Mental Health: Children and Young People

Lord Storey Excerpts

Thursday 23rd November 2023 Lords Chamber

[Lord Storey (LD)]

My Lords, I want to look at mental health in the context of schools. Before I do, I congratulate the noble Baroness, Lady Hale, on her maiden speech. She is wearing a butterfly brooch, as opposed to a spider, and I feel more relaxed seeing that. I also congratulate my noble friend Lord Russell on his speech. I thought it was very honest, and perhaps brave of him, to reference his own family and his daughter in an open Chamber.

I will give two brief examples before I turn to children. Four years ago, as part of Learn with the Lords, I went to speak to some secondary pupils at a school in Cheshire. The school was on a large council estate. I went into the school and the head sort of pushed me off with one of her teachers, and so I went in and spoke to the pupils. When I came out, the head asked me if I would like a cup of tea, and I said yes. I got into her office and she just burst into tears. I did not see it coming and I did not know what to do. She just stood there crying, so I naturally gave her a cuddle. She pulled herself together and said, “I’m really sorry about that. I have just had a letter from Ofsted telling me that we are a failed school, and I don’t know how to tell my staff. My staff are so hard-working. This is a very difficult circumstance for the school and I just don’t know what to do.”. We talked it through, and that made it clear to me that when we talk about mental health in schools, we should think about the teaching and non-teaching staff as well.

Interestingly, a friend of mine is head teacher of a three-form entry primary school of more than 500 pupils in a very deprived part of Liverpool. I asked—I will call him by his first name—Andrew how he is coping in his community. He said, “Well, I see my job not as a head teacher but as a social worker, quite honestly”. I turned to the subject of mental health and how he supports the pupils in that school. He said that from his school budget, he is able to spend £10,000 on one person to support the probably hundreds of pupils in his school who need mental health support. He said that the problem is that professionals are in high demand and other schools will pay more to poach them. He said, “I am lucky to get somebody to stay with me for a year”. That is a major problem. If we are to support pupils, children and staff in schools, we will need to be sure that professionals are available to do that and that they will not suddenly leave, leaving disappointed pupils and a case load of other children for somebody else to deal with.

My noble friend Lord Allan mentioned the second problem we face in education. There are literally—this is no exaggeration—hundreds of thousands of children missing from our school registers. They are missing because they were at home during Covid, they came back to school and they could not cope. They went back to their parents, mainly in deprived communities, and said, “Mum, dad, I don’t want to go to school. I can’t cope”. “Oh, stay at home. We will have home education”, they were told. As we know, home education is not registered. After a brief period, those children increasingly do no home education at all.

Imagine the strain that puts on the parent and the mental problems it will create for those children in the future. We can see that in the published figures and the increasing numbers of children who are permanently excluded from school. We have hundreds of thousands of children missing from our school registers, and there are even children who have been put on education healthcare plans who are permanently excluded from school, so we cannot implement those plans. That does not seem in the best interests of our pupils’ education.

Why has the number of children with mental health problems in school increased? Perhaps we have always had children with mental health problems in our schools but have never recognised or realised it. Perhaps we thought, “This is a disruptive child” or “This is a child with behavioural problems”. Thankfully, that is not the case now.

We know why there has been such a dramatic increase: Covid was one reason. I was also interested in my noble friend Lord Allan’s comments on social media, but the pressures of it—of having to respond, and the potential bullying—all create mental anguish and problems.

Our school system does not help. We are the most tested country in the world. We subject our children and young people to more tests than any other country does. Imagine the pressure that puts on young children. Imagine the pressures of Ofsted: I mentioned the example of the head teacher I met, and we know the tragic circumstances of the head teacher who took her own life as the result of an Ofsted inspection. All those pressures are happening at schools, with the high grades that schools require their pupils to achieve. What happened to the enjoyment of school? What happened to discovery and fun in school? It is all focused on a results outcome.

We name and shame. We put banners outside schools saying, “We are a good school”. In schools that do not have that banner, do parents and children feel a sort of anguish as a result? Our education system is not conducive to people’s well-being.

As has been said, we need to ensure that teachers are properly trained. As I have said on so many occasions, I do not think that Teach First, which takes a graduate, gives them a few weeks’ intensive training and then puts them in a school with a mentor, is the best possible way to train a teacher. It took me three years and when I started teaching, I was still learning. There needs to be an understanding of child development, for example, and of how to identify special educational needs. Part of that training should also include an understanding and recognition of mental health problems.

Finally, we need to support parents. We also need parents to understand what they can do to support their children. They need to bring routine to their children’s lives, to talk to their children, to ask how they are doing, to encourage them and be able to speak to them.

Mental health is a very serious issue in education and schooling. If we think that we can just put in a few million pounds here and make a promise there, it will not go away. We need dedicated, well-trained professionals in our schools who know what they are doing and how to support those pupils.

Health Promotion Bill [HL]

Lord Storey Excerpts

2nd reading
Friday 2nd December 2022 Lords Chamber

[Lord Storey (LD)]

My Lords, I start by thanking the Whips for allowing me to speak despite my late arrival. I perhaps needed healthcare when I arrived: I left Liverpool on the 7 am train, which was supposed to take two hours but took two hours and 45 minutes, and my dash from Euston station got my heart going. I also thank my noble friend Lord Addington for this important Private Member’s Bill. Given the comments from noble Lords, it seems to have support right across the House and I hope the Government will take note of that.

Having heard all noble Lords speak, it seems that we have the strategy in front of us. I have listened to all the comments made and, along with the Select Committee, your Lordships seem to have come up with a strategy. We heard from the noble Earl, Lord Devon, about the importance of funding at a local community level; the noble Baroness, Lady Bennett, about recapturing the streets; the noble Lord, Lord Moynihan, about schools and opening schools—I shall come to education in a moment; and my noble friend Lady Randerson. A couple of days ago, she said to me, “I’m going to talk about a very niche area”, because I wanted her to wind up for my party. I say to my noble friend that it is not a niche area; that is what we should all be doing, not just in Wales, where it has been done, but right across the UK. I thought the noble Lord, Lord Kamall, was very brave and honest in his comments about apathy from government. It is not just the current Government; I think we have seen apathy from all Governments in this regard.

A report was published today by the Sutton Trust—which regularly does surveys of opinion and polling on education matters—about the impact of the rising cost of living on pupils. One of its interesting comments was that, in state schools, 74% of teachers have seen an increase in pupils who are unable to concentrate or are tired in class, and 67% saw more students with behavioural issues. There are lots more comments in that report. If we dug down a bit deeper, we would find that the majority of those students come from poor backgrounds or disadvantaged homes. One of my concerns is that, if I look at my home city of Liverpool—a number of noble Lords spoke about this issue—the facilities are mainly geared to a handful of sports. For example, football, in the main, predominates; I do not see hockey pitches or netball courts there. It is also very unfair to women, as the facilities are mainly for men. If you go to other facilities in the local cricket clubs or tennis clubs, you see—I never know what the correct term to use is—very few young people from ethnic backgrounds and very few from disadvantaged backgrounds. We have to open sport up to those people. We have to make sure that people from disadvantaged backgrounds go to those clubs and are welcome at them, and we have to have the facilities.

I have often thought that if we want to change the way we do things in sport, we cannot just sit there, waiting and hoping that somebody coming from Norris Green council estate will come to the club. We have to create a link for them and schools are best placed to do that. The noble Lord, Lord Moynihan, suggested the importance of schools operating Saturday clubs, but I think we also need outreach work for those young people. Imagine if those young people were visited, encouraged and taken to those facilities, because transport and getting to them is a huge issue—those figures that I just read out would be different. The best way to deal with mental health is to be physically engaged in activities. The best way to deal with the problems of disadvantage is to get people into sport, and we are not doing that. That is a great shame.

During Covid, we saw a dramatic decline in the number of children from disadvantaged backgrounds attending schools; many have not gone back to school. They have said to their parents, or parent, “I don’t want to go to school. I’ve got problems, and I want to stay at home”, and the parent has then used the excuse of home education, or home tuition, to keep them at home. Thousands of children from disadvantaged backgrounds are “home educated”, but they are not—they are just languishing at home. Again, imagine if we could involve those children in sport, using our schools and encouraging them. We would see a huge change.

I wish my noble friend Lord Addington well with the Bill. He has huge support across the House, and I am sure he will score many goals.

Health and Care Bill

Lord Storey Excerpts

Lords Hansard - Part 2 & Committee stage
Monday 31st January 2022 Lords Chamber

[Lord Young of Cookham (Con)]

My Lords, I shall respond to the injunction from the Front Bench and speak for less than two minutes. I had not planned to intervene in this debate, but I was provoked by my noble friend Lord Reay, with whom I find myself in respectful disagreement, and further provoked by the noble Baroness, Lady Bennett.

Listening to my noble friend’s speech took me back 42 years. It was like Groundhog Day, because in March 1980 I had to sit through a speech lasting more than one hour by Ivan Lawrence on fluoridation. I was lucky because in 1985 he set a new record by speaking from 5.12 am until 9.35 am. I was refreshing my memory about what I said in response to the debate 42 years ago in just two paragraphs—I should explain that I was the Minister responsible at the time, when I said:

“I think I should first explain that fluoride occurs naturally in most water supplies, sometimes at a satisfactory level for the prevention of dental decay. Fluoridation consists merely of the adjustment to the optimum level for dental protection—one part per million in temperate climes—of the fluoride content of those water supplies that are deficient in it naturally. When water containing the optimum level of fluoride is consumed during the years of tooth formation, the protection conferred in childhood continues during adult life.”—[Official Report, Commons, 6/3/1980; col. 792.]


I wound up:

“Finally, as my right hon. Friend indicated last January”—


that was January 1980—

“it remains the Government's view—like that of their predecessors for many years—that extensive trials throughout the world have shown that fluoridation safely and effectively reduces the prevalence of dental caries—one of the commonest diseases and one which has lifetime consequences for general and dental health.”—[Official Report, Commons, 6/3/1980; col. 799.]

Since that time, government policy has not been delivered, as the noble Lord, Lord Hunt, explained. Initially it was the area health authorities that did not do it, and now it is local authorities. It is now imperative that government policy is delivered, and that is why I wholeheartedly support these clauses in the Bill.

[Lord Storey (LD)]

My Lords, I shall speak briefly on Amendments 224 and 261 and share my views on fluoridisation. I agree with the noble Lord, Lord Reay, that it is a pity we did not have a proper full debate on this matter.

There is a real problem among young children, particularly those in deprived communities, who have increasing levels of bad teeth—dental decay. You would think that as a result of that situation we would be trying to do something more practical about it, yet we see dental inspections in schools decreasing. When I was first a head teacher, the dental services would come in twice a year to inspect children’s teeth and would give a little note to the parents so they could go to their dentist. The second problem we face is that, as we heard from the noble Lord, Lord Hunt, you cannot find an NHS dentist, particularly in a deprived area, for love nor money. That is a problem for families that cannot afford to use a private dentist, even if one was available.

When I was leader of the council in Liverpool, all political parties together—I have to tell my colleagues—decided against fluoridation, so we took the view that perhaps there was a different way of doing it. We were setting up the network of children’s centres in the early 2000s. We therefore made dental health in the nought to five age group one of the highest priorities in the city council’s strategic plan. We also issued additional guidance to our primary schools, asking them to make encouraging better dental health a higher priority. As a result, 10 years later in 2013, the British Dental Association’s 10-yearly survey showed that a reduction of 28% in caries had been achieved in Liverpool’s schools. The targeted approach achieved an outcome double that identified in the York review as the average caries reduction from fluoridation. We will also have helped many children to develop lifelong good personal dental hygiene habits, which is a crucial part of the strategy.

Whether we have fluoridation or not, we need to be absolutely sure that the journey we are going on is correct. In the meantime, we should look at other ways. We should also look at what our colleagues in Scotland have been doing with their Childsmile project, which has been shown to be safer, less wasteful and more effective, and better value for money. I hope that at some stage we will revisit this issue and have a much longer and more considered debate.

[Baroness Walmsley (LD)]

My Lords, this group rightly began with an amendment about adequate provision in dentistry. As we have heard, there is currently a massive shortfall in provision of NHS dentists and indeed dentists as a whole, so much so that a charity called Dentaid, which normally works in the third world, is now working in Dewsbury and Batley—and possibly in other parts of the country that I am not aware of—because people cannot get free dentistry. The situation is made worse by the backlog of treatment caused by the pandemic, whereby dentists were at first unable to see patients and later had to reduce the number of aerosol-producing treatments they could carry out each day.

I have no doubt that the condition of the nation’s teeth has deteriorated during the past couple of years. Nearly 1,000 dentists left the NHS between 2020 and 2021, according to the BDA. However, problems with access to NHS dentistry predate the pandemic. Government spending on dental services has fallen by a third in real terms in the last decade, and the £50 million one-off injection of funding announced recently will barely make a dent in the unprecedented backlog that NHS dentistry now faces.

However, it is also well proven that fluoride, however administered, can strengthen tooth enamel and help teeth to resist decay. The 2018 report from Public Health England made that clear and did not report adverse effects. In Clauses 147 and 148, the Government intend to ensure that the whole country has access to drinking water with at least 1 milligram per litre of water, the level believed to be most effective in reducing tooth decay without the unwanted effects mentioned by the noble Lord, Lord Reay, and without waiting for local authorities to initiate schemes. I have to say that I believe Public Health England rather than the noble Lord.

I am always in favour of prevention and of reducing health inequalities, and it is claimed that this measure would do both, but there are some issues which I wish to probe. Currently only two areas in the country, Hartlepool and Braintree, have the optimum level of naturally occurring fluoride in their water. Other areas, covering about only 10% of the population, mainly in the north-east and Birmingham, already have schemes initiated by the local authority. I accept that a number of costly and bureaucratic barriers have been identified to more local authorities initiating such schemes, and I understand these clauses are an attempt to overcome them by making national regulations. These would remove some of the consultation costs from local authorities. However, some local authorities are reluctant to give up their local autonomy on this issue and believe their residents should be consulted before fluoridation occurs. This must be considered.

I have some questions for the Minister, which fall into two categories. The first is about costs and where they fall. We are told in the impact assessment that current schemes will not be affected, and existing and future capital costs will continue to be borne by the Department of Health and Social Care. What will be the additional burden on the funding of the Minister’s department of bearing the capital costs for every area in the country? I understand that regulations will allow for future costs to be shared by his department with water companies. What impact is that expected to have on the water bills paid by households, since the companies will undoubtedly try to pass it on to customers?

Water companies can well afford to pay these costs themselves, rather than take the money from the health budget. This is clear from the eye-wateringly high earnings of their leading directors. We know from a briefing from Yorkshire Water that the costs can be considerable. A few years ago, it did a feasibility study when only one area—Hull City Council—was looking into fluoridation. At the time, it estimated the capital cost to be £1.6 million to £2 million and the annual operation costs to be approximately £330,000 per year. These costs would have fallen on Public Health England and the local authority at the time, but under the new proposals they would be covered by the Department of Health and Social Care.

Over recent years, capital investment in water and sewerage services has been covered just by income from water bills, but investment in infrastructure has not been adequate, since we still have raw sewage being discharged into water courses and leaks wasting water at an unacceptable level. So, we can expect the companies to accept some of the cost of fluoridation themselves, without passing it on to the customer.

Can the Minister also say what is the plan for regular measurement of the fluoride content of water, and at what point in the delivery journey will it occur? What will this cost, and where will the cost fall? Will the Government allow companies to pass this cost on to the consumer too, although they can clearly afford to absorb it? The reason I ask is that water companies share water all the time and there is a possibility that, without frequent monitoring, the fluoride content delivered to customers could turn out to be either too high or too low to be effective.

The second category of question concerns what other proposals for reducing the incidence of tooth decay have been considered by the Government, as mentioned by my noble friend Lord Storey. I have dealt with the availability of NHS dentistry, but it is excess sugar and acids in the diet that cause tooth decay. Sadly, poor diet is a major problem, particularly among poorer children, for whom the most common reason to be admitted to hospital is the need for complex extraction of rotten teeth. Fluoride can, of course, can be administered in other ways: either applied by the dentist or by regular use of fluoride-containing toothpaste—fortunately, most toothpastes contain fluoride. However, many children eat too much sugar, drink too many acidic fizzy drinks and do not brush their teeth regularly.

As my noble friend said, there used to be a school dentistry service to check for problems, and dental nurses used to visit nurseries and primary schools to teach good dental hygiene. I have myself sat in on such a session and it was excellent, but I do not believe it happens any longer. Have the Government costed a return to these schemes? As for diet, we will be dealing with that in a later group of amendments. So, while accepting the potential benefits of what is proposed, I ask the Minister to assure the House of the cost-effectiveness of the measures, explain the impact on family budgets and tell the House what other measures are being considered to achieve the same ends, which we all want to see: better and more equal dental health.

Clinical Negligence Claims

Lord Storey Excerpts

Wednesday 10th November 2021 Lords Chamber

Asked by

[Lord Storey]

To ask Her Majesty’s Government what assessment they have made of the increase in the value of clinical negligence claims, which are expected to cost £8.3 billion from incidents in 2019-20.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)]

The costs of clinical negligence are rising at an unsustainable rate, eating into resources for patient care. Annual cash payments have quadrupled in the last 15 years to £2.2 billion in 2020-21. That is equivalent to 1.5% of the NHS budget and these costs are forecast to continue rising. This is despite our substantial safety programmes. The Department of Health and Social Care is working intensively across government to address these issues.

[Lord Storey (LD)]

I thank the Minister for his reply. I have raised this issue every year and have heard a similar response from the Minister sitting there every year. When a child is born severely disabled, the parents have to fight to get compensation or money to be able to look after that child. That can often take years. Does the Minister agree with the former Secretary of State for Health, Jeremy Hunt, that we should look at the Swedish model in which, if a child is born severely handicapped, the money is made available straightaway and the parents do not have to wait for the courts to provide support?

[Lord Kamall (Con)]

The Government have looked at a number of different schemes from abroad. It is always very important to learn from good and bad practice, but what happens in a number of those cases is that the costs of compensation end up increasing. So We are looking at various solutions.

Health Protection (Coronavirus, Local COVID-19 Alert Level) (Very High) (England) Regulations 2020

Lord Storey Excerpts

Wednesday 14th October 2020 Lords Chamber

[Lord Storey (LD) [V]]

My Lords, I speak on this statutory instrument as a Liverpool city resident and, for eight years, the leader of its city council. Liverpool’s people have a strong sense of community and justice, and what is fair and right. If there is a wrong against the city and its people, they will always join together to fight that wrong— as our Prime Minister has found, to his cost. The agreement hammered out by Boris Johnson and the city’s regional mayor to put Liverpool in tier 3 was tough and has major consequences for the economy of the city region and the jobs of its people. Liverpool has seen cases of Covid-19 rise and rise, although not to the highest in the country. Intensive care units at Liverpool’s main hospitals are now at 95% capacity.

The deal hammered out by the Prime Minister and Labour’s mayor Rotheram is certainly tough; it has put Liverpool City Region as the only region in tier 3, with all the restrictions that entails. This puts a real strain on the whole community and its cohesion, with families separated, people’s jobs and livelihoods lost or put at risk and the city’s economy in danger of going back to the 1980s. Given the severity of the situation, the people of Liverpool are entitled to ask questions and expect straight, honest replies.

Why was Liverpool put in tier 3 when areas of the country with a higher rate of infection were not? What does the Chief Medical Officer mean when he says that these tough restrictions will not be sufficient without tougher local action? Will we get the resources to have a proper test and trace system in place, as the current system has badly let us down? Does the Minister not agree that it would be sensible for all the schools to have a two-week half-term now? Liverpool has 70,000 university students, the majority living in residential communities. Does the Minister consider there is a case for students to study online from home? How many so-called Covid marshals have been recruited in the region? Finally, travel restrictions are tough: they advise not travelling out of the city region and certainly not staying overnight. Are the Government making arrangements so that the city region’s MPs can work and vote from home?

Queen’s Speech

Lord Storey Excerpts

Thursday 9th January 2020 Lords Chamber

[Lord Storey (LD)]

My Lords, I for one was in the main delighted with the education part of the Queen’s Speech. Its opening statement,

“To ensure every child has access to a high-quality education”,


and the statement that

“A great education is fundamental to the success of children, their families and our communities, as well as the success of our country”


set the right tone. The severe funding issues that schools and colleges have faced is now being addressed, and we must never allow schools to face such a financial crisis again. The focus on further education and technical education was welcome. At long last, the Cinderella of our education service is finally going to the ball.

I have said many times that the most important resource in our education system is the quality of our teachers. Good teachers inspire, motivate and drive ambition and learning forward. Good school and college leaders create places of learning where teachers and their pupils thrive. Yet we have a very serious teacher recruitment crisis. The Department for Education forecasts that, over the next six years, pupil numbers are set to increase by almost 20%. The number of children in classes of 36 or more is increasing at an alarming rate. Many schools across England regularly have classes of over 40, and only 80% of the number of secondary trainees were recruited last year. We are in the middle of a significant teacher shortage. We must prevent a crisis from becoming a catastrophe.

The days when a teaching career was seen as the most aspirational in society appear to be over. However, in other European countries, teachers are highly valued. We need the best minds teaching young people, from the nursery to the sixth form, so why are we experiencing a recruitment crisis? Is the answer better salaries? That must go some way to attracting those who want to teach, but it is not clear that more money will attract more teachers, considering the impact that bursaries have had thus far.

Teachers working today feel undervalued. When I speak to teachers, the main issue they cite is not the money but the workload. Stressful teachers do not make for productive or happy teachers. If we are to achieve the Queen’s Speech peroration, we need well-trained, well-paid, highly motivated and highly regarded teachers. Without them, class sizes will continue to increase, subject specialist shortages will continue to grow, and the drop-out rate of teachers will accelerate.

We hear a lot about inspections and testing. Of course schools need to be inspected and children tested so that we can find out how to support and help children, but it is about how we do this so that schools and teachers are less stressed, more valued and more productive. It is my hope that in this new Parliament the Government will be less dogmatic in their approach to education. Let us recognise that we have a varied system in the types of school that provide for our children, and that maintained community schools should not be seen as educational pariahs waiting to be picked off and converted into academies as soon as they put an academic foot wrong.

By the way, it is interesting that maintained community schools in England outperformed academies and free schools in the national exams taken at the end of year 6. Department for Education figures show that last summer, among pupils taking stage 2 standardised tests in maths and English, known as SATS, those in maintained community schools on average performed better than those in academies. Interestingly, free schools—the Government’s flagship means of opening a new school—also compared poorly with maintained community schools. It is worth noting, however, that the gap relating to pupils whose first language is not English has almost disappeared, which is well worth celebrating.

I want to touch briefly on a couple of other issues that are not covered in the Queen’s Speech but are of huge importance: alternative education and academic integrity. The Minister will be aware that there has been a 50% surge in permanent exclusions from schools in England. These children are placed in alternative provision, but many of those alternative providers are unregistered and therefore uninspected. There are often appalling practices in child safeguarding and pupil registration that go completely unchecked. Two hours a day on an iPad is not education. It is unacceptable in the 21st century that public money should be used to pay these unregistered providers. Shame on central government and local authorities for allowing that to happen. It is not surprising that the children who are being recruited into gangs and county-lines crime may be a significant factor in the increasing levels of knife crime.

We are proud of our universities; we boast some of the finest in the world. It is vital that we do all in our power to safeguard their academic integrity. So why are we allowing companies to help students to cheat? The growing presence of essay mills and contract cheating is alarming. We should make sure that these activities are closed down. The damage that they are doing to higher education is extremely dangerous. No wonder 45 vice-chancellors and heads of organisations in UK higher education wrote to Damian Hinds urging that action be taken against the essay mill companies.

I welcome the rhetoric in the Queen’s Speech, and I hope it is matched by the reality. Our children are our future. We must make sure that every child really does matter.