Education and Training: People with Hidden Disabilities

Lord Ramsbotham Excerpts

Thursday 28th June 2012 Lords Chamber

[Lord Ramsbotham]

My Lords, I, too, thank the noble Lord, Lord Addington, and congratulate him on obtaining this debate. Like other noble Lords, I admire the determination with which he has pursued these issues on many occasions in the House. I welcome the fact that we are debating this issue with the Minister because, from our exchanges both during education Bills and subsequently, I know what a keen interest he takes in these matters. Knowing that we are dealing with and talking to someone who has such an interest is encouraging for those of us who have concerns in this area.

I, too, have benefitted from the briefing that we have had for this debate, particularly from Dyslexia Action. However, I do not want to speak only about dyslexia because I find from the briefings that I get from organisations in all the various parts of the spectrum—ADHD, autism and so on—that they all have similar areas of concern. The best thing we can do is to bring all those groups and their concerns together and try to unite them in a common strategy. After all, the process is the same, as I shall discuss, and it is only individuals with particular problems who have to be treated differently within an overall strategy.

I declare an interest as chairman of the All-Party Group on Speech and Language Difficulties. Currently we are conducting an inquiry into the links between speech, language and communication needs and social disadvantage. I shall mention some of the emerging evidence that we are getting because it is relevant to this issue. In that connection, we have had two days of evidence this week, which I have found the most valuable and inspiring days I have spent in this House, listening to practitioners in the field.

As I have explained to the House, my motivation stems from an experience in a young offender establishment in Scotland when the governor said to me that if he had to get rid of all his staff, the last one out of the gate would be his speech and language therapist. When I asked why, he explained that the offenders could not communicate either with each other or with the staff, and until and unless they could, no one knew what to do with and for them.

I met the marvellous woman who was carrying out this work and asked her what she did. She said she had assessed them all and found hideous shortcomings, which she was able to do something about. I asked her who was the best person in England to do this work and she named a professor at Surrey University, who I asked to come with me into a young offender establishment, and she did. She assessed the boys there and found all kinds of things which were not being picked up in other assessments conducted in reading, writing and other skills.

These include substance-abuse-induced memory loss, hearing problems and sight problems. Most telling of all, however, 100% had the communication difficulties associated with 1% of the population. Clearly, there is a link in all this. I will not bore the House, but subsequent work in putting two speech and language therapists into young offender institutions for two years, academically evaluated, proved within a month that they were an absolutely essential part of the establishment.

Secondly, it identified very clearly that picking up these problems at the age of 15 was far, far too late. It has got to be done earlier. It is not just being able to engage with the people who were looking after them in the young offender establishment; they had missed out on being able to engage with teachers throughout the whole process of life until then. No doubt, that failure had a lot to do with the fact that they were in those establishments. A statement was made to me, which I have never forgotten, that the inability to communicate was the scourge of the 20th century, and it is certainly that of the 21st century. I couple that sentiment with two other statements that I have repeated on many occasions in this House. One was the marvellous remark of Winston Churchill’s in 1910 that,

“there is a treasure, if you can only find it, in the heart of every man”,

with the clear implication that it is your duty to find it. Secondly, it is my firm belief that the only raw material that every nation has in common is its people, and woe betide it if it does not do everything that it can to identify, nurture and develop the talents of all its people, because if it does not and it fails, it has only itself to blame.

Thinking that through, therefore, I am very concerned that people with hidden difficulties and disabilities which could be identified early must have them identified, so that the talents and the treasure can be nurtured and developed not just for their benefit, but for the benefit of the nation as a whole. In preparing for this debate, I looked at my shelves upstairs and I was staggered at the amount of information and the number of reports on the subject. For instance, we had the Bercow report of 2008; the Department for Children, Schools and Families’ better communication plan; the Field report on the foundation years; the Marmot review of health inequalities; the Allen report on early intervention; a joint consultation on the new approach to special educational needs from the Department for Education and Department of Health; the Department for Education’s statutory framework for the early years; the 2012 Green Paper and the pathfinders; and, only today, another document from Dyslexia Action, Dyslexia Still Matters. These reports, together with masses of papers from the Communications Commissioner, the Children’s Commissioner and many practitioners, all say the same thing: that if we are going to make progress, we must intervene early—and the earlier the better—to discover difficulties and disabilities and do something about them as soon as possible.

I turn to the evidence that we have been hearing. I was very pleased to hear from the Department of Health that four new service models are being produced jointly by that department and the Department for Education, together with royal colleges, health visitors, UNISON and others, with pathways for parents, children and practitioners. Two have already been introduced; one for pregnancy and the early weeks of life and one for pre- and early school from two to 10. Another two will be introduced for the nine to 19 year-olds. Furthermore, I am glad to see that there is one for the criminal justice system. There is clear evidence in this that the health and well-being boards which were formed in the recent Health and Social Care Bill have a very important part to play in this. Interestingly, however, a number of our witnesses have said how much they wish that the phrase “mental health” was eliminated from our vocabulary and “mental well-being” was used instead. It is a much more satisfactory term; “well-being’ is a “doing” word, and might make people understand the problem better.

I come to the practicalities. We heard from a health visitor and a speech and language therapist from Northern Ireland that compulsory assessments are being conducted on every child at the age of two, and that health visitors have been trained by speech and language therapists to understand the symptoms they are looking for. They are picking up difficulties as well as disabilities, which is enormously encouraging. Northern Ireland has an advantage in that health and social care work together, which is not the case all over the country. The witnesses highlighted how hugely important this is because otherwise you begin to get fragmentation, which is difficult to deal with.

We then heard what is being achieved in Stoke-on-Trent. It has adopted a motto to the effect that communication is everyone’s business and regards intervention as a multi-agency activity. Some 5,000 people have been trained to identify symptoms. They are not only teachers and parents, but policemen and voluntary sector workers. People are on the lookout for these things and the response is co-ordinated. Stoke has developed a staged pathway which I believe is a model that others could follow with advantage. Indeed, Staffordshire has been fortunate to have had for many years some visionary people working in this area, with research that goes back 10 years showing the benefit of taking this sort of work further.

We heard from representatives of children’s services and speech and language therapists in Walsall. They realised that children entering secondary school had also not had problems identified. They have been assessing people as they enter secondary school. They have been doing this as a pilot for three years and they have some interesting data. Moreover, some schools have found that they have to do these assessments not just when pupils arrive, but at various stages of their passage through the school. I hope that that is not something which will be dismissed. It was interesting to note that after our evidence session, the people from Stoke married up, if you like, with the people from Walsall because they clearly reckoned that they had something to learn; you have to carry on beyond the early years.

Carrying on is the lesson in some excellent work that has been devised by the English Speaking Board for enhancing employability. What is absolutely crucial is the word “transition”. Whatever we do with those who have hidden disabilities and difficulties, having found them, we have to concentrate on the transitions from stage to stage not only throughout their education but on leaving school and making the transition into the workplace, and then on through life.

Later in the year we shall issue a report about this. It will say, frankly, that we think this is an area that needs national oversight. We are concerned that local authorities will be responsible for certain parts of it, with the healthcare and teaching sectors responsible for others. Unless someone pulls all this together, people will continue to fall through the cracks.

The other message that comes through strongly in the report I saw today from Dyslexia Action is that the solutions lie in using existing knowledge and good practice because there is masses of it out there. Rather than reinvent the wheel, for heaven’s sake, let us exploit the valuable expertise and experience of the marvellous people who do this terrific work.

As the title of this debate suggests, it is essential that appropriate teaching and training are available and accessible to all people according to their ability and talent. The ethos of the English Speaking Board is that every person is an individual with unique capabilities and problems who must not be compared with another; rather, each must be judged on their own merits. I hope that the Minister will be able to assure the House that a national approach which makes certain that people are not allowed to slip through the net from the moment of an early assessment at two years of age is what the practice will be, and that what is done in Northern Ireland will become common practice throughout the whole of the United Kingdom.