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12.29 pm

Mr. Peter Ainsworth: I am aware of the time and of the fact that the Minister’s Parliamentary Private Secretary has been sitting behind him patiently waiting to introduce his Bill. I suspect that he had no option but to be patient this morning, and I shall therefore be brief.

The debate has been interesting and worth while, with contributions of high quality. Three themes emerged: empowerment and ownership, about which so many hon. Members spoke; the need to engage with people, and the Government’s acceptance of the need to move on to enable people to engage with the agenda. We also heard about energy security. All sorts of good things have come together.

I started by saying that the Bill was modest, but hon. Members’ generosity has persuaded me that I might have been excessively modest in my description. The measure is capable of moving significantly towards the greener, safer way of producing energy that we all support. I am delighted to see clear evidence of growing cross-party consensus about the sort of measures that we need to take if we are to modernise our energy systems properly and make them fit for purpose in the 21st century.

I am extremely grateful to all those who took part in the debate. I listened to the Minister with great care. He made it clear that he and I have had conversations about the Bill and his comments today coincided entirely with my understanding of where those conversations would lead. I look forward to continuing to work with him positively to ensure that the “guts”, as he put it, of the Bill end up on the statute book as soon as possible. That is what industry needs and the public expect.

Question put and agreed to.

Bill accordingly read a Second time; to stand committed to a Public Bill Committee (Standing Order No. 63).

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Schools (Health Support) Bill

Second Reading

12.32 pm

Mr. Jim Cunningham (Coventry, South) (Lab): I beg to move, That the Bill be now read a Second time.

It has been a pleasure to witness the Bill that was considered before mine and deals with energy, energy supply and the environment receive a Second Reading. However, that is not my brief today.

I have had fruitful discussions with the Under-Secretary about this Bill and I have received reassurances, which I hope she will reiterate today. I pay tribute to the hon. Member for Basingstoke (Mrs. Miller), the Opposition spokesman, with whom I had discussions. I was treated very courteously and, with some reservations, she is sympathetic to the measure.

Nobody should interpret the Bill as an attack on education policies, teachers, head teachers and the staff who assist teachers or the medical profession. It should be seen as a way of tackling some of the concerns and problems that some children experience at school. I recognise from what the Under-Secretary has told me that much progress has been made, and I do not want to detract from that. Indeed, I am probably the last person who would want to do that.

Nevertheless, it is worth highlighting some of the problems that some children experience. I appreciate that the subject is broad, especially when we consider some of the illnesses and disabilities that many children experience. I have had quite a bit of co-operation from the Liberal Democrats. The other day, I attended a meeting of the all-party group on diabetes. Many parents were at that meeting. I listened not only to them, but to the children, and I heard about the problems that they were experiencing as a result of illnesses and disability, and equally about the concerns of the parents, who sometimes clash with the authorities over what their priorities are. For example, the education authority could have a totally different priority from, say, the health authority. There are certain elements in my Bill that would bring such authorities together.

The Prime Minister has had some difficulties this week, but he agreed at very short notice to meet one or two parents and some of the children. That is a side of the Prime Minister that the public do not often see. I am sure that the parents and the children appreciated the fact that he was taking an interest. In fact, if the House wants to know, he said to me, “Even Obama’s interested in this health area.”

Nevertheless, we need to get on. I am grateful for the opportunity to bring the issue of health support in schools before the House. I hope that the Bill will provide the impetus for those in all parts of the House to realise the importance of decent support for all children with long-term health conditions in schools. I hope that the Bill will enable the House to do something about that. My Bill would amend the Education and Inspections Act 2006, establish standards in schools for the support of children with specified health conditions and make provision for the inspection of such support. The 2006 Act places a duty on schools to promote pupil well-being. However, as it does not explicitly refer to the support of children with health conditions, their needs
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are not being met in many schools. Local authorities, primary care trusts and schools must work in partnership to ensure that all children receive the appropriate support that they need to live a full school life.

Let me pay tribute at the outset to the many organisations that support the Bill—in fact, some of them are represented in the Gallery. Their expertise has been crucial in bringing the Bill to the House. I am going to read their names out, because the public and the House do not always see the tremendous effort or the hours that they put in, sometimes voluntarily, in this case for the welfare of our school children. Those organisations include the Anaphylaxis Campaign, Asthma UK, the British Heart Foundation, the Children and Young People HIV Network, CLIC Sargent, Coeliac UK, the Cystic Fibrosis Trust, Diabetes UK, Epilepsy Action, Input, Juvenile Diabetes Research Foundation International, the National Centre for Young People with Epilepsy, National Voices, the Royal College of Nursing, TreeHouse, Scope, Sickle Cell and Young Stroke Survivors, the Stroke Association, the UK Children with Diabetes Advocacy Group, Vision 2020 UK and YoungMinds. In addition, I would like to express my appreciation for the hard work that my staff have done on the Bill, along with the organisations that I have named. They have shown tireless dedication to the cause and I appreciate their help.

I recently met a young constituent who was at Westminster as part of a lobby of Parliament by a leading health charity, Diabetes UK, on behalf of children. That lively young man enjoys, for the most part, a successful and fulfilling life at school, despite the challenge that type 1 diabetes poses. My constituent’s condition is well matched by a caring and well-informed family, excellent support from a local GP and outstanding care from the diabetes unit at the local hospital in Coventry. I do not doubt that the House is unanimous in its admiration for the thousands of medical professionals and families, such as those I have referred to, who support children with long-term health conditions across the UK.

That determined young man does not allow his condition to obstruct his education. My constituent and his family face the test of ensuring that the consistency with which they and their medical team treat his condition is matched by his school’s aspiration to ensure, in a holistic sense, that his educational well-being is guaranteed. In expressing that concern, I intend no criticism of my constituent’s school, as I think I have made clear. Chief among the school’s aspirations is excellence in primary education, and I hope that the House will join me in commending it and its peers for their unswerving desire to achieve that standard, which it reaches and surpasses.

I want to underline, however, that while many schools do provide excellent medical support for children with long-term conditions, that standard is not universally upheld. There is every reason to change that. I believe that the Government are genuine in their use of the maxim Every Child Matters. In an age when many strive for universal equality, it is crucial that Members of this House, and particularly of the Government, ensure that the desire for inclusion places children and young people at the forefront. My Front-Bench colleagues have sought to improve educational attainment and the quality of school life, and they have achieved much in doing so. The Schools (Health Support) Bill is aimed at
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promoting the universal equality that the whole House strives for, and offers practical steps to allow us to prove that every child matters.

My constituent’s struggle to obtain adequate health support is not unique. An estimated 20,000 children under 15 in the UK have type 1 diabetes, 83 per cent. of whom do not have good blood glucose control. In fact, the UK has the lowest number of children attaining good diabetes control in Europe. The struggle is not unique to children with diabetes. Across the UK, more that 1 million children go to school every day while braving the trials of a long-term medical condition. On average, two children in every classroom have asthma, and 57 per cent. of those children and their carers lack the confidence that someone would know what to do if they suffered an attack. A further 12,500 people suffer from sickle cell disease in the UK, yet only two out of the 107 local education authorities surveyed by the Economic and Social Research Council had written policies on the sickle cell disease in schools.

One in 10 children and young people between the ages of five and 16 have diagnosable mental health disorders. Children and young people with a disorder such as attention deficit hyperactivity disorder—ADHD—or a conduct disorder are more likely to be excluded from school. Exclusion in this context refers not only to physical exclusion but to social exclusion, because poorly managed mental health problems, as with any others, mark children out as different from their peers. In common with children with physical illnesses, many have problems accessing medication on school premises. Children who suffer from sickle cell disease also have an increased risk of experiencing a stroke, potentially at school.

These examples cover just a few conditions, but the problem of finding decent medical support in schools is endemic, and there is a raft of other long-term and chronic illnesses from which children and young people suffer. Decent school health support allays carers’ fears about the adequacy of support in the event of an emergency. It also allows children to participate fully in school life, meaning that they do not have to be excluded from activities that their peers take for granted, such as sport or school trips. Decent health support is vital if children are to reach their full potential. Without it, conditions such as diabetes can have an impact on a child’s cognitive functions and ability to learn. Decent health support means that inclusion need not be an illusion. For the cost of providing health support training to schools that do not have a policy in place, the benefit is multiplied many times over.

Let us imagine a child who needs to inject insulin up to four times a day, whose school does not have a health support policy in place. If they are unable to inject themselves, someone—a parent or guardian, perhaps—might have to make the journey to school at least once a day.

Tim Loughton (East Worthing and Shoreham) (Con): The hon. Gentleman is making a good case for his Bill and I agree with him about the problems that he alludes to. I recently went out with school nurses who were training teachers in how to administer adrenaline for a particular child who had various allergies and might
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suffer anaphylactic shock. This is an eminently sensible way of ensuring that teachers are on hand and trained in what to do in case of emergencies. I am told that because of the shortage and diminishing number of school nurses, they are no longer available in many schools to provide that sort of advice, which makes it difficult for certain children to go to those schools if they cannot be sure of receiving the necessary emergency treatment. Is the hon. Gentleman as concerned as I am about the shortage of school nurses?

Mr. Cunningham: I believe we are all concerned about what the hon. Gentleman has outlined, but that is one of the reasons why health authorities and local authorities must, as I said earlier, sit down together to develop joint priorities. The other day I met a lady who had similar problems, and it was clear to me that the local authority viewed its priorities in one way while the health authority viewed them in quite another. As long as that continues, there will be problems; this is one issue that my Bill is designed to address—or to get the Government to address. While that division continues, we will never get a proper set of priorities for treating these illnesses. At the end of the day, as I am sure the hon. Gentleman knows, resources come into play here.

Mr. Stewart Jackson (Peterborough) (Con): I warmly congratulate the hon. Gentleman on securing this Second Reading debate. I join him in paying tribute to charity organisations in his and my constituencies and throughout the country.

I would like to raise an issue touched on by my hon. Friend the Member for East Worthing and Shoreham (Tim Loughton). I was recently dealing with a constituency issue relating to problems with the provision of Epipens for treating children allergic to nuts, for example, for anaphylactic shock. The key issues there were about resources and consistency of practice across the entire local education authority. Inevitably, there were resource implications. I am worried that in dealing with a whole load of illnesses and long-term conditions, the resource implications are going to be very significant. Does the hon. Gentleman have any definitive data on how many children and local education authorities are involved and what level of resources we are talking about?

Mr. Cunningham: I agree with the hon. Gentleman in general terms, but I shall come on to deal with the point later in my speech.

The parent or carer responsible for injecting the child may not be in employment and this responsibility can create a knock-on effect of financial burden to the whole family and beyond. Furthermore, children who are not supported in the management of their health condition are more likely to suffer from complications that can threaten their lives and place an increased burden on NHS services in primary and secondary care.

Health support in schools should be an integral part of medical support for young people. That is not to say that schools should be required to give comprehensive medical support rather than merely to augment the work done by medics and carers. The Royal College of Nursing advocates the use of school nursing in providing health support. It is simply not possible for a school nurse to be present for the event of any medical emergency or a health incident that might require any degree of
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support. School nurses have a vital part to play in health support, however, as they provide expertise that teachers cannot be expected to have. Conversely, in terms of health support, it is crucial that they are able to expand their mandate of health education to provide teachers with advice on how to handle situations that long-term conditions can give rise to.

The key element in the provision of health support is ensuring that teachers are able to teach while being aware of the health support that is a critical part of some of their pupils’ education. The current voluntary guidance is not working and implementation is patchy: while some schools provide fantastic support, others are failing their most vulnerable students. An explicit requirement is needed, backed up by effective regulation from Ofsted, to ensure that all schools meet the needs of all children with long-term conditions.

In closing, I hope that my Front-Bench colleagues will be able to offer some hope on school support to the charities and campaigners who have worked so tirelessly for this cause. I believe in my Bill. Finally, in response to the hon. Member for Peterborough (Mr. Jackson), I point out that there are roughly about 1 million children who, one way or the other, have a difficult medical condition.

Mr. Stewart Jackson: I hope that the hon. Gentleman will forgive me for referring to the situation in my constituency, but linked to the specific issue of resources is that of children whose first language is not English. I have three schools where more than 95 per cent. of children do not have English as their first language. The resource implications for and the pressures on those schools are significant and they have not received recompense through ethnic minority achievement grant. In these straitened, less than benign economic times, how does he see the problem of children whose first language is not English? For instance, they may also have diabetes, which is prevalent in my constituency too.

Mr. Cunningham: I thank the hon. Gentleman for his intervention. To a certain extent, I sympathise with what he says. I am thinking about the parent tongues of those who go to a particular school in my constituency. They speak about 27 different languages and the school does a magnificent job. To take a step forward in dealing with the problem he outlined, we must start with, on the one hand, the Department of Health and the health authorities and, on the other, the Department for Children, Schools and Families and the education authorities, to see what their priorities are. Unless we can get a joint approach, we will always have these problems.

As I said earlier, some schools do well in relation to medical treatment for such children, but the situation is not the same across the country. Unless we can get some uniformity and agreement between the health authorities and the education authorities, we will not get the national cohesion to deal with those problems that we would like.

I have outlined the problems, and while I would not expect the Department for Children, Schools and Families to solve them all, one of my objectives today, and certainly one of the objectives of the voluntary organisations and the professional people who have put such a tremendous effort into this, is to highlight some of the difficulties experienced by those children and their parents.

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We must bear in mind the fact that a family might contain only one breadwinner. If the family is of reasonable size, that one breadwinner might be required to go to the school to give three or four injections a day. That has a host of implications. By and large, we always try to encourage the family unit, whichever way it is defined, and the best way to start to address those problems is more and more to unite the family unit. Most of those in such families are affectionate towards one another and have a good home life, but if they begin to have medical and economic problems sitting on their doorstep, that can lead to a lot of tensions.

Those are the issues and the range of social problems that we want to address, and my Bill is a little step in the direction of trying to address them. Once again, I offer my appreciation of the support that I have had from Opposition Members such as the hon. Member for Basingstoke and from my hon. Friend the Under-Secretary. I am looking forward to her giving in her winding-up speech an indication of how we can take these matters forward.

I also appreciate the work done in this area by the Department for Children, Schools and Families. I am not criticising the teaching profession, headmasters or schools. I am trying to get a united approach across the country to deal with some of these problems, because if we are not careful, we could end up with a lottery. Hon. Members have heard that expression in relation to many fields where the service that people receive can depend on the area they live in.

12.53 pm

Mrs. Maria Miller (Basingstoke) (Con): I commend the immense amount of work that the hon. Member for Coventry, South (Mr. Cunningham) has done to bring the Bill to the House. I think everybody would agree that he has made an exceptionally strong case for the Bill, and I reiterate the thanks he gave to the many different organisations associated with children’s health that do so much behind the scenes to ensure that we are properly briefed on the issues that face families today. Those organisations include Diabetes UK, which made a comprehensive briefing available in advance of today’s debate.

Nothing is more important than our children’s health. When a woman finds out she is pregnant and when she has her child, one of the first things she wants to know is that the child is as healthy as can be. One of my children suffers from asthma and often has to medicate at school, and I am thankful for the support he gets from his teachers. However, parents who have to live with the day-to-day realities of a child with a long-term chronic condition want them to be able to participate in everyday life as best they can, and school is a pivotal part of every child’s life.

My hon. Friend the Member for Peterborough (Mr. Jackson) alluded to the fact that many children throughout the country have long-term conditions that affect not just their academic performance in school, but their ability to participate in other ways. Social exclusion can be a real problem for children with long-term conditions, and they have to be able to deal with it. The Bill highlights the importance of this issue, and I commend the hon. Member for Coventry, South for bringing it to the attention of the House.

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