Report (6th Day)
Health and Social Care Bill
Baroness Massey of Darwen (Labour)
My Lords, first I apologise on behalf of the noble Baroness, Lady Tyler, who cannot be here today due to another speaking engagement. My amendments in this group seek to cover listening to the voice of the child in whatever structures or systems we end up with in the course of the Bill. The voice of the child is clearly important and I wish to address this one issue today. This is not just about adult patients among the public but children, too. I make explicit that HealthWatch England's advice on the views of patients and members of the public must also refer to the views of children. These amendments are supported by numerous children's groups and by the Royal College of Paediatrics and Child Health.
Children's involvement in healthwatch organisations was debated in Committee on
"local healthwatch needs to represent the views of all people within the local population, including children and young people".
However, they rejected amendments that cited children as a specific group to be reached by healthwatch, saying,
"if you list one group you are in danger, therefore, of excluding others".
Taking account of those concerns, I have tabled a new set of amendments, drafted to make explicit that the remit of healthwatch includes children without inadvertently suggesting that they should take preference over adults or any other group. In Committee, the Government offered assurance that when,
"the pathfinder local healthwatch organisations come into play, we will ensure that what noble Lords have said is flagged up to them".-[Hansard, 15/12/11; col. 1499.]
I am concerned that flagging up the issue to emerging local healthwatch organisations will not be sufficient. I seek further assurances that consultation of children and children's rights will be addressed. There must be a clearer steer at national level to make sure that the voices of children and young people are heard in the health system. I call on the Government to do three things. First, they should develop and disseminate guidance for local healthwatch organisations on effective engagement with children, drawing on pathfinders' experiences. Secondly, they should conduct a review on how HealthWatch England and the local healthwatch organisations have involved children in their work two years after commencement. Thirdly, they should appoint a champion for children within HealthWatch England to oversee this work and drive forward standards on children's engagement and decision-making.
This Bill is the first opportunity that parliamentarians have had to respond to the findings of the Kennedy review, published in September 2010, Getting it Right for Children and Young People. The Government response to the review accepted Sir Ian Kennedy's powerful arguments about the need to engage children in the NHS, saying:
"In the past, the NHS was not always set up to put the needs of patients and the public first. Too often patients were expected to fit around services rather than services around patients. Nowhere was this more the case than for children, young people and their families ... If we are to meet the needs of children, young people, families and carers, it is vital that we listen to them in designing services, gather information on their experiences and priorities, provide them with the accessible information that they need to make choices about their care, and involve them in decision making".
In a welcome move, the Government promised in December 2010 to give due consideration to the Convention on the Rights of the Child when making new law on policy. As a signatory to that convention, the UK must take all possible steps fully to realise the rights and freedoms in the convention, including Article 12, which says that children should have a say in all issues affecting them and that their views should be,
"given due weight in accordance with the age and maturity of the child".
The international monitoring body for the CRC, the UN Committee on the Rights of the Child, has been clear that the article applies to collective decision-making processes as well as matters affecting the individual child. Among its main recommendations was that the UK should promote respect for the views of the child. My amendments would implement recommendations in relation to children's healthcare.
Local healthwatch will take forward the work done by local involvement networks, or LINks, in seeking the views of local service users in health and social care and involving them in the development of services. I urge noble Lords to amend the Bill today to make it clear that HealthWatch England and the local healthwatch should effectively involve children in their work.
A great deal of research has been done on this, including by the National Children's Bureau, which found that not all LINks understood that engaging children was part of their official remit. The review of law policy and practice by Participation Works found that although 41 per cent of GP practices had patient participation groups there was no evidence of children's engagement in these forums.
The Council for Disabled Children document, Managing My Way, researched with disabled children and healthcare professionals, found that the majority of professionals felt they did not receive enough training to develop their skills in communicating with young people, especially those who have different communication needs. Research by the Institute of Child Health has found that the views of under-16s were sought in only one of 38 national surveys of patient experience in the NHS between 2001 and 2011. Young Minds found that in 80 per cent of cases young people were not involved in shaping local services. The Royal College of Paediatrics and Child Health and the NHS Confederation recently published a guide to involving children and young people in health services, which underlined the key role that children can and should have in planning and service delivery. The report says that,
"there is little incentive for organisations to systematically ensure a good and consistent standard of service for children and young people",
unless they are involved in those services.
I look forward to the Minister's response, particularly the three issues-guidance to the local healthwatch, a review of the involvement of children in healthwatch and a champion for children in healthwatch. I beg to move.