Motion made, and Question proposed, That the sitting be now adjourned.—[Liz Blackman.]
I welcome the opportunity to initiate this debate on the education of children with speech and language difficulties. I begin by declaring an interest as the father of Oliver, three years old next week, who earlier this year was diagnosed as suffering from severe verbal dyspraxia.
Last week, at its inaugural meeting, I had the privilege of being elected chairman of the all-party group on speech and language difficulties. It will be immeasurably boosted by the involvement as officers of the noble Lord Ramsbotham, the former chief inspector of prisons, the right hon. Member for Rother Valley (Mr. Barron), the Chairman of the Health Committee, and the hon. Member for Stourbridge (Lynda Waltho).
It is peculiarly fortuitous for me to have the chance this week to air the issues involved in seeking effectively to educate children with speech and language difficulties. It may benefit right hon. and hon. Members if I set the scene or establish the background of what we are, properly, to debate today.
What is the situation as far as children with speech, language and communication difficulties are concerned? Somewhere between 5 and 8 per cent. of pre-school children suffer from such difficulties; it is estimated that the figure is nearer 10 per cent. among children of primary school age. It is noteworthy that there is something of a continuum of people suffering from speech, language and communication disorders. At one end, there are those who suffer only from mild speech or language delay; at the other, there are children, best described as non-verbal, who depend on augmentative communication and the use of symbols to be able to communicate at all.
Something in the order of one in 500 children suffers from an impairment so severe that it is likely to be not transient but enduring, significant and potentially insuperable. It is the responsibility, among others, of the speech and language therapist to deal with all those different conditions. No one in this Chamber should underestimate the significance, extent or effectiveness of the potential role of the speech and language therapist. That person is responsible for screening children, for assessing children, for the planning of services for children, for the delivery of services for children and for the management of individual children’s cases. That person is responsible for consultation with external providers and other agencies, which requires him or her to develop a certain political sophistication in addition to his or her other qualities. At his or her best, that person should be responsible for communicating with parents—talking to them, listening to them, respecting their views and treating them genuinely, sincerely, meaningfully, practically and enduringly as partners.
The Minister and other right hon. and hon. Members with an interest in this debate will be acutely aware of the significance of early intervention in addressing the impairments from which children suffer. That can make a crucial difference to whether the child’s problems are overcome or minimised. If intervention takes place early in a child’s life, the impact of their impairment on their learning, attainment and subsequent employability can be minimised. In that desirable scenario, there is a great saving to the public purse of the spending that would have been made necessary by subsequent, delayed and inevitably much more expensive interventions.
The thrust of the research shows that if such intervention starts at an early age—certainly at pre-school level—it has a discernible impact on the child’s other skills. Put simply, if a child’s speech, language or communication impairments have been effectively addressed by the time they are five and a half, the chances are that they will be able to read and spell normally, communicate relatively effectively and avoid suffering some of the disadvantages that would otherwise flow. If, on the other hand, meaningful intervention takes place only when they are eight, or if it has not taken place by then, there is a real danger that the problems will become endemic, that the interventions required will be more numerous or intense and that the cost will be greater.
Unquestionably, learning intervention can be effective, but we have to be clear that it should be intensive. It is not possible—or even, in this debate, desirable—precisely to specify what constitutes “intensive”. Suffice it to say that it can mean specialist help in very small settings, or even a one-to-one environment, with a specialist providing help, nurture, encouragement and assistance. That might have to take place for hours a day, several days a week. There is a short-term cost; I do not in any sense seek to burke the reality that if one proposes intervention and wants to be effective, there is no point in half measures. One has to go the whole hog and make substantial investment at the outset on the basis that it will yield a benefit and avoid other costs later.
The corollary of the benefits of early intervention is that there are real dangers to late intervention. If intervention takes place only very late, the dangers are manifold and real. There is a danger of emotional and psychological difficulties, of behavioural problems, of lower educational attainment, of persistent communication handicap, of poorer employment prospects, of significant challenges to mental health and even of a regrettable descent into criminality. Those are the consequences with which we will have to reckon if, as a society, we make the judgment that we are not prepared to invest significantly up front because the issue does not have the political attractiveness to warrant it. We shall then have to bear consequences that people of good will in all parties will come to rue almost as much as the direct victims themselves.
There is another danger or downside to a failure to intervene early and a belated judgment—sometimes, even then, only half-heartedly—to intervene. There is a real economic cost to this country. As right hon. and hon. Members, we have to open our eyes to the reality that is staring us in the face. Research by the charity I CAN calculates that £26 billion is lost to this nation’s economy as a consequence of late intervention.
In Milton Keynes, Buckinghamshire and Oxfordshire alone, an area that incorporates my Buckingham constituency, it is calculated that there are currently no fewer than 2,063 16 to 18-year-olds who are designated as NEETs—not in education, employment or training. It is postulated by those who have undertaken research that approximately 1,000 of those 16 to 18-year-olds are NEET predominantly or exclusively as a consequence of speech, language and communication impairments that society has failed to address. There is a cost as a result of each individual so affected of £97,000.
Yes, there is a short-term cost in getting involved, in making judgments, in plumping for specialist expertise, in making resources available, and in applying one’s set of values but also one’s intellect to the challenge, but there is a far greater cost to the individual, to families and to society as a whole if we make a judgment, whether by commission, omission, deliberate will or simply a sort of moral carelessness that we are not prepared to deal with such matters because they are insufficiently important or salient in electoral terminology.
I would like to discuss some of the issues with which people who are interested in this field across political parties and in the wider public are presently concerned. Let me give an illustration of some of the things that come on to my agenda as a parent grappling with such matters or by virtue of direct representation from my constituents in Buckingham.
I hope that the Minister will take this in the spirit in which I intend it—I mean it most sincerely. First, there is a lottery in the public provision of services for children with speech, language and communication impairments. Services very much depend on where one lives, with which local education authority they deal, whether a personal relationship is established, and whether the people in charge are genuinely interested in the views, anxieties, concerns and recommendations of parents, or whether they pay lip service, if that, to the concept.
To those who endlessly preach the mantra of localism—there are people in that category in all parties—I offer a rider, or valid caveat, that it is not good enough simply to offload responsibility to the local level. Still less is it good enough to say that if people do not like the services that are provided, if they feel that they are unsatisfactory and there has been a failure to perform, they can make a conscious judgment to remove the offending local education authority at the subsequent municipal election. With great respect, that is a politically convenient ruse, but it represents a triumph of theory over the evidence of demonstrable practice.
The truth is that, although such matters are immensely important, the political purchasing power of the speech, language and communication difficulty class of voters is very limited indeed. Most people are not aware of their day-to-day concerns because they are not affected. They would probably be sympathetic to the affected class if they knew more about it, but they do not. The idea that, in the main, such issues will influence the result of a local authority election across a whole borough or district—still less across a county—is, frankly, fanciful.
The lottery of provision is a serious problem. I invite the Minister, who is an immensely capable but also an enormously reasonable man, to reflect carefully on the verdict in the recent report of the Education and Skills Committee, which called for a national lead on a central strategy, and for a sense of purpose and direction.
Many hon. Members who took part in the debate on 26 October, which was ably contributed to by the hon. Member for Mid-Dorset and North Poole (Annette Brooke), felt that the Government’s response was, to put it mildly, operating below the level of events. As I believe I said at the time, the document was poorly composed. Clearly, it was put together by one of those clever officials who knows everything and nothing, and who thought it slightly impolite and cheeky of mere amateur, uninformed, interfering politicians to second-guess the wise judgments at which he or she had arrived.
Please, Minister, think again. The document was badly written. It suffered from statisticitis. It was all about inputs and it was highly defensive. It said that there was not much of a problem, and that where there was one, it was being dealt with anyway. It simply did not reflect the preponderance of opinion across the piece among my constituents and those of other right hon. and hon. Members. Their experience is that there is something rotten in the state of Denmark. That does not mean that good work is not being done by professionals, but there are real problems. I appeal to this high-flying, widely popular Minister to take account of those representations and to seek effectively and constructively to respond to them.
A second relevant concern in respect of speech and language therapists is that we are discussing a shortage profession. At present, some 7,000 therapists are on the books. It is estimated that there is a shortfall of 2,283, which, on current work force planning assumptions, will be met only by 2013. Many commentators believe, in the light of current widespread and savage PCT cuts across the country, that that prognosis is likely to err on the side of optimism rather than of pessimism. The shortfall is serious indeed.
The evidence is reinforced and compounded by a recent survey by the Royal College of Speech and Language Therapists, which found that 78 per cent. of managers questioned said that their budgets were being frozen. Fifty per cent. said that they would be obliged to provide an inferior service or to conclude that the service was altogether non-viable. Perhaps most damning of all, 80 per cent. of those who had come out of college and qualified as speech and language therapists could not get jobs. Out of 700, only 140 were able to get jobs. This nation must be mad—literally berserk—to contemplate with anything other than horror a situation in which there is a demonstrable, growing, intense and urgent demand for the provision of speech, language and communication services, yet people go through the colleges, get qualifications and demonstrate their commitment to serve, but are denied the opportunity to do so. Something is seriously wrong.
A related concern in respect of speech and language services is an example upon which I confess I have zealously focused over the past seven months. I make no apology for that, as it is a practical, identifiable and factual case. The Nuffield speech and language unit is a renowned centre of excellence for the treatment of children with severe verbal dyspraxia. There is nothing like it anywhere in the country. It happens to be based in Ealing, but, for historically anomalous reasons with which I will not trouble right hon. and hon. Members, it falls within the auspices of the Royal Free Hampstead NHS trust. “Every Child Matters” contains 32 references to the importance of specialist provision, and “Removing Barriers to Achievement”, which was published in 2004, contains 68 such references.
The Government are on the record as saying that special schools should not be closed nor the number of places in such institutions reduced unless and until high-quality, local alternative provision is available. I have to say to the Minister that that simply is not the case in respect of the children who will be turfed out of the Nuffield speech and language unit. I have been disgusted to the point of virtual sickness—I use strong language, but I do so advisedly—by the attitude of the Royal Free Hampstead NHS trust. The part-time chair and full-time chief executive of that trust have conducted the phoney consultation process in respect of that valued facility with an arrogance, incompetence and insensitivity of a kind to which I have seen no equal in the 20 years since I entered public life. It appals me that, simply in the name of fobbing it off on to someone else and getting on with the important business of cutting their deficit and seeking foundation status, they are prepared knowingly and probably irrevocably to damage the educational prospects and life chances of some of the most vulnerable children in our community.
I would welcome it if, in addition to the discussions that I have had with the Department of Health and the Secretary of State for Health on the subject, there was some indication from the Department for Education and Skills that it was prepared to engage with the issue. I have not yet seen it. That leads me to the related concern of joint commissioning of services, which was provided for in the Health Act 1999 and talked about in the Children Act 2004. It was supposed to happen, and it was very much the established orthodoxy and favoured buzz word on the lips of Ministers, but the commitment seems always to founder on the rock of financial shortfall.
I want simply to put a series of propositions to the Minister and to colleagues about the sorts of things that ought to happen and the types of problems that require to be addressed. First, there should be a speech and language therapist as a matter of course in every multidisciplinary team assessing the feeding and swallowing needs of disabled children. Secondly, there should be a speech and language therapist in interdisciplinary teams that are responsible for the provision of family services, notably those of Sure Start. Thirdly, there should be a speech and language therapist attached to every mainstream school that is committed to an inclusive environment and the best possible provision for children with speech, language and communication difficulties.
I believe that we need far more explicitly to tackle the problems that arise from the failure to deliver joint commissioning. We have an opportunity to confirm a commitment to that with the advent of the new children’s trusts. There is a great opportunity to say that it will happen, the obstacles will be removed, the financial rows will not continue and the services will be delivered. I find it extraordinary that a scoping study into desirable practice in speech and language provision, the responsibility of Canterbury Christ Church university, has still not appeared. In a written answer on 27 February, the then Under-Secretary of State for Education and Skills, the hon. Member for Liverpool, Garston (Maria Eagle), told a parliamentary colleague that the findings should be available to the Department in August 2006. On 13 September, the Under-Secretary of State for Education and Skills, the hon. Member for Corby (Phil Hope), told another parliamentary colleague that the report from that university study should be available in January. What is happening? If this were operational in the private sector, heads would roll, people would be dismissed, individuals would be called to account and there would be a significant public scandal, yet it simply is not happening.
I believe that these matters need to be dealt with urgently and firmly. I believe, too, that we need to attach the greatest possible importance and urgency to delivering more specialist provision within the field. I find it quite disappointing and not a little alarming that on pages 18 and 19 of the “National Audit of Support, Services and Provision for Children with Low Incidence Needs”, undertaken on behalf of the Department for Education and Skills, categories are listed for the project specification—multi-sensory impairments, severe visual impairments, severe/profound hearing impairment, profound and multiple learning difficulties, severe autistic spectrum disorders and severe behavioural, emotional and social difficulties—and nowhere in that list do we find reference to speech, language and communication difficulties or disorders. There is something wrong there, even if the authors—clever chaps and chappesses, without doubt—argue that it is in the ether and implicit in the work undertaken. It is not up front or explicit, and it is not acknowledged. There are people out there—I have met a good many of them over the past six months—who, as parents, providers or charitable representatives, are at the end of their tether.
We need, as Ofsted has said and the Audit Commission has periodically acknowledged, greater focus on the provision of specialists. We need data to be kept by local education authorities. It beggars belief that a lot of them do not even know how many people suffer, the extent of the suffering or the nature of the provision, its extent or its outcome. People are treated simply as features of a production process that is mechanistic and the quality output of which is a secondary consideration if it is a consideration at all.
We need major investment in this field, we have to be prepared to commit to it, and we need a different mindset. We have to relegate the old bureaucratic arrogance to the back seat of the room or, better still, to kick that attitude out of the room altogether. If I can put that graphically, we need to bring from the front of Ministers’ minds on to the table the best thoughts that they have about how to improve services.
I am incredibly grateful to the Royal College of Speech and Language Therapists, to I CAN and, perhaps above all, to my friend Linda Lascelles, who runs the charity AFASIC—the Association for All Speech Impaired Children—for the briefings that they have provided for this debate. There could hardly be a more important subject related to the needs of vulnerable children than this. As I say, I both like and respect the Minister and look forward to his response. I hope he will recognise that I have raised this matter conscientiously in a public-spirited fashion and not for the pursuit of party advantage. I want my party to get it right, and I have a hunch that my right hon. Friend the Member for Witney (Mr. Cameron) and my hon. Friends the Members for South Holland and The Deepings (Mr. Hayes) and for Bognor Regis and Littlehampton (Mr. Gibb) will do just that. Above all, what I am interested in is providing the best service to children, and I think that that is a characteristic that unites every hon. Member in this Chamber.
I am mindful of your injunction about the time, Miss Begg, and I shall try to let all my colleagues in.
It is a great pleasure to follow my hon. Friend the Member for Buckingham (John Bercow), who is also my constituency neighbour. He spoke with great passion and knowledge and, if he will forgive me, it was not least an oratorical tour de force to speak for that long without a single note.
I heard Lord Ramsbotham speak many years ago at a conference, and he made the point that if he had to sack every single member of staff in a prison at which he was governor, the last person that he would want to go through the prison gate would be the speech and language therapist. That remark struck me forcefully. As my hon. Friend has already mentioned, we must wonder how many people are languishing at Her Majesty’s pleasure for want of having speech and language difficulties addressed earlier.
In my constituency, I have been aware of the general difficulty in speech and language provision for some time. In particular, it seems that there is a gap between the provision made by the Department of Health and that made by the Department for Education and Skills and the local education authority. I am not a great fan of local area agreements as I think that they are just another quango imposition on local authorities. I have said to my own local authorities that I will set them a simple test. If they can show me that the local area agreement in Bedfordshire can actually close the gap and get health services and education services working together to meet children’s needs, the agreement will be worth while. However, we will have to wait and see what happens.
In my own county of Bedfordshire there are no specialist speech and language units. I understand that in the neighbouring county of Hertfordshire there are eight stand-alone speech and language units, whereas Essex county council recently closed all its speech and language units so all the provision is in mainstream schools. There is a patchwork of provision, differing according to local authority area. I am not saying that mainstream provision can never work, but it should be of concern that provision is so different in neighbouring local authorities. There is a patchwork lottery, no doubt for historic reasons, or reflecting the local taxpayer base and other issues. That is a matter of concern.
I want to focus my remarks on one child in my constituency. She is a six-year-old little girl by the name of Jade Chambers who until recently attended Heathwood lower school in my constituency. I have visited the school and met the head teacher and other teachers, and overall it is a good school providing a good education. Jade Chambers was placed in the school, and when her needs were assessed in October 2005, the school made it clear that it was concerned that Heathwood lower school was perhaps not the right place for Jade to be educated. The local education authority did not agree with that assessment and Jade was placed in an enhanced language provision in the school.
The aspect of that case that most concerns me and on which I want to focus the bulk of my remarks—I should be grateful if the Minister would provide some idea of his thoughts on it—is the issue of the physical restraint of all children. This is a debate on children with speech and language difficulties: Jade Chambers has speech and language difficulties. She is a six-year-old girl with the speech and language understanding of a three-year-old child, who has been placed in a mainstream setting. At home she is not a difficult child, but at school, because she does not understand what is going on around her, she often presents in a difficult manner to the extent that the police were called to the school on a number of occasions. Indeed, the police will be acting as witnesses at the special educational needs and disability tribunal for this case on 5 December. The issue that I find totally unacceptable is that a child can be repeatedly physically restrained in a school without the parents knowing that it is happening.
I hope that the Minister is aware of the circular from the Education Act 1996 known as 10/98, which only provides guidance on that issue and is not mandatory. There are, of course, many reasons why schools will need—absolutely rightly, properly and correctly, although regrettably—to restrain children. They may be behaving appallingly badly or putting other children or staff in danger. Sadly, physical restraint is, of course, needed in our schools. However, the relationship between the child and the school is triangular, not linear. The parents are absolutely key and want to be part of the solution and to be integrally involved in ensuring the success of their children’s education. At the very least, they need to know whether physical restraint is being applied even once, let alone repeatedly, to a child.
When we are talking about children with speech and language difficulties, a further issue is that these children cannot come home and tell their parents what is happening. The first that Jade Chambers’s mother knew about what was happening was when her daughter came home with ripped trousers, had a tremor on her lip and was barely able to describe what had happened. That is simply unacceptable.
The Government have said that the Minister’s colleague in another place, Lord Adonis, does not know how many children are being physically restrained in our schools and that is unacceptable. We should gather those data, and some local authorities have made it mandatory as far as circular 10/98 is concerned. I do not know a lot about St. Helens council—I am not even precisely sure where it is—but it has made the policy contained in the circular mandatory. It has decided to do so in its capacity as a local education authority.
The Minister will know that the Education and Inspections Act 2006 has actually given schools more powers in that area. Sadly, there is perhaps good reason and need for that—I understand that. But may we please have in tandem with that the requirement that parents are kept informed, and that there is training in the use of restraint? Account should be taken of a pupil’s age, gender and size, and the use of restraint should be properly recorded, with detailed notification being given in writing and orally to the parents when it has happened. In addition, Ofsted and a designated school governor should review the restraint registers.
My hon. Friend will be aware that under the Education and Inspections Act 2006 provision is made for a review of training for ordinary staff and potentially for special educational needs co-ordinators. Is he aware that, in the other place on 31 October, Baroness Sharp of Guildford asked Lord Adonis for a commitment that SENCO training should include some knowledge of and experience in speech, language and communication difficulties? Lord Adonis said that the Government would certainly look at that. Does he not need to do so now and reach an affirmative conclusion sooner rather than later?
My hon. Friend is absolutely right—Lord Adonis does, of course, need to do so.
In conclusion, will the Minister give me and this Chamber an assurance that the repeated physical restraint of children in our schools, whether or not they have speech or language difficulties, will be something that parents are immediately informed about so that they can be aware of what is happening and be part of the solution to help the school manage the issue?
I thank the hon. Member for Buckingham (John Bercow) for triggering the debate. I know that he takes a great interest in the subject and I am sure that his contribution will be appreciated by many outside this Chamber. He was eloquent, forthright and passionate, and I congratulate him on his speech. I am also aware that the Royal College of Speech and Language Therapists is taking an interest in what is said today, and I am sure that many parents and children who have a direct or indirect interest in the issues already raised will be suitably impressed by his contribution.
I hope to make a relatively short speech as others have far greater experience of the subject. I look forward to learning more today and have already learned much from the opening speech and from the hon. Member for South-West Bedfordshire (Andrew Selous), who mentioned something that was discussed when I recently met speech and language therapists at their annual awards ceremony: the significant reduction of re-offending rates in prison of those who have received speech and language intervention. Qualified speech and language therapists are available, but they cannot find jobs. I am sure all hon. Members would agree that the cost involved in finding them jobs is a wise investment for the future.
I should declare an interest. It is not to be found in the Register of Members’ Interests, but it has a greater significance as it is an emotional interest. Like the hon. Member for Buckingham, I also have a family member who has speech and language problems. I was delighted when my daughter Sarah and son-in-law George became parents two years ago following the birth of a baby girl, Maria. Although at the time I felt much too young to become a grandfather, it was the best thing that has happened to me since becoming a Member of this House—even better than being elected with a 13,600 majority. Unfortunately, following a bleed in the brain at birth, Maria now suffers from cerebral palsy and like many children with that condition, she has already benefited from the skills of many people, including speech therapists. From 3 am on Friday last week, over the weekend and still today, she is in the sick children’s hospital in Edinburgh. Many other children on the ward are in a much worse condition, and my heart goes out to them and their families.
Two nights ago, one young boy with cerebral palsy lay there, screaming and trying to communicate with his family; he knew what was going on, but was unable to communicate. He reminded me of a son of good friends of mine who lived his life in that way until he died at the young age of 21. The boy in the next bed, the young man who died and my little granddaughter deserve the best help and support that we can provide. If we cannot deliver that, we will have let them down.
Little Maria will not only need the help and support of all those who love her, but will depend on those who can bring the best out of such children, who have a range of difficulties that will be present throughout their lives. As the hon. Gentleman said, early intervention can open up a new world of communication for children and reduce the frustration that builds up when communication is a problem. We all know how frustrating it can be to have a speech ready and not to be called—to have a message that we wish others to hear but which, for a variety of reasons, is not heard. Imagine that that was the case every single hour of every single day. For many children with speech and language difficulties, life can be a desperate challenge. That is why I hope that the debate will play a small part in keeping this important issue on the agenda.
In my own city of Edinburgh, we are fortunate to have an excellent range of facilities and many excellent dedicated staff who work with children who have such specialist needs, and their families. If I can pay tribute to just one such organisation, it is Capability Scotland, which has the slogan, “Turning disability into ability”. That sums Capability Scotland up. What it provides, and what is a key to success, is support and encouragement for parents to work with their child and to provide new and stimulating experiences through play and other enjoyable pastimes so that the learning is not all hard work. Children learn much more when it is fun. That organisation knows that it is important to include the parents in the education of children who have a range of difficulties, as parents are not only involved in their care from dawn to dusk, but are the best judges of what is working and what is not. The experts are important, but they must listen to the parents to develop the best way forward.
Many children with speech and language difficulties will face a number of other challenges throughout their lives: mobility, possible bullying, how they move on to independence and, later, earning a living, to name just a few. Delivering the education that those children require is vital and must be done in conjunction with other services provided at local authority level, by private companies and by voluntary organisations, as well as by central Government. For instance, disabled access on buses can make all the difference to a family if their child cannot walk. Speech and language provision may be available somewhere, but if they cannot get to it because of a physical barrier, that is a real problem. Facilities, help and support can be made available, but the users must be able to get there to make use of those facilities, the experts, the medical support and the support offered in many schools.
Many children and their families require support, advice and information about what is available: practical help, financial help, respite and much more. Despite the fact that such help is often available for parents of children with special needs, many are not aware that it exists, sometimes even when it is on their doorstep, although I appreciate that often it is not. When parents do find out information, it is normally limited and related only to the body that has provided them with the information. For example, a local health centre may suggest that a child is entitled to an occupational therapist, but it might not advise parents that they could also be entitled to respite care. Similarly, a parent may be informed by a council that they are entitled to a reduction in their council tax, yet they may still be unaware that they could receive disability living allowance. The problem is that different bodies—the NHS, local health authorities, education departments, social work departments and other Government offices—often do not liaise with one another. There is poor communication among departments, so although each may be perfectly capable of informing parents of what its field has to offer, there is no one source where parents can find out about everything to which they are entitled.
To help to fill that gap in my constituency, I have produced a special needs information pack. I would like to offer the hon. Gentleman a copy of it, and if it helps one or more of his constituents, I shall be delighted. The pack provides information on a wide variety of issues, including benefits, social work, child care and leisure facilities. It is specifically tailored to Edinburgh, West, but other things can help children who suffer from speech and language problems, because they often have many other problems in their lives, and the pack also deals with aids, adaptations, equipment, advocacy, advice and counselling, detailing what is available locally. It also includes useful contacts for other sources of information and a selection of information leaflets on other matters, such as
“what to expect when your child is in hospital”.
The pack has been praised by local parent carers groups and individual parents of children with these needs. It has helped some parents in my constituency and I hope to put it online to make it more widely available. I hope that, through a variety of means, we can contribute in a practical sense, as well as through debate, to helping a group of children who face real challenges throughout their lives and who are some of the most delightful individuals on the planet.
I, too, congratulate my hon. Friend the Member for Buckingham (John Bercow) on securing the debate and on speaking so powerfully about a subject on which he obviously has a very deep interest. He talked about a continuum applying to children who have deafness and hearing impairment, and that continuum necessitates a diversity of provision when it comes to education.
I am fortunate that there are a number of specialist schools in my constituency which deal with many learning difficulties, including speech and hearing impairment. I am referring to Maple Ridge school, Dove House school, the Loddon school and Limington House school. All are of immense value to our community in north Hampshire. The commitment of the staff and the leadership of the head teachers mean that the children in my community who have perhaps more severe needs are dealt with in a way that is a credit to both our community and our education authority.
In considering the delivery of education to the children on the continuum that my hon. Friend talked about, we should also consider the importance of provision for those who can attend mainstream schools. Hon. Members may well have seen a report issued by Ofsted in July this year which said that obviously there are sometimes difficulties in providing specialist units in mainstream schools, but when there is effective qualified specialist teaching, those units can be immensely valuable for children who have these needs, particularly speech and hearing impairment.
The National Deaf Children’s Society feels strongly that it is important that there are choices of mainstream provision for children who have to deal with such problems. Its chief executive, Susan Daniels, has said that choice is important, but she also draws out the problem that choice is rare and urges local authorities to do more by way of forward planning and to work with neighbouring authorities to ensure that such choice is available in local communities.
My hon. Friends talked about the lottery of provision. Perhaps I, in Basingstoke, am fortunate to have drawn the right numbers, or perhaps I just have an excellent local education authority that understands the importance of both specialist provision and provision of education in mainstream schools for children with hearing impairment and deafness. In my constituency, there is a local pyramid of schools with deaf and hearing impaired units. At secondary level that is provided at Aldworth science college, and at junior and infants level it is provided at Park View infant school and Park View junior school. We are very fortunate to have those facilities locally for children who have that particular need, providing the sort of choice that the National Deaf Children’s Society has advocated so strongly.
My concern is that each of those three valuable units faces the threat of closure. That threat exists for one simple reason: the local authority needs to consider their viability. Of course, when specialists in education talk about viability, they look at numbers, but I believe they also look at the money. Although Hampshire has an excellent local education authority, it receives one of the lowest dedicated school grants in the country, as I am sure the Minister is aware. The formula certainly does not work in the favour of the children in my constituency.
The loss of those three units would be a great loss to my community. It would mean a loss of expertise in teaching. When one visits those schools and talks to their head teachers, it is clear that that expertise has been built up not just over recent years, but over a lifetime of dedication to serving children who have those particular needs. It would also mean a loss of teaching in the community for children with those needs. They already face great difficulties, which many of us would find difficult to contemplate for ourselves. To remove the choice so that they have to be shipped out to schools that are not in their community—I know that constituents of many hon. Members are in that situation—is a very retrograde step.
It is perhaps worth drawing out one other line of thought, which has been brought to my attention locally by health visitors. As my hon. Friend said, health visitors have an important role because they see children very early in their lives and are often integral in identifying hearing problems at an early age. I was therefore most concerned to hear from mothers and health visitors about the loss of the eight-month check for young children in Basingstoke and the north Hampshire area. In the context of reviewing a child’s development, that check is important for many reasons, but one of its most important aspects is to check a child’s hearing, just as it is important to check language and speech development at the age of two. Both those checks are being put to one side in north Hampshire because of financial pressures. That is another retrograde step, and I would appreciate the Minister’s comments on it.
As my hon. Friend said, late intervention in speech and language matters can create enormous future problems for children. We should be concerned about the loss of the ability to identify those concerns early in a child’s life through health visitors, and we should seek a Government response. We should not be looking for the closure of the units in my constituency. If anything, we should be thinking about how to increase the support for those units in future.
My hon. Friend talked about effective education of deaf and hearing-impaired children, and that is indeed what we should be focusing on, through specialist schools as well as by supporting units in the mainstream sector. I want to hear what the Minister would like to do to support local authorities such as mine, which are, frankly, struggling to support specialist units in the community. We need to do all that we can to ensure that the group of children in question, who face immense problems as it is, are not dislocated from their community. They already face significant challenges and we should do all that we can to reduce the pressure on them and their families, rather than increasing it by closing units.
You will have no problem with me, Miss Begg.
It is a pleasure to follow my hon. Friend the Member for Basingstoke (Mrs. Miller), whom I entirely support in her desire to prevent the closure of special schools. I shall deal with that subject, but first I want to comment on the speech of the hon. Member for Edinburgh, West (John Barrett). He spoke extremely well. I am intrigued by the information pack initiative, and I wonder whether he could make one available to me as well. I am sure that I shall not be the only hon. Member in the Chamber to ask for one. I see him nodding his assent, and I thank him.
My hon. Friend the Member for Buckingham (John Bercow) spoke with his usual eloquence and great passion. He and I are at the two ends of the spectrum where speech making is concerned. Perhaps I may tell hon. Members a story of a boy who did not, they tell me, say a word until he was six years old. Then he went to speech therapy, until he became a teenager. He stopped going there not because they cured him but because it was too embarrassing to sit there with all the tiny children. In fact, in Yorkshire they all said that they eventually wished that when they mended him they had put in a switch—they said, “He couldn’t speak till he was six and he hasn’t stopped since.” Those are the sort of comments that this child had to face. I am sure that we all accept that being unable to speak does not necessarily mean one is stupid. There are many people with complex needs who have learning difficulties as well, but there are those who just have speech difficulties.
I want to talk about the closure of special schools. There is pressure on such schools in Essex. In my constituency, a wonderful school for those with moderate learning difficulties, Cedar Hall, is under great pressure. The pressure is largely on MLD schools, not those dealing with severe learning difficulties. There is a feeling that it is more appropriate for children with moderate learning difficulties to be taught in an inclusive environment in the mainstream, and that is exactly right for some children. However, there are children for whom an MLD school is right. It is necessary to keep those schools open and support them fully, and not to refuse to refer children or tell parents about those options. We need to make sure that county councils support the MLD schools, as well as the important SLD schools. Closing MLD schools and moving the children into mainstream schools tends to exacerbate the difficulties in giving them speech and language support. That is my experience.
I have two points to make to the Minister, to which I hope he will respond, because, as he knows, I sincerely believe that he is a good chap. One is that children who require speech and language therapy—even those whose requirement is statemented—sometimes do not get that help from trained specialist speech and language professionals. They receive help from other people, who work with fantastic good will and enthusiasm, but who cannot provide what is needed to help those children as quickly as possible, which is very important. I hope that the Minister will deal with the issue that emerged this morning from the remarks of my hon. Friend the Member for Buckingham: the shortfall in numbers of professional therapists. We are looking for the Minister to give us comfort and to tell us this year, if not this morning, what he will do to ensure that the gap in the provision of trained professionals is closed before the end of the decade.
Does my hon. Friend agree that when it is agreed that speech and language therapy is to be provided by someone from the primary care trust, there must be a watertight legal right to enforce the provision on the PCT? The ducking and diving and reneging on commitments is wrong, damaging and regarded with contempt by parents.
My hon. Friend makes the point more forcefully and eloquently than I could have done, and I am grateful to him for doing so.
My second point for the Minister relates to the fact that when I was a business man with companies in the 1980s, I had sheltered employment schemes. We were a community, not just a business. In the constituency of the hon. Member for Mid-Dorset and North Poole (Annette Brooke), we had a unit with 10 people who did all sorts of wonderful work, with great value added. They brought the whole work force together as a community. They added more to my businesses than I added to their lives. We were able to do that because the Government provided encouragement and financial support for the schemes. I wonder if we can look again at how to make sure we can provide decent, dignified employment for such people. Many of the people whom I employed had never earned a wage before. I wonder whether there is a way to get that debate rolling again. If there is one thing we can do in this House, it is to provide dignity and quality of life for vulnerable people in our constituencies. We have a duty to do that.
Someone who cannot read or write or do sums will get by in life—many such people do—but when someone cannot speak or communicate people look the other way. Someone with those problems will have great difficulty; their human dignity will be offended and their quality of life will be much lower. That is the essential point that we must address when we consider education and caring for vulnerable people.
I, too, congratulate the hon. Member for Buckingham (John Bercow), who was inspiring, as he usually is on this subject. I hope that my good neighbour, the Minister, will be duly inspired by the very good speeches that we have heard. I congratulate all who spoke, but particularly my hon. Friend the Member for Edinburgh, West (John Barrett), who brought his own special visual aid. I hope that we will all be able to share that information and that it can eventually be used to help our constituents.
This subject has been highlighted before. The important Rose review states:
“Speaking and listening, together with reading and writing, are…central to children's intellectual, social and emotional development.”
My party currently has a four Rs commission, in which the fourth R is articulation. As we have heard throughout the debate, poor skills in those areas go on to affect behaviour. It is not surprising that children who are not understood try to communicate in other ways that are less than satisfactory to most of us. Young children who do not have educational attainments are held back throughout their adult lives, and may become involved in criminal activity. I do not suggest that all people who have language problems and speech impairments will go on to become criminals, but a high proportion of prisoners have those inabilities. It is therefore important to take on board the impact of those problems on our society.
It is important to appreciate that speech and language therapy is complex and covers a spectrum, from children with transient language difficulties—their number is increasing simply because of our lifestyles and because people do not talk enough in the home—through to children with the persistent difficulties about which we have heard a lot today. Clearly, early intervention is key—indeed, there appears to be a critical age by which speech and language skills should be developed to prevent problems with subsequent development. A longitudinal study found that children whose language difficulties were resolved by the age of five and a half were more likely to go on to develop good reading and spelling skills. Many children’s communication difficulties are transient and can be resolved through early intervention. As we have heard over and over again, if children do not get that early intervention, the costs to society are large. As well as needing specialists, we need our mainstream teachers to have an understanding of communication, because many of the transient problems could be picked up in the classroom setting. For that to happen, we need all our early-years teachers to be suitably trained in this issue.
I do not want to go into the whole debate about mainstream schooling and inclusion, but I can go back 20 years and think of children and young people who were in special schools but who would not have been there if they had received speech and language therapy. That is critical. We have, to a large extent, moved on with the Government’s agenda, but we know that children who are included, particularly those with more complex needs, are not getting adequate support in mainstream schools. We should keep in mainstream education children who simply need a year’s course of speech therapy and will then be able to access all of the main curriculum, but it is crucial that children who are included should receive that full support.
Statistics show that one in 10 children in the UK have communication problems, but I suggest that as many as 50 per cent. of five-year-olds arrive at school without the speech and language skills that they need to participate fully and to achieve their potential. The majority of children with communication problems are educated in mainstream schools, and we know that communication problems can accompany other disabilities. We need to take on board the fact that a large number of children with statements of special educational needs have been identified as having speech, language and communication difficulties. As the hon. Member for Buckingham said, in our debate on the Select Committee on Education and Skills report, we discussed at great length the point that the money available must match up with the requirements set out on the statements.
Many MPs have supported the Make Chatter Matter campaign and have signed up to the early-day motion on it. The campaign is all about giving information to parents and having skilled staff, communication-friendly early-years settings and specialist provision. The debate is timely because I visited Carden nursery in Brighton just a week ago to see an interesting project initiated by I CAN. The nursery is on a school site and has children in mainstream sessions but pulls out 10 children in the morning and 10 in the afternoon for special sessions. Those sessions are intensive and involve three adults working with a maximum of 10 children. I was able to watch the sessions without the children seeing, and have learned about Makaton and cued articulation. I also learned that most of those three and four-year-olds had been identified as having language difficulties by their health visitors, so I make a plea: we must have a sufficient number of health visitors to pick up those problems at an early stage. All the children there have a relatively high level of cognitive development, and the intensive work will almost certainly result in all of them ultimately accessing mainstream education—it will allow many of them to go straight into mainstream schools at five. The project is obviously expensive, but it will save money in the long run.
How big is the problem? Do our local authorities know the extent of it, taking into account the whole range of communication and language difficulties? We know that the general shortage of speech and language therapists means that children in some areas are unable to access crucial services; there is a postcode lottery. The Education and Skills Committee report on special educational needs highlighted problems in partnerships with health authorities. There is a lack of joining up. In the past three months, I have had problems with children being allocated to a nursery school in the county council area that is not their parents’ first choice, which takes them out of their primary care trust area. It has been a huge battle to get therapeutic services aligned to individual children. That is outrageous, especially for the poor parents who are in the middle of it all and who had to accept placements for their children that they did not want in the first place. They should not have to battle or come to their MP to sort out such problems.
Evidence submitted to the Select Committee highlighted that issue, and the Committee responded by calling for a national strategy. The Government’s response to the report, particularly on page 8, made me see red. I will add another word to those used by the hon. Member for Buckingham to describe it. Complacent—that is how I would sum it up. It is good news that there is some research coming through from Canterbury Christ Church university, but even so, I am concerned. We have heard that the budgets of 78 per cent. of speech and language therapy services across the UK have been reduced or frozen, and we know that speech and language therapy graduates have been unable to find jobs. Furthermore, there is a boom and bust problem: my local university, Bournemouth university, and other universities are saying that PCTs are not commissioning places for the future. So not only do we have unemployed speech and language therapists now, but in four years we will not have enough therapists coming through. That is ridiculous.
I know that I CAN has proposed a programme to the Minister in respect of its Early Talk course. I do not want to promote a particular provider, but I hope that the Minister will give due consideration to I CAN’s proposals.
Today, we have heard about Oliver, Maria and Jade. I agree that we need to get a grip on the procedures for restraining children, as we discussed in the Committee that considered the Education and Inspections Bill. The point, however, is that there are hundreds of thousands of children with specific needs, and we are not doing our best for them.
I congratulate my hon. Friend the Member for Buckingham (John Bercow) on securing the debate and, indeed, on the oratorical grasp and passionate embrace that he brought to it—it was a mix of Pericles and Mark Anthony. He has a growing reputation for championing good causes, and there is none better than the special needs of these special children. The issue warrants and needs our attention.
The care of children with special needs has been a particular concern of mine for 20 years, since my time as shadow chairman of education in Nottinghamshire. In that role, I took a robust view of the dangers of the agenda that emerged following the Warnock report and I defended the interests of children and parents who wanted out-of-county and, indeed, out-of-country special provision placements to meet their needs.
It was then that I first witnessed the superb work being done in special schools and the care and devotion that they invest in bringing greater opportunities to children who are too often forgotten by those in positions of influence and power. One such school—Dawn House in Nottinghamshire—teaches the full national curriculum to children between the ages of five and 16 with severe communication difficulties, and has twice been included in Ofsted’s list of excellent schools. As we debate the matters before us today, we should remember their important work and the success of similar schools.
We are rightly proud of a country that contains such schools, the whole ethos of which is rooted in excellence and care. It has been said by many wise men—not least, most recently, the Leader of the Opposition—that the mark of a civilised society is the way in which it treats its most vulnerable and defenceless members. Who, I wonder, could be described as more vulnerable than those children whose youthful fragility is intensified by their incapacity to communicate their hopes, fears and needs? They are indeed special and they deserve our special care and concern.
When the work of the House is done at the end of each week, I, like other Members, return to the innocent eyes and soft kisses of beautiful children. I marvel at their great energy as they push and pull me. I marvel at their small bodies, which are fragile and perfect. I enjoy the protective instincts that they invoke in me. I invite hon. Members to imagine how they would feel if their children were all the more vulnerable—physically or emotionally—because of disability. I ask every Member in considering my hon. Friend’s argument, to share that flight of imagination.
I do so knowing that Members from all parties care and knowing that the Minister cares too. I say it mindful of the comments that have been made by the other contributors to the debate: my hon. Friend the Member for South-West Bedfordshire (Andrew Selous), who talked about the importance of parents and of training teachers; the hon. Member for Edinburgh, West (John Barrett), who spoke of the need for early intervention, reinforcing the remarks of my hon. Friend the Member for Buckingham; my hon. Friend the Member for Basingstoke (Mrs. Miller), who talked about the importance of special schools in her constituency, which, like those in my constituency—Gosberton House school, Garth school and Priory school—do such excellent work; my hon. Friend the Member for Castle Point (Bob Spink), who focused on the need for adequate numbers of specialists; and the hon. Member for Mid-Dorset and North Poole (Annette Brooke), who talked about the dynamic nature of special needs and the need for us to be sensitive to that dynamism and to adjust provision to meet those changing needs. Indeed, no needs change more than those of children with communication and language difficulties.
This is not a matter of party doctrine, but, sadly, it is sometimes a matter of dogma. The unlimited pursuit of integrationist policies that followed Warnock in 1978 and the Education Act 1981 closed many special schools. It closed minds and damaged lives. Of course, some of the Warnock legacy was fuelled by the best intentions, but the cost to schools and children has been profound because the people who drove this misguided agenda were as powerful as those whom they affected were powerless. The integrationist, broad-brush approach to an infinitely complex issue has damaged the educational prospects of countless children, not least those who suffer from speech and language difficulties.
Those without the capacity to communicate with their peers, parents and siblings often feel isolated, frustrated, misunderstood and desperate. They find themselves outside the social spheres that we take for granted: the family chat, the workplace gathering and even today’s debate.
For the fortunate, however, there is a place where they can feel included, understood and connected. That place is in the classroom in schools such as Dawn House and, since 1971, at the Nuffield speech and language unit, the work of which has been championed by my hon. Friend the Member for Buckingham and, altogether less fluently, by myself over the past year. There, talented staff, whose specialty is communication, can give children the one-on-one care and attention that they so desperately need. Such a focus is simply not possible without adequate specialist provision; with 30 children clamouring for the attention of one or two adults, it is inevitable that a child with speech and language needs is the last to be heard. Such problems have profound effects on the nation, as a recent report from the I CAN organisation suggests.
I also amplify my hon. Friend’s point about the proven link between communication disability and emotional behavioural problems, which often lead to social exclusion and eventually to not in employment, education or training status. It is a scandal for our society and for the Minister, who has been so generously described as high flying, capable and reasonable, that the number of NEETs has grown since the Government came to power.
The Minister will not be surprised to hear that I have five particular questions for him. Some have been raised already; others, are all my own. First, what measures have the Government put in place to ensure the early identification of such special needs? Secondly, what steps have been taken to promote inter-agency work to assist children and families who are dealing with the range of difficulties that ensue? Thirdly, what plans does the Minister have to ensure that local authorities maintain proper data on the speech and language difficulties of children in their area?
Fourthly, I turn to the issue of augmentative and alternative communications equipment, on which there was a written statement yesterday. We welcome that statement, which said that much of that equipment will be given free, following the campaign run by Scope, and, humbly assisted by myself, through communications with Ministers, but what provision will be made to ensure that equipment is updated? As the hon. Member for Mid-Dorset and North Poole said, the special needs that we are discussing are dynamic; they change and so the equipment must change accordingly. On the same subject, how can the Government guarantee that those who use the equipment will be adequately trained? It is vital that training is in place for those who use equipment that is so valuable to people with communication difficulties.
Finally, how can the Government guarantee a smooth transition between early years, children’s and adult services?
No, question four had two parts—Roman one and Roman two. The Minister was not listening as carefully as he should have been.
The seamless approach that I have described will be essential as people with a communication impairment move through life, because it will enable them to grasp opportunities to learn, develop and work.
My hon. Friend the Member for Buckingham has done the House a great service by bringing this matter up for debate. He has my assurance, as I think he knows, that those on the Conservative Front Bench will be unrelenting in their defence of the interests of special needs children. The Minister has an opportunity today to make his mark and to fly even higher than he has already in the estimation of my hon. Friend by being sensitive and responsive to the arguments that have been advanced here and elsewhere. Indeed, in making that appeal to the Minister, I pay tribute to Scope for its work on this subject and for the support and guidance that it has offered me as I have dealt with the matter and, alongside my hon. Friend, advanced the interests of children with speech and language difficulties. I invite the Minister to make his mark and I give him adequate time, I hope, to deal not only with my five questions, but with the altogether more incisive comments of those who have spoken before me.
So much to say, so little time to say it. This excellent debate was instigated by the hon. Member for Buckingham (John Bercow). Beyond offering him the customary congratulations on securing it, let me genuinely pay tribute to him for his impassioned, informed, highly articulate and fluent presentation of his argument, which, as everyone has said, is the standard to which we have grown accustomed from him. We are grateful to him for introducing a well informed debate.
I wish to respond mainly to the hon. Gentleman’s points, but I shall first run through some of those made by other hon. Members. The hon. Member for South-West Bedfordshire (Andrew Selous) made a good speech, particularly on the problems of his constituent, Jade Chambers, and wanted me to address the matter of physical restraint. The Department’s guidance states that physical restraint should be used, where necessary, in a way that is reasonable and proportional to the threat or danger posed, and that parents should be informed. We are working on guidance on the use of physical force specified in the Education and Inspections Act 2006, and we need to address training on the matter for teachers and other staff in schools. I anticipate that the basis of the guidance will be much as it is at the moment, whereby parents must be informed. If I need to write to the hon. Gentleman with further details, I shall certainly do so.
We were all struck by the information pack mentioned by the hon. Member for Edinburgh, West (John Barrett). Naturally, I would be delighted to see it.
The hon. Member for Basingstoke (Mrs. Miller) reiterated my view that local authorities should develop choice. I was married in Basingstoke and have a great affection for it. I used to live there and I hope to return in the new year to visit Queen Mary’s college and one or two other establishments.
The hon. Lady talked about the funding for Hampshire. In Dorset, we look jealously at the funding per pupil that Hampshire receives, because it qualifies for additional cost adjustment, which we in Dorset do not. In my constituency, we have excellent special educational needs provision despite the paucity of funding, with an outstanding school for pupils with moderate learning difficulties and a brand new special school for severe learning difficulties pupils that I look forward to opening in the next few months. It is possible to give priority to such things.
I shall examine with interest what is going on in the three pyramids about which the hon. Lady is concerned and the matter of the eight-month checks in north Hampshire, and I shall correspond with her.
I wish to discuss the points made by the hon. Members for Castle Point (Bob Spink), for Mid-Dorset and North Poole (Annette Brooke) and for South Holland and The Deepings (Mr. Hayes), in response to the main points made by the hon. Member for Buckingham in his excellent speech. First, as is customary, I should mention evidence of the real progress that has been made in helping children with special educational needs and disabilities to achieve their potential. Ofsted, as has been referred to, has reported improvements since we published “Removing Barriers to Achievement”, our long-term SEN strategy, in 2004. We can see those improvements, for example, in the declining percentage of children with SEN not achieving at least level 3 in maths at key stage 2. It decreased from 28 to 25 per cent. in just the two years from 2003 to 2005. In English, the percentage of children not achieving at least level 3 decreased from 31 to 27 per cent.
Those improvements undoubtedly reflect the hard work of dedicated staff and the support that they receive from parents with the passion and impatience that was so well articulated by the hon. Member for Buckingham. Also, they are there thanks to increasing investment by the Government in children with SEN.
The hon. Gentleman mentioned only the Government’s inputs, not our outputs, so I have started with the outputs, but the inputs are also great. He will be familiar with, for example, the rise of 43 per cent. from £1.3 billion in 2003-04 to £1.8 billion in 2006-07 in SEN funding for mainstream schools, and the 23 per cent. rise over the same period for special schools. I shall not dwell on that, because we must always do better.
The hon. Gentleman rightly put great emphasis on early intervention. When a child is experiencing difficulties, it is of course important that they are identified as soon as possible and that steps are taken to address them. Early identification and intervention are central to our approach to SEN. Children with two years of high-quality early education can boost their overall development by up to six months.
For children from disadvantaged backgrounds, pre-school education is particularly important in raising development above the expected minimum in literacy, language and numeracy at key stage 1—in other words, in preparing them for key stage 2. The Childcare Act 2006 places important new duties on local authorities to improve outcomes and reduce inequality for children, which I hope will have an important effect on early intervention. It requires them to secure sufficient child care provision to meet the needs of parents of disabled children who wish to resume or remain in work or undertake educational training. It also requires them to provide information, advice and training to those children’s child care providers.
Language plays a central role in supporting children’s attainment later in their lives. The Government are supporting a number of schemes in that respect—for example, the early support programme for very young children with disabilities has improved inter-agency working, planning and delivery across local services by providing information for parents, some of which I have in front of me. One set of information focuses on speech and language difficulties, and explains how children normally develop communication, language and speech; how adults can help; and when and how to seek help from professionals. We have commissioned the communication matters project, and through national strategies we are doing important work.
The hon. Gentleman is right to say that great importance is attached to the use of speech and language therapists. All the measures that I have mentioned, and others that I wish to mention, help to ensure that the school work force are equipped to deal with speech, language and communication needs, but for some children direct input from a specialist will be needed.
Whenever possible, therapists should agree intervention strategies that can be implemented where children normally learn. They should discuss and agree an approach with teachers so that changes are made to a child’s whole learning experience. When such arrangements are made, children benefit from a rounded programme of support geared to their particular needs. Teachers benefit too: their contact with therapists helps them to have heightened awareness of some of the less obvious problems that children face and thus equips them to nip such problems in the bud.
The prime responsibility for the training, supply and deployment of therapists lies with the national health service, but where speech and language therapy is specified as an educational provision in a child’s statement of special educational needs, the local authority is ultimately responsible for securing that provision, even if the local primary care trust cannot or will not provide it. We are aware that some local authorities and schools are increasingly having difficulties in securing such provision from the NHS, and I am grateful to the hon. Gentleman for focusing my mind on the matter. I shall continue to keep an eye on it.
Local authorities have to use their own funds to procure private therapy services if they cannot secure them from the NHS. I hope that that is a way to address the problem, which he spoke about so eloquently, of there being unemployed therapists and yet a shortage of therapists in the NHS. We hope also to address it through our joint study work, and I hear the comments about the joint study with the Department of Health. The delay was not down to the research team or the DFES; it arose because of problems in securing ethical approval from PCTs. That was frustrating.
I cannot, because I have so much to say.
I look forward to the report early in the new year, and I shall be pressing officials to ensure that it comes, and we can respond to it, as soon as possible, given the concerns raised today.
I agree with the hon. Member for Buckingham that we need to improve joint commissioning and use the children’s trusts to do so. We must use extended schools as a way to bring together a multi-agency approach—the infamous joined-up working that we all chase after and get frustrated about because we do not see it in our constituencies.
The Government are broadly in sympathy with the general thrust of where the hon. Gentleman wants us to go. I entirely accept his impatience and belief that we are not going fast or effectively enough in certain cases. There is something of a lottery, which is down to how certain local authorities choose to commission services. I shall reflect on that and consider the extent to which we should take a national lead in helping the new children’s trusts and the development of extended services to join things up properly.
Ultimately, special schools will definitely be part of future provision. They will be a focus of specialism that can feed out into mainstream schools and bring coherent provision in this important area to needy children across England.