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1.
Medical needs in schools:
I work with children and their families who are living with and
learning to cope with the enormous burden of type 1 diabetes, a
chronic health condition that requires continuous attention to its
management. Type 1 diabetes arises when the child’s
body stops producing insulin, a hormone vital to sustain life and
is necessary to regulate blood glucose levels. This
auto-immune condition cannot be predicted nor prevented and can
present at any age during childhood and adolescence. The
management of the condition requires the child to take regular
insulin injections (4-6 every day) or to be continuously connected
to an insulin pump. In addition to insulin replacement, the
child must check their blood sugar levels regularly throughout the
day (4-10 times) and eat a healthy diet to avoid blood glucose
fluctuations as well as calculate the quantity of carbohydrates
consumed in each meal and snack. The primary aim of type 1
diabetes management during childhood is to maintain near normal
blood glucose levels in order to promote standard growth and
development and to minimise the risks of developing the many acute
and chronic complications associated with the condition.
These include life threatening severe low or high blood glucose
levels as well as eye-sight problems, that can lead to blindness,
kidney problems which can result in dialysis and requiring a
transplant, damage to the nervous system which can result in limb
amputations and also premature death.
Blood glucose levels are affected by many factors, not just food
and insulin intake. Activity levels, growth hormones,
illness, emotions, daily routines as well as appropriate and
sufficient support are all integrally linked to how well controlled
children’s diabetes is. In order for children
with type 1 diabetes to thrive both at home and in school, the
support they receive is directly linked to their health and
educational outcomes.
Children spend 16% of their life at school, this is a considerable
portion of time where good diabetes control is vital to ensure
their health is not compromised and that their potential for
maximising their educational attainment is fully supported.
In order for children to receive the support they need to manage
their complex condition at school, staff must have the appropriate
training in order to feel confident to support the child with
diabetes. In addition to training (which I provide) staff
must have the time and support from their head teacher to carry out
diabetes management safely and effectively at
school.
I believe that there is a need for a change in legislation in Wales
to introduce a statutory duty of care for children with medical
needs in schools. There is an opportunity to include this
within the newly proposed Additional Learning Needs (ALN)
Framework.
The Welsh Government’s proposed ALN Framework documentation
states that children with medical needs will not be covered by the
ALN Bill (see page 30 of the draft ALN Code of Practice). I
firmly believe the Committee must consider including medical needs
in the Additional Learning Needs Framework.
Current WAG guidance for the management of medical conditions in a
school setting differs in Wales compared to England. In England,
the Children and Families Act 2014 came into force on 1 September
2014. Section 100 contains a statutory duty to support pupils with
medical conditions, meaning that in practice schools
must make additional arrangements for supporting
pupils at schools with medical conditions.
The legislation does not apply to schools in Wales. The rights of
children and young people with medical needs in Wales during the
school day are not protected in law to the same level as children
in England. The current system in Wales puts children with medical
conditions in Wales at an academic disadvantage in comparison to
their peers in England.
I regularly come across resistance from school staff to provide
health management support to pupils with diabetes. Fear about
making mistakes, unwillingness to take on the responsibility for
health care as well as no legal requirement to do so are all
reasons staff cite for not being able to / willing to become
involved in diabetes management. This puts pupils with
diabetes at significant disadvantage both medically but also
educationally. It is vital that children are kept safe and healthy
whilst they are learning to enable them to achieve their full
potential.
Children and young people with medical conditions, like type 1
diabetes, must have access to appropriate support to enable them to
participate in all aspects of school life. This requires a
co-ordinated effort and I would like to see the Committee using the
opportunity of including ‘medical needs’ in the
Additional Learning Needs Framework, as I believe this will assist
in ensuring children with medical needs get both their health and
educational needs met whilst at school and will prevent the ongoing
disadvantage Welsh children face when compared to their peers in
England.
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