Joint Briefing - Health and Social Care Bill Report

8/3/2019 Joint Briefing - Health and Social Care Bill Report

http://slidepdf.com/reader/full/joint-briefing-health-and-social-care-bill-report 1/4

1 of 4

Health and

Social Care Bill

House of Lords Report Stage

February 2012

We are calling for the Bill to be amended so that Healthwatch England and Local Healthwatch

effectively involve children in their work.

Amendments

227 Clause 180, page 177, line 10, leave out “people” and insert “adults and children”

Purpose

To make explicit that Healthwatch England‟s functions to provide advice (to the Secretary of State, the NHSCommissioning Board, Monitor and English local authorities) on the views of patients and members of thepublic, refer to the views of children.

Amendment

233 Clause 182, page 180, line 14, at end insert—

“(1A) In subsection (2)(a), (b) and (c) omit “people” and insert “adults and children””

Purpose

To make explicit that Local Healthwatch organisations‟ functions in: promoting and supporting patient and public involvement in the commissioning, provision and scrutinyof local care services; and

obtaining patient and public views about people‟s needs needs for, and their experiences of, local careservices,includes carrying out these functions with children. The amendment also ensures that Healthwatch Englandwill provide support and assistance to Local Healthwatch organisations in relation to this.



2 of 4

BriefingHealthwatch England is being established to represent the views of the public, service users in health andsocial care, and Local Healthwatch organisations. Local Healthwatch will take forward the work done by localinvolvement networks (LINks) in seeking the views of local service users in health and social care andinvolving them in the development of services. We urge Parliamentarians to amend the Bill to make clear thatHealthwatch England and Local Healthwatch should effectively involve children in their work. We are alsocalling on Government to:

Develop and disseminate guidance for Local Healthwatch organisations on effectiveengagement with children, drawing on pathfinders’ experiences.

Conduct a review into how Healthwatch England and Local Healthwatch have involved childrenin their work, two years after commencement.

Appoint a champion for children within Healthwatch England to oversee this work and to driveforward standards on children’s engagement in decision-making.

The exclusion of children's voices in the NHSEvidence shows that children's views are often not sought or are overlooked within the NHS.

Research commissioned by the National Children’s Bureau1 found that not all LINks understoodthat engaging with children was part of their official remit. Even those LINks that engaged with childrenoften set different age parameters for their involvement, many of which excluded younger children, andchildren‟s involvement in setting the LINks‟ agenda was limited.

Participation Works’ recent review of law, policy and practice in relation to children‟s participationin the NHS and other public services and settings found that in their efforts to support user involvement,health authorities and NHS Trusts had not specifically identified children as service users. The reviewalso found that although 41% of GP practices reported to have a Patient Participation Group, there wasno evidence of children's active engagement in these forums.2

The Council for Disabled Children’s Managing My Way research with disabled children andhealthcare professionals found that the majority of professionals felt they did not receive enoughtraining to develop their skills in communicating with young people, especially those who use different

communication methods. The result is that professionals do not feel confident communicating withyoung people who in turn feel excluded from decisions about their own health care.3

Research by the UCL Institute of Child Health has found that the views of under-16s were onlysought in 1 of 38 national surveys of patient experience in the NHS between 2001 and 2011. Thiscomprised <0.6% of respondents, despite the fact that children represent a substantial service usergroup. Where the views of 16-24 year-olds had been sought, they consistently reported poorerexperience of care than older patients.4

The Royal College of Paediatrics and Child Health and the NHS Confederation recently publisheda guide to Involving children and young people in health services which underlined the key role thatthey can plan in both planning and service delivery. Without that involvement, 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 through their whole health journey”.5

Concerns around children's involvement in patient and public voice mechanisms in the NHS were alsoreflected in the report of the NHS Future Forum.6

1 NCB (2011) LINks involvement of children and young people2 Burke, T. (2010). Anyone listening? Evidence of children and young people's participation in England. Participation Works. Pages 39-46.3 Council for Disabled Children (2011), Managing My way

4Dougal S Hargreaves & Russell M Viner (2011) Children and young people‟s experience of the National Health Service in England: a review of nationa

surveys 2001-20115 RCPCH, NHS Confederation and OPM (2011) Involving children and young people in health services page 5

6NHS Future Forum (2011) Summary report on proposed changes to the NHS, page 26



3 of 4

The establishment of Healthwatch offers an opportunity to make sure the voices of children, young people andtheir parents and carers are better heard. There is a real risk that this will not be realised however. A recentsurvey of health scrutiny chairs by YoungMinds found that 80% had not had outlined to them how children andyoung people could get involved in shaping local services through local Healthwatch or Health and WellbeingBoards.7

It is essential that Local Healthwatch and Healthwatch England work for all ages, including children. TheGovernment must ensure that these organisations have a clear mandate, and the capacity and skills, toengage with children from a variety of ages and backgrounds, including the most vulnerable.

Responding to the Kennedy ReviewThis Bill is the first legislative opportunity Parliamentarians have had to respond to the findings of the KennedyReview, „Getting it right for children and young people: Overcoming cultural barriers in the NHS‟, published inSeptember 2010. The Government‟s response to the review accepted Sir Ian Kennedy‟s powerful argumentsabout the need to engage children in the NHS:

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 [our emphasis].8

Convention on the Rights of the ChildIn a welcome move, the coalition Government promised in December 2010 that it would give due considerationto the Convention on the Rights of the Child (CRC) when making new law and policy. As a signatory to theCRC, the UK must take all possible steps to fully realise the rights and freedoms in the Convention, includingArticle 12 which states that children should have a say in all decisions affecting them and that their viewsshould be given due weight according to their age and maturity.9

The international monitoring body for the CRC, the UN Committee on the Rights of the Child, has been clear

that Article 12 applies to collective decision-making processes, as well as matters affecting the individual child.In its General Comment on Article 12, the Committee notes:

… wide interpretation of matters affecting the child and children helps to include children in the social processes of their community and society. Thus, States parties should carefully listen to children’s viewswherever their perspective can enhance the quality of solutions.10

In October 2008, the UN Committee issued its recommendations to the UK and, in relation to Article 12, urgedthe Government to widely ‘ promote, facilitate and implement, in legislation as well as in practice , … theprinciple of respect for the views of the child [and] support forums for children’s participation [our emphasis] ’ .11

The above amendments would give effect to this recommendation in relation to children‟s healthcare.

7Between December 2011 and January 2012 151 English local government Chairs of Health Scrutiny Committees were sent a survey by the children

and young people‟s mental health charity YoungMinds. Over a quarter of all Health Scrutiny Chairs replied. Seehttp://www.youngminds.org.uk/news/news/528_changes_to_nhs_landscape_devalue_young_people_s_participation 8

Department of Health (September 2010). Achieving equity and excellence for children. How liberating the NHS will help us meet the needs of childrenand young people. Pages 4 and 6.9 United Nations Convention on the Rights of the Child http://www2.ohchr.org/english/law/crc.htm 10

United Nations Committee on the Rights of the Child (2009). General comment no. 12. The right of the child to be heard. Page 8.11

United Nations Committee on the Rights of the Child (October 2008) Concluding observations on the UK. Page 8.

http://www.youngminds.org.uk/news/news/528_changes_to_nhs_landscape_devalue_young_people_s_participation


http://www2.ohchr.org/english/law/crc.htm





Joint Briefing - Health and Social Care Bill Report

Documents

Transcript of Joint Briefing - Health and Social Care Bill Report