Tag Archives: health

Growing up in England: The Children’s Commissioner’s Report

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The Children’s Commissioner, Dame Rachel de Souza, has issued a comprehensive report on growing up in England. ‘The Childhood Lottery: The hardest places to grow up in England’ The Childhood Lottery: The hardest places to grow up in England | Children’s Commissioner for England The data comes from matrixes across the Commissioner’s six pillar of work

Health: health services and outcomes

Care: social care and outcomes

Community; policing, youth justice and services available to children in l where they live

Education: jobs and skills: schools and  post-16 plus educational outcomes

Family: housing, play , poverty and family life

Better world: the environment, children’s voices and citizenship

The data are for the 150+ upper-tier authorities, so London boroughs, metropolitan districts, unitary councils and the remaining shire counties. As a result, the authorities range in size from Rutland to Lancashire and Kent. Some areas are more homogenous than others: some are contiguous with health, police and other non-local government functions, while others are part of larger organisation for policing and health with policies set outside the local authority areas. Some functions are split between upper and lower tier authorities, such as housing and recreation facilities.

Despite these issues, that in some cases make the average for the authority not reflective of its different parts, and highlight some of the issues with dashboards, discussed in a recent post on this blog. Are dashboards useful? | John Howson this is a powerful report bringing together lots of useful data.

There are dangers here. Oxfordshire is ranked equal 11th with York, and the fourth best county to grow up in England. But, tomorrow, I will be at a workshop , initiated by an Oxfordshire-based multi-academy trust, aiming to improve the lives of children in the most challenging part of the county’s urban landscape. (The report classifies Oxfordshire as rural). The issues in this area would have been highlighted if district councils had been used as the data point instead of upper-tier authorities. Parliamentary constituencies, where most of this data is probably kept somewhere for MPs questions, might have been an even better and more equal frame of reference, allowing different between both Tottenham and Highgate within Haringey to have been judged separately.

Rural areas may also have a bit of a raw deal: you can’t count bus data where there are no buses. The data on childcare placement more than 20 miles from their home doesn’t discount kinship care that might be valuable, but not local in a large rural county.

However, it is easy to carp, and one cannot but praise the efforts of the Children’s Commissioner. The survey may also reveal how weakened local government has become. Take youth justice: how many councillors attend local committees to discuss approaches to this vital topic. Do cabinet members for Children’s Services even know that they often have this responsibility?

I was fortunate, when a Cabinet member, to have both a Director of Children’s Services and a Youth Justice lead that kept me informed, and allowed me to understand the importance of this area. On the other hand, the Health and Wellbeing Board was a challenge for me, as it covered so many different areas, and children’s health didn’t have a sub-committee. The fact that Oxfordshire is a Marmot County had nothing to do with me as a cabinet member for children’s services.

There are messages for politicians at all levels in this report, not only about childhood, but also into young adulthood. Sadly, many adults face the same problems, and solving those issues might also help future generations of children and young people growing up in a divided England.

Should the NHS pay more to support children with SEND?

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The new index of deprivation, published today by the government, contains an important message about affluent areas such as Oxfordshire.  English indices of deprivation 2025: statistical release – GOV.UK

Oxfordshire ranks highly on three of the four areas I looked at, and especially so on Health and Employment, where the lowest rankings are 65/296 in health and 36/296 in employment, and the highest 8/296 in health and 4/296 in employment.

District CouncilEducationHealthCrimeEmployment
South Oxfordshire258288287292
Vale of White Horse235284283275
West Oxfordshire233279285263
Cherwell155252231260
City of Oxford156231123262
District CouncilEducationHealthCrimeEmployment
South Oxfordshire38894
Vale of White Horse61121321
West Oxfordshire63171133
Cherwell141446536
City of Oxford1406517334

However, the ranking for both Cherwell and City of Oxford districts for education, at 141 and 140/296 compare badly with the ranking elsewhere in the county. Overall, the education ranks are still the lowest ranking scores for all districts, except for the City of Oxford, where the ranking for crime is 173/296, over a hundred places lower than any other district in the county.

The comparison between the education rankings and the health rankings raises an interesting question. Why is education doing so badly in Oxfordshire, especially in the urban areas of Oxford and Banbury? It is difficult to blame the local authority, as all but one of the secondary schools and many primary schools are academies and part of MATs.

Perhaps the formula for education funding is so linked to the county’s rank across all indices that the current funding formula for schools cannot compensate for the needs of Oxfordshire children living in its most deprived communities.

It is clear that there are issues nationally with the formula for the High Needs Block that funds SEND, but again does Oxfordshire lose out more than other areas? After all, it schools are generally highly regarded by ofsted; it has two world class universities, and leading science and technology companies driving the economy.

On the SEND issues, one question is whether the NHS is pulling its weight on supporting children with SEND? Assuming that the overall ranking for the county is not going to see any government be more generous to Oxfordshire with regard to funding, however the present county may be configured post local government reorganisation, then there must be a strong case to require the NHS to spend more resources on supporting children with special needs even if its overall ranking slips a few places as a result. This would reduce the need for the county, and the schools within the county, having to prop up spending on SEND that should really come from the health budget.  

There is no doubt Oxfordshire is not a county with a high degree of deprivation, but what deprivation there is can be concentrated in a few wards in the urban areas abut also spread out across the rural parts of the county. The former is easy to identify, the latter more of a challenge. Both need more funding for education.

Windfall profits and SEND

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There is no doubt that the rise in demand for special school places over the past few years was neither anticipated nor effectively dealt with by the State. One consequence is that large amount of off-balance sheet debt being carried by many local authorities responsible for schooling in England. Another consequence, highlighted by the Liberal Democrats in a press release issued today, is what might be described as the ‘windfall’ profits being made by a few in the SEND sector. Lib Dems demand cap on SEND providers profits as top firms rake in £100m – Liberal Democrats

When the highest paid director of a company operating both care homes for children and special schools is paid over £300,000, or more than twice the salary of a Director of Children’s Services commissioning the use of places in the schools and homes, it seems sensible to question whether such use of public money should continue.

At this point, I must make clear that I am a capitalist. The 40 years I have traded on my own account and through a company, as well as held a portfolio of investments in other companies. However, there are two issues that concern me. Where should the boundary line between services offered by the State and those run by the private sector be drawn? And how should price be determined?

It is interesting, as I have noted before, that in the USA and many other countries, public transportation is just that: a service run by the State. In England it has become a battleground between the State and private enterprise and the differing political opinions. Most would expect SEND to be a public service.

What often seems to be lacking is a mechanism to regulate the costs of suppliers to the State. When the private sector funds its enterprise by borrowing to provide the services and then expects the State to service that debt with a profit element added, it seems to me like time to take the service out of the private sector, and back into public provision.

In the case of SEND school places, national and local government should work together to prove places in state-run schools that would obviate the need for private sector intervention. This means the State, in this case the DfE, being much more interventionalist than has been the case.

The Liberal Democrats, of which I am a member and activist, noted in their press release that

‘Research commissioned by the party and carried out by the House of Commons Library showed that the top handful of profiting companies each took home tens of millions a year. One Group, operators of 28 special schools, turned over just over £200 million a year, making £44 million in profit – a margin of over 20%. That profit is 150% what the company made in 2022.’

How many more teachers might the £44 million have funded? While we wait for the government to produce a White Paper on SEND, perhaps the Local Government Association should set up a taskforce to remove the need to use the private sector.

I am sure that when John Stuart Mill, the nineteenth century philosopher, said that’ it was the duty of the State to see it citizens were educated, not to educate them itself’ he did not expect the cost to the State to be more than a reasonable amount.