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Haemophiliacs with Hepatitis C: Correspondence

Lord Morris of Manchester asked Her Majesty's Government:

The Parliamentary Under-Secretary of State, Department of Health (Lord Hunt of Kings Heath): We will consider the correspondence carefully and reply to my noble friend as soon as possible. A copy of the reply will be placed in the Library.

National Institute for Clinical Excellence

Earl Howe asked Her Majesty's Government:

Lord Hunt of Kings Heath: Quinquennial reviews were abolished following the publication in July 2002 of the report Better Government Services: Executive Agencies in the 21st Century. The National Institute for Clinical Excellence was examined by the Health Select Committee in 2002, and is arranging for an external quality assessment of its technology appraisals.The Government will keep under review the need for any further inquiries.

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Severely Disabled Children

Lord Ashley of Stoke asked Her Majesty's Government:

    What is the present number of severely disabled children; and how many there were in 1970; and[HL1321]

    How many severely disabled children are (a) living in institutions and (b) attending special schools; and[HL1322]

    How many (a) institutions and (b) special schools providing care for severely disabled children are in the United Kingdom; and who currently funds them; and[HL1325]

    What is the average cost of maintaining a severely disabled child (a) full time in institutions, (b) full time in a special school; and (c) at home with no full-time residential carers; and[HL1326]

    What is the amount and nature of care provided to severely disabled children by social services departments; and what is the cost to those departments; and[HL1323]

    How the present level of financial provision for families with severely disabled children compares with that in 1970; and what it consists of; and[HL1324]

    Whether they monitor the problems of families with severely disabled children; and[HL1329]

    Whether they will set up an inquiry into the extent of the problems of families with severely disabled children.[HL1330]

Lord Hunt of Kings Heath: The Office of Population, Censuses and Surveys (OPCS) research published in 1989 estimated that, overall, there were 110,000 severely disabled children under the age of 16 in Great Britian. This survey remains by far the largest exploration of childhood disability ever undertaken in the United Kingdom. There were a number of earlier smaller surveys undertaken in the 1970s, but none was sufficiently comprehensive to provide a baseline for subsequent comparisons.

We do not collect statistics broken down by severity of impairment. The number of disabled children living in residential placements was estimated at 31 March 2001 to be nearly 2,300. Of these 550 were in residential schools. There are about 6,600 pupils in maintained and non-maintained residential special schools, plus a further 4,400 in independent residential special schools. Nearly all these children have statements of special educational needs, but data are not collected about whether they are disabled or not. We do not collect central information about the number of institutions that provide care for disabled children. As at January 2002, there were some 1,400 special schools in the country, including 227 which provide residential placements.

We do not centrally collect statistics on the average costs of maintaining disabled children in institutions, special schools or at home without full time residential carers. A reanalysis of the 1989 OPCS survey [Kavanagh and Opit 1998] showed that the weekly cost

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for children (0-16 years) resident in private households was £330 per week at 1994–95 prices. For children in communal establishments, the average weekly cost of the placement and other services use was between £554 (private residential homes) and £1,128 in local authority residential homes. The average per capita budget cost of local authority maintained special school provision in England was £11,210 in 2001–02. In independent and non-maintained special schools there is a wide range of fees as a result of individual tailored provision and it is not meaningful to provide an average figure.

We are providing substantial financial support to families of disabled children. Tackling child poverty is a complex and multi-dimensional issue. It is not just about income; it is also about extra investment in healthcare and education services, and improvements in the sytem for children and teenagers who are vulnerable or disabled. The Government increased the disabled child premium in income-related benefits by £7.40 a week more than the normal uprating in April 2001 and again in April 2002 by another £5 more than inflation, to £35.50 a week. This premium is benefiting the families of around 85,000 children with disabilities and currently, together with the enhanced disability premium paid to families with around 40,000 severely disabled children, costs some £160 million in 2001–02. Spending of £200 million is planned for 2002–03, of which about £20 million is expected to be spent on the enhanced disability premium. In addition 232,000 in 2001–02, forecast of 247,000 in 2002–03, disabled children with care and/or mobility needs are helped by disability living allowance at an annual cost of £674 million in 2001–02. Spending is forecast to rise to £744 million in 2002–03. Benefit spending on children in addition to the spending on disability living allowance is £13,081 million in 2001–02, and is forecast to rise to £13,764 million in 2002–03. This figure includes benefit spending only and excludes tax credits.

The disabled child tax credit element of the working families' tax credit was introduced in October 2000 for families with children getting disability living allowance or who are registered blind, or who have left the register in the last 28 weeks. This is currently worth a maximum of £35.50. The child enhanced disability tax credit, currently worth £46.75 a week, was introduced in April 2001 for severley disabled children getting the higher rate care component of DLA. From April 2003 the new child tax credit for families will include family elements and child elements. The child element for disabled children will be worth £3,600 per year, while the child element for severely disabled children will be worth £4,465 per year. The Government also provide funding to the Family Fund

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Trust which provides grants to help reduce the stress on families with severely disabled children. This increased from £26.4 million in 2001 to £27.4 million this year and will increase by a further £1 million in 2003–04.

Disabled children receive a range of care and support from social services departments. This includes advice and guidance; family support including short-term breaks; residential provision; selfcare and independent skills training; drop-in clubs and groups; activities at family centres; transition support sevices. The Children in Need survey 2001 shows that the average cost to social services of each disabled child in residential care during the survey week in September/October 2001, excluding those that received respite care alone, was £1,400. The average cost to social services of each disabled child supported in their family or independently during the census week was £130.

As part of the Government's £885 million Quality Protects programme, we set national objectives for children's social services and through inspections, monitoring and annual reviews the department's Social Services Inspectorate monitor progress towards their achievement. The objectives include specific sub-objectives for disabled children, which are a priority area in the programme. Last year's Quality Protects Management Action Plans (MAPs) show that local authorities are beginning to improve the services they provide to disabled children, including providing more family support services such as home based respite care and sitting services. For severely disabled children the draft national overview of the MAPs says, "There are a number of examples of innovative partnerships with health to enable the appointment of health care assistants and developing roles for paediatric home care services. Services have also looked at the role of nursing support in special schools and the development of community services." Next year (2003–04) the earmarked funding for disabled children will double from £15 million to £30 million.

The Children's National Service framework, which will be published later this year, will set national standards across health and social care for children's services. The external working group developing NSF standards for disabled children's services has set up a specific task group to consider the needs of severely disabled children. This is addressing the current support being provided to severely disabled children and their families and how they can be improved. It will make recommendations about the interventions needed to maximise life chance benefits from educational opportunities, healthcare and social care. We do not therefore feel that there is a need to set up an inquiry at this point.

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