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The Bill also relates to mental health—an issue identified by the charities to which the hon. Member for Coventry, South referred. However, of itself, mental health is a
major issue and a growing problem for children and young people, and I am not entirely sure that the national clinical frameworks are yet able to cope with it. On a recent visit to my local district general hospital, one problem that clinical staff identified was the lack of provision at weekends and out of hours for teenagers and young people with mental health problems.
Litigation is also a consideration. I talked earlier, when intervening on the hon. Gentleman, who was very generous with interventions, about anaphylactic shock, allergies and Epipens. The bureaucracy and problem in providing a consistent policy across my local education authority for a relatively small number of children with such problems, which are obviously life threatening, demonstrated to me how complicated the issue is, particularly its resource implications for training and skills, let alone its legal implications.
Mrs. Maria Miller: My hon. Friend brings to mind a visit that I made recently to Chatham and an organisation called The Place2Be, which operates in a local school with children who, as a result of incidents in their lives, are vulnerable to mental health problems. Does he agree that that is one example of the many schools throughout the country which already go above and beyond what is expected and try to fill the gap—particularly in mental health services—that exists due to a lack of provision by local primary care trusts?
Mr. Jackson: My hon. Friend makes a pertinent and astute point, which is worth reinforcing. For the avoidance of doubt, I should make it clear that I am not implying that through his laudable Bill the hon. Member for Coventry, South is undermining the work already being done. However, in many respects there are exemplars of how to deal with children with long-term conditions.
That brings me to another issue on which we need a joined-up policy. I hope that I am not being unfair to the hon. Gentleman, but I do not think that his Bill takes it into account. I am thinking of children with conditions who are carers themselves. In this country, we have still not given sufficient attention to the issue of young carers. To give them their due, the Government have moved forward on local provision for carers, but we should not forget about the issue.
My hon. Friend the Member for Basingstoke wisely alluded to school nurses. In many local education authorities, the delivery of that service is undermined by a lack of people—mainly women, but also men—who put themselves forward for the important role of school nurse. The role is similar to that of a district nurse, and it is vital for delivering first-class medical and clinical care and education into the community.
Earlier, I mentioned the pressures in some local schools with diverse populations. In many parts of the country, mainly in urban areas, many children come into school without being able to speak English; the hon. Gentleman will have instances of the same thing in Coventry. Yesterday, I was talking to someone I know whose wife is a teaching assistant. Virtually her whole day is taken up in giving one-to-one tuition to a little Bulgarian boy. That is fine, but think of the resource implications if we intend to impose the regulatory framework that the Bill would involve, and how that would affect schools across the country. It would be very resource-intensive. If the Bill goes into Committee, I would be interested in
whether we could conduct an impact assessment and ascertain the likely cost and the resource drain on local authorities. The aim is laudable, but we live in difficult times. I suspect that it would be a big ask to make schools such as some in my constituency—schools with structural issues of demography and population—deliver the level of service, which is consistent across the country, involved with that aim.
I shall conclude. We all welcome the Bill and the chance to debate what has rightly been described as the situation of invisible children, who are often overlooked and pushed to the side in mainstream schooling. While I am at it, I should pay tribute to some of the superb schools in my constituency that look after children in these situations. Middleton primary school in Bretton has a unit for deaf children, and Jack Hunt secondary school also looks after deaf children.
It is right that we should have this debate. These children have a right to the best education, irrespective of their long-term conditions, and we have the responsibility to deliver it. At the same time, however, we should recognise existing best practice and not lightly dismiss the revenue costs that might fall on local education authorities. With those caveats, I congratulate the hon. Member for Coventry, South. I hope that the Minister has some good news for him in her remarks.
1.29 pm
Mr. Andy Slaughter (Ealing, Acton and Shepherd’s Bush) (Lab): I, too, congratulate my hon. Friend the Member for Coventry, South (Mr. Cunningham) on his speech and on his promotion of this excellent Bill. I hope that the Government’s response will recognise the need for the proposals within it.
My principal reason for speaking in the debate is to highlight the courage and determination of one of my constituents, Sophia Loizia. Sophia is 17 and now a sixth-former, but a year ago, during her GCSEs, she was diagnosed with Hodgkin’s lymphoma. Thankfully, she is now in remission and in good health, but she has had one of the toughest years imaginable for a young person. Earlier this week, she attended the lobby, which many other hon. Members will have attended, organised by the coalition of charities that has been alluded to. She was one of five young people who went to Downing street to petition the Prime Minister in support of my hon. Friend’s Bill.
I do not intend to say anything more about what are intensely personal matters, as well as matters of public interest, save that I was so impressed not only by how highly intelligent Sophia was but how extraordinarily mature. It occurred to me that the fact that younger children, or those who may not have the same levels of accomplishment, have to suffer and go through serious medical conditions, as well as trying to cope with their education and the other pressures concerned, highlights the need for provisions such as this Bill. Thankfully, childhood cancer is relatively rare, although I pay tribute to the work that CLIC Sargent does in supporting children who have cancer.
A condition that is not rare—indeed, it affects up to one in 10 or 11 young people—is childhood asthma. I should perhaps declare an interest in that, many years ago now, I missed at least two years of mainstream schooling through asthma. I attended a special school
and then went back into mainstream schooling. At that time, in the 1960s, there would have been no real understanding within mainstream schooling of the needs of children with medical conditions. I should underline that both the schools I attended were absolutely excellent. I should also say in passing that both—Chartfield school in Putney and Peterborough school in Fulham—have been closed by Tory councils in the past three years, despite vigorous campaigns to keep them open.
This week, on 5 May, we had world asthma day. Also this week, Asthma UK, one of the supporters of the Bill, launched its report, “Missing Out”, which specifically concerns the effect that asthma has on schoolchildren. I was shocked to find that 40 years on, 50 per cent. of children with asthma say that they have problems joining in lessons and going on school trips, and three quarters say that they have problems joining in sporting activities. Medication for asthma has improved hugely over the past 40 years, and it is amazing that children—up to two in every class nowadays—can still be restricted in that way.
The third condition to which I want to draw attention affects children on the autistic spectrum. That, too, is recognised far more than it would have been several years ago as a condition that affects very large numbers of children, many of whom will be in mainstream schooling. Again drawing from personal experience, my godson attended a superb school for autistic spectrum children, Queensmill school in Fulham. As a consequence of the excellent education there he was able to go into mainstream schooling, and his experience has been unfailingly good. Despite what we have heard about the need for more resources, that is partly because of the level of resources that the Government have put into both special needs schools and teaching assistants and support for mainstream schools. Largely, however, it is due to individual teachers who, although they had no experience or knowledge of autism, went and found out about it so that they could deal with autistic spectrum children.
That additional burden should not be put on individual teachers without support, because the general experience of parents of autistic spectrum children is that they do not have a good time in mainstream schooling. I wonder whether that is partly because it is regarded more as a behavioural than a medical condition, and because teaching professionals who would not presume to know about the treatment of medical conditions think that they know how to deal with children on the autistic spectrum. In fact, they need just as much support on that as on other matters.
Mr. Stewart Jackson: I respect the hon. Gentleman’s position, which comes from personal knowledge and experience. On provision for autistic children, is there not an unfortunate choice for many parents to make between a lower level of care locally, particularly respite care, and out-of-borough or out-of-county provision? That might be just as good, but it restricts their access to their children, which is detrimental to family life.
Mr. Slaughter:
This is an all-party debate and I do not want to introduce party politics into it, but a lot of this goes back to resources. In my experience, it is
difficult to get Conservative councils in London to provide sufficient resources for special needs children, which is an expensive area of provision and easy to cut. It has been shown over the past 10 years that there is a need for commitment to that. However, I take the hon. Gentleman’s point. There is something of a postcode lottery, as provision is different in different parts of the country and even of the capital. The more that can be done to maintain support for children on the autistic spectrum in mainstream schooling, the better it will be, although there is clearly also a need for special needs education for those with more severe conditions.
I do not wish to take up a lot of time, but I have mentioned these slightly anecdotal matters because they show that for a large number of children—we have heard that it is 1 million across the UK—there are serious daily problems. I emphasise that we are talking about not special treatment but equitable treatment. It is about enabling children who have medical conditions and health problems to get the same level of education as children who do not. Some of the examples that I have given illustrate the fact that problems often occur when children move out of special needs education into mainstream schooling, which we all welcome, or when children who have been out of school for a long period come back following medical treatment.
The solutions are quite common-sense in a way, such as informing both teachers and pupils about the need to consider the problems that individual children have. I am sure that many teachers ensure that that happens as part of their pastoral care, as is suggested by my own experience as a governor of a sixth-form college with a strong pastoral tradition. However, there are also examples of crass behaviour, such as a teacher saying a child returning after a long absence for medical reasons, “Well, you’ve got no excuse for not catching up with your work now”, or fellow pupils who were friends in the past feeling awkward or in extreme cases indulging in bullying.
It simply requires people who understand the conditions to sit down with their staff and pupils and explain them, so that the children who return to school do not have constantly to explain to every teacher and pupil the nature of their condition and their continuing symptoms and needs. In almost every case, there will be continuing treatment—medication, chemotherapy and so on—that needs to be administered, and continuing frailty. Children inevitably go back to mainstream education before they are fully recovered.
Opposition Members have suggested that the Bill might involve too many resources or be too bureaucratic. I think that it is a light touch measure, which focuses on two or three principal needs for information and training and on a substantial number of children—not a small minority—in schools throughout the UK, who need such support and help.
I am pleased that the measure has support from all parties; I hope that it also has Government support.
1.40 pm
Simon Hughes (North Southwark and Bermondsey) (LD):
I commend the hon. Member for Coventry, South (Mr. Cunningham) for introducing the measure. I approach the debate not only as a Member of Parliament, but as one very conscious of my role—I suspect that other
colleagues also play such a role—as chair of governors of a local primary school as well as trustee of a city academy. The subject of the Bill has been a real issue for us and I have had occasion to discuss it with fellow governors and our head teacher.
It is clearly right to pay the Bill serious attention when 22 organisations form a coalition and ask us to support it. As constituency Members of Parliament in England—I say “England” advisedly; it is an England measure—we have all been involved with some of those organisations. I put on record their names: 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 Multiple Sclerosis Society, the National Centre for Young People with Epilepsy, National Voices, the Royal College of Nursing, TreeHouse—which is the national charity for autism education—Scope, Sickle Cell and Young Stroke Survivors, the Stroke Association, the UK Children with Diabetes Advocacy Group, Vision 2020 UK and YoungMinds.
Those organisations represent young people—some also represent adults—with 16 different conditions, which are not uncommon in many schools in this country. Four of the organisations lobbying today are concerned with children with diabetes. Indeed, Diabetes UK has led the campaign. This municipal year, the mayor of Southwark has chosen that organisation as her charity. She suffers from diabetes and has done good work to raise funds and increase the profile of the needs of those with diabetes. I know colleagues in the House who have also done such work because they, too, are sufferers.
Two organisations in the list specifically deal with epilepsy. That triggered in my mind a realisation of the importance of the obligation on schools to ensure that there is a proper understanding of and response to people with such conditions. When I was at secondary school, somebody had an epileptic fit in front of me. I had never seen an epileptic fit before. For the first minute or so, I had no idea how to respond. I did not even register logically what was happening. That showed me the importance of preparedness among staff and pupils to deal with those conditions. I stress “and pupils”, because they need to know that it is not unusual, and should not be a problem for them, that one of their school colleagues might have a condition that needs help. Nearly everybody at school needs help, be it be emotional, psychological, mental or physical help. Schools will be better places and the quality of education and opportunity there will be better if they and all their members—the governors, the teaching staff, the non-teaching staff, those who come into schools and the pupils—know how to deal with those issues.
I want to signal how important the work done by the associations that I have mentioned is, by referring to three of them, one of which—the Multiple Sclerosis Society—is based on my constituency. I have had good involvement with the Multiple Sclerosis Society, which is led by Robert Meadowcroft, whom I have known for many years. A former member of my staff works for the Multiple Sclerosis Society now. We all know what fantastic work the society does in raising consciousness and awareness, increasingly through young people sharing their experiences, ensuring, as happened with the lobby
here, not only that adults or workers come to lobby us, but that the people who live that life come to see us, and not only in our constituencies and surgeries, at meetings and in our communities, but here, too.
Also in my borough, although not in my constituency, is Sickle Cell and Young Stroke Survivors. Sickle cell disease is a condition that disproportionately affects those from Afro-Caribbean communities. I have the privilege of representing the local authority with the largest African community in Britain, and the issue is relevant to that community, as it is to people from black and other communities. Finally, there is Scope, for which, again, a former member of my staff works. Those examples indicate how good and effective those organisations are. Through the medium of the Bill, they have come to us to say, “Please see if you”—Parliament—“will agree to this very simple change in the law.”
That leads me to my next point, which is to commend the hon. Member for Coventry, South for producing a superbly short Bill. Private Member’s Bills are much easier for the House to deal with if they are short. The title of the Bill is short. There is also a good, robust view about when it should come into effect, namely within two months of the day on which it is passed. That is unusually refreshing, because normally the start date for legislation is way down the track. Clause 2 says that Ofsted should consider how schools deal with the issues covered in the Bill as part of its inspections.
The key to the Bill is clause 1, which would impose on schools’ governing bodies the obligation to produce and implement a medical conditions policy, which would have two components. Proposed new section 38(11) of the Education and Inspections Act 2006 says that the policy should set out
“the means by which records of the specified health conditions of children at the school are to be recorded and maintained”
“the preparation of an individual healthcare plan for each child”.
Clause 1 would also require the training of staff to enable them to respond, which would include not just teaching staff, but teaching assistants, the people in the kitchens and so on. There are also other things, which, to be honest, are incidental, including an obligation on NHS bodies, local authorities and primary care trusts to co-operate.
The hon. Gentleman has also been in wise in saying that at this stage he does not want to specify which health conditions would be covered, which he is leaving to Ministers. That is both a good thing about the Bill and a weakness, because until a Minister did that, the Bill would have no substance or import. There is no obligation on Ministers to do that by a certain date, so I guess there would have to be an amendment in Committee to change that.
Mr. Jim Cunningham: Obviously, I cannot predict the outcome today, but I would have thought that if the Bill reached Committee, that would be the stage at which to thrash those issues out. After all, that is why we have a Committee stage.
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