My Lords, I am grateful to all noble Lords for their comments on Amendment 57C, tabled by the noble Lord, Lord Kennedy, and the noble Baroness, Lady Howe, and to all those noble Lords who have brought these matters to our attention. We are in consultation on the guidance and we welcome all noble Lords’ comments on it and on all other matters. I hope that I can assure the noble Lord, Lord Kennedy, and other noble Lords that further primary legislation is not necessary.
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I agree that it is very important for local authorities, health bodies and governing bodies to work collaboratively to ensure that pupils with medical conditions are supported effectively in school. It is crucial that children and young people receive the right support from relevant organisations and appropriate professionals to assist them in their daily lives. The time that they spend in school is a very large part of this and it is entirely reasonable to expect all agencies to work together to ensure that their needs are met.
I fully support the intention behind the amendment but I believe that there is no need to place a direct duty through primary legislation on clinical commissioning groups and local authorities to co-operate in this way with schools. We need to focus on ensuring that the right framework and the right practice are in place to make sure that pupils receive the support that they need in school, and this is achieved by what we are setting up through the new duty, alongside existing legislation. I hope that noble Lords will agree that, as we have said many times before, this is about achieving a culture change so that every child is supported at school to succeed and be safe.
As noble Lords may be aware, a duty to promote co-operation already exists in Section 10 of the Children Act 2004. This requires a local authority to make arrangements to promote co-operation between its relevant partners to improve the well-being of children in its area. These include health bodies, such as clinical commissioning groups, and governing bodies. Local
authorities are required to make such arrangements with a view to improving the physical and mental health, emotional well-being and education of children in their area. This duty to promote co-operation also extends to any other persons or bodies who exercise functions, or are engaged in activities, that relate to children in the authority’s area. I believe that the new duty and statutory guidance, when taken together with this existing legislation, will provide the framework that is needed to meet the concerns raised by noble Lords.
The relationship between schools, health bodies and local authorities is extremely important and we have good examples of where it already works well. Local authorities are commissioners of school nurses and they look to CCGs to ensure that sufficient provision is available to meet need—for example, ensuring that school staff can be trained to support pupils with medical conditions as appropriate. CCGs and local authorities will also take a strategic view of what is needed to support schools.
There are further existing models of good practice that we can draw from. Specialist local nursing teams, for conditions such as asthma or epilepsy, work closely with schools, and the NHS offers training days, hosted by schools, for school staff on how to cope with emergencies and support children with such conditions. This is exactly the sort of arrangement that we want to see and encourage, and it is the sort of co-ordinated approach to co-operation that the Children Act duty supports.
I am confident that the combination of the co-operation provisions in the Children Act, the new duty and the new statutory guidance will provide the legislative framework needed to ensure that pupils with medical conditions receive the support they need, and that this will be sufficient to deliver the underlying aims of the amendment. The statutory guidance has an important role to play in ensuring that pupils’ needs are met holistically on the ground and that the required cultural change can be achieved. This is where we can set out our expectations and clearly explain the roles and responsibilities of all those involved.
In Committee, I gave a commitment to update your Lordships on progress with the guidance ahead of Report. I am pleased that we have been able to share with noble Lords a full indicative draft of the guidance ahead of this debate. Importantly, this has been developed in close collaboration with the Health Conditions in Schools Alliance and a wide range of other stakeholders. I take this opportunity to thank those organisations for working so closely and collaboratively with us.
The noble Lord, Lord Kennedy, made a point about governors’ obligations in this regard. In fact, we have recently emphasised in the Governors’ Handbook the importance of governors considering all pupils’ well-being. However, I will take back the noble Lord’s point and look at it again.
Noble Lords will be able to see that the guidance specifically refers to the co-operation duty in Section 10 of the Children Act 2004 and articulates our expectations that health service, social care and education organisations and their professionals will work together
to ensure that pupils with medical conditions receive the support they need at school. The noble Lord, Lord Kennedy, referred to training. This should ensure that schools are given enough training. Of course, if the support is not there, this can be taken up with the local authority. We will need to look at this carefully and see how it goes. My officials and I would be very happy to discuss this point with the noble Lord further because I think that it is an extremely good one in practice.
The noble Baroness, Lady Young, made the point about Ofsted. Noble Lords may recall that in Committee I said that I would write to Ofsted about this issue asking it to reinforce the new duty through the inspection process. I am pleased to report that having done that Ofsted has replied saying it places great importance on this matter, and has confirmed that it will take into account the new duty when preparing its inspection guidance ahead of September 2014.
The noble Lord, Lord Storey, asked about children who may not have a plan. Most children will have a plan but there may be some returning to school following illness who need to finish a course of medication and do not need a plan. We need to cover those pupils as well. On opting out, the governing body makes the decision on who has a plan, in consultation with parents and health professionals. If the practice is not happening on the ground, the school will need an extremely good reason for not delivering it. If, for whatever reason, parents are dissatisfied, they can make a formal complaint through the school’s complaints procedure. If that is not satisfactory, they can then complain to the Secretary of State via the DfE’s complaints unit asking him to intervene. The noble Baroness, Lady Brinton, made the point about unacceptable practice and taking into account a doctor’s diagnosis in developing a plan. We will look at that to make it more clear.
As I have said, we will be testing all these points during public consultation. We will of course consider carefully all comments that we receive. We plan to launch the consultation next week and would be grateful for comments from noble Lords on this before finalising the guidance for schools to use from September this year. It is my view that the right drivers and incentives are now in place to ensure we achieve our objectives on this important issue. Culture change is never easy and does not happen overnight but I believe that on this issue we are all united and behind the same goal. As the new duty is implemented, we will keep the arrangements under regular review. I hope that that is sufficient to reassure noble Lords and I urge the noble Lord, Lord Kennedy, to withdraw his amendment .