Motion made, and Question proposed, That the sitting be now adjourned.—[Mark Tami.]
Good morning, Mr. Illsley. In welcoming you to the Chair for what is the first Adjournment debate in Westminster Hall since before the summer recess, I confidently look forward to your firm, fair and wise stewardship of our proceedings.
On 3 September this year, I was pleased to accept the invitation extended to me by the Secretary of State for Children, Schools and Families, supported by the Secretary of State for Health, to lead a review of services for children and young people with speech, language and communication needs. The review is charged with advising the Government of the day on the range and composition of the universal and specialist services that will be required to meet, in an affordable manner, the diversity of needs that exist. It will also consider how planning, performance management and effective co-operation nationally and locally can spur beneficial early intervention with the effect of securing improved services. Furthermore, it will look at those examples of best practice in the commissioning and delivery of services that could usefully be regarded as benchmarks for the wider development of services across the country.
That is quite a broad remit, and within it fall a large number of issues, on which I do not have the time, and I do not intend today, to focus, although I should like to address some of them. That, however, is the background to the events that are likely to unfold over a period of months. It is also probably as well to say that when this Adjournment debate was secured on 25 July, courtesy of the ballot undertaken in Mr. Speaker’s office, I had it in mind, as a result not least of discussions with a range of interested parties, to highlight a series of quite specific issues, and it is on those that I shall concentrate the thrust of my remarks.
It is probably a good idea to set out the background to our consideration of these important issues. In other words, what is the problem? Approximately, 5 to 8 per cent. of pre-school children suffer speech, language and communication problems, and the figure rises to 10 per cent. for children of school age. About one in 500 children suffers a severe and intractable communication impairment. That is the context that right hon. and hon. Members need to address in considering these issues.
I want to focus specifically on three main areas and then listen intently to the contributions from colleagues on both sides and the Minister’s response. I want to say something about training and co-operation in the delivery of services, and about the statementing process. I have agreed with the Secretary of State that the review is not intended to reopen the question of Government policy on statementing, although I confess that the Government have not quite got it right at the moment. The Secretary of State has agreed, however, that I certainly am entitled to look, and should look, if the review is to be complete and full functioning, at the impact of statementing on children with speech, language and communication impairments, because that is fundamental. I want to look at language units, which are often a proper source of provision for the affected category of children. There are a number of issues relating to language units on which we need to focus and which should be proper matters for consideration in the review.
What is to be said about training and co-operation? Good work is being done out there; there are some excellent professionals and there are examples of good practice. I say that at the outset for the avoidance of doubt, lest anybody think that I am seeking to create an impression of doom and gloom. I am not seeking to do that, because that would not be justified, but there are legitimate concerns about public policy and current practice, and the Government must take those into account if they are to build on the work that they have done in recent years.
I have been struck by the survey evidence that I have seen and by two pieces of evidence in particular. A YouGov survey undertaken for the Communication Trust showed that 73 per cent. of adults in contact with children in schools did not believe that they had had any training that would equip them adequately to cope with children who suffered speech, language and communication impairments. That is a significant deficit, which we need to address. The second piece of opinion polling evidence that struck me as relevant was the finding in the poll undertaken by the National Union of Teachers, which showed that only 32 per cent. of respondents felt confident in accommodating and dealing with children who suffered speech, language and communication impairments. A large number of professionals therefore say that they have not had the necessary training and only a small proportion of teachers—less than a third—feel comfortable enough to deal with the client group with which I am concerned.
That evidence seems to highlight the importance of the inclusion development programme. I am conscious that that programme is now to be unveiled and rolled out—relatively widely, I hope, across the country—but there are issues that the Government need to consider. First, there is the perennial issue of funding. Have we got the wherewithal to make this a meaningful commitment? Secondly, will the Government, in upskilling the entire work force, as the evidence that I have adduced demonstrates is necessary, take proper account of the need to make a greater priority of ensuring that there are sufficient specialists who will be able to address the needs of children with more severe impairments? In other words, we can upskill the general work force to deal with the relatively widespread but modest impairments from which children suffer—that is one issue—but we must also ensure that we have sufficient skilled specialists to provide the expertise and intensity of care that the more serious sufferer requires.
Finally, I ask the Minister not to discount the likelihood that, as a consequence of unveiling the programme and, as I hope right hon. and hon. Members will understand, raising expectations, he will generate an increase in demand for the very services on which my review must focus. It is a question, therefore, not only of whether there are sufficient resources today, but of whether the resources are likely to be adequate as events unfold in the months ahead.
I congratulate the hon. Gentleman on raising this subject and endeavouring to move things forward, and I am sure that we shall all play our part in supporting and helping him. I just wanted to point out that the title of the next debate suggests that health funding can lead to inequalities in the system. I am very interested, as I know the Government are, in inequity and inequalities in this country. Will the hon. Gentleman address that problem and realise that somebody such as Stephen Hawking, who is very creative, can access equipment that people in other parts of the country find difficult to access or to get support or continuing funding for? There is an inequity problem that I hope the hon. Gentleman will address in his review.
That is a fair point—the short answer to the hon. Gentleman’s question is yes, I will. In the terms of reference agreed with the Department for Children, Schools and Families and the Department of Health, we have factored in the requirement to look at the circumstances of people from lower socio-economic backgrounds and those from areas of significant deprivation because problems in those communities can be intense. I accept the salience of the hon. Gentleman’s point. As in so many other walks of life, people who have means or who have contacts and therefore access to means are able better to cope with their significant difficulties than those who do not have such means or access to contacts who could provide means. I hope that, I have reassured the hon. Gentleman that although his concern will not be the only or prime focus of the review, it must be part of the equation.
I spoke about training and co-operation and I shall now say something about the need for that co-operation. In acknowledging that important work has been undertaken and that good examples of effective practice can and will be identified, we cannot shy away from the fact that there are significant challenges, to put it fairly and dispassionately, which are represented not least by some of the critical reports that have been issued in recent months. The Minister may recall that we last debated these matters on 28 November 2006. Since then, there have been no fewer than four reports that, in one form or another, posed a significant challenge or raised a pertinent question.
A report from the National Audit Office focused specifically on the subject of the Sure Start children’s centres. It perturbs me that the report said that, of 27 centres surveyed, only five demonstrated a close working relationship with a local primary care trust. That is not good enough. I accept that the children’s centres, which are a welcome development, are of recent origin, so I am not saying that they should be damned for ever or seriously lambasted, but there is a policy failure and the NAO properly drew attention to it. The Audit Commission has also produced a report, which lamented the lack of multidisciplinary support services at local level. An Ofsted report said that standards in communication in schools were lower than expected. Finally, a report from the Public Accounts Committee explicitly said that more had to be done to meet specific needs such as the requirement for speech and language therapy.
I hope that the Minister will take note of those reports in a constructive spirit and agree with the general proposition that they underline, perhaps most strikingly of all, the need for co-operation at all levels—among practitioners on the ground who are charged with the delivery of services, between schools and local authorities and, critically, between local authorities and PCTs. The issue of joint protocols or concordats from PCTs and local authorities would perhaps be a portent of better things to come. It would be a sign that they accepted a responsibility to translate the theory of joined-up working into demonstrable practice—demonstrable not only to service providers and those responsible for strategic management, but to the recipients of services. Such co-operation, joint working and a sense that we have an obligation to seek to provide so far as possible a seamless service is of the essence.
I should emphasise how incredibly important joint working and a seamless service are as far as children are concerned. Specialists in the field generally conclude that one of the best predictors of, or guides to, the outcome for the child is whether the agencies concerned come together early and meet as necessary relatively often, both to plan what to provide to the child and to monitor how those provisions work, and to improvise as necessary. I say that in the context of what I believe Members on both sides of the House will accept as the basic fact of the enormous benefit of early intervention and the huge danger of its absence. Simply stated, the benefit of early intervention is that children can have teething problems addressed, as it were, and they will then be in a position to access the national curriculum and to fulfil their potential.
The Government have signed up to the principle of early intervention. The downside of its absence is difficult to overstate. I do not in any sense seek to be melodramatic about it and I am working simply on the basis of what I understand, as an interested lay person, to be the evidence. If there is no early intervention, there is a risk of emotional and psychological difficulties, behavioural problems, lower educational attainment, poorer employment prospects, persistent communication handicap, challenges to mental health and, indeed, in the worst-case scenarios, a descent into criminality. If we are to avoid that grisly scenario, we must ensure that agencies come together early, regularly and effectively to translate the aspiration of good policy into practical effect at local level.
Does the hon. Gentleman agree that another important aspect of agencies working together is that parents and other non-educational sector interested parties make maximum use of the time that the children affected spend outside their educational establishments? Co-ordination within the educational setting would mean that maximum use is made of the time that a child spends outside it.
That is certainly true, in which respect the hon. Gentleman prompts me to make an additional and, I hope, valid observation about the incredibly important role of parents. They must be a part of the delivery of the best possible care for their children, but information and support for parents is sometimes not what it might be. Parents ought to have some sort of toolkit, the better to enable them to play their part in helping children. That would require effective planning within an educational setting with a view not only to that environment, but to the time that a child spends outside school.
I apologise for being a few minutes late. I should like to invite the hon. Gentleman to follow up on the issue of early intervention. A lot of work has been done on early intervention concerning what does and does not work. Actually, we must be clear about the form that early intervention takes. Some programmes are successful. The incredible years programme—aficionados call it the Webster-Stratton programme—has been rolled out in all Sure Start centres in Wales, and their performance has outstripped that of centres in both Scotland and England. The programme is dedicated and committed and is centred around parents, but it does some important work with children. While looking at early intervention and working with parents, I hope that the hon. Gentleman takes on board work that has shown that we must be clear about which programme is being followed, and that we must monitor programmes carefully to produce particular outcomes.
The right hon. Lady makes the point that it is not good enough simply to sign up to the principle of early intervention, but that one must be clear about what form it should take. I do not claim to be an expert, or seek to prescribe a precise blueprint for application across the whole country. That said, she is right that there are examples of obviously good practice that follow a particular model and that could perhaps be benchmarks, as I mentioned at the beginning of my speech, for the development of services across the country. I am not sure that it is for me to invite myself to the project that the right hon. Lady describes, but if she, through her good offices, felt able to weed out an invitation, it is perfectly possible that my colleagues and I might find the time to go there to see for ourselves what good work it is doing.
That is exactly what we want to see—good practice. Actually, we should like to see some examples of bad practice, but not with a view to playing the blame game or because we want to point the finger or to apportion responsibility between one individual and another. At the risk of sounding pious, which I do not intend or want to do, the issue is bigger than that. We are trying to arrive at constructive solutions, so I am very happy to look at what the right hon. Lady suggested. There are of course examples of I CAN programmes, among others, that work very well, but there is a range of different provision, and we should be open-minded in looking at what is effective.
I said that I should like to say something about the statementing process, specifically as it relates to children with speech, language and communication impairments. I hope that the Minister will understand when I say that one of the difficulties that parents have is that there is not always that much material on paper that can be easily viewed and presented to Ministers. It is therefore necessary to some extent to work on the basis of examples heard from reputable pressure groups, and to reach a view about whether those are isolated instances of malpractice, inefficiency or lack of forethought, or whether they are emblematic of a wider trend about which we should be concerned. I am not saying that the statementing process misfires in every local authority in the country, but I believe that the evidence of inadequacy, poor practice and grounds for concern is sufficiently extensive—if not prevalent—for us to need to address the subject.
I have some specific considerations for the Minister and colleagues. I know from the contact that I have had with campaigning organisations and charities in the field—including AFASIC, I CAN, the Royal College of Speech and Language Therapists, the National Autistic Society, and Treehouse, which I had the privilege of visiting earlier this year, to name but a few—that there are anxieties among parents. For example, a lot of parents are actively discouraged from pursuing a statement for their children, or are not even told of the existence of the statementing process. If they come to know about it they are told, “It is very unlikely that you would get a statement; it is not worth trying. There is a Government preference for their reduction and it simply is not the right route to follow. You should go about things in a different way.” That can happen justifiably, but it can happen when manifestly the child would benefit from a statement of special educational needs.
I think that we know—and the Minister can testify from personal experience, I am sure—that in a vast number of cases, if a child does not have a statement of special educational needs, he or she is unlikely to receive speech therapy on any sort of regular basis at all. The argument concerning such a child is that he or she is not the most seriously affected, and that school action—or school action plus a bit of monitoring, waiting for the developmental process to happen and an assessment in due course—will do. However, that is the danger; very often if the intervention does not take place, and if nothing is provided by way of speech and language therapy, the problems of those children will be significantly exacerbated, necessitating a greater investment, and more extensive intervention later, or, failing that, leading to the virtual certainty of seriously aggravated difficulties for the individual and probably for the economy and society as a whole.
Some children who do have statements of special educational needs—this is not a party political point; I found examples of good practice in authorities with different political labels around the country, and I found that some local authorities run by my own party were good, while others were very bad—get very little speech and language therapy. It might, for example, amount to a termly assessment and a brief session with a therapist. I put it to hon. Members that when someone has been deemed sufficiently needy to warrant a statement of special educational needs, to get simply a termly session, or a couple of sessions a term, is palpably insufficient.
There are examples of children having to wait a long time between agreement to the statement and implementation of the requirement to provide speech and language therapy. I know of a case—other hon. Members may be able to invoke still worse and more serious cases—in which a child’s parents had to wait seven months from the time when the statement was agreed to the time when provision was put on the table for the child in the educational setting. There are many instances in which the speech and language therapy is unquantified in the statement—very likely in violation of the letter, and certainly of the spirit, of special educational needs legislation in general and the code of practice in particular—and in which that unquantified commitment is then undelivered. The requirement is unquantified and undelivered and, therefore, the need is unmet. That suggests to me that we should at least consider in the statementing process some sort of scrutiny by an external source of the content of statements, and monitoring of implementation of statements. That failsafe would guarantee to parents that what was in a statement was translated into practice. Parents need that safety valve or reassurance, which is I think lacking at the moment for many children. Let those issues be debated in the course of the review, the visits that we make and the evidence that we receive.
The final issue on which I want briefly to focus is language units. I mentioned that they are often very suitable sources of assistance to affected children. I have declared an interest in this matter before, Mr. Illsley, but for the avoidance of doubt may I declare that interest again, as the father of a child approaching the age of four? My son, Oliver, is in a language unit at a mainstream primary school in Pimlico, and he is getting fantastic help. It is a brilliant unit. He is very fortunate. The unit does not appear to be threatened. Although my interest in the subject of speech, language and communication was, as I have openly and honestly stated, initially founded on and driven by my personal experience, I am not complaining about what my child is getting. We have been very fortunate. Many people have not been as fortunate, and we all have a responsibility to try to do something to better their prospects and improve their care and provision.
What is it about language units that concerns me at the moment? In at least five cases—this is the only point at which I shall name names, of organisations, at any rate—it would be very difficult to ascertain that the local authority provided such units at all. In the cases of Bristol, Durham, Norfolk, Salford and Wandsworth, it is difficult to see from my research and from looking at websites that such a facility is available. The question that I want to ask is, how can parents ask for a place in a language unit if they are not aware of the existence of the unit? The truth is that they cannot.
It seems to me that the wider issue of data collection—having a store of information that is kept locally and perhaps transmitted to the national level—is worth considering in the months ahead. I know of several cases in which people have said, “There is a cut in the number of placements in the units, brought about by the drive to reduce the incidence of statements.” If the cut in the number of places were the consequence of a declining need objectively identified, I should not be wasting colleagues’ time and yours, Mr. Illsley, complaining about the situation. If, however, the reduction is the result of arbitrary and capricious decisions taken to meet some wider and separate but not necessarily justified public policy, it is a source of concern.
People have reported to me through pressure groups and parents’ organisations that a language unit may be gradually run down, and the authority will then say that there is no demand for it. Parents in such authorities have come to me or to colleagues and said, “We were told simply that we had to place our child in a mainstream class”—not in a language unit within a mainstream school—“and we were not informed of the unit’s existence as an option at all.” That seems to constitute an arbitrary run-down of provision.
I know of instances in which such units have come to house children who are on the autistic spectrum and who perhaps have behavioural, emotional and social difficulties. Although some units can cater to such children’s needs, if a child’s primary need is not speech and language therapy, one must at least ask whether a language unit is the proper or best place for that child. We must be careful not simply to push children into a particular facility without reference to their objectively identifiable primary need.
The challenges are considerable. The Government have at least three sources of guidance on the stocks, which I think have been publicly released, that are supposed to inform the consultation process on the future of such units. I have raised the matter with the Secretary of State for Children, Schools and Families, and I should like to be clear in my mind that authorities know clearly what those sources of guidance are, that we can establish what mechanism exists for monitoring their enforcement, and whether Ministers are satisfied that the rules are being followed in both letter and spirit.
I raise the issue in such terms because I am not saying categorically that there is a rampant or majority abuse of the procedures. I should not go so far as to suggest anything of the sort, but the evidence that has come to me is more than merely anecdotal. I hope that colleagues will forgive me if I say that the special needs community, although it is gradually becoming more demanding, articulate and vociferous, and rightly so—I am looking at the right hon. Member for North-West Durham (Hilary Armstrong), who had responsibility for social exclusion for a considerable period—is still not particularly powerful.
I have sometimes cavilled when Ministers, or representatives of any party, have said, “Well, of course these matters must all be determined locally. Local education authorities are elected bodies. They must make their dispositions in these matters, and if parents are dissatisfied they can kick out the authority at the ballot box.” To that piece of institutionalised cant, I tend to reply, “Get real.” For the most part, such parents are few and far between and thinly spread, and they often do not know each other. The idea that by objecting to a particular decision on a given institution in an individual locality they will be able to drive the local authority from office is for the birds. In dealing with vulnerable children, we need protective mechanisms. The Government have a special responsibility, which I am confident they will accept, to monitor what is occurring with a view to securing improvements and redressing bad practice wherever it proves necessary.
The House has indulged me so far, for which I am grateful. I do not think that the issues are ideological at heart. I have reflected on them long and hard. There are differences of emphasis—sometimes quite important ones—between the advocates of inclusion and those who are absolutely and indomitably opposed to it, but my sense, having mixed with a wide variety of people in the field during the past 18 months, is that most people do not subscribe to either position in its extreme form. Most are fairly pragmatic. They can see the benefit of an eclectic mix of provision tailored to the particular circumstances of individual children, and most are prepared to depend on and be guided by what the evidence proves.
In most cases, it is not an ideological matter or the source of a great philosophical tension between the political parties; it is a question of pragmatics and of trying to bring the big issues to the fore. If the Minister will forgive me—I would say this whomever the Government in power were—it is a question of ensuring that, while we are, very properly, preoccupied with our big battles about the future of the health service, education provision and social care, we do not forget those important services that are needed admittedly only by a minority, although a significant minority, and that require uplifting in political priority and public consciousness.
It is worth trying to co-operate across the parties. It is much easier to walk away into one’s hole and avoid any criticism by saying, “Never the twain shall meet; we can’t possibly work with people of another party.” That judgment probably makes for a quiet life, but it is the wrong judgment to make. I am proud to be a Conservative Member of Parliament. I happen to think that such issues are important, and I believe that this place is, on the whole, pretty tribal. Most politicians are too tribal, as are most commentators, but I think on the whole that the public are not very tribal. They rejoice in instances of politicians across the spectrum coming together and considering how to put aside our party differences and work together to better the public provision, especially when the beneficiaries are a group of children who are often very needy, frightened and vulnerable.
I remind colleagues that children with speech, language and communication impairments are disabled children. That is often not recognised. The hidden disability of an incapacity to communicate can be a source of great problems for the individual, for his or her wider social network and—ultimately, if those problems are not tackled—for the country. It would say something positive about this country’s political DNA if we came up during the next nine months with a set of constructive and practical proposals, the implementation of which would alleviate some of the difficulties, improve the quality of provision and raise the life chances of some concerned and frightened children who need our help sooner, rather than later.
I welcome the debate that the hon. Member for Buckingham (John Bercow) has secured, and I enjoyed his excellent speech. I know that he will be busy later today, as he is sponsoring a reception for the Children’s Services Development Group, underlining his point that we owe so much to the many organisations involved in the field. They are right to seize the moment and focus on the issues that he raised, and which hon. Members from all parties have raised in the Chamber and in the various Committees and Departments with which we are associated.
When I saw just before the recess that the hon. Gentleman had secured this important debate, I welcomed it, as I am sure did hon. Members from all parties. During the recess, when I had the opportunity to visit schools in my own constituency, I saw the meaning of many of the things that he said. I welcome the fact that he did not paint a picture of doom and gloom, because there have been many achievements, and we are entitled to acknowledge that. Nevertheless, challenges remain. In my constituency, I have visited excellent schools such Drumpark school in Bargeddie, which deals with special needs children, and Portland school in Coatbridge, which deals with children with behavioural problems. What stood out principally was the dedication of the outstanding people working day in and day out for solutions to many problems and trying to ensure that their children achieve their absolute potential. I realised that this debate would give us the opportunity to offer support and to push things forward a little more urgently, as the voluntary organisations would wish.
I was also encouraged to listen to the hon. Gentleman and to follow his speech, in common with my hon. Friend the Member for Norwich, North (Dr. Gibson), the hon. Member for Mid-Dorset and North Poole (Annette Brooke) and others, because I was delighted to have had the opportunity to chair the all-party review on the needs of disabled children, a review that received outstanding support from the consortium and which campaigned under the slogan “Every Disabled Child Matters”. Indeed, the right hon. Member for Normanton (Ed Balls), now the Secretary of State for Children, Schools and Families, was very encouraging and proactive, and we were able to produce a report that was inevitably much more general than the specific issues that the hon. Gentleman is dealing with this morning but which led to a very positive response.
I can tell the Minister for Schools and Learners, who will reply to the debate, of the very considered response to the work of the all-party group. It listened to those organisations that wanted to be heard, and even to some disabled children—for example, young people who were concerned about that period of transition. When considering the response to the all-party report, we saw that the Treasury and the then Department for Education and Skills was allocating an additional £340 million to deal with those issues. My Scottish colleagues will be delighted to know that under the Barnett formula we received £34 million—something that I hope the hon. Gentleman will remember in his review.
The all-party group made steady progress, but it would not have been right then to sit on our laurels and say “That’s fine. We’ve done a good job. End of story.” Our constituents would have told us that, as would parents, because our experience of visiting schools and working in education—I know that this debate is largely to do with education—shows that there are problems of poor provision and low attainment.
Speech, language and communication are extremely important. The challenge is to ensure that the policies of Government and Parliament, in their respective roles, have a clear influence to ensure that progress is made.
Like the hon. Gentleman, I welcome the contribution of the organisation I CAN. It has shown through projects such as Make Chatter Matter and initiatives such as the Chatterbox Challenge that, in many ways, the voluntary sector is leading the field. I doubt whether anyone would want to dispute the important role of the voluntary sector and the charities in this important matter because, in truth, they are addressing some serious problems, such as those of early identification—something that many local authorities have yet to address.
It is often said, although it is regarded as trite to say so, that to some extent there is a postcode lottery, and I am afraid that the facts indicate that that is so. Some local authorities appear to have other priorities. I do not criticise those priorities, but on the evidence and based on our experience it is absolutely right that we should address those issues this morning. For example, 1.2 million children in the United Kingdom have a communications problem that requires special help. On average, that is three children in every classroom. We are told that children are arriving at school without the skills to achieve their full potential. That is the principal challenge. In some areas, particularly in those with heavy unemployment and housing that is below acceptable standards—in other words, areas of deprivation— 80 per cent. of those children are being doubly penalised because we are not addressing, as we want to, the issue of speech and language services.
The hon. Gentleman rightly referred to the question of training, which is hugely important. He also mentioned the Communications Trust survey; and the trust is doing a first-class job. However, another finding of the YouGov survey was that preparation and training for serving children with special needs, who have speech and language difficulties, is that such preparations are often falling apart in some local authority areas. It showed that 61 per cent. of staff over the age of 45 had SLC training, yet only 37 per cent. of staff aged under 35 had it. That is extremely worrying, and obviously unacceptable. It is important, therefore, to underline training—as the hon. Gentleman did. Communications problems can occur in isolation and as a result of other disabilities such as autism or Down’s syndrome, or even hearing impairments. We should have a proper collection of data. In other words, we should find out what the problems are so that we can compare and evaluate achievement and try to encourage a rise in standards; but that is not the case, and I think that they were doing a fine job in seeking to achieve the objectives upon which I think we can all agree.
I underline the excellent points made by the hon. Gentleman about early intervention. It is absolutely crucial. We hear of tackling the difficulties of children with behavioural problems, but who knows what lies behind those problems? Who knows what family influences there were as the children left for school in the morning? In some cases, I wonder whether attainment in speech and language is not influenced also by those other problems. If so, we must take it on board.
I welcome the debate. I know that the Minister takes these matters seriously, and I hope that he has the opportunity to respond to all the points raised this morning. I hope that there may be a closer working relationship—the Minister’s body language is interesting—between Departments. We want to see them working together, and the Department of Health looms large in that. We want to ensure appropriate local authority responses, and we want to know that the Government will respond effectively to them and others in commissioning speech and language services.
I welcome the opportunity to speak on this important issue. I wish the hon. Gentleman well—particularly on the important review in which he is so heavily involved—and congratulate him on introducing the debate.
Thank you. I was confused by the time.
I congratulate the hon. Member for Buckingham (John Bercow) on securing the debate, on his speech and on his new role in leading a major review for the Government on the provision of services for children and young people with speech, language and communication needs. Since our last debate in Westminster Hall on the issue, which was almost a year ago, not only has a major review been announced, but the communication trust has been set up.
Those announcements were preceded, however, by the various reports that have been mentioned. For example, the Pubic Accounts Committee report concluded that
“more needs to be done to meet specific needs such as speech and language therapy to provide the early intervention that is critical to child development.”
The Ofsted report on the foundation stage said that
“standards in communication, language and literacy were lower than expected and children’s speaking and listening skills were weak in a third of the settings visited”.
If we were writing a report for the Government on progress on the issue during the past year, we would judge that they can and must do better. Although there are examples of excellent practice, progress has been patchy overall and the new initiatives face challenges. I am absolutely committed to the fact that children’s communication skills must be at the core of the Government’s development of children’s policy. However, it is not just a matter of policy; there must be real changes on the ground.
We have talked this morning about early intervention, and I agree that we need to understand exactly what we are talking about and to identify good and not-so-good practice. We know that about 50 per cent. of five-year-olds arrive at school without the speech and language that they need to fully participate and achieve their full potential. That figure rises to 80 per cent in areas of high unemployment and poor housing.
The Ofsted report to which I referred identified a widening gap between boys and girls. We must consider the significance of that gap in respect of future educational attainment. Much is made of attainment at age 11 and of the fact that a quarter of children do not achieve satisfactory standards in literacy and numeracy. How much of that problem stems from a lack of early intervention and a failure to deal with the issue when it needed to be dealt with? We know that poor language and communication skills have a knock-on effect on behaviour. Not surprisingly, when a child becomes socially isolated and does not have the tools to integrate with his or her peers, behavioural problems develop. We know that many young people who end up in young offenders institutions have poor language and literacy sills. It is vital that we put more emphasis on a holistic approach to the issue.
I would like to emphasise that speech and language needs are complex. We are talking about a whole spectrum of needs, and I worry about the suggestion that one solution fits all. Transient problems can be sorted out with sufficient speech therapy and with back-up in the home. Such transient language difficulties are probably caused by our lifestyle—watching too much television, not sitting down for meals together and a lack of communication in the home. However, there are also very severe and highly specialist needs that may or may not be accompanied by another disability. We must be very clear about what approach we need to deal with this issue.
I shall refer to a case study that I have been dealing with this summer, but I will of course also discuss more general points. A grandmother came to see me whose grandson was aged four and did not speak a word, which was quite alarming. I raised the case separately—I could not get to talk to one person—with the primary care trust and the head of children’s services. That process started reasonably well because Tyler was first referred to the speech and language therapy service by his health visitor—my first point of call. The provision of health visitors across the country has become patchy, and although I support the intensive help given by family nurses to vulnerable families, basic health visitor provision is vital because that is how these issues are most likely to be picked up. The Family and Parenting Institute study has clearly shown that there are deficiencies in health visitor provision.
Returning to the case study, that first referral was the good news, and Tyler was seen in June 2006. Unfortunately, staff shortages meant that Tyler was not seen again until 7 December 2006—six months on at a critical time in the child’s life. Treatment then improved as speech therapy was given and it was recommended that Tyler receive specialist nursery provision. However, the provision was in another authority and a lone parent could not get the child there. There was no offer of transport or other help. I then wrote to children’s services and asked why such specialist provision was not in our authority. The reply said that the
“development of daily ‘drills’ by the therapist passed on by the pre-school staff are in the view of many professionals preferable to occasional attendance at group sessions.”
That proves the point that we need the whole spectrum of provision to match the whole spectrum of needs. Some children will benefit from projects such as I CAN and from intensive provision in a pre-school setting. Other children will benefit from speech therapy that is backed up with support from home. It must be the right mix for the right child, and I do not apologise for talking about an individual case, because the crux of the matter is that we are talking about individual children for whom we must get the best support. I am greatly concerned that a child would have fallen through the net if it was not for their grandmother raising the issue. It is difficult for parents who do not know their way around the system to access what they need.
We have repeatedly said this morning that training is critical for nursery school teachers. I had a parliamentary answer in July saying that only £37 million of the children’s transformation fund for training had been spent. Surely we should be spending the money to put the essential training in place. We must use the early years foundation stage, which becomes statutory in 2008, as an opportunity to ensure that staff are trained and that we do not have the rigid curriculum that some of us fear. We must take the opportunity to ensure that we have early identification and intervention, and most of all that we foster language and communication skills for every child.
As good as we as a society—not me personally—may be at information and communication technology, we have a problem with basic communication. We need to know how big the problem is, as the right hon. Member for Coatbridge, Chryston and Bellshill (Mr. Clarke) said. Considering the range of communication and language difficulties, do our local authorities know the extent of the problem? We have discussed statementing this morning. The Government must not bury their head in the sand and pretend that all is well. As MPs, we know that that is not the case. There is much more to be done to ensure that children can access the support that they need, that the finance is there and that we have qualified professionals who are trained to deliver that support. Joint working between health and education services locally and nationally is vital. For a long time I have been concerned about a situation with Dorset county council. However, we should congratulate it this morning because it has employed a full-time health worker in its children’s services whom I have met and spoken to at great length. It is such a pity that I have so many different authorities in my constituency; I can always find problems.
Finally, I want to mention some of the important points Scope made to us about—I shall have to read this bit in full—the availability of appropriate additional augmentative communication aids; now I can say AAC. Scope has been raising those issues for some time, and its conclusions were really interesting, as they are the same as those that we are making on other points. It referred to:
“Better training on AAC for Speech and Language Therapists and teachers…joined-up services across all ages”
and the need to establish who is responsible for the provision of the equipment. That is another dimension that I hope will be covered in the review of the hon. Member for Buckingham.
First, the answer to that is yes. That is an important issue; I did not address it because I wanted to focus on other subjects today, but the question of assistive and augmentative technology is important. It will certainly fall within the terms of the review, and we will consider it very seriously. Secondly, the hon. Lady might be interested to see a quite informative article in the education section of The Guardian today that focuses, among other topics, on that point.
I thank the hon. Gentleman.
In conclusion, I want to re-emphasise that we are looking for the right provision for each individual child, whether that is in mainstream education with proper support or in a specialist unit. Whatever comes out of our debate today, it is about ensuring that our children are able fully to access a curriculum at school and to have a rich lifestyle. They cannot have that if they have those language and speech impairments.
First, I declare my interest, as in the Register of Members’ Interests, as the chairman of a company involved in educational support services.
I add my congratulations to my hon. Friend the Member for Buckingham (John Bercow), who made a typically well-informed and robust oration, all without notes—another 30 minutes and he would have equalled the achievement of my right hon. Friend the Leader of the Opposition at the party conference last week. It was a particularly impressive, detailed and heart-felt contribution, but then my hon. Friend has form in this area. He mentioned the debate that he instituted in this Chamber almost a year ago, his role as the chairman of the all-party group on speech and language difficulties and, of course, his close personal interest because of his son. That interest is shared by my right hon. Friend the Leader of the Opposition through his personal experience, which is why he has concentrated for much of his time during his years in this place on the subject of special educational needs. The subject is close to many of our hearts, and all hon. Members will have a personal interest or will have been approached by many constituents. It is right that that should be mentioned.
My hon. Friend the Member for Buckingham made a number of points, and I do not need to repeat them, but I was particularly interested by his undertaking that he is interested in seeking out best practice, because the experience is patchy up and down the country. I was encouraged by his reference to the role of parents, because it is the parents who have the 24-hour, day in day out responsibility and care and often do not get the support that they need. He also mentioned the great dedication of some of the people involved in the lobby, but it is a fairly disparate lobby and so it is right that this place should speak up for a minority that desperately needs support.
We hear an awful lot about the numbers of doctors, nurses and teachers, the number of heart operations that take place, improvements in cancer treatment, the number of GCSE passes in schools and so on. We hear very little about the problems connected to speech, language and communications, and virtually nothing about the number of practitioners and therapists available up and down the country—I fear that there are woefully few. Communication is vital to social and educational development and, as the right hon. Member for North-West Durham (Hilary Armstrong) said, the right sort of early intervention is the right investment to make as early and as appropriately as possible, and it is a false economy not to do that. It is also right that early intervention should involve a joined-up approach between schools, pre-schools, Sure Start—that is why I am so pleased about the I CAN pilot projects in Sure Start children’s centres—and the health service, too, so that a seamless support operation can be put in place.
We need more specialists and a greater understanding among teachers and other professionals in health and education. Apparently, an estimated 7,000 SLC therapists are on the books in this country. It is estimated that we need at least some 2,300 more and there is a question about the training places available for many of those coming out of university who want to go into that area.
A survey by the Royal College of Speech and Language Therapists recently found that 78 per cent. of managers questioned said that their budgets were being frozen, and 50 per cent. said that they would be obliged to provide an inferior service or to conclude that the service was altogether non-viable. The area has not had the attention or investment given to other areas of education and health.
Does the hon. Gentleman accept that although we will always need more specialists, if we have more effective intervention at an early age, new parents learn how to communicate with their children and do so much more effectively? Does he agree that that is the way to ensure that many of the most disadvantaged children, rather than those with a specific disability, get through their speech and language difficulties?
The right hon. Lady’s point is self-evidently right, and hence my point that it is a false economy not to make that early investment and to work with parents and everybody else.
We will all recall that the Select Committee report published last year made some concerning comments about the SEN system in this country. Many hon. Members have mentioned the statistics about the six in 100 children who will at some stage have a speech, language or communications difficulty. The hon. Member for Mid-Dorset and North Poole (Annette Brooke) mentioned the high number of children who arrive at school without the basic speech and language abilities that they need. My hon. Friend the Member for Buckingham mentioned the 73 per cent. of staff who have not had proper SEN training. The right hon. Member for Coatbridge, Chryston and Bellshill (Mr. Clarke) made a good point about the demographics, too. The expertise is with older staff who are coming up to retirement and less with younger staff. There is a potential demographic time bomb that we seriously need to deal with.
I CAN’s “Cost to the Nation” report noted that impoverished language is an emerging 21st century problem that results in lower academic outcomes in children with persistent language difficulties. We obviously need to tackle it young. As we know, there has also been a reduction in specialist provision. There are 146 fewer maintained special schools than in 1997. The number of places in state special schools has fallen by more than 5,000 since 1997. Although it is appropriate in some cases for children to be able to go through the mainstream school sector, in many cases that can be viable only if the support is available in those schools, often on a one-to-one basis. I am afraid that that level of support has not been matched in too many cases.
I want to praise the work of I CAN and many of the other organisations involved in this area. I CAN operated a school in my constituency that unfortunately had to close a few years ago but had an excellent reputation. I CAN commented on the Ofsted report on the foundation stage, which came out in March of this year, and made the point that
“it is clear that more should be done from top to bottom to identify and then support young children with SLC difficulties.”
It identified this fact:
“Workforce reform is something that is critical to this process and the government and Local Authorities must do more to up-skill the workforce in this area.”
It also said:
“I CAN wants to see more being done to support all staff who work with children, with particular consideration to be given in ensuring that additional speech, language and communication support is made available in areas of high deprivation where the links to impoverished language are clear.”
I CAN also commented, as did my hon. Friend the Member for Buckingham, on the relationship with health and the need for greater joined-up working between education and health, and on the joint working and ownership of the work force, because speech and language therapists might be employed by health services, local authorities, schools, charities or social enterprises, or might be working privately. A vicious triangle is operating here. Often, those who bring cases to me requiring speech therapy support have gone already to their education authority, which has said, “Oh, that is not for us. It is health.” They then go to their PCT or hospital and are told again, “Oh that is not for us, but for children’s or social services”. That is a vicious triangle. The problem does not go away if we pass the buck. The longer that that buck is passed, the bigger the problem with that child might become. We need much better joined-up working.
Although I welcome the greater joined-up working in Sure Start children’s centres, I fear that because of budget constraints, PCTs have too often been retrenching on some of their joint funding arrangements and that a bigger burden of the bill has therefore fallen into the lap of local authorities, which is putting particular strains on the provision of some services through Sure Start children’s centres. There are reports from around the country that some language units are being closed without proper consultation or risk assessments, often for the very reasons that my hon. Friend mentioned. It is very important that we have integrated working across health and education for the benefit of children with speech, language and communication needs. Surely, that is a crucial part of the “Every Child Matters” agenda as well. The fact that only five of the 27 children’s centres surveyed by the National Audit Office work closely with their PCTs shows that such joint working has a lot further to go.
I want to make two other brief points. As I said, the Conservative party has taken this matter very seriously. Earlier this year, a commission headed by Sir Robert Balchin reported on the question of special educational needs and made this recommendation:
“Statements should be replaced by Special Needs Profiles (SNP) drawn up by Profile Assessors, who would be educational psychologists and others, possibly operating in consortia.
These Profiles would be cumulative and subject to regular review to ensure that the continued provision is as dynamic as the child’s needs. As early intervention is crucially important. Special Needs Profiles should be created as early in a child’s life as possible.”
My hon. Friend touched on the problem with statements: there is a reluctance to refer people to get a statement, and ignorance about the availability or mechanism for getting one. However, if a person does not get one, they are very unlikely to get the services that go with it. That is a Catch-22 situation, which is absolutely intolerable and serves only to worsen the situation and the concerns and angst of parents having to deal with very complex problems with their children.
Does my hon. Friend agree that when we get people writing or coming to our surgeries seeking a statement for their children and it transpires that their need is demonstrable, we as Members of Parliament often end up thinking, “Thank goodness that we have been able to help them, but what about all of those who did not know that they could come to us”? I know that that is emblematic of many other features of public policy across the piece, but I put it to him that there is a gulf between people who are educated, articulate, broadly middle class and not completely empty-pocketed, who on the whole are used to jousting with authority, and who can write letters and fight a battle, and those who are uneducated, inarticulate, hard-pressed, possibly in very difficult family circumstances and who cannot cope. We have an obligation to them.
My hon. Friend is absolutely right. Those whom he mentioned at the end are most usually in the greatest need of support, but perhaps it is the most articulate and tenacious whom we see and who then take up the cudgels.
What impresses itself on me more than anything in this respect is the battle that such people have with local authorities, or whatever agency. If the money that is wasted on rejecting claims and on the appeals process—the number of appeals has increased enormously—were targeted at providing the services, rather than on trying in too many cases to deny parents what is a right, the system might work rather better. We should be putting every piece of support and help at the disposal of those parents, rather than seeking to put obstacles in their way, as appears to be the case so often.
Finally, may I leave the Minister with a few questions, to add to the great list that I think he has already? His Department has said that it will be making speech, language and communication a key issue, so we would like to know exactly what it intends to do to improve the situation for children with communication difficulties. Will he commit to working more closely with the Department of Health at a senior level to explore what more can be done between agencies and to provide joined-up political leadership? What will the Government do to ensure that all members of the educational work force are trained to identify and support children with a communication disability? What will he do to ensure the appropriate local assessment and provision for children with SLC difficulties? How will the Government support local authorities and PCTs to effectively commission speech and language services?
I know the Government’s commitment on that matter. The work that the Minister’s colleague, the Secretary of State for Children, Schools and Families, did earlier in the year was excellent, with the support and great energy of the right hon. Member for Coatbridge, Chryston and Bellshill. However, we need action and to see how this will happen. We need to ensure that suitable resources are targeted in the right place, so that we can have serious results for those whom we all see in our constituencies, whose case was so well articulated by my hon. Friend.
It is a pleasure to respond to what has been an excellent debate with well-informed and interesting contributions from all right hon. and hon. Members. In particular, I commend the hon. Member for Buckingham (John Bercow) on securing this debate and on being, as always, such an eloquent and persuasive advocate for children and young people experiencing communication difficulties.
I also take the opportunity to congratulate the hon. Gentleman on his appointment to lead the recently announced review of services for children and young people with speech, language and communication needs. That has left me in an interesting position in responding to him, because, clearly, we have acknowledged not only that we want to improve such services further—we would not have commissioned a review otherwise—but his expertise. It was tempting to ask him to write my wind-up speech for me. However, it is important to acknowledge that the fact that he is doing this review does not mean that he does not remain an independent and staunch advocate for the children about whom he has been talking today.
The hon. Gentleman’s appointment to head the review is a signal of the need for us to co-operate across parties, as he talked about towards the end of his remarks, and of the need to move away from tribalism when dealing with such vulnerable young people. I shall not fall prey to the temptation to reel off statistics about how, although 166 special schools have closed in the last 10 years, it is not as many as the 234 in the previous 10 years, and all that kind of stuff, which bores everybody.
We have heard well-informed and insightful observations during the debate. I tried to listen carefully and shall respond to as many of them as I can in the time that I have. The hon. Gentleman raised substantial points about training and co-operation. An informed and confident work force are essential if children with special educational needs are to receive the support that they need. I think that it is right that he is concerned and that other right hon. and hon. Members echoed his points.
To help early years practitioners, we have issued Communicating Matters training material and are working in partnership with I CAN—a children’s communication charity—to pilot its early talk training programme in 200 children’s centres. Similarly, all schools staff need to have the skills and confidence to support appropriately children with special educational needs, including those with speech, language and communication needs. To help raise teacher confidence, we are launching, in one week’s time, through our national strategies work, a major programme of professional development for teachers and other staff in the form of the inclusion development programme, which the hon. Gentleman mentioned.
The IDP is funded with £2 million to support the first body of work that is attached to it, and local authorities will also have the school development grant to support the training and development of teachers. I am sure that the hon. Gentleman will consider that issue. However, we have told the IDP to begin by focusing on speech, language and communication needs and on dyslexia, which demonstrates the importance that we attach to children’s ability to communicate.
The newly formed Communication Trust will build on the IDP by guiding teaching staff to more specialised training and sources of information and assistance. My Department has committed £900,000 in support of the trust, which is a collaborative venture between the communication charities I CAN, AFASIC and the Council for Disabled Children.
The hon. Gentleman also discussed specialists and supply therapists, but before I move on to that issue, I shall touch on the issue of early intervention, which he raised, as did my right hon. Friends the Members for North-West Durham (Hilary Armstrong) and for Coatbridge, Chryston and Bellshill (Mr. Clarke), and the hon. Member for Mid-Dorset and North Poole (Annette Brooke).
Early identification is the key to supporting special educational needs effectively, ensuring that all the right support measures are in place as soon as possible. From September 2008, all settings offering early years provision will be required to deliver the early years foundation stage, which supports all settings in their planning of activities and experiences that can help all children to make progress in their development and learning. It stresses the importance of practitioners being alert to the early signs of needs that could lead to later difficulties, and it provides a framework to enable early years practitioners to respond quickly and appropriately, involving other agencies as necessary.
Collaboration between services is essential to the provision of good speech and language support. Sure Start children’s centres that are aimed at the youngest children have a critical role to play, as our practice guidance for centres acknowledges. We are ensuring that all children’s centres promote language acquisition and identify speech and language difficulties as part of their universal provision. All children’s centre staff should be trained in language development by a speech and language therapist to help develop a centre-wide strategy and approach, and to ensure consistency among all staff. Through Children’s Trust arrangements, local authorities and health services should jointly commission speech and language services to ensure that children’s centres offer easy access to those services.
However, we recognise that, as the hon. Gentleman said, not all centres currently provide services of the quality that we would like. That is why the children’s centres practice guidance that was issued in November 2006 gave details of the best practice that we want all children’s centres to develop. We are also working in partnership with I CAN to pilot its early talk training programme in 200 children’s centres.
As far as I understand, the guidance will not be mandatory, but I shall look at that issue, and if we need to give the hon. Gentleman more information about it, naturally, we will do so.
During the debate, we heard important points about the involvement of, and information for, parents. Local authorities have a clear legal duty to make available to parents information about the SEN provision in their area, including specialist speech and language resource provision or units. Local authorities must make that information available on their websites and provide a written copy on request. The statutory SEN code of practice, by which local authorities must be guided, advises authorities that they must ensure that information is available and accessible for all parents, and that they should work with the local parent partnership service to secure that outcome. The parent partnership services work to minimum standards that are also set out in the code. The standards state that partnerships should ensure that parents are provided with accurate and neutral information on their rights and on the wide range of options that are available for their children’s education, including specialist speech and language provision.
In our response to the report by the Select Committee on Education and Skills about SEN last year, we undertook to exemplify the minimum standards in the SEN code. We set clear expectations for parent partnership services in every area to increase parental confidence in their impartiality and the quality of information and advice that they provide. That work is well under way, and it will be issued later this term. That issue is about more than information, however. It is something on which I shall reflect, and I look forward to the comments in the review that the hon. Gentleman is leading, so that I can reflect a little more on the way in which we encourage better involvement, particularly from that broadest range of parents whom he described during his intervention on the hon. Member for East Worthing and Shoreham (Tim Loughton).
I accept that there is a certain amount of anxiety among parents about statementing. Parents have a right under the Education Act 1996 to request that local authorities assess their children’s special educational needs with a view to the children being given statements. If the local authority declines the request for an assessment, the parents can appeal to the SEN and disability tribunal, whose decisions are binding on local authorities; and as I have said, in each local authority, the parent partnership service should give practical, unbiased advice about special educational needs, including statementing. Local authorities cannot have blanket policies not to assess certain groups of children. The Secretary of State will investigate any complaints against authorities, and if there is evidence of such policies, he will issue directions to the authorities to remedy the situation.
The SEN regulations also set out statutory time limits for completing statements, which amount to 26 weeks from the initial request for an assessment. Figures collected by the Audit Commission show that in 2005-06, 95 per cent. of draft statements were completed in the statutory 18 weeks, when none of the allowable exemptions, such as health or social services being late with their advice, came into play; and that almost 80 per cent. were completed when they did. We are introducing a new indicator to monitor how many statements are completed within the statutory 26 weeks, and we hope that it will improve matters.
I do not sniff at the fact that the speed with which statements are completed is an important subject; I know that the Government have a target for it, and that they are pleased that there has been some progress. However, may I put it to the Minister that it is not necessarily either the only or the best target and that what is incredibly important is that, once the content of the statement is agreed, the lead-in time to its implementation should be as short as possible? Does he agree that delays of several months and more are simply unacceptable?
I certainly agree that such delays are unacceptable. As soon as a statement is finalised, a local authority has a statutory duty to arrange the educational provision set out in the statement, including any speech and language therapy that is specified as necessary educational provision. In practice, there may be some delay—for example, with the local authority having to arrange speech and language provision with the health service; but in cases in which there is an unnecessary and lengthy delay in putting the educational support in place, parents can complain to the Secretary of State on the ground that the local authority is failing to carry out a statutory duty. Naturally, we would consider such situations seriously, because some delays that we hear about anecdotally are unacceptable.
I shall return to the issue of the supply of speech and language therapists. It is important that we bring services together through such measures as extended schools and children’s centres, which I have discussed. The number of qualified speech and language therapists has increased by more than one third since 1997, but we must do more. We must ensure that we match up affordable demand and supply in the NHS work force, and we must focus on strengthening front-line capacity through increases in productivity and the skill mix. I am sure that we will hear more about that from the hon. Gentleman in due course.
The hon. Gentleman also referred to concerns about unit closures. He has raised those concerns in the House, most recently at oral questions on 26 July. Since May 2006, local authorities have had to apply a statutory SEN improvement test when they plan to close a dedicated language unit or to remove resource provision. To obtain a clearer picture about the situation regarding language units, our national strategies SEN advisers have been asked to identify the number of existing units in each local authority and any plans to change the number in 2008. The review that the hon. Gentleman is leading will—I am sure—consider the merits of going further on data collection, with due regard to the need to minimise burdens on schools and local authorities. I look forward to seeing what his review suggests.
Supporting children and young people with speech, language and communication needs and their families is a key priority for the Government, but no political party can or should claim any monopoly of concern about this subject. Much is already being done to help improve services and provision, but more must be done to ensure that everyone gets the type of support that they need, when and where they need it. We are committed to improvements in the system and better collaboration between health and education.
The review that the hon. Gentleman is leading will—I am sure—cast new light on those elements that are working well and on those elements that need improvement and change. We await with interest its outcome.