who do not need help along the way, unlike the 2.8% on statements and the 16% on school action or school action plus plans, could merely be progression through the educational system, but it would be a plan. However, the Bill as presented, instead of seizing a priceless opportunity to bring order and logic into a system that requires the co-operation and joint working of so many different ministries and agencies, by laying down a default position and then highlighting how individual necessary alternatives are to be identified and delivered, does not contain the necessary strategy and leaves a number of key requirements unresolved. These include further assessments at various stages along a pathway to identify changes of need and oversight of the whole process.

Amendment 72, about which I am extremely grateful for the detailed legal advice of David Wolfe QC, focuses on one important part of special educational provision, as well as trying to seal a potential crack in the presumed strategy. The importance of speech and language therapy was highlighted for me when, as Chief Inspector of Prisons, I was wondering what could be done with and for the more than 60% of young offenders who were found to have speech, language and communication needs. If only those needs had been identified and challenged earlier in their lives, they might never have truanted or been evicted from school, or ended up in young offender institutions. Luckily, Lady Helen Hamlyn funded a two-year trial of putting a speech and language therapist into each of two young offender institutions. The two governors of these institutions were saying, within a week of the therapists’ arrival, that they did not how they had managed before they came along.

To cut a long story short, everyone agreed how invaluable their contribution was, because at last all young offenders could communicate with education, healthcare and disciplinary staffs, which enabled individual plans to be made. Despite this, I could not persuade either the Home Secretary or the Secretary of State for Education to pay for them, because speech and language therapists belonged to the Department of Health, whose Secretary of State in turn refused to pay, on the grounds that all such funding was delegated to what were then called primary care trusts. The development of thousands of children has gone by default, and the same could happen to millions more if speech and language therapy is not enshrined in government child development plans.

Therefore, I welcome the Government’s apparent intention to maintain the existing position, confirmed in both case law and the current Special Educational Needs Code of Practice from 2001, which, in Chapter 8.49, says that,

“since communication is so fundamental in learning and progression, addressing speech and language impairment should normally be recorded as educational provision, unless there are exceptional reasons for not doing so”.

The new, separate definition of healthcare provision in the Bill creates a risk that speech and language therapists, because they are provided by the NHS to address this impairment, could be reclassified as healthcare provision, rather than, as currently, educational provision.

This raises two problems. First, parents could lose their right of appeal to the Special Educational Needs and Disability Tribunal. Secondly, healthcare provision does not have to be included in an educational health and care plan unless it is, to quote the Bill, “reasonably” required, which implies that it could be left out on cost grounds. Although Clause 21(5) mitigates the risk of reclassification, it does not remove it, and the rewording that I am proposing in Amendment 72 is designed to ensure unambiguously that the existing classification of speech and language therapy as educational provision is maintained. I beg to move.

[Baroness Jones of Whitchurch (Lab)]

My Lords, our Amendment 73 is in this group, and it has the same intent as that of the noble Lord, Lord Ramsbotham, and the amendment from the noble Baroness, Lady Greengross. We have just gone about it in a slightly different way. The issue is one of what should be classified as special educational provision. As the noble Lord, Lord Ramsbotham, quite rightly pointed out, this is important because, by its nature, this determines what issues parents can take to appeal, and we should make that classification as broad as we possibly can.

We have debated before in Grand Committee how broad a definition we are going to apply to special educational needs, and that we believe that a whole tranche of disabled children are not classified and included in that. This issue touches on that somewhat as well. As we said at the time, it is important to get a standard classification of special educational needs and disability included throughout the Bill. We have not tabled amendments to this clause to take that on board; however, earlier clauses ought to clarify it more clearly.

Clause 21(5) sets out that healthcare provision and social care provision can be classified as special educational needs if they are,

“made wholly or mainly for the purposes of … education or training”.

However, according to many in the sector, backed up by the legal advice that we have received, there is a concern that the new definition of the phrase “wholly or mainly” sets a higher threshold than that which exists. We have heard from, among others, David Wolfe QC, the adviser mentioned by the noble Lord, Lord Ramsbotham. That is why our amendment would remove “wholly or mainly” from the clause.

The initial draft of the Bill did not include a requirement for educational provision to be wholly or mainly for educational purposes. It stated that anything provided by the health authority was health provision and that anything provided by social care was, similarly, social care provision and therefore not enforceable or appealable to the tribunal. The new wording was introduced as a result of opposition to the initial draft but we still do not feel that it deals with this problem. I think the Minister will be aware that there is considerable concern about this issue, particularly around therapies such as those for speech and language, which may be classed simply as health service provision under this clause and therefore, apart from anything else, not appealable.

In addition, we have also received the following legal advice:

“Following case law dating back to 1989 the general position has been that any provision which is directly related to an educational need can be classified as educational or medical and it is for the tribunal to decide. Guidance has been given that speech and language therapy will normally be considered educational because of its importance in communication, whereas other therapies such as occupational therapy vary according to the type of difficulty the child has and how far the therapy relates to an educational objective. Tribunals have consistently held that where a provision has a beneficial educational aspect, and is directly related to the child’s educational needs, it can be described as educational provision and specified in the statement. This aspect needs to be set out in the current bill if parents’ rights are not to be eroded. The current wording set a higher bar and reduces the rights of the child and parent”.

This issue was raised briefly in the Commons by the Conservative MP Robert Buckland. At the time, the Minister there replied that,

“the clause maintains the existing right of appeal to the tribunal for special educational provision so that parents will not lose their current protections”.—[Official Report, Commons, Children and Families Bill Committee, 19/3/13; col. 372.]

However, this is not what the experts are telling us, so it would be extremely helpful if the Minister could clarify this and work with us to find alternative wording which would ensure that we are not raising the bar and eroding parents’ rights. In his letter to us following Second Reading the noble Lord, Lord Nash, wrote that,

“the Government recognises the concerns and is looking for ways to address them”.

I would be really grateful if he could tell us how far he has got in looking at ways to address these concerns, and whether he would now be prepared to find an alternative form of wording to address this issue.

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[The Earl of Listowel (CB)]

My Lords, before my noble friend does that, as I imagine that he may well do, I very much hesitate to speak in this debate. I have just been chairing a discussion on child development in schools. Attending it were head teachers, the former head of the TDA and a number of other experienced practitioners in the area that we have just been discussing. Unfortunately, I was four or five minutes late to this discussion so I hesitate to make any contribution to it. However, since the Minister referred to what is being done about the standards to ensure a better understanding of child development, which is very welcome, I should like to make two points.

First, in welcoming the effort by both the previous Government and this one in raising the status of teaching, and particularly in welcoming the advent of Teach First, we heard from the man responsible for Teach First in London. He said how successful the scheme is and that 30% of graduates were getting into the schools that needed their help most, so that really tough inner-city schools were getting these excellent graduates, particularly in science and maths. However, although he could speak only anecdotally, he said that he had met many of these teachers and they said they felt hopeless. They did not know how to manage the challenges presented by the young people they were working with. We need to get this right because otherwise we might lose the wonderful new crop of young teachers we are recruiting into the profession, who will make a huge difference to outcomes for young people.

The other point to arise from this meeting is that a generation of teachers has not learnt anything significant about child development. That means that head teachers and lead teachers today will not have learnt much about child development in their training. So, while I welcome what the Minister has said about the changes in the standards, the challenge presented by this issue should not be underestimated. I hope there will be ongoing discussions about what we can do in this area, which is vital for the educational outcomes that we want to see for our young people. We need to retain our new, young, enthusiastic teachers on the front line, help them to understand why children sometimes behave so challengingly and enable them to engage with them effectively. I apologise to the Grand Committee for intervening but I hope that it has been helpful.

[Lord Ramsbotham]

My Lords, I thank the Minister for that positive response and all those who have contributed to the debate. The fact that there is a strategy for schools proves my point because it is the strategy for the early years being hooked on to the strategy for schools which seems to be missing. The strategy for after-school transition up to the age of 25 is also missing. You have local government, healthcare, business initiatives and skills and others all joining in on this; it is not only schools. There is more to it and education is not only about what happens in school.

Accepting what the Minister has said, I am grateful for the opportunity to discuss this issue. I suspect that not only will the Royal College of Speech and Language Therapists, the Communication Trust and the people I am involved with wish to take part in this but so will other Members of the Committee because this is an extremely important issue. With that, I am happy to withdraw the amendment.

Amendment 71 withdrawn.

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[Baroness Jones of Whitchurch]

I am covering for my colleague here, so I am doing a double act.

Amendment 75 proposes a new clause, which very much picks up on the point that the noble Lord, Lord Ramsbotham, made in the debate about the importance of early identification. We believe that identifying and supporting children with SEN as early as possible is the most important factor in improving their outcomes, so our new clause would put early years area SENCOs on a statutory basis, like school SENCOs. It would require local authorities to employ enough of them to support all the identified needs locally. Clause 22 requires local authorities to seek to identify children and young people in their area who may have SEN. Our amendment would insert “as early as possible”, which again echoes the points we made in the earlier debate.

The professionals who work with children have a crucial role to play as the first educators with whom those children come into contact. A number of issues such as speech and communication problems, developmental delay, behavioural issues and literacy problems can be better addressed by having a good quality early years provider, meaning that children start school in a much better position than they otherwise would have. Fewer resources would then be required in later years, so the case is well made and cost effective.

However, the early years workforce is typically the least qualified in the education sector, while cuts to local authority budgets have meant that councils have cut their training budgets for early years staff by 40% since the election, resulting in many cutting back on the early years area SENCOs that they previously employed to provide advice and training in early years settings. Yet the support that they provide is now needed more than ever. A recent Communication Trust project, Talk of the Town, evidenced that, across a federation of schools, children and young people’s speech and language needs were underidentified by an average of 40%. The Communication Trust says that it,

“remains concerned over how the Bill will ensure that the mechanisms for identification will work in practice across all educational phases and also on local authorities’ ability to identify needs as early as possible, and to respond to these needs”.

The NDCS, the RNIB and Sense are also concerned that overall proposals do not place sufficient emphasis on the importance of early years support for children with sensory impairments and their families.

Labour tabled these amendments in the Commons. At the time, the Minister said that he would reflect on whether and, if so, how some of the good practice of area SENCOs could be reflected in the code of practice. As I have just hinted, I have only just acquired this brief this afternoon. I have looked at the code of practice and I am struggling to see where that might be. There is certainly reference to maintained nurseries having a role, but nothing that spells out the role that area SENCOs can have with the more diverse group of early years providers. I look forward very much to hearing what the Minister has to say about that, but I hope that we can agree that more can be done within the Bill and the code to emphasise the importance of these early years area SENCOs. I beg to move.

[Lord Ramsbotham]

I rise to support this amendment, and to speak to Amendments 79, 108, 116, 128 and 238. I am glad that the noble Baroness mentioned the importance of assessment and intervention as early as possible, particularly for this area. I was very struck last Wednesday, at a meeting with the Minister, when he confirmed that only just over 10 years ago, 80% of communication between young people was verbal and 20% electronic. That is now reversed, with 80% being electronic and only 20% verbal. We need verbal communication above all to enable us to engage not just with teachers but healthcare workers, family, friends and ultimately with employers and customers. If we are to enable our children to live in today’s world, it is crucial for them to communicate with each other and for those who have to engage with them to help.

Amendment 79 requires schools and registered early years settings to identify special educational needs while offering guidance on how to do so. This is very important because, as we discovered when doing the report, which I have mentioned several times, the health visitors who were doing the early assessment in Northern Ireland were extremely glad that they had been trained to do so by speech and language therapists—not that they could offer therapy, but at least they knew what signs to look for to alert them that somebody had a problem. This is very important, and it is a lesson that should be applied right across the country.

Amendment 108 extends local offers to include access to services for children who are educated in non-maintained early years settings. It should not be restricted only to those with EHC plans, which, for the vast majority of people who have children with speech, language and communication needs, do not make them eligible for any additional support. That is wrong. The people with speech, language and communication needs do need support to enable them to engage. It is not just for those on EHC plans, which, as we know, is a small proportion of the whole.

Amendment 116 requires local authorities to inform parents of what special educational needs and local office support is available to children educated in non-maintained early years settings. This is again something that should not be left to chance because, as we know, there is a vast variety of provision and a vast amount that parents do not know or understand and with which they need help. Somebody has to co-ordinate the giving out of that advice, which suggests that local authorities have a role to play.

Amendment 128 makes local authorities responsible for special educational needs provision to those who have them identified in private, voluntary and independent early years settings, and for establishing the necessary mechanisms to enable and ensure that both identification and provision are available. All those may seem very much the same, but what they are saying collectively is that there is a duty here for the local authorities to make certain that identification and provision are available for all children in the local authority area, whether they are in mainstream or PVI settings. We must not let that go by default.

Amendment 238 highlights something that else that is lacking and is not clear from the Bill. Schedule 4 to the Bill amends the Childcare Act 2006 to require the registration of childminder agencies and certain childcare providers on childcare registers. However, the Bill is currently unclear about the position regarding private, voluntary and independent providers. As nearly 80% of the early years providers come from the private, voluntary or independent sector, this seems to be a gap that needs to be filled. We must ensure that everyone is covered. I am not simply saying that there is a gap; I am trying to suggest that there may be a way out of this. I suggest that all childminder agencies should be required to employ a SENCO, and that all non-maintained providers—that is, all the PVI providers—should be required to register with one of these childminder agencies. In that way, the SENCO can relieve the PVI of what the Government have said that they do not want to do, which is to belabour it with too much bureaucratic work that it has to do. A SENCO with the same status as the others would be able to act as a bridge between these 80% of providers and the local authorities to ensure that every child is covered.

Again, this may sound complicated, but I say to the Minister that the Communication Trust and others, who have thought this through and drafted this amendment, which I am very pleased to put forward for them, are very happy to engage with officials to discuss how this might be provided for, and to make certain that the gap is covered. The Communication Trust includes those working in the area now, and we have contacts with the Local Government Association, which I know would be very happy to contribute.

[Baroness Perry of Southwark (Con)]

My Lords, my concern in this whole topic is that I make a fair estimate that a lot of childminders are not trained or equipped to identify children with special needs. Surely the agency that ought to pick up special educational needs very early is the district nurse, who visits in the very early stages of a child’s life. One of the things that they are trained to do is to test for special needs. Is this not an opportunity, in this Bill that is trying so hard and so admirably to bring together all the different services, such as health services and educational services, to tie up the measurement, the testing and the observations that a good district nurse will make of a baby—and that I guess a midwife would make—to ensure that this is passed on to the childminders? Here we are very much occupied, rightly, in pointing out the things that need to be done when a child has been identified, but there is very little about how the identification takes place. I would be grateful if the Minister could make some reference to how this could be brought about. It is not asking for anything new; it is asking for exactly what the Bill tries to do, which is to bring the bits together.

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[The Countess of Mar]

My Lords, I support the noble Lord, Lord Ramsbotham, and the noble Baroness in their amendments. When my elder granddaughter came to visit us, we found it very difficult to understand what she was saying. When she got to the age of three and a half my husband, who was a schoolteacher, was saying, “Huh, huh, huh” or “Ber, ber, ber” to her to try to get her to pronounce things. My daughter got into a furious rage and took her home, but then realised that the child could not communicate and was getting very frustrated because we could not understand what she was saying. She took her to a speech therapist. On the health service, it would have been 14 or 15 months before she could get help, so she took her privately. My granddaughter was diagnosed as being quite severely dyspraxic. She struggled through school but got her A-levels and is now deliriously happy at university doing a course in fine arts, restoration and conservation, which is right up her street. She was caught early, which is so important. She will have a career; everyone wants someone who can conserve things. She has been to the House and visited the conservators.

It is important that we catch them early. My granddaughter started off being able to speak at the age of nine months, but then had an accident involving a head injury that was not picked up, so midwives or district nurses would not have seen that. The noble Lord, Lord Ramsbotham, and the noble Baroness have an important point.

[Lord Ramsbotham]

I just say to the noble Baroness and the noble Lord, Lord Storey, that I was referring to the assessment required now in the early years foundation stage, which must be carried out by health visitors. I was saying that that is a compulsory healthcare test. I was mentioning that the healthcare visitor to whom we spoke in Northern Ireland mentioned the value that she had had from being trained by the speech and language therapist to identify the particular triggers for speech and language difficulties, which I believe ought to be common practice everywhere.

[Baroness Northover (LD)]

My Lords, this debate has covered the important issue of SEN in early years settings, and noble Lords have been probing a perceived gap in the legislation in that regard. Clearly, as noble Lords have said, many of the duties in Part 3 apply only to maintained nursery schools, not to other early years providers, which has led to concerns that children in playgroups and independent nurseries or with childminders might not have their special educational needs met. We reassure noble Lords that that is not the case. Duties are in place throughout the Bill and through the Childcare Act 2006 which should ensure that special educational needs are identified and addressed in early years, wherever a child is.

I point the noble Baroness, Lady Jones, who I realise leapt in having not realised that she was about to deal with this amendment, to page 70 of the draft guidance, which is on the role of the SENCO in early years provision, so that she can have a look through that.

Amendments 116 and 108 seek to include early years provision within the local offer. We absolutely agree that this should be the case. Perhaps when I have explained some of these areas the noble Lord, Lord Ramsbotham, will be reassured and will want to see whether that meets most of the concerns of those who were advising him.

Schedule 1 to the draft Special Educational Needs (Local Offer) Regulations 2014 already makes clear that the local offer must include special educational provision from,

“providers of relevant early years education”.

These providers are explicitly referred to in paragraph 1(a) of that schedule. The regulations also require the local offer to include the arrangements that such providers have for “identifying … special educational needs”, in paragraph 4(a), and for,

“securing the services, provision and equipment required by children”,

with SEN, in paragraph 4(c).

Relevant early years education is defined as that childcare which is provided to meet the duties under Section 7 of the Childcare Act 2006. Noble Lords may be reassured that this would include all local authority-funded early education for two, three or four year-olds, whatever the status of the provider. It is not limited to maintained nurseries and 96% of three and four year-olds access such early education through local authority funding, so I hope the noble Lord, Lord Ramsbotham, is reassured that non-maintained early years providers are already included. We share his concern that children are identified as early as possible. This is particularly important in areas of disadvantage, where the current two year-old offer of 15 hours’ free childcare per week is targeted.

Amendment 128 would require the local authority to use its best endeavours to identify children with SEN in early years provision, and then to secure the relevant services for them. In relation to the concerns of my noble friend Lady Perry, I know from the Department of Health that this issue has been picked up there. I assure her that there is cross-government working in this regard. We recognise the importance of health service involvement in identifying very young children who may have SEN as soon as possible. That is why Clause 24, which my noble friend may want to look at, provides for health bodies to tell local authorities about young children under compulsory school age who may have SEN. It is also why we are training an additional 4,200 health visitors by 2015 to help improve early identification. I hope that my noble friend finds that reassuring.

The Government want to reassure noble Lords that local authorities must ensure that all providers that they fund in the maintained, private, voluntary and independent sectors effectively meet the needs of children with SEN and disabilities. Local authorities should remove barriers in access to early education and work with parents to give each child support to fulfil its potential. All early years providers, regardless of how they are funded, must follow the welfare requirements set out in the EYFS framework to have and to implement a policy and procedures for children with SEN and disabilities. This should include how the needs of these children will be met and how reasonable adjustments will be made. Providers are also required to assess children regularly and to keep parents informed. They must consider whether a child has a special educational need or disability which requires specialist support. They should link with families and help them to access relevant services from other agencies as appropriate. These requirements are reflected in the draft SEN code of practice, which also gives practical guidance to early years providers on responding to special educational needs. I hope that the noble Lord, Lord Ramsbotham, will look carefully at that.

Amendment 238, again tabled by the noble Lord, seeks to place requirements on childminder agencies, including a requirement to appoint a SENCO with the prescribed qualifications, and a regulation-making power to set out requirements on how childminders registered with an agency should support children with SEN. I heard the reason he gave for taking that route, and I hope that to some extent what I have already said has reassured him that there is not quite the gap he is seeking to plug here. I also note what my noble friend Lord Storey said about this. The provision to create childminder agencies in Part 4 is an enabling one. We do not think it would be helpful to try to tie these providers into agencies. I am sure we will hear arguments to the contrary when we get to Part 4.

Returning to the key issue of early years childminders, we agree that childminders need also to look out for children in their care. Clearly, they need to be subject to the same duties and expectations whether they are registered with an agency or independently registered with Ofsted. The Government’s intention is that the agency-registered childminders should follow the same guidance on SEN as other types of early years providers, as part of that jigsaw of involvement with young children.

Page 70 of the draft code of practice, which I have just referred to, sets out guidance on the role of the SENCO in early years. It makes clear that the SENCO role may be shared between childminders in the network and suggests a similar approach be applied to agencies. For most early years settings, the SENCO is not required to have a particular qualification. Currently, and in the draft code, only SENCOs in schools and maintained nurseries must hold specific qualifications, including qualified teacher status. We feel that it would not be appropriate to impose additional burdens on childminder agencies over and above those in place for other early years settings. The framework provided by the early years foundation stage and the SEN code of practice makes this unnecessary.

Amendment 75, tabled by the noble Baroness, Lady Jones, seeks to require local authorities to appoint sufficient area SENCOs to support early years providers, drawing attention to an important role. As my noble friend the Minister mentioned in a debate last week, page 70 of the draft SEN code of practice states that,

“local authorities should ensure that there is sufficient expertise and experience amongst local early years providers to support children with SEN”.

It goes on to outline the role of area SENCOs in the early years. By including the role in statutory guidance for the first time, we are recognising its importance and creating a clear expectation about the support that local authorities should provide for children in early education.

Turning to Amendment 79, we fully endorse the importance of early identification of SEN, which this amendment seeks to secure. One of the main aims of the reforms we are debating is to seek to ensure that children and young people have their needs identified earlier—whether through district nurses, as my noble friend Lady Perry indicated, or through others involved with young children—so that the right support is put in place quickly.

The education providers listed in Clause 29(2) have a duty under Clause 62 to use their,

“best endeavours to secure that the special educational provision called for by the pupil’s or student’s special educational needs is made”.

Actively identifying special educational needs is an integral part of this duty. The draft SEN code of practice makes this absolutely clear. Chapter 6 of the code requires schools to assess pupils on entry, make regular assessments of pupils progress and ensure that teachers are equipped to spot potential special educational needs quickly.

I have perhaps been too comprehensive. However, I hope that I have been sufficiently comprehensive to address the questions and needs of all those who are rightly concerned about this area. I hope that my response reassures noble Lords that effective duties are in place because we agree with what noble Lords say they are seeking to achieve. We will continue to work with the Communication Trust and other expert organisations to ensure that the SEN code of practice provides effective guidance on all these issues. I therefore hope that the noble Baroness will be happy to withdraw her amendment.

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Sense, NDCS and RNID understand that it may not always be realistic for a local authority to provide services to children with sensory impairments and low-incidence needs on its own account when the numbers of children with such needs in the area is very small. However, they state that they believe it is possible for such a local authority, by collaborating with other local authorities, to meet its responsibilities for these children. Although we welcome the endorsement of this approach within the revised SEN code of practice—which is currently out for consultation—we would like the Government to go further to encourage such collaboration in the Bill.

[Lord Ramsbotham]

My Lords, I shall speak to my Amendments, 89 and 92 to 97, and add my support to Amendment 100, mainly because it becomes very relevant when we come to Clause 70, dealing with people in detention.

My other amendments are to do with something I find odd about Clause 26. Although on the face of it local authorities and partner health bodies are required to make, have regard to and keep under review joint commissioning arrangements, there is no obligation on them to operate any of those arrangements, let alone to reach agreement. That seems very peculiar. Even when they operate the arrangements and reach agreement, the resulting provision is limited to what they agree to be reasonably required.

I go back to my amendment to Clause 21(5), because, as I mentioned then, health bodies may well argue that their position is constrained by what they consider necessary. Given how many such bodies apparently give very low priority to speech, language and communication needs and the provision of speech and language therapists, that might mean that little or no speech language therapy would be provided for children or young people other than those who are on EHC plans. This brings us back to the problem of the vast majority of children with these needs who are not on those plans.

Clause 26 does not allow the assumption that children without plans will get what they require; nor does it mention any requirement to publicise what arrangements and agreements are available for parents or the people affected; and it does nothing to ensure that there is consultation on the joint commissioning arrangements. My amendments are designed to strengthen Clause 26 by making its tone “must” rather than “discuss”.

[Baroness Northover]

My Lords, this group of amendments relates to Clauses 25 and 26, which deal with promoting integration and joint commissioning. These provisions are at the centre of our reforms and I am grateful to noble Lords for their careful consideration of these issues. Children and young people with special educational needs need integrated services. Too often they have to tell their story over and again, and too often they or their parents struggle to navigate a system that makes no sense either to them or to the professionals who are supposed to be helping them. In this mini-debate we have had an echo of the discussions we had on both the Health Bill and the Care Bill, where noble Lords were very keen, as were the Government, to take forward better integration and working together across these areas. Noble Lords who have just come from the Care Bill will be extremely well aware of how the Government have sought to take this forward, addressing how people have so often fallen between the cracks. This, too, is part of the attempt to ensure that those with special educational needs are better supported and that the authorities responsible for them work more closely together.

These clauses seek to tackle those issues head on. The integration duty sits alongside duties for a local authority and its local partners to co-operate with each other. I remember extremely clearly, as other noble Lords no doubt will, how integration, as debated in the Health Bill, had to be part of the new arrangements for the health service. This echoes much of that. It links closely to the joint commissioning clause that provides the statutory framework to enable partners to work together effectively to deliver a better experience for the child or young person and their families, and support improved outcomes. Joint commissioning sets out the framework for key elements, such as the local offer, education, health and care plan assessments, and personal budgets. It seeks to improve both the working relationships between local authorities and health bodies, and the provision to children and young people with special educational needs. It requires the local authority and health bodies to establish clear procedures for making decisions and, in particular, to agree what support is needed locally and which agency will deliver it. Crucially, they must agree how they will resolve disputes between partners, as well as how they will deal collectively with complaints concerning education, health and care provision.

The new draft SEN code of practice’s chapter on joint commissioning has developed a great deal, and I hope it may help to reassure noble Lords to know that it puts great store on the importance of making decisions in joint commissioning arrangements—an issue to which the noble Lord, Lord Ramsbotham, has just referred. It specifies that the arrangements should be robust enough to ensure that all partners are clear about who is responsible for what, who the decision-makers are across education, health and care and how partners will hold each other to account where there is a dispute. It recognises the importance of getting elected members and chief executives across education, health and social care on board, and recommends that the arrangements for children and young people with SEN should be specifically accountable to councillors and senior commissioners. It recognises that local accountability can take the form of a programme board, acting as a bridge between the local authority’s education and social care leadership and health partners.

It also reflects that health bodies must work with the local authority in commissioning integrated, personalised services and designing the local offer, including ensuring that relevant contracts with providers reflect the needs of the local population. Local authorities, clinical commissioning groups and NHS England should develop effective ways of harnessing the views of their local communities so that commissioning decisions on services for those with SEN are shaped by people’s experiences and aspirations. The dovetailing of the SEN reform clauses with the NHS reforms is central. The NHS mandate requires clinical commissioning groups to consider the needs of children and young people with SEN and disabilities, so we see immediately the crossover. The Health and Social Care Act reforms require local authorities and clinical commissioning groups to participate in the health and well-being board and to produce a joint strategic needs assessment and a joint health and well-being strategy that sets out how local needs will be met. So the needs are to be identified, and plans have to be put in place as to how they are met.

The health and well-being board has a duty—and I well remember it—to encourage integrated working. For the purpose of advancing the health and well-being of the people in its area, it must encourage people who arrange for the provision of health or social care services in the area to work in an integrated manner. As I said, the Care Bill has been taking that further forward and making it a reality. I hope that that context helps when looking at how we are trying to tackle the needs of these particularly vulnerable children.

I heard what my noble friend Lady Sharp said about the probing nature of her amendment. As ever, she probes extremely effectively. She is seeking to explore how these new arrangements will work in practice, and obviously she is absolutely right to do that.

My noble friend wondered whether SENCOs would have too much on their plate. Since 2009, the Government have funded more than 10,000 new SENCOs to study for the National Award for SEN Coordination. We will support a further 800 places in 2013-14 and this will help them in their important role in linking with other agencies, such as health and social care. I hope that that helps to take this matter forward.

Many of the amendments in this group reflect an apparent desire to puts lots of detail in the Bill. This is an argument with which everyone here will be very familiar—whether it is necessary to specify certain things in the Bill in order to make sure that certain things happen. I am sure that we are all seeking to go in the same direction, which is to achieve what the Bill sets out to do. From noble Lords’ probing as to whether it is going to be delivered by the Bill as it is, I certainly sense that there is agreement on that.

However, noble Lords will also be familiar with the fact that if you specify in great detail in a Bill, you can inadvertently exclude things that you have not included. That is why there is always discussion about what happens in guidance and secondary legislation and so on, and that is why I am so pleased that we have the SEN guidance. It is comprehensive and, I hope, addresses a number of issues that noble Lords are concerned about. From that guidance, your Lordships can see how the Bill translates into what we intend in practice.

As noble Lords will appreciate, we feel that there is a danger that if too much is specified in the Bill, that will then hinder the kind of flexibility that may also be required at a local level. Noble Lords who heard the pathfinder organisations, which came to address us the other day, probably share my feeling that the often very imaginative and creative ways in which they were going about their work and the way they were working with other organisations in their local areas to address the needs of the children were very impressive. One would not wish to do anything that stifled that. One would wish to support them in taking that forward. The aims of what one is seeking to achieve and the details being spelt out in the guidance—

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[Baroness Northover]

I hear what the noble Baroness says, and she speaks from a great deal of experience. That is the kind of challenge that has led to us trying to move forward across the board on SEN to ensure that what is provided for children is more uniform and more joined up. If need be, I will write with more detail in response to her but, as I said, what the pathfinders were saying was encouraging. They said that they would link up with those who came after to try to spread best practice. As noble Lords have said, it is often what happens in practice on the ground that may be wanting.

That links up with an issue raised by the noble Baroness, Lady Jones, about how families might hold their local authority and CCGs to account for having arrangements for joint commissioning in place. Ultimately, families could take out a judicial review, but we believe that there are other, more effective ways to hold local bodies to account through local complaints procedures and through NHS England, which will review how CCGs are fulfilling their duties under the NHS mandate. I remind noble Lords that the NHS mandate refers specifically to children and young people with SEN. Therefore, there are those novel routes. That is a new lever.

As the services that result from joint commissioning arrangements will be reflected in the local offer through direct involvement in developing and reviewing it, we hope that that will bring about the opportunity to improve things in the way that both noble Baronesses seek.

Returning to my script, as opposed to my thoughts, Clause 26 requires local authorities and CCGs to keep the arrangements under review, so that service provision will evolve over time and continue to meet the needs of the community that it serves. I have spoken about the pluses and minuses of putting duties in the Bill.

I also note that service providers must take responsibility themselves for how they best use their resources to provide services for children and young people with SEN. I was struck by what the pathfinders said about how often that meant finding a cost-effective way to do that. It was not necessarily the case that working together was more costly. That was interesting to hear.

The final paragraph in Amendment 86 highlights the importance of key workers, which is something that we support and have specifically included in the code of practice. Chapter 3 makes clear that the kind of support that local authorities should offer children, their parents and young people should include key work and support, such as individual casework and informal advocacy, support in attending meetings or contributing to assessment and reviews, and participating in decisions about outcomes.

There was reference to how the NHS provides services and how that might mesh. The fundamental principle of the NHS is that provision should meet reasonably required needs. We have to be careful. There is a wide understanding, certainly among noble Lords, as to why that is the case and why, for example, the previous Government set up NICE to assess treatments and to work out what was effective. An NHS that was free at point of need, universal and comprehensive had to make sure that what it was providing to the population made sense and that clinicians would agree as to what was an effective treatment and so on. All of that is built into the way the NHS has always operated. We therefore have to be careful that we do not inadvertently seek to change that fundamental principle of provision to meet the reasonably required need.

The CCG has a statutory duty to provide services to meet the reasonable needs of those for whom it is responsible. We have a good understanding of that. We may challenge it around the edges, but we do have an understanding of it. It must act consistently with the NHS mandate—

[Lord Ramsbotham]

My Lords, I am sorry to intervene but the point of raising my concern is that, in many areas, speech and language therapy has not traditionally been accorded the impetus that has been required by the NHS. I welcome the talk about health and well-being boards. Indeed, as I mentioned earlier in the debate, because they are the bodies that are in touch with all people from nought to 25, I hope that they will have a role and that it will evolve. Accepting the way in which the NHS operates, I hope that in future it will take account of speech and language therapy needs because of its increasing importance for our children today.

[Baroness Northover]

The noble Lord made a very cogent case before and my noble friend was sympathetic to what he said. It will always be the case that, at any one time, there will be debate as to what is essential, what ought to be provided and what will best help children or any member of the population, and, therefore, debate about what the NHS or any other provision ought to cover. As I said, the noble Lord made a cogent case and my noble friend responded sympathetically, so it is a matter of let us watch this space. As I have mentioned, the NHS mandate includes a specific objective that children and young people with SEN have access to the services set out in their care plans. I hope that is reassuring.

I have referred to pathfinders and the wording in the clause reflects the fact that the parties involved are expected to follow the arrangements made unless there is good reason to depart from them. Allowing that flexibility will enable partnerships to adapt to accommodate unique circumstances or changing priorities locally which the arrangements may not have anticipated.

Noble Lords may be anxious that this flexibility could mean that partners have to have only some of the arrangements in place before achieving any agreement. I hope I can reassure noble Lords that this is not the case and is certainly not the legal effect of these provisions. Clause 26(4) makes it clear that these partnerships have the clear function of securing the care that children with SEN need. Therefore they must be able to agree a clear course of action in every case. This point is backed up by the new draft SEN code of practice.

There may be other elements that I need to address. I turn to the point that the noble Baroness, Lady Jones, made about transparency. We certainly agree with her point about needing transparency for parents but we do not think that we should replicate other legislation in the Bill. I am sure she will be disappointed about that. The place to bring this together, we feel, is in the code of practice, and that is what we have sought to do. Again, that is something that comes up in legislation all the time: should we make reference to previous Acts or should we include it in the new Bill? We feel that the draft code of practice helps to bring everything together very clearly, and I hope that she will accept that.