Amendment 36

Health and Care Bill - Report (2nd Day) – in the House of Lords at 11:50 am on 3rd March 2022.

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Lord Kamall:

Moved by Lord Kamall

36: Clause 20, page 21, line 25, at end insert—“(ba) set out any steps that the integrated care board proposes to take to address the particular needs of children and young persons under the age of 25;”Member’s explanatory statementThis amendment requires the joint forward plan for an integrated care board and its partners to set out any steps that the integrated care board proposes to take to address the particular needs of children or young persons under the age of 25.

Photo of Lord Kamall Lord Kamall The Parliamentary Under-Secretary for Health and Social Care

My Lords, I thank the House for its continued focus on addressing the needs of babies, children and young people and thank noble Lords for bringing forward amendments on this issue again today. I am also really grateful to noble Lords who have engaged with the me and my officials, and I hope that this has resulted in amendments that your Lordships’ House feels that it can support.

I start with Amendment 36, in my name. This amendment will require an integrated care board to set out any steps that it proposes to take to address the particular needs of children and young people under the age of 25 in the forward plan. In addition, the Government have committed to produce a package of bespoke guidance, which explains how the ICB and the ICP should meet the needs of babies, children, young people and families. This guidance will contain provisions for the integrated care partnership’s integrated care strategy to consider child health and well-being outcomes and the integration of children’s services, as well as providing that the integrated care partnership should consult local children’s leadership and children, young people and families themselves, on the strategy.

NHS England has also agreed that it will issue statutory guidance, expecting that one of the ICB executive leads will act as a children’s lead, with responsibility for championing the needs of babies, children and young people. I hope that noble Lords are supportive of this government amendment and its underpinning commitment to support, improve and enhance services for babies, children and young people.

I turn to Amendments 157, 185 and 186. Safeguarding children is a priority for the Government, and we share the horror and concern provoked by the awful murders of Arthur Labinjo-Hughes and Star Hobson. The Government are committed to addressing barriers to safe, timely and appropriate sharing of information to safeguard children, and we have heard clearly the strength of feeling across the House on the value of a consistent identifier for children. In particular, I pay tribute to the noble Baroness, Lady Tyler of Enfield, and other noble Lords, for pushing us on this issue.

To this end, we are committing in this legislation to publish a report, within one year of the section coming into force, that will describe the Government’s policy on information sharing in relation to children’s health and social care and the safeguarding of children and will include an explanation of the Government’s policy on a consistent identifier for children. It will also include the Government’s approach and actions to implement the policy set out in the report. The Government agree with noble Lords that action is needed. The report will reflect a cross-government position on what actions will be taken to improve safe and appropriate information sharing.

This amendment, of necessity, is limited by reference to health and social care, reflecting the scope of the Bill. However, the report to which this amendment refers will be laid by the Secretary of State for Education, who intends that it will cover improved information sharing between all safeguarding partners, including the NHS, local authorities and the police, as well as education settings. The Department for Education has already started its work, which will look at the feasibility of a common child identifier. I hope these amendments will reassure noble Lords that the Government are committed to safeguarding children and improving services for babies, children and young people. I beg to move.

Photo of Baroness Hollins Baroness Hollins Crossbench

My Lords, I am grateful to the Royal College of Speech and Language Therapists, the National Children’s Bureau, the Disabled Children’s Partnership and the Royal College of Paediatrics and Child Health for their support with this amendment and for their constructive engagement with the Department of Health and Social Care. I also thank the noble Baroness, Lady Tyler, for adding her name to this amendment.

I welcome the amendments that the Minister has laid relating to the needs of babies, children and young people but, despite the good progress made, this amendment seeks to go further by requiring NHS England to conduct a performance assessment of each ICB in meeting the needs of babies, children and young people in each financial year. This includes its duties concerning the improvement in quality of services and reducing inequalities and the extent of its public involvement and consultation.

There are significant challenges in meeting the health and care needs of children and young people, including their mental health needs, which are different and arguably more complex than for adults. This is particularly the case for disabled children and young people and those with special educational needs. A recent survey by the Disabled Children’s Partnership and the parent campaign group, Let Us Learn Too, found that 40% of families with disabled children have seen their savings wiped out by fighting and paying for support.

I shall give one brief example from the West Midlands. Joanne, whose autistic son also has pathological demand avoidance and communication difficulties, explained that the local authority refused to do an occupational therapy assessment, so she paid for one privately. Eventually, she took the local authority to tribunal at considerable expense in legal fees. Despite winning, it is one year on and still no support is being provided by the local authority.

One in three families with disabled children said they needed publicly unprovided essential therapies for their disabled child, but could not afford them. Some 60% of families with disabled children have sought NHS mental health support for a family member due to the stress of fighting for basic services. The Disabled Children’s Partnership cites individuals feeling a sense of societal resentment toward disabled people, says that carers are persistently undervalued and underrepresented in policy and details the enormous physical, emotional and financial burden they endure in caring for their disabled family member without adequate support from the health and care sectors. Joanne said, furthermore, that the local authority blamed her for her son’s disability and put a child protection plan in place rather than supporting her, although thankfully it was removed shortly afterwards.

Integrated care boards have a crucial role in commissioning primary and community healthcare services directly for babies, children and young people. They will play a key role in the joint commissioning of services for disabled children and those with special educational needs, as well as contributing to education, health and care plans and in the commissioning of joined-up services in the first 1,000 days of life, in which the Government are, importantly, investing. Crucially, ICBs will be jointly responsible for the leadership of local child safeguarding partnerships, together with the police and local authorities.

Yet support for children and young people varies geographically. Local systems find themselves pulled in different directions by different government initiatives and separate pots of funding, which creates a profound risk of destabilising what are relatively new local safeguarding partnerships. The Wood report, published in May 2021, reviewed the new multi-agency safeguarding arrangements put in place by the Children and Social Work Act 2017. It revealed just how stretched the resources are in protecting children, as well as the need for a more effective culture of joined-up working and a more consistent and detailed understanding of the role of the three statutory safeguarding partners—the local authority, the CCG and the chief officer of police. The Wood report also emphasised the importance of accountability regarding the quality of these services and the need for inspectorates and regulators to develop a model to analyse performance against what is deemed to be best practice, something that this amendment goes a long way to trying to achieve.

Perhaps more worryingly, an assessment conducted by NHS England in December found that only three ICBs were considered ready to take on their safeguarding responsibilities, with a remaining 39 still in progress or in need of support. That highlights how important it is that ICBs are both supported and held to account with regard to these duties.

I recognise that the aim of the Bill is not to overprescribe what local systems do, and I agree that ICBs must be free to respond to local need. But to deliver the best outcomes for children, there must be a clear vision for children’s health and welfare that is shared at national and local levels and with the necessary accountability for delivering it. I hope that the Government can provide assurances to your Lordships’ House that all children and young people, including disabled youngsters, will be properly reflected in the NHSE performance assessment frameworks currently being developed, that the role of ICBs in meeting their needs will be an ongoing focus of NHS England and Her Majesty’s Government, and that all ICBs will be supported to be ready to take on their safeguarding responsibilities from July this year.

The proposed amendment would help to deliver on the recommendations of the Wood report by ensuring important multiagency working and accountability for the welfare of babies, children and young people. I urge the Minister to accept the amendment.

Photo of Baroness Tyler of Enfield Baroness Tyler of Enfield Chair, Children and Families Act 2014 Committee, Chair, Children and Families Act 2014 Committee 12:00 pm, 3rd March 2022

I support and very much welcome government Amendments 36, 157 and 185 in response to the powerful debates in Committee on children’s health, safeguarding, data-sharing and particularly the case for a unique identifier for children, on which I put forward an amendment in Committee. I thank the Minister for engaging so fully and positively on these issues and for the various meetings which led to these amendments being tabled. It is also very welcome that Amendment 36 includes children in the Bill, which so many of us have argued for.

On the unique identifier as a means of identifying children in touch with multiple services, aiding safeguarding and promoting joined-up support, I strongly support the government amendment to lay a report before Parliament on information sharing and on a single unique identifier for children. That is a real step forward, and it is clear that the Government acknowledge that there are serious and distinct challenges with sharing relevant information across not just children and social care sectors but others too, including schools and the police.

There is always more to do, so I will never be 100% satisfied and I note that the amendment as tabled does not actually commit the Government to any specific timed action beyond publishing the report. Therefore, it was good to hear the further assurances that the noble Lord, Lord Kamall, gave at the Dispatch Box. I think I heard him say clearly and unequivocally that the Government are committed to developing plans not just to look at the case for but to adopt a single unique identifier for children. I think I also heard a commitment to developing a set of cross-government proposals for implementing that, and then, I hope, acting on the findings of this report within a defined timescale. If the Minister could reiterate those commitments, I would be extremely grateful. I would also welcome a commitment to involving those organisations representing children and young people, who have been so much a part of our discussions and debates, as part of the production of that Bill.

I support Amendment 59 from the noble Baroness, Lady Hollins, which I signed, requiring NHS England to assess annually how well each ICB is doing in meeting the needs of children and young people; it provides much-needed accountability and transparency, particularly in relation to the new and crucial safeguarding responsibilities that ICBs are taking on. I welcome the statutory guidance, which I know the Government intend to produce, on having a children’s lead on the board of every ICB. That is really important.

I support the suite of amendments in the name of the noble Lord, Lord Farmer. I will leave him to set out the case for them, but I agree that family hubs play a really important role in improving early intervention services, helping integration and data sharing among public services and involving the voluntary sector. Importantly, and germane to this Bill, that includes children’s health services, which are often better delivered in community settings with other family support services. I particularly support Amendment 75, which calls for each local authority to provide a family hub. That is central to a national rollout of family hubs. which I would like to see at the very core of a national strategy on child vulnerability.

Photo of Lord Farmer Lord Farmer Conservative

I start by thanking the noble Baroness, Lady Tyler, for her support; it is very much appreciated. She has been a doughty warrior accompanying us along this path for many years.

I will speak to my Amendments 64, 66, 68 and 75 and I thank the Minister for the meetings I have had with him and the Bill team to hear his concerns, particularly around being overprescriptive.

Amendment 64 simply replaces “may” with “must” and thereby requires integrated care partnership strategies to lay out how health-related services can be more closely integrated with health and social care. In Committee, I said that “may” made that aspect of integration voluntaristic, and I would be grateful if the Minister could explain why, as I am genuinely mystified, the ICP is at present only invited to do that.

Amendment 66 has been revised after the discussions mentioned earlier. I propose adding new subsection (5A) to Clause 116ZB to specifically invite ICPs to consider how family help services, including those accessed through family hubs, could be more closely integrated with arrangements for the provision of health services and social care services in that area. I avoid using “must” in that case, because it could place an overly prescriptive requirement on ICPs. I also avoid mandating the use of family hubs. They are simply mentioned as an important potential access point.

I recognise and applaud the many ways that the Government have improved the Bill with respect to children’s health. However, I explained in Committee that many children’s health needs are psychosocial: they need practical, not just medical, solutions and addressing them needs a whole-family approach. That is also particularly important when parents experience drug and alcohol problems, which can affect their children almost or as much as the parents themselves.

Early family help commissioned by local authorities therefore needs to be integrated with health as well as many other departments of government. Family hubs are mentioned in my amendment, not prescriptively but as the model that could enable that to happen. In Committee, I described how DWP’s Reducing Parental Conflict programme, DLUHC’s Supporting Families and the MOJ’s private family law pilots all looked to family hubs as an access point for those who need this support. The Bill could and should help to make that model proliferate to benefit families. As it operates according to principles, not an overly prescribed framework, it can be tailored to local need, including by drawing in the bespoke work of the local voluntary and community sector. Historically and currently, health services have had a poor track record in integrating with local government and wider partners. The Children’s Centre movement frequently lamented the lack of engagement with health. The opportunity the Bill provides to avoid that pattern being repeated should not be missed.

My Amendment 66 gives meaning to the phrase “family help” and points towards an amended Schedule 2 to the Children Act 1989 to explain what is meant by “family hubs”. In Committee, I explained that

“services which improve children’s lives through supporting the family unit and strengthening family relationships to enable children to thrive and keep families together” is the independent care review’s working definition of “family help”. This is not a concept to be set in concrete in the lead reviewer’s final report, but simply one that is qualitatively different from “family support” in local authority usage. The latter leans towards late-stage statutory child protection, which ideally prevents children entering care and is far from the early help so many parents need.

Finally, my Amendment 75 necessarily changes how the Children Act 1989 refers to family help infrastructure to reflect more closely the way it has developed. It has also been adjusted since Committee to avoid mandating local authorities to provide family hubs, which would have significant cost implications, ultimately for the Treasury. As a result of my amendment, new Schedule 2(9) to the Children Act would state:

“Every local authority shall provide such family hubs as they consider appropriate with regard to local needs in relation to children and families within their area.”

“Family hubs” means an access point where children, their parents, relatives and carers can access advice, guidance, counselling or paediatric health services as well as occupational, social, cultural or recreational activities. This removes the anachronistic reference to and description of “family centres”. These were never consistently implemented in the way probably envisaged by the draftsmen of the 1989 Act, although children’s centres did emerge to fulfil many of their purposes in response to research on the importance of children’s early years.

To address the Minister’s concerns that putting family hubs into legislation would introduce unhelpful rigidity and prescription, I end by making an analogy with the Supporting Families programme. This does have a legislative underpinning, but the early troubled families programme from which it evolved provided principles for a tried, tested and consistent way of working, illustrated these with case studies and supported local authorities to develop their own bespoke approaches to that way of working. The DfE is taking a similar non-prescriptive approach in its family hubs framework, which emphasises principles—namely, access, connection and relationships—and avoids determining how local authorities implement these. Just as the Supporting Families programme has developed but is still recognisably the same way of working launched as “troubled families” 10 years ago, I and others anticipate the same continuous improvement trajectory for the family hubs model or way of working.

Family hubs are now official government policy, backed by a £130 million commitment, a major evaluation programme and decades of supportive research. The model is not prescriptive but enabling and supported by many local authorities and those designing health systems. I would be grateful, in conclusion, if the Minister would explain, after these assurances, why this important social infrastructure, the fruit of 30 years of reform, which builds on and extends Labour’s legacy of Sure Start centres, has no place in the Bill.

Photo of Baroness Walmsley Baroness Walmsley Co-Deputy Leader of the Liberal Democrat Peers

My Lords, I congratulate the noble Lord, Lord Farmer, on his efforts to keep the issue of prevention and early intervention before us: it is vital. I also thank the Minister for the government amendments and the way he has engaged with us over this issue. I was particularly pleased to hear him use the word “action” at least two or three times in his introduction to the amendments. I congratulate the noble Baroness, Lady Hollins, and my noble friend Lady Tyler, on all they have done but in particular for pointing out, in their Amendment 59, that there could be a bit of a gap here. We have the CQC, which will inspect individual healthcare settings and, under the Bill, it will also have to see how the new integrated care system is working, but there is no guarantee that it will see it as part of its duty to see how that system is working for children. This is something that the NHS could do through the report called for in Amendment 59.

Photo of Lord Shinkwin Lord Shinkwin Conservative 12:15 pm, 3rd March 2022

My Lords, I too thank my noble friend the Minister for Amendments 36 and 157. I shall also speak in support of Amendment 59 in the name of the noble Baroness, Lady Hollins. Before I do so, I hope your Lordships’ House will allow me to take this opportunity to thank the healthcare professionals at Guy’s and St Thomas’s, who recently looked after me so well following major surgery. Some noble Lords may have noticed my absence. I have had half my leg rebuilt and am now the proud, if involuntary, owner of a Meccano set inserted by my excellent surgeon, Marcus Bankes, and his registrar, Christian Smith. I apologise in advance if any noble Lord seeks to intervene and I dare not sit down to take their intervention as I am not sure I would be able to get back up again.

Although the pain was excruciating and the morphine, which I am weaning myself off, very welcome, it saddens me to say that that pain was compounded by the way in which I received no support from your Lordships’ House. I might as well have been dead. It reminded me that this wonderful institution remains a place whose rules and modus operandi were designed by and for rich, non-disabled men. I will say no more on the matter now, but it is clear to me that this needs to change if we are to become a stronger, more diverse, more representative House. If we do not want to be consigned to the past, we must stop living in the past. The appalling way we treat Members whose disability enforces temporary absence from your Lordships’ House is indefensible and cannot continue.

Returning to the substance of the amendments under discussion, I am hugely grateful that the Government have listened to concerns I raised at Second Reading and others raised, in my absence, in Committee. All credit goes to noble Lords for the strength and the passion with which they did this, and to the Minister for so obviously listening and taking their concerns on board. Taken together, Amendments 36 and 157 should make a real difference to the lives of all babies, children and young people in this country, particularly those with speech, language and communication needs. I should declare at this point my interest as a vice-president of the Royal College of Speech and Language Therapists. I know the Minister and his colleagues across government, not just in the Department of Health and Social Care but also in the Department for Education and the Ministry of Justice, share my ambition and the ambition of other noble Lords in wanting children and young people with communication needs and their families to have the best possible level of support so they can realise their potential.

To help deliver that ambition, I ask my noble friend to reflect on four things. First, I would be so grateful if he would look kindly on Amendment 59, so ably spoken to by the noble Baroness, Lady Hollins. This would help to close any potential accountability gap and considerably strengthen the provisions of Amendment 36.

Secondly, will the Minister pledge to ensure that all the guidance to the Bill specifically references children’s speech, language and communication needs? The statutory guidance and accountability lead for SEND is a very positive development, but it is not sufficient. The vast majority of children with communication needs do not have an education, health and care plan. This includes children with developmental language disorder—over 7% of all children—those who stammer, and those with speech-sound disorders. The guidance must, therefore, ensure that the needs of those children are supported. A model that the Government have already established for this is the statutory guidance to the Domestic Abuse Act, where speech, language and communication are listed as a specific intersectionality.

Thirdly, will the Minister agree to meet the chief executive of the Royal College of Speech and Language Therapists to discuss how the guidance on the Bill can best capture those issues? Fourthly, on Amendment 157, can the Minister reassure the House that the report will include commitments to act to improve information-sharing? Finally, may I reiterate my huge thanks to my noble friend the Minister, and say how pleased I am to be able to do so in person, in your Lordships’ House? It is good to be back.

Photo of Baroness McIntosh of Pickering Baroness McIntosh of Pickering Conservative

My Lords, I welcome my noble friend back and commend him for his bravery. We came into the House at the same time, and he is a source of constant inspiration to us all; I have endless admiration for him. I apologise to the House for having omitted to declare my interests when I spoke for the first time on Report on Tuesday. I refer to my entry in the register of interests, and in particular to the fact that I work with the board of the Dispensing Doctors’ Association. I am also a patron of the National Association of Child Contact Centres and a co-chair of the All-Party Group on Child Contact Centres and Services.

I again commend my noble friend the Minister for summing up and assessing the mood of the House and tabling the amendments today; I am grateful to him for that. I also support the noble Baroness, Lady Hollins, and her Amendment 59, which is very appropriate. I hope my noble friend will look favourably on it, and I pay tribute to the work of the noble Baroness. One of her remarks earlier on Report which struck a chord with me was about the shortage of psychiatrists and other mental health professionals, particularly for those in the age group affected by these amendments.

I endorse and support the amendments in the name of my noble friend Lord Farmer. He refers in particular to the family hubs, and I make a plea to the Minister to recognise, as part of a family hub, a child contact centre. Centres are usually manned by volunteers, and they do fantastic work—not necessarily in keeping families together, because, unfortunately, their role largely comes into play when families have broken, but they play a fantastic role in maintaining contact with the absent parent.

Obviously, in these constrained times, the budgets of all organisations come under increasing scrutiny and pressure, so I urge the Minister to use his good offices to speak to those in the Ministry of Justice and the Department for Education to ensure that the budget for child contact centres will be renewed not only for two years but for three years—the period promised earlier. Those centres do fantastic work, under great constraint, and I am proud to be associated with them. I wanted to use this opportunity to support the amendments and to urge my noble friend the Minister to use his good offices in this regard.

Photo of Baroness Wheeler Baroness Wheeler Shadow Spokesperson (Health and Social Care), Opposition Deputy Chief Whip (Lords), Shadow Spokesperson (Levelling Up, Housing, Communities and Local Government)

My Lords, I too welcome the government amendments—bur first I wish the noble Lord, Lord Shinkwin, all the best for a speedy recovery from his hospitalisation; I am sure everyone will join me in that. I welcome the government amendments to ensure that the Bill recognises how important sharing information on children’s health and social care across government departments and public authorities is to safeguarding and protecting them and to promoting their welfare. The commitment in Amendment 157 to reporting to Parliament within a year on implementation, and explaining where the use of the consistent identifier for each child would facilitate information-sharing, is a significant step forward, as is the emphasis on overcoming the barriers that stop services being joined up, which have a serious—and, sadly, all too often fatal—impact on keeping children safe and well.

We also support government Amendment 36 to Clause 20, which leads this group, on how ICBs’ joint forward plans will address the needs of children and young people. Amendment 59 tabled by the noble Baroness, Lady Hollins, complements this in relation to performance assessments, and says how they should address the matter, particularly the duties relating to disabled children and children with special needs. I hope the Government will respond positively to this and will consult widely with stakeholders, after the promise in the Minister’s recent letter of a package of “bespoke” statutory guidance from NHS England explaining how ICPs and ICBs will meet the needs of babies, children, young people and families, and be accountable for integrating services. The Minister’s letter, and his introduction today, provide a number of assurances on important issues, such as having children’s leads on ICB executives. We will see how it all works through in practice in the structures of the new bodies.

As noble Lords have stressed, the whole issue of sharing information across multiagencies will be difficult and challenging. Two of the major barriers for previous efforts were the clash between the value of sharing electronic information and fears about it getting into the wrong hands. That is why we need a clear status picture of where we are starting from, to be able to analyse what needs to be done, how progress can be made, assessed and monitored, and the priority areas for identification of consistent identifiers.

The Minister has promised that the report will cover all safeguarding partners including the NHS, local authorities, education and the police. Will he write to noble Lords on the categories of information currently shared between those bodies, so that we can see where we are starting from?

Finally, the noble Lord, Lord Farmer, has again spoken strongly on his amendments about family hubs, which we supported in Committee on the Bill and on other occasions. I look forward to the Minister's updated response. We do, however, always—today is no exception—make the very obvious point that if the Government had not shut down the excellent Sure Start centres up and down the country, many of the provisions that the noble Lord is calling for in support of children, mothers and families would all be in place now.

Photo of Lord Kamall Lord Kamall The Parliamentary Under-Secretary for Health and Social Care

I thank all noble Lords who have raised important points in this debate; I also thank them for accepting some of the amendments that we have tabled in response to their engagement. That engagement was very constructive, and I hope that as they look to hold the Government to account we will continue to have engagement on these issues.

First, I shall deal with a couple of specific questions. The noble Baroness, Lady Tyler, again asked about the identifier. As I have made clear, the report will include an explanation of the Government’s policy on a consistent identifier for children. It will also include our approach and actions to implement the recommendations in the report.

We all agree that the principle of a consistent identifier is right, but there are complex issues in applying that consistent identifier in safeguarding children. This is why we want to investigate all the issues thoroughly in a report that will be laid before Parliament a year after commencement. There is one issue in which I am personally interested—I am sure noble Lords will remember that I geeked out on this one. I think there are some technical solutions, but I can also see some technical unintended consequences. I myself will look very closely at the report, especially at the technical solutions.

Like other noble Lords, I welcome my noble friend Lord Shinkwin; it is good to see him back. I thank him for engaging with me—almost from his hospital bed, I think, which demonstrates his commitment to these issues. He talked about speech and language therapy, and the Government recognise the importance of communications needs, and the important part that they play in children’s development. We will work with stakeholders on the development of guidance, and ensure that we engage with the Royal College of Speech and Language Therapists.

I now turn to Amendment 59 brought forward by the noble Baronesses, Lady Hollins and Lady Tyler. The Government and NHS England are committed to ensuring that ICBs specifically consider the needs of babies, children and young people. NHS England performance assessments will look at a number of the ICB duties, including improvement in equality of service and how to reduce health inequalities. These duties apply to the whole population, including babies, children and young people. The Bill also places a duty on NHS England to have regard to any guidance published by the Secretary of State in connection with assessing the performance of ICBs each year. The guidance can include provisions for the assessment particularly to consider children and young people.

The Bill also places a new duty on the Care Quality Commission to review integrated care systems. The Bill proposes that these assessments will review how ICBs, local authorities and providers of health, public health and adult social care services are working together to deliver safe, high-quality integrated care to the public, including children and young people. The amendment addresses ICBs’ duties in relation to safeguarding children, including those with special education needs and disabilities. To ensure appropriate accountability for duties, we have an agreement with NHS England that its statutory duty will provide that the responsibility for those functions should be delegated to an ICB executive lead. NHS England statutory guidance will clarify that the ICB annual report must set out how it has discharged its duties in relation to child safeguarding.

We should also look at issues around the 2021 Alan Wood review. The cross-government Safeguarding Children Reform Implementation Board, which DHSC jointly chairs, reviewed Sir Alan’s recommendations, and Ministers have discussed them with him. Officials continue to work with Sir Alan to embed his findings where appropriate.

I now turn to Amendments 64, 66, 68 and 75 and thank my noble friend Lord Farmer for bringing this important topic before the House and for engaging and pushing us on this issue which is clearly very close to his heart. We agree that ICPs and ICBs should work closely with a range of organisations to consider the whole needs of families. I stress that it is important that there should be a degree of local flexibility, as we discussed earlier. The package of bespoke guidance, which I mentioned previously, will cover services that my noble friend considers part of family help and the role that family hubs can play. We intend to include in statutory integrated care strategy guidance that family hubs, where appropriate, should be considered in the integrated care strategy where there are opportunities to integrate further its arrangements with health and social care services. My noble friend Lord Farmer will be aware that a range of work is ongoing in this area. The independent review of children’s social care is still considering the definition of family help, and it may be further refined as a result of the ongoing consultation. I would gently ask the noble Lords that the Government are given time to consider the review’s findings and recommendations.

My noble friend will also be aware of the upcoming ambitious programme of work with 75 local authorities to develop effective family hub models, but I must gently remind my noble friend and other noble Lords that as a matter of good governance, good law and the proper sequence of events, the Government feel that they must wait for the care review, and our work to develop family hub models at scale, before drawing implications for the statutory framework for either of them. Doing otherwise risks jumping the gun or being premature. While the Government strongly support and champion in principle the move to family hub models, they need to be able to adapt to local needs and circumstances. They also need to operate affordably, making use of a diverse range of local and central funding streams. In both these regards, local democratically elected councils hold the ultimate decision-making power over whether to adopt a family hub model and how it should function. Although I note my noble friend’s welcome efforts to soften its impact, we believe that there is still a risk that Amendment 75 would impose an additional burden on local authorities in their delivery of local services. It is for these reasons that I ask my noble friend and noble Lords not to move their amendments when reached.

Photo of Lord Mackay of Clashfern Lord Mackay of Clashfern Conservative 12:30 pm, 3rd March 2022

Before my noble Lord sits down, does “children” in this amendment include children in care?

Amendment 36 agreed.

Amendments 37 to 54 not moved.