My Lords, national guidance for improving standards of care for children with diabetes was published in the Diabetes National Service Framework in 2001. That was supplemented by further standards published in the Children's National Service Framework in 2004. As a result of monitoring the implementation of those standards, the national clinical directors for diabetes and for children have established a working group to help improve the ability of the NHS to meet the standards.
My Lords, I thank my noble friend for that Answer. Nevertheless, does he recognise the important role played by specialist paediatric diabetic nurses, especially at a time when as many as four in five diabetic children fail to achieve proper monitoring of their blood sugar levels in their tests? Does he regret that only one in four PCTs is prioritising the appointment of such nurses in its local delivery plans? Can he also ensure that we have a full complement of school nurses and teachers trained in the treatment of diabetes, to avoid regrettable incidents such as that last week when a six year-old child was dismissed from school in Dorset?
My Lords, it is for local diabetic teams to determine the appropriate composition to meet the needs of their communities, but we recommend multi-disciplinary paediatric diabetes teams, including specialist nurses, in the national service framework. I share the concerns expressed by my noble friend about the episode in Dorset. I think that the school has apologised, and in conjunction with the Department for Education and Skills we have produced guidance to help schools in this area.
My Lords, is there a target for the number of designated consultant paediatricians who are specialists in diabetes, and how far have we come to meeting such a target?
My Lords, I am not aware that there is such a target, but I will check and write to the noble Lord.
My Lords, does the Minister agree that type 2 diabetes should be avoided at all costs? Should not schools offer health education to encourage children to take more exercise, eat less sugar and follow a healthy diet, so that they grow up without developing diabetes?
My Lords, it would be difficult to disagree with the noble Baroness. Public health measures are in place to try to tackle the problem of obesity in children, which often leads to the development of type 2 diabetes. A good example is the WATCH IT! programme in Leeds, which tries to tackle some of the problems.
My Lords, will my noble friend congratulate the Austrian presidency on prioritising diabetes as a matter of concern, especially type 2 diabetes? Does he recognise that there are 20,000 children with type 1 diabetes and, at the moment, only 200 a year with type 2? Children with type 1 diabetes must not be forgotten.
My Lords, my noble friend is right. We need to tackle issues around both type 1 and type 2 diabetes in children. We fully support the initiative taken by the Austrian presidency, which has made diabetes a key issue, and we are participating in the work that it is doing. Our national clinical director for diabetes is leading the work that we are doing with the Austrian presidency.
My Lords, there are a variety of ways of providing support to children in this area, including inhalation pumps. I shall write to the noble Lord with more details of the processes.
My Lords, I do not have the precise figures. We leave it to PCTs to assess the health needs of their local community and to determine their priorities in the light of that.
My Lords, the specialist nature of managing childhood diabetes and childhood obesity often requires hospital attention, as opposed to going to the GP. Given that, will the White Paper mean that treatment facilities of this kind may be transferred closer to the patient's home, removing the need for children to attend hospital, which can often be a daunting experience?
My Lords, the noble Earl is right: visiting hospital can be a daunting experience for children. It will be for the PCTs in the light of their discussions with specialist clinicians to set up the most appropriate services, but, like him, I hope that some of the services could move closer to home, as is the spirit of the White Paper.
My Lords, we know that type 2 diabetes is much higher in a number of ethnic minority communities, in poorer areas and in more disadvantaged groups of the population, so my noble friend is right.