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Warnock (1978) Notes on the text
Appendices Appendix 1 List of contributors
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The Warnock Report (1978)
Special educational needs Report of the Committee of Enquiry into the education of handicapped children and young people London: Her Majesty's Stationery Office 1978
ISBN 0 10 172120 X
Chapter 16: Relations between professionals, confidentiality and coordination of services
INTRODUCTION 16.1 The development of close working relations between professionals in the different services concerned with children and young people with special needs is central to many of the recommendations in this report. In particular, it is a prerequisite of the effectiveness of our proposed procedures for assessment and of provision for children with special educational needs whether in ordinary or special schools. We recognise that the development of such relations is necessarily a slow process, depending as it does on the establishment of trust between different professionals and understanding of each other's functions. This process can, however, be facilitated in various ways, particularly by the development of good practice in the sharing of information and by the provision of opportunities for members of different professions to take courses of training together. In this chapter we consider aspects of the communication of information and of inter-professional training. We also make proposals for formal machinery for coordinating services at different levels, since such machinery, though not sufficient in itself, can help to provide a framework within which relations between different professions can develop effectively.
I THE DISSEMINATION OF INFORMATION 16.2 It was widely argued in the evidence submitted to us that information is often not shared between doctors, nurses, psychologists, teachers and social workers, and that in the interests of individual children it should be. The inadequate communication of information both between and within different professions and between professionals and parents also emerged very clearly from the report of the research project on services for parents of handicapped children under five which was undertaken on our behalf by a team under the co-direction of Professor Chazan and Dr Laing of the University College of Swansea. (1) 16.3 We concur with the view expressed in evidence that information should be shared between those professionals concerned with meeting the special needs of a particular child. We emphasised in Chapter 4 that information about any special needs that a child may have should be passed to community health and other professional community services, including the education service where appropriate, as quickly as possible after his birth so that suitable provision can be made for him without delay. We also stressed the need for all pertinent information that is available from educational, medical, social and other sources including, wherever possible, the parents to be taken into account in assessing special educational needs at all of the stages of our proposed assessment procedure. Further, we have urged that information about a child's special educational needs should be given to the head teacher when the child starts school and that it should subsequently be passed on when he moves from one school to another or from school to an establishment of further or higher education or a training centre. 16.4 We recognise that in practice, however, professionals are faced by many difficulties in deciding what information should be passed and to whom, not least those arising from considerations of confidentiality. The issue of confidentiality has become increasingly sensitive in recent years as more personal records have been put on computers and have thus become capable of almost instantaneous retrieval. Many professionals therefore feel very cautious about passing on information given to them both in confidence and in the belief that they would act responsibly in making use of it. At the same time, however, as the findings of the research project referred to in paragraph 16.2 showed, confidentiality is often used as an excuse for failure to communicate. Moreover, concern was expressed in evidence submitted to us by handicapped young people and parents of handicapped children that confidentiality was tending to inhibit the development of a wider understanding of the problems and needs of children and young people with disabilities. Clearly, therefore, there is an increasing need for the establishment of general principles to guide professionals in deciding what information should be passed to others. 16.5 Some professions already have or are in the process of developing codes of practice which cover the sharing of confidential information. Doctors, in particular, are bound by a strict ethical code of practice. The Health Visitors' Association has issued guidelines to its members which include advice on the communication of confidential information and the British Psychological Society has drawn up a statement on personal privacy. Both the Association of Educational Psychologists and the British Association of Social Workers have produced codes of practice for their members which cover this subject, while the Institute of Careers Officers is currently engaged on preliminary work which may lead to the production of a professional code of practice. We welcome the development of such codes provided that they are drawn up in close consultation with other professions. Teachers also are likely in future to be in increasing need of guidelines on the sharing of confidential information, given the move towards educating more children with disabilities, including some with severe or complex disabilities, in ordinary schools. At the same time, through the close contacts they have with parents, teachers may obtain information likely to be useful to other professionals concerned with meeting a child's needs. We therefore recommend that teachers' associations, in consultation with local authority associations and representatives of other professions, should draw up guidelines for teachers on the handling of confidential information as well as the sharing of information with members of other professions. 16.6 There are already certain general principles which are followed by many professionals in deciding what information should be passed on. We identify them below, though we stress here that their application in individual cases always calls for professional judgement. Observance of these principles can, by enabling professionals in the different services to demonstrate their ability to handle sensitive information with care, be a very effective way of developing inter-professional trust. General principles 16.7 We start with the basic general principle that relevant information should be shared between professionals concerned with meeting an individual child's needs whenever that is in the best interests of the child and his parents. In the majority of cases these interests will coincide but where they diverge the child's interests must take precedence. In every case, however, it must be a matter for professional judgement on the part of the person in possession of the information whether or not it is in the child's interests that it should be passed on and, if it is in his interests, to which professional or professionals it should be passed. 16.8 In some cases it may be in the child's interests that a particular piece of information should be treated as confidential. This is particularly likely to be so where the child or his parents would regard the information as being in some sense 'shameful' or embarrassing. This type of sensitive information may be medical information, information about home circumstances or family relationships, or information about behaviour which could be regarded as undesirable or antisocial. We proposed in Chapter 4 that sensitive information given in confidence about a pupil's social background or family relationships as well as the results of professional consultations concerning his special needs should be kept in a confidential folder to which access would be restricted. 16.9 The fact that information is confidential should be an important consideration, but not an overriding one, in determining whether it should be communicated and in what degree of detail. Where confidential information of a particularly sensitive kind is judged to relate to another professional's work it may be possible to provide that professional with a useful insight into a child's background without providing details. This could be done in general terms which are implicit, rather than explicit, and morally neutral but nevertheless convey a message. The degree of detail in which information should be provided can be determined only by the professional judgement of those in possession of the information, taking account of the needs and responsibilities of the person to whom it is to be passed. We believe that it should be unnecessary to convey sensitive information in a way that reveals that the information is 'shameful' except in rare cases where this is essential to the safety or welfare of a child, for example where there are grounds for suspecting that he has been subjected to physical violence. 16.10 Where professionals in different services are working in a team, questions of confidentiality are less likely to constrain communication because certain basic principles are implicitly if not explicitly accepted by the team. In these circumstances, and particularly where common records are kept, it is possible for members of the team to develop the idea of 'extended confidentiality' so that information given to one member of the team can be shared by the group and, at the same time, remain confidential to the group. A case conference about the problems of a sick or ill-treated child, for example, or discussion in an assessment centre is, in fact, a procedure for the sharing of information which is widely practised. 16.11 Whether or not information that is communicated from one person to another is confidential, it must be intelligible to the recipient. There is no point in passing on information that is so highly technical in expression or so obscure as to be bewildering to the person for whom it is intended. We commend the development of Form 10bM, which is designed to provide for educational use a summary by school doctors of medical findings and recommendations for individual children. The equivalent in Scotland is the Health Record Section of pupils' progress records. When properly used, Form 10bM can provide the school with an up to date and comprehensible record of medical conditions with significance for a child's education or care, practical recommendations for his management and notification of any drugs or appliances required. We recognise that not all local education authorities use Forms 10bM and that, where they are used, the manner and degree of detail in which they are completed vary considerably. We believe, however, that the maintenance of a short medical record of this kind designed for retention in schools is essential for the efficient education of children, especially those children with disabilities or significant difficulties who attend ordinary schools. We therefore recommend that Form 10bM or its equivalent should be used properly and consistently for all school children. 16.12 It is inherent in all that we have said that members of different professions must regard each other as partners so far as the exchange of information is concerned. Similarly, parents too should be treated as partners in this process wherever possible. They should be the most important source of information about their child and, as we have emphasised, should be consulted as part of our proposed assessment procedure. In their turn they should be able to see most of the factual information about their child. They should, as a matter of course, be able to see their child's folder containing records of his progress and other facts about him, which we proposed in Chapter 4 should be maintained in school for every pupil. The results of professional consultations, however, would be maintained in a separate, confidential folder as we recommended in that chapter. Whether or not parents are shown the actual reports on their children must be a matter for the judgement of the professional concerned. Some professionals may be ready to show parents their actual reports on children; but for others the knowledge that parents would be able to see their reports could lead to the production of less detailed reports. The overriding consideration should always be whether or not it is in the child's best interests that the parents see the reports on him. Where a child is recorded by the local education authority as requiring special educational provision, the parents should, as we recommended in Chapter 4, have ready access to the documents comprising his record, namely the completed Form SE4 with a profile of the child's needs and a recommendation for the provision of special help, as well as a separate note on how that recommendation is being met in practice and the name of their Named Person. 16.13 Wherever possible, parental consent should be obtained to the passing of information about a child from community physicians to professionals outside the health service. Parental consent should also be sought to the passing of information between services other than the health service, though we would expect this to be done in a very informal way. As we have already emphasised, however, the child's interests must be regarded as overriding. Where the parent's consent cannot be obtained or is withheld and the child's welfare is considered to be at risk information available to one service about any factors which suggest the need for special help should be passed to others as may be necessary in the interests of the child. 16.14 Where parents are asked to consent to the transmission of information about their child, they should be helped to understand to whom and for what purposes the information is to be passed. This may be done by suitable explanations on any forms the parents are asked to complete or, wherever possible, by a personal interview. Where parents have given explicit consent to the passing of information about their child from one professional to another, it cannot be assumed that they have thereby consented to that information being subsequently forwarded to a third party. For example, where a parent has consented to medical information about his child being passed by a school doctor to a careers officer, it does not follow that he has thereby consented to the careers officer forwarding that information to an employer. Nor, when parents have given consent to the passing of information on one occasion, can it be assumed that their consent holds for its transmission at a later date. The recipients of information must consider whether they need to go back to the parents or, in the case of young people over 16, the young people themselves to obtain their consent to its further transmission or to its transmission at a later date than was originally envisaged. 16.15 The methods of transmitting and storing information must be determined by the professional judgement of those concerned. All methods of communicating confidential information carry with them the risk of improper disclosure. The communication of highly sensitive information by word of mouth involves the risk that the information may be misunderstood and the recipient may make an incorrect or unbalanced record of it; moreover there can be no check on the nature of the information passed in the event of subsequent complaint about breach of confidentiality. On the other hand, the communication of such information in writing carries with it the serious risk that the information could fall into the wrong hands. Each professional must decide which method of communication carries least risk of improper disclosure. Clearly his task will be facilitated if his relations with professional colleagues are founded on mutual trust. 16.16 Records and reports must obviously be stored securely and access to them carefully controlled. The most effective way of keeping records secure will vary according to circumstances but, as a general rule, they should be kept in an area to which access is restricted. They should always be kept locked when unattended. The clerical and support staff who handle the records should be made aware of the need for discretion in handling them. All school health records (except Forms 10bM) should be centrally controlled by the school health service, which is responsible for their production, but should not necessarily be centrally stored. In large ordinary schools or in special schools which have their own health service staff and a designated room for health purposes, complete health records may be held in the school under the control of the school doctor or nurse. It is an important but easily overlooked requirement that the source of any information contained in records and the date on which it was obtained should be noted and the information regularly reviewed and updated. 16.17 Finally, it should be recognised that the production of guidelines and of codes of practice on the sharing of information cannot be a substitute for personal knowledge on the part of individuals of their professional colleagues who are also concerned with meeting a particular child's needs and appreciation of their colleagues' professional expertise. Indeed, without such personal knowledge and trust it is unlikely that any exchange of information will be as useful as is possible. In the following section we turn to ways of developing the insight of different professionals into each other's work through inter-professional training.
II INTER-PROFESSIONAL TRAINING 16.18 Courses organised on an inter-professional basis provide an invaluable opportunity for members of different professions to get to know each other and learn about each other's work. As the evidence which we received on this subject stressed, such courses can be an extremely effective way of promoting understanding between members of different professions concerned with meeting the needs of children and young people who require special educational provision. 16.19 Inter-professional training can take two forms: joint initial training courses leading to a dual qualification and post-qualification courses organised on an in-service basis. Joint initial training courses for a dual qualification in teaching and librarianship have been developed but there are no comparable courses, for example courses leading to a dual qualification as a teacher and a social worker or as a teacher and a health visitor, in our field of enquiry. There is a range of post-qualification courses in our field which have developed in a piecemeal fashion. In the following section we consider the scope for developing both forms of inter-professional training for professionals engaged in meeting the needs of children and young people who require special educational provision and their parents. Joint initial training courses leading to a dual qualification 16.20 We recognise that there are already professionals who are qualified in more than one field as a result in most cases of having taken consecutive courses of training. We are aware from our own experience and visits that the possession by teachers of a second professional qualification, for example as a social worker or speech therapist, combined with practical experience in a second field, can considerably enhance their contribution to the work of a school. We believe, however, that there is a need for the development of some joint courses of training for two professions. This might enable people to gain two professional qualifications in a shorter period of time than would be possible by consecutive studies and, in addition, would be a particularly effective way of furthering cooperation between different professions. 16.21 There are, however, objections to concurrent training for two qualifications, not least the very understandable fear that it might lead to lower professional standards, and the undoubted difficulty of organising and staffing a single programme, possibly lasting four years, which would bring together theory and practice in separate, if related, fields. Nevertheless, whilst appreciating the difficulties, we think they can be overcome, and we are swayed by the advantages to which we have referred. We therefore recommend that establishments of further and higher education as well as the bodies responsible for the training of members of the health, psychological and social services should explore the possibility of developing initial training courses leading to a dual qualification. We further recommend that a limited number of such courses should be introduced on an experimental basis as soon as possible (with the students receiving mandatory awards for the whole period of the course) and that their benefits should be evaluated with a view to their further development if the results are favourable. 16.22 Whether or not it proves possible to develop joint initial training, we hope that the amalgamation of colleges of education with other institutions and the diversification of courses in establishments of further and higher education will increase the scope for shared elements in training courses for members of different professions, for example teachers, health visitors and social workers. Post-qualification courses of inter-professional training 16.23 Post-qualification courses of inter-professional training have a dual function: first, to enable members of different professions to gain an insight into the contribution each can make to meeting the needs of children and young people who require special help and into each other's patterns of working; and secondly, to extend and improve skills and practice in areas of common concern to the participants. We consider that there is scope for the development of such courses in three ways: through lectures by workers drawn from different professions; through short courses; and through longer advanced courses. We examine these in turn below. 16.24 Lectures can be an effective way of improving understanding between members of different professions, particularly if adequate time is allowed for discussion. It is desirable that, wherever possible, lectures should be organised over a weekend so that the participants have sufficient opportunity to get to know each other and discuss each other's work. 16.25 The most practicable and effective means of developing inter-professional training in the near future is likely to be through short courses of one to three weeks' full-time study or their part-time equivalent. Such courses are already run successfully by a number of organisations. Part-time courses might be organised on the basis of one evening's study a week for a term or a number of weekend workshops. We recommend that there should be an expansion of the provision of short courses of inter-professional training which focus on subjects of common concern to members of different professions engaged in meeting the needs of children and young people who require special educational provision. We have identified three areas in which we believe such courses are particularly needed: first the early development of children, which would be of interest to teachers and other professionals in the education service, particularly peripatetic teachers and those in nursery schools and classes, as well as to the staff of playgroups and day nurseries and to members of the health and social services; secondly the needs of children in residential special schools, which would be of particular concern to teachers, nursing and child care staff, educational psychologists and social workers; and thirdly the problems of adolescence, which is an area of common concern to many professionals, including teachers, careers officers and members of the health and social services. 16.26 Wherever possible short courses on the lines proposed should be provided jointly by two or more services. There would clearly be advantages in their provision being planned on an area or regional basis: the Joint Consultative Committees and regional conferences on special education, to which we turn in the following section, might well be instrumental in coordinating the arrangements. We recommend that initiatives to develop courses on the lines suggested should be taken by the colleges and departments of education and the special education advisory and support service as well as by those bodies responsible for the organisation of post-experience training for professionals in the health, psychological and social services. 16.27 Finally, we see scope for the development of one-year full-time or equivalent advanced level courses of inter-professional training on subjects of common concern to professionals working with children or young people who require special educational provision. We envisage that some might lead to a higher degree or diploma, for example in fields such as the education and training of young children with special needs, or counselling.
III COORDINATION OF SERVICES 16.28 Contact at working level between members of different services is, as we have already emphasised, essential to the effective delivery of those services. We consider that it can be encouraged, though never replaced, by formal machinery for the coordination of services. In this section we examine machinery for coordination of services at different levels. Joint Consultative Committees 16.29 We referred in the last chapter to Joint Consultative Committees (JCCs), which were set up by each area health authority and the matching local authority (or authorities where the area health authority is not coterminous with a single local authority) in England arid Wales under the National Health Service Reorganisation Act 1973. The Committee's functions are first to advise the two sets of constituent authorities on the performance of their statutory duties to cooperate, for example in the field of school health, and secondly to further the collaborative planning and operation of services of common concern. No provision was made in Scotland for the formation of statutory bodies analogous to the Joint Consultative Committees but, where they do not already exist, Joint Liaison Committees are being established in accordance with the recommendations of a recent report. (2) 16.30 We believe that the JCCs could be in a key position to promote the effective coordination of services for children and young people with special needs and, as we suggested in paragraph 16.26 above and in Chapter 12, the development of courses of inter-professional training. At present, however, they have the disadvantage that they do not cover the employment service. Moreover, they vary considerably in effectiveness and some lack the status and prestige necessary to exert a major influence. 16.31 Despite these disadvantages, we consider that the existing structure of the JCCs should be utilised to promote the coordination of services for children and young people with special needs. We have noted the suggestion in the Court Report (3) that JCCs may wish to appoint a sub-committee of members of health and local authorities to advise on the development of services for children, including children who are mentally or physically handicapped. We believe, however, that there is a need for the establishment under the auspices of the JCCs of working groups on the lines of the Area Review Committees for Non-Accidental Injury, with a wide membership extending beyond the two constituent authorities of the JCCs and adequate supporting staff. These groups should have a clearly defined remit concerned with the coordination of services for children and young people with special needs. Such groups could not only be instrumental in achieving better coordination of the services with which we are concerned, but could also have the desirable effect of increasing the influence and prestige of the JCCs themselves. We therefore recommend that working groups should be set up under the auspices of the JCCs to review the provision and operation of services for children and young people up to the age of, say, 25 with disabilities or significant difficulties, with a view to identifying deficiencies in provision and practice, developing strategies and programmes to meet those deficiencies and, as necessary, recommending policies for improving the effectiveness of the separate services and of their cooperation with each other. 16.32 The composition of the working groups should be large enough to include officers from the education, employment, social and health services, and representatives of voluntary bodies and of employers' and employees' organisations, but not so large as to be unwieldy. We suggest that the groups should have about a dozen members. Although the membership will be for decision by the individual JCC, we envisage that it should include as a minimum the following: two or three officers designated by the local education authority, probably the assistant education officer for special education or the senior adviser in special education or both, together with the specialist careers officer; one or two representatives of the employment and training services, designated by the regional offices of the Department of Employment, with special knowledge of the problems of young people with special needs; one officer designated by the local authority social services department, probably a deputy or assistant director with special knowledge in this field; one or two officers designated by the area health authority, probably the Specialist in Community Medicine (Child Health) and the Area Nurse (Child Health) or their representatives; people designated by the voluntary organisations in the area, including at least one parent of a young person with special needs and a handicapped person himself; and one representative designated by each of the local representative employers' and trade union organisations. The chairman should be appointed by the working group. The need for the groups to be adequately serviced should be taken into account in determining the work loads of those officers expected to service them as part of their official duties. 16.33 The working groups should report annually through the JCCs to the two constituent authorities and the employment and training services. Their reports might include statements on work completed or put in hand as well as plans for the future. Although, like the JCCs, the groups would not be executive bodies, we suggest that consideration should be given to the possibility of some measure of joint funding which would enable them to support schemes designed to promote the coordination of services. We hope that their activities would be seen as sufficiently important to engage the interest and secure the cooperation of the chairmen of the vital local authority committees, namely the education, social services, policy and finance committees, the chairman of the area health authority and the key people in other agencies, whose support is essential if their recommendations are to be accepted and implemented by the constituent authorities of the JCCs as well as the employment and training services. At least for an initial period the progress of the working groups should be regularly reviewed by the National Advisory Committee proposed below. Local coordination 16.34 In addition to the JCCs, we see a need for various forms of local machinery to coordinate the provision of services for particular groups of children or young people. The need for the local coordination of services for children under five is widely recognised. A number of examples of effective coordinating machinery for the purpose established by different authorities was given in the annex to a circular letter issued jointly by the Departments of Education and Science and Health and Social Security in March 1976. (4) These included a standing committee made up of members from the social services and education committees and also from voluntary bodies; a panel made up of elected members and officers from the local authority social services and education departments, with observers from the area health authority and various voluntary organisations; and a liaison committee composed of elected members from the social services and education committees and officers from the area health authority and the social services and education departments. Without wishing to prescribe any particular form of arrangement, we would urge those authorities which have not already set up machinery for the coordination of services for children under five to do so. Such machinery should include representatives of voluntary bodies engaged in making provision for children under five. The very valuable contribution of voluntary bodies and the importance of their inclusion at every stage in the planning of such provision were stressed in a more recent circular letter issued by the two Departments. (5) We return to the contribution of voluntary organisations in the next chapter. 16.35 We believe that the same need for local coordination of services applies to provision for young people with special educational needs during and for some time after the transition from school to further or higher education, training or employment. In addition to the social services and education departments, the local authority housing department is concerned with this group of young people, and liaison with health authorities, employment and training services and voluntary bodies is also important. We therefore recommend that local authorities should set up local machinery for the coordination of services for young people with special educational needs during and for some time after the transition from school to further or higher education, training or employment. Regional conferences for special education 16.36 Coordination of services at regional level is usually taken to mean coordination of the services provided in one field, say education or health, by a number of authorities in a particular part of the country. There already exist in England regional advisory councils for further education, regional conferences for special education, regional health authorities, regional machinery for the coordination of social services for children and regional offices of the Department of Employment, the Training Services Agency and the Employment Service Agency. Regrettably, their boundaries often do not coincide. 16.37 We indicated in Chapters 7 and 8 the strong desirability of effective cooperation between local education authorities in the planning of special educational provision, including the development of some special schools as specialist centres for relatively rare and particularly complex disabilities. It is important, therefore, that there should be some kind of regional machinery for coordinating education services for children and young people with special needs: and it should be so constituted as to be able to promote the coordination of education and other services for this group of children and young people. 16.38 It would seem sensible to build on the existing regional machinery, namely the regional conferences for special education, particularly as the series of meetings held in 1975 on the initiative of the Department of Education and Science appears to have been successful in reviving their activity. These conferences, which consist of nine separate groups of local education authorities, provide a forum for a systematic review of special educational provision in each region. They are advisory bodies, with no effective powers, and their membership varies widely from one region to another. 16.39 While we would not wish to see any change in their status as advisory bodies, we believe that the regional conferences will need to become more effective if they are to promote coordination of services in the way we have suggested. We therefore recommend that the functions of the regional conferences for special education should be extended to include considering the annual reports of the working groups set up under the auspices of the JCCs; reviewing the existing facilities for special educational provision in the region (including those provided by voluntary organisations) and planning for the maximum possible degree of regional self-sufficiency; facilitating inter-authority arrangements for in-service training on an inter-professional basis; and identifying the requirements of young people with special needs for further education and promoting the provision of suitable courses for them. As part of their function of planning for the maximum degree of regional self-sufficiency in special educational provision they would be particularly concerned with those schemes which require joint funding by local education authorities, for example the development of some special schools as specialist resource centres for the region. In promoting the provision of suitable courses of further education they will need to work in collaboration with the regional advisory councils for further education. Similarly, in coordinating arrangements for in-service training on an inter-professional basis they will need to collaborate with any new regional machinery set up as a result of the proposals in the report of the Working Group on the Management of Higher Education in the Maintained Sector under the chairmanship of the Minister of State for Education and Science, Mr Gordon Oakes. (6) 16.40 If the regional conferences for special education are to influence the effective coordination of the various services in the region concerned with children and young people with special needs, not just the education service, they must include in their membership representatives of those services. We recommend that the composition of the regional conferences for special education should include local education authority elected members and officers, representatives of employment, health and social services, of employers' and employees' organisations and of voluntary organisations, and teachers with responsibility for children with special educational needs. We recognise that the regional conferences will require adequate support if they are to carry out effectively the functions proposed. The local education authority responsible for servicing each regional conference must therefore have some additional administrative and clerical support specifically for regional conference work. 16.41 In Scotland the need for inter-regional provision for disabilities of infrequent incidence is particularly likely to arise, given the geographical nature of the country. Any national conference of education authorities may therefore have to be supplemented by inter-regional conferences in certain parts of the country. 16.42 In Wales the Welsh Joint Education Committee (WJEC) has responsibility for coordinating the provision by local education authorities of special education, particularly those aspects which have implications for the country as a whole. In parallel with the revival by the Department of Education and Science of the regional conferences for special education, arrangements were made by the Welsh Office for a conference of local education authority administrators and advisers concerned with special education. This was attended by representatives of all the Welsh authorities. It has been recommended that such conferences should be held in future on a biennial basis. We recommend that the WJEC should continue its responsibility for coordinating the provision of special education by local education authorities in Wales. We also recommend that conferences on special education should be organised on the basis of arrangements agreed between the Welsh Office and the WJEC and that these conferences should reflect the wider range of membership we have recommended for the regional conferences in England. Further, the Welsh Office should consider, in consultation with the WJEC, what arrangements might be made in Wales for the receipt and review of the annual reports of the proposed working groups to be set up under the auspices of the JCCs. A National Advisory Committee on Children with Special Educational Needs 16.43 The area and regional coordination of services for children and young people with special educational needs requires to be matched by effective national machinery. Throughout this chapter we have used the term coordination in the sense of broad concern with the quality and efficiency of the different services, working together. Thus the area and regional coordinating bodies will variously review, advise, plan, monitor, promote and develop. The Joint Consultative Committees, and their working groups, and the regional conferences for special education, which we have recommended should form the coordinating bodies, are well placed to carry out the variety of functions which we have assigned to them. Although not themselves executive bodies, their membership consists mainly of those with direct responsibility for the provision and operation of local services and who in that capacity can be influential in translating precept into practice. 16.44 At national level this machinery has its counterpart in the formal and informal arrangements whereby Ministers, officials and professional staff in the education, health and social services and employment departments collaborate in the development of joint policies and practices. In furtherance of their work government departments are able to draw upon advice and information from many sources and have their own network of contacts with the local and regional arms of their respective services and with professional and voluntary bodies of all kinds. 16.45 These arrangements are indispensable to informed and effective national administration of special services for children and young people. But they are not in our view wholly sufficient. Much of the interchange between departments takes place under the stress of day to day events and is constrained by immediate requirements: whilst departmental contacts with outside organisations tend to be concerned with particular aspects of the services as distinct from their operation as a whole. There is in our view a need for arrangements whereby knowledgeable and experienced people, drawn from a variety of specialisms, who are conversant with the services for children and young people with special needs and able to take a synoptic view of what is going on, can offer informed, objective and coherent advice to Ministers on the coordination and future development of the services, and, in turn, provide an authoritative viewpoint on any matters on which Ministers themselves might wish to have collective advice. 16.46 The need for advisory machinery of this kind has been recognised by the government in its decision, which we warmly welcome, to accept the recommendation in the Court Report that the Central Health Services Council and Personal Social Services Council should establish a joint committee concerned with children. The committee will advise the Secretary of State for Social Services and Secretary of State for Wales on the coordination and development of health and personal social services as they relate to children and families with children. Although the joint committee will not be concerned with the education service we would expect it to devote considerable attention to the provision of health and personal social services for children with special educational needs and their families, and we are pleased to note that two of the members will be appointed on the advice of the Secretary of State for Education and Science. 16.47 We see the need for a similar committee to advise Ministers on the provision of educational services for children with special educational needs with particular regard to their coordination with other services. The work of this committee would thus be complementary in many respects to that of the joint committee concerned with children, and close links between the two committees would be essential. Like the Advisory Committee on Handicapped Children, which was suspended on our establishment, it would report to the Secretaries of State for Education and Science and for Wales. We therefore recommend that a National Advisory Committee on Children with Special Educational Needs should be established to advise the Secretaries of State for Education and Science and for Wales on the provision of educational services for children and young people with special educational needs and their coordination with other services. A separate advisory committee should be appointed for Scotland. 16.48 We envisage that the proposed advisory committees would consist of people with a special knowledge of the educational services for children and young people with special educational needs together with a small number of people with a special knowledge of the health, social, employment and training services in this field, who would be appointed in England and Wales on the advice of the Secretaries of States for Social Services and for Employment. Each committee should be as compact as possible and should not in our view have more than twenty members. The committee for England and Wales might wish to appoint a standing advisory sub-committee to advise it on matters pertaining to Wales.
CONCLUSION 16.49 Good practice in the sharing of information together with the development of inter-professional training on the lines proposed in this chapter will, we hope, serve to foster goodwill among members of different professions and confidence in each other's professionalism. Moreover, the machinery which we have proposed for the coordination of services at different levels should provide a framework which will facilitate day to day contact between members of different professions at working level on matters of common concern, make for greater efficiency, extend horizons and promote development. We hope that by these means good relations between different professions, on which so many of our recommendations depend, will be promoted and consolidated.
References (1) For details of the research project see Appendix 5. (2) Working Party on Relationships between Health Boards and Local Authorities - Report (HMSO 1977). (3) Fit for the future The Report of the Committee on Child Health Services. Cmnd 6684 (HMSO 1976), Vol I, p 348. (4) Local Authority Social Services Letter LASSL(76)5 DHSS, Reference No S21/47/05 DES, Coordination of local authority services for children under five (9 March 1976). (5) Local Authority Social Services Letter LASSL(78)1, Health Notice HN(78)5 DHSS, Reference No S47/24/013 DES, Coordination of services for children under five (25 January 1978). (6) Report of the Working Group on the Management of Higher Education in the Maintained Sector. Cmnd 7130 (HMSO 1978). 
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