Another Fine Mess

The BBC (16 June 2009) reports concern over school medical care.

‘Schools are putting teaching assistants under increasing pressure to carry out medical procedures without appropriate training, a union warns. Unison says most support staff only hold a basic first aid certificate. But some are being asked to carry out procedures such as administering drugs for heart problems, changing colostomy bags and testing blood sugar levels.’

“Imagine the pressure of being told that a child could not go on a trip unless you would change their colostomy bag” Christina McAnea Unison.

Government guidelines say staff must be properly trained before carrying out any medical procedure. They stress that it is the responsibility of schools to make sure that is happening. Unison is calling for the introduction of new, tougher guidelines setting out what support staff should and should not be asked to do. The survey found 85% of the 334 respondents were expected to provide medical support, and 70% to administer medicines as part of their job – even though these are voluntary duties.

Michelle McKenna, a school support worker, “it is only a matter of time before something terrible happens”.

One in four respondents did not feel competent and comfortable with the responsibility of administering medicines or providing medical support. And one in three said they were not familiar with school policy on how to do it.

Put very simply, carers are not nurses, and in a care home as against a nursing home, only qualified district nurses can legally undertake nursing procedures. I can’t believe that the same should not apply in our schools. Care assistants have their rights too.
Local Authorities have a duty of care laid down in a case in the highest Court in the land, the House of Lords, when four of them tried unsuccessfully to disown it.

The picture gets worse. A recent government consultation paper on the role of school support staff DfES, 2002 Education Policy Partnership, December 2003 Review – The impact of paid adult support on the participation and learning of pupils in mainstream schools indicated that there were over 100,000 support staff working in schools – an increase of over 50 percent since 1997.

I quote from the report.

• ‘Paid adult support staff can sometimes be seen as stigmatising the pupils they support. Paid adult support staff can sometimes thwart inclusion by working in relative isolation with the pupils they are supporting and by not helping their pupils, other pupils in the class and the classroom teacher to interact with each other.
• Paid adult support shows no consistent or clear overall effect on class attainment scores. Paid adult support may have an impact on individual but not class test scores.
• Most significantly, there is evidence from several studies of a tension between paid adult support staff behaviour that contributes to short-term changes in pupils, and those which are associated with the longer-term development of pupils as learners. Paid adult support strategies associated with on-task behaviour in the short term do not necessarily help pupils to construct their own identity as learners, and some studies in this cluster suggest that in such strategies can actively hinder this process.
• Paid adult support staff can positively affect on-task behaviour of students through their close proximity. Continuous close proximity of paid adult support can have unintended, negative effects on longer-term aspects of pupil participation and teacher engagement. Less engaged teachers can be associated with the isolation of both students with disabilities and their support staff, insular relationships between paid adult support staff and students, and stigmatisation of pupils who come to reject the close proximity of paid adult support.
• Given current interest in involving users in planning, carrying out and evaluating research, it is surprising that so few studies actually focus on the pupils’ views.’

This is every bit as damning as the BBC Report.
And here are a couple of extracts from a piece of research from the Research Unit of Newcastle University. They explain absolutely everything, even though it may not be what its authors intended. Please note the year. The policy was well under way by then.
8 Extracts from Costs and Outcomes for Pupils with Moderate Learning Difficulties in Special and Mainstream Schools 1999
p 14 ‘We have some generalised findings on outcomes from our literature survey and these are highly suggestive – but they do not make it possible to evaluate the cost-effectiveness of the schools in our study,…..For many, inclusion is a fundamental human right – not simply one form of SEN provision amongst many, to be evaluated on the balance of advantage it confers on children. It is important to be clear, therefore, that an analysis of costs and outcomes cannot properly be used to determine questions of rights.

P71 The state of our knowledge about outcomes for pupils with MLD is not good, and our understanding of the relationship between costs and outcomes is even worse.’

For those who imagine that the policy of Inclusion saves taxpayers’ money please note that one classroom assistant costs more than the entire cost of a pupil’s education in a special school.
(There are now over 200,000 non-teaching care assistants. A recent report from the Sutton Trust says that they are not good value for money.)