‘There was,’ said Donna Ockenden, the senior midwife charged with examining catastrophic failures in maternity care at Shrewsbury and Telford NHS Trust, ‘a culture of not listening to the families involved.’
It is an approach that contributed to the deaths of up to 200 babies and nine mothers. ‘We've had to fight all the way along in this,’ the mother of one dead baby told the BBC, ‘to finally be heard… is a great achievement.’ Mothers in particular said they were made to feel as if their baby’s death or disability was their own fault.
This isn’t an article about Ockenden’s report. But past conduct at Shrewsbury and Telford NHS Trust is a powerful reminder that terrible things happen when distrust and disrespect towards ‘ordinary’ people is baked into a system.
It is a timely reminder, because distrust and disrespect is exactly what the government’s SEND Green Paper seeks to entrench with proposed reforms to the dispute resolution options available to disabled children and their families who are in dispute with their local authority.
Local authorities lost 96% of cases in the SEND Tribunal, according to the most recent figures available. So alarm bells ring when, at page 66, the green paper states: ‘Local authorities are uniquely placed to be a champion for the best interests of every child and young person in their area.’
The green paper was an opportunity to address the situation whereby a local authority repeatedly losing cases faces no adverse consequences. Instead, the green paper proposes additional stages as obstacles to children, young people and their families.
As 39 Essex barrister Steve Broach points out on his Twitter account: ‘The SEND Green Paper is proposing not just one but two compulsory stages before families can even lodge a Tribunal appeal – mediation, then local review. How,’ he asks, ‘can this level of bureaucracy be in the best interests of children? What is the benefit of local review?’
The Local Government Association, which lobbies for its member councils, has found common ground with the government on this issue. A recent report for the LGA by the Isos consultancy blamed ‘affluent’ parents for bringing cases to the Tribunal, and suggested the ‘statutory framework’ was ‘unbalanced’.
As I reported earlier this month, the Department for Education has handed a £1.5m contract to private consultancy Impower which claims that on SEND it can ‘reset parents’ and professionals’ expectations around support’. (DfE still has not responded to the Gazette’s questions on the Impower contract.)
Policy makers are understandably queasy about actually saying they are downgrading provision for disabled children and young people. So a preferred tactic to cut costs (for which read ‘support’) is to use process – to make it harder to do anything other than accept what a local authority feels like offering.
Two extra layers of dispute resolution strings things out, adding to the existing deterrents to accessing the tribunal, which already include cost and time.
Another eye-catching idea is that Education Health and Care Plans will restrict parents to a pre-approved list of school options that are acceptable to the local authority, rather than allowing parents to request any school as at present. (Why? Well here is one suspicion: not all councils have schools that can meet a child’s needs, but sending a child out of borough or to a specialist school is more expensive.)
Will there be a way of contesting this restricted list of options? Presumably, but of course, that’s another process, another dispute.
Few people of any political persuasion enter public life with the aim of cutting services to vulnerable people. And at the Shrewsbury and Telford NHS Trust, I assume no-one working in maternity services wanted to harm mothers and babies. But in both cases, for a variety of reasons, these people find themselves under pressure.
A natural response people have to the pressure that things going wrong creates is to blame someone else – in today’s examples, parents. Those parents experience distrust and disrespect. They find it harder to get heard – and when they are not heard, things that were going wrong get worse.
That was true in Shrewsbury and Telford, and it will be true at a local authority near you.
The SEND Green Paper could have included proposals that focused the minds of local authorities on implementing the existing legal framework for supporting children with SEND.
Instead it includes a blueprint for making access to justice harder – and so contributes to a culture where families involved in the process need not be listened to.
This is an approach that never ends well.
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