My Lords, the amendment would introduce a new clause after Clause 36, requiring local authorities in England to establish and maintain a register of sight-impaired and severely sight-impaired children and young people ordinarily resident in their area. Perhaps I should declare my interest, which is in the register, as a vice-president of the Royal National Institute of Blind People.
Local authorities have been required to maintain registers of blind and partially sighted people since the introduction of the National Assistance Act 1948. That obligation applied to both adults and children. Following a recommendation in the Law Commission’s report on adult social care in 2011, the Care Bill currently going through Parliament lays a duty on local authorities in Clause 73 to establish and maintain registers of sight-impaired and severely sight-impaired adults ordinarily resident in the area. However, under this Bill, no such obligation exists in relation to sight-impaired and severely sight-impaired children.
The registers, which have been maintained for some 65 years now, play a critical role in enabling local authorities to assess population level need for specialist visual impairment services and support. Evidence indicates that young children and parents greatly benefit from receiving integrated support from an early stage, following identification of a child’s sight condition. Early referral, aided by a robust system of registration, is fundamental to achieving that.
Registers serve three main purposes. First, they provide a local resource to support the local authority and partner agencies with the strategic planning of services. Secondly, they indicate a person’s eligibility for certain benefits. As a matter of fact, under universal credit, children who are registered blind will be entitled to receive the severe disability addition in recognition of the household’s need for greater support. Thirdly, in the case of children and young people, the process of being registered with the local authority assists with early referral to specialist services and support, including help from voluntary groups. The requirement to maintain a register for adults assists local authorities in planning services and meeting individuals’ needs. If the same duty is not placed on local authorities with regard to children, it seems inevitable that the service planning and arrangements to meet the needs of a specific group of children and young people will be less effective.
Existing legal provisions on the maintenance of a register of disabled children are inadequate. The Children Act 1989 states that local authorities “shall open and maintain” registers for “disabled children”, but those
general registers are scarcely used and do not meet sensory services requirements. The certification and registration process in relation to those with a visual handicap is unique in its potential to bring health and social care together. The situation for children is even more complicated, because social care and education both need to be involved. For example, early access to mobility training arranged through social care has a profound impact on blind and partially sighted children’s development and ability to benefit from education.
The greatest fear is that, without a statutory basis, registers of visually impaired children could fall into disuse.
On 7 September last year, in response to a Parliamentary Question from Stephen Gilbert MP, the Minister in another place said that:
“A local authority is required to keep a register of disabled children within its area and this will include children who are sight impaired and severely sight impaired”,—[Official Report, Commons, 13/9/12; col. 384W.]
but there, as your Lordships will appreciate, he was referring to the general registers. These registers for all disabled children are scarcely used and many practitioners regard them as obsolete.
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The RNIB, the Royal London Society for the Blind, the Guide Dogs for the Blind Association, the Royal College of Ophthalmologists and VISION 2020 (UK) all strongly support local authorities holding registers of children certified as sight impaired or severely sight impaired. This provision also needs to be in the Bill because the duty on local authorities has already been given statutory expression in the corresponding legislation concerning care and support for adults. What is left outside the Bill will inevitably assume lower priority or even become discretionary.
When blind and partially sighted children reach the age where they are eligible for adult social care, it would greatly ease the process of transition if they were already recorded and recognised by their local authority as sight impaired. On a general population level, visual impairment is a low-incidence disability. However, we now have a strong body of evidence to suggest that in the youngest age cohorts, the incidence of visual impairment is steadily increasing. The annual incidence of new paediatric blind registration has increased: an incidence of 0.17 per 10,000 in 1982 had doubled to 0.41 per 10,000 in 2011. The annual incidence of new paediatric partially-sighted registration showed a comparable trend. Over 30 years, there has therefore been a greater than twofold increase in blind and partially-sighted registration of children in England. This underlines the need for registers to assist with service planning.
The long-term growth rate is especially prominent in children with profound, multiple and complex disabilities. Better awareness of this is needed to ensure that adequate resources are available to help these children. Amending the Bill to include a duty to establish and maintain sight-impaired registers will help local authorities and schools to maintain an accurate overview of what care services need to be developed alongside education. This amendment would
introduce a new clause after Clause 36, which would require local authorities in England to establish and maintain a register of sight-impaired and severely sight-impaired children and young people ordinarily resident in their area. Local authorities have been required to maintain registers of blind and partially-sighted people since the introduction of the National Assistance Act 1948.
To conclude, this matter has been raised during the Commons stages of the Bill and there has been extensive discussion with Ministers and officials but the department seems to have set its face against making this change. For the life of me, I cannot think why, since all that is being asked is that the current system for children should be maintained and put on the same footing as that which operates for adults, with generally beneficial consequences. Not to do so will simply amount to a derogation from established practice, which has operated successfully for 65 years. I beg to move.