Children: Speech and Language

Lord Ramsbotham Excerpts

Tuesday 29th January 2013 Lords Chamber

Asked By

[Lord Ramsbotham]

To ask Her Majesty’s Government what plans they have to co-ordinate their response to the recommendations of the Better Communication Research Programme; and how they plan to ensure that those recommendations are reflected in local authorities’ local offers.

[Lord Ramsbotham]

My Lords, I beg leave to ask the Question standing in my name on the Order Paper, and declare an interest as chairman of the All-Party Group on Speech and Language Difficulties.

[The Parliamentary Under-Secretary of State for Schools (Lord Nash)]

My Lords, my department and the Department of Health are working with the Communication Trust and its partners to disseminate this excellent research, and I am grateful to the noble Lord, Lord Ramsbotham, for giving the House the opportunity to discuss this today. The research will help those who plan, commission and deliver support for children and young people with speech, language and communication needs to improve the way they identify those who need help and the effectiveness of the support they provide. We will take account of the findings of the research in developing plans for the local offer.

--- Later in debate ---

[Baroness Whitaker]

My Lords—

[Lord Ramsbotham]

My Lords, I am grateful to the Minister for that reply. We have been waiting for the government response to this quite excellent programme since last June, and I remind the House that it consists of a report, two volumes of findings, four thematic reviews and 10 technical reports, which have been drawn up by experts over a considerable period and represent an absolute mine of evaluation, information and advice. I feel that we have not yet heard who will actually be responsible for driving the whole thing forward. The Minister mentioned the Departments of Education and Health, but there is also the Department for Communities and Local Government, the Ministry of Justice, the Department for Work and Pensions and others whose contribution must be aggregated to make the best of what is in this report for all the children in this country.

[Lord Nash]

My Lords, I agree with noble Lord, Lord Ramsbotham, that this is landmark research which is undoubtedly the most extensive of its kind into the subject. The issues that it raises are so wide-ranging that they are clearly not the province of one agency or government department, as the noble Lord says, which is why we want to make sure that the research is widely available and disseminated as widely as possible. My department and the Department of Health are working closely with the Communication Trust to co-chair the communication council which the Communication Trust is facilitating. The council brings together representatives from government, local authorities, health agencies, the Royal College of Speech and Language Therapists, early-years settings, and schools, parents, young people and the voluntary sector. The council will keep up the momentum by developing a comprehensive dissemination plan for the research, sharing learning about effective approaches to supporting children with SEN and promoting better awareness of speech, language and communication needs.

Education: Early Years

Lord Ramsbotham Excerpts

Thursday 8th November 2012 Lords Chamber

[Lord Ramsbotham]

My Lords, I, too, thank the noble Baroness, Lady Walmsley, for obtaining this debate and in doing so salute her for the consistency and determination with which on the Floor of this House she pursues issues affecting children. I would like to focus on one issue which the noble Baroness identified, and that is school readiness because it is no good talking about education unless you are certain that the child is ready for that education. As chairman of the All-Party Group on Speech and Language Difficulties, I want to focus on the necessary communication skills which, if absent, will prevent children learning.

It is interesting to note how the impact of the electronic age on our children has crept up on us during the latter part of the 20th century and the 21st century. Too many of them are just parked in front of a television set or handed a computer game. They simply end up being unable to communicate, either with each other or anyone else. This was put to me very well last week during a dinner that I was helping to host for Durham cathedral when my neighbour told me of the frustrated anger of her two year-old niece who, like many of her contemporaries, had been issued with an iPad of some kind. She issued frustrated cries of rage when she wiped her hand across a television set and it did not respond.

Members of the all-party group have conducted research into what is happening now and what can be done about it. We were very struck by a graph produced for us which showed that a child with a high IQ coming from an unsupportive or socially disadvantaged background was overtaken at the age of five and a half by a child with a low IQ coming from a supportive background. That to my mind is an indictment of the system. We must do something about it. On discussing this with experts, I was interested to learn that the age of five and a half is very important as it marks the end of a critical window where interventions can be made effectively and identified gaps can be closed. Therefore, it seems hugely important that we should focus on the years up to the age of five and a half to make certain that that crossover never happens.

We are very glad that the Government have done a number of things recently, including bringing in the integrated review incorporating health visitor checks at the age of two and the pre-school progress checks in the reformed early years foundation stage. I welcome the duty that is being put on local health and well-being boards. However, I am very concerned that by putting the duty on local health and well-being boards the Government are introducing the possibility of postcode lotteries, and they worry me. I welcome the early support programmes and the early years foundation stage profiles as a factor but I wonder about the use that is made of them. I also welcome the involvement of speech and language therapies at various stages of education.

However, I am concerned that I have already mentioned the involvement not just of local government but of the Department of Health, the Department for Education and another department. They all need pulling together because individual organisations are doing their own thing. It is very important to recognise that the good they are doing will not be aggregated unless their efforts are pulled together. As I have said many times, the thing that worries me most about prisons is that nobody of a particular type is in charge of who is responsible or accountable for making things happen. Until you have somebody who is responsible and accountable nothing will happen. We cannot afford to let this situation go on. Therefore, my first question to the Minister is: who will be in charge of all the development I have outlined?

During research for a report which my group will publish—we hope before the children and families Bill is published—on the connection between social advantage and speech, language and communication needs, we discovered that the Department of Health and the Department for Education together have published four potential pathways consisting of guidance for workers. One is guidance for health visitors and midwives on pregnancy and the early weeks. Another is guidance for health visitors and school nurses on supporting children from the age of two, and their families, until settled into school. The third is guidance for school nurses on supporting children with complex and/or additional health needs; that continues until age 25, linked with provision for people with special educational needs. The final guidance is for school nurses and youth justice workers on supporting children at risk of entering the criminal justice system. I welcome those publications because they provide a framework within which everything I have been talking about can be brought together. However, I must emphasise that this requires management, not just allowing the pathways to be published and the individual organisations to get on. We must make certain that everyone is required to conform to their pathway; otherwise we will not achieve the results.

Of course, a lot of training needs to go with this. I have been fascinated while we have been undertaking the inquiry, because we have learnt of wonderful examples of work where, for example, Stoke-on-Trent has been training everyone down to the dinner ladies and the lollipop men to identify people who might have the sort of problem that could be helped. There are masses of good examples that need to be pulled together. Under all this, I come down to the fact that until and unless children can engage with a teacher and therefore engage with education, they are never going to make progress. The lesson we have learnt is that until and unless you enable people to do that communication—after all, education boils down to contact between a teacher and a pupil—they will not be ready for the school and the education that is the subject of this debate.

Children: Looked-after Children

Lord Ramsbotham Excerpts

Thursday 25th October 2012 Lords Chamber

[Lord Ramsbotham]

My Lords, I begin by joining in the congratulations offered to the noble Earl, Lord Listowel, on obtaining this debate and pay tribute to his continuous championing not just of the causes of the children we are talking about, but particularly of the staff who have the responsibility of looking after them. I also thank Edward Scott in the Library for producing, as is so often the case, such a comprehensive briefing for us. I want to talk not so much about the particulars of this subject, but rather more generally around the service of looked-after children. Like other noble Lords, I shall quote some of my own experiences as justification for making suggestions.

When I took over as the Chief Inspector of Prisons in 1995, my first experience was that of inspecting Holloway prison, where I discovered that four 15 year-olds were somewhere in the establishment who the governor knew nothing about. When we found them, it turned out that all four had been in care. Immediately I went to see the then Chief Inspector of Social Services, my noble friend Lord Laming. We decided that we had to have some form of partnership so that whenever I went to inspect anywhere where children were incarcerated, I would have a social services inspector with me. My noble friend ensured that an inspector would be available. During the first inspection we carried out of an establishment holding children, the social services inspector and I found all sorts of horrors which should not have been happening, not least that the Prison Service was claiming Crown immunity from the Children Act 1989; in other words, the status of children was not being officially recognised. We fought against that, even threatening to take the Secretary of State to judicial review. Eventually it was overruled.

It was symptomatic of the way children were being treated. We were also shocked to find that 55% of young offenders had experience of care and, as others have said, many of them had been in care either for their whole lives or in excess of two years. Most disturbing of all was the frequency of change of location, foster parents and social workers. The result was that we agreed that it would be sensible for the different inspectorates to come together and produce a joint inspection to which we would all contribute since we were all dealing with a particular aspect of safeguarding children. The first joint inspectors’ report was published in October 2002, and I shall quote two paragraphs from it. Paragraph 4.18 states that,

“some young people in care have reported in the past that they had had five or six social workers over the past year, and so had lost confidence in social workers and looked for continuity and consistency of planning to the chairperson of their reviews”.

That is absolutely the wrong way of going about it. Further on in the report, paragraph 4.41 states:

“Staff from many agencies emphasised the importance of regular supervision. They saw it as a key element in maintaining quality and therefore safeguarding children. They reported that frequency and quality of supervision could vary. The quality of supervision was strongest within the probation service where it was backed up with regular appraisal”.

Before taking part in the debate I checked to see whether that last sentence was still the case. Sadly, it is not, because of what has happened to the probation service in recent years. I would ask the Minister to take note of that, because next week we are to start work again on the Crime and Courts Bill, and we will focus on the importance of having a viable probation service, which makes a very important link to some of these looked-after children.

What are we doing about this? I will tell the House a little bit about where we are getting with an organisation called the Secure Foundation—formerly the Young Offenders Academy—which is an attempt to produce a different type of looking after children who come into the hands of the criminal justice system and the state. It is a combination of the Foyer Federation’s accommodation for homeless children, custody for those who are the bottom end of the criminal spectrum, and looking after those serving community sentences, who are on the cusp between the two. The idea is to set up one site within a one-mile radius by public transport so that people are available, and give these children activities, education, work and substance abuse treatment, of course, but also other activities linked to the local area.

The key thing that came out of the advisory board that looked at all this, which included social workers, local government and other people, was that it is essential that there should be long-term contact with a responsible adult. That is why people should not be moved. This project is now called the Secure Foundation because the emphasis is on the security of young people, and it is currently being targeted in Haringey following the riots. Thankfully, the Mayor of London is co-operating with a number of organisations which have produced money for a pilot. It is interesting that this focusing also includes the problem of the children in care, who of course will qualify for attending such an academy, where they will have that long-term contact with people who can help them.

I am chairman of the All-Party Group on Speech and Language Difficulties, which has been conducting an inquiry into the link between social disadvantage and speech, language and communication needs. I pay tribute to the Minister because his interest in this subject is recognised and hugely appreciated by all those working in the area. We have come up with some very disturbing facts and figures that show that children with high IQs from poor backgrounds—I do not mean poor financially but in terms of care—are overtaken at the age of five and a half by children with low IQs from good backgrounds. This is not acceptable.

I am very encouraged that the Department of Health and the Department for Education are developing pathways for regular assessment of children linked to remedial treatment to enable them all to engage with education at the age of seven, and go on through the system. I am aware that there is a lot of work going on with those with special educational needs and disabilities, but we must not forget the ones with difficulties, and who do we find coming out as the most victimised in all the disadvantage that we see? It is children in care. As they are the state’s responsibility, this should not be.

My final two points concern oversight and supervision. I was very sad when the office of Chief Inspector of Social Services was abolished in 2005, not because it was failing but as a budgetary measure. Thankfully, this House saved some of the other inspectorates but not that one. I think that the movement of young people to Ofsted and the elderly to the CQC has made social services the poor relation of both, and that there is a link between some of the troubles that have happened and the loss of that inspectorate. I ask the Minister very seriously to investigate bringing back the Social Services Inspectorate so that there really is a champion, as there used to be, to make certain that the consistency of delivery of services, particularly to children in care, can be restored.

Secondly, in the Queen’s Speech it was said that the roles of the Children’s Commissioner and the Children’s Rights Director would be brought together. I understand that that is going to be discussed in the children and families Bill that is to come before this House next year. At the moment the Children’s Rights Director has responsibility for children in care. It is very important that whoever takes over the joint post should have responsibility for all children in the care of the state, whether in care or custody or wherever. The key word that must be in all their care is consistency. The chances are that if someone is overseeing the result of the neglect that happens in care when children come into custody, they may be the champion to lead us out of this.

Finally, I cannot help citing an experience in 1812—I was not there myself—when my regiment was marching to inevitable disaster at Walcheren. The people whom my regiment was relieving called out, “Bad luck, boys—you, too, are being made the sport of theory”. I hope to goodness that theory can end and fact can drive forward the treatment of these children.

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.

Education: Special Educational Needs

Lord Ramsbotham Excerpts

Monday 25th June 2012 Lords Chamber

[Lord Hill of Oareford]

That takes us a little away from autism, and it is the case that we need to think about the particular help that we put in place to help children with special educational needs and learning disabilities all the way up to the age of 25. I would not like to lose sight of that, as that is what lies behind the Question.

As for the university technical colleges, the Government have increased the number significantly. We have a number now going forward. We inherited one from the previous Labour Government, and I have been happy to build on that. Now, some 34 have been approved and are moving towards opening.

[Lord Ramsbotham]

My Lords, can the Minister confirm that support will also be given to those with special educational needs who are in the hands of the criminal justice system?

[Lord Hill of Oareford]

Yes, my Lords. I know that that is a subject that the noble Lord, Lord Ramsbotham, feels very strongly about. He and I have had the chance to discuss that issue, and we need to do what we can to address those needs. It is obviously the case that special educational needs and behavioural issues often lie behind the reason why those young people are in those institutions in the first place.

Schools: Nutrition

Lord Ramsbotham Excerpts

Wednesday 13th June 2012 Lords Chamber

[Baroness Parminter]

My Lords—

[Lord Ramsbotham]

My Lords—

[Lord Lawson of Blaby]

My Lords—

--- Later in debate ---

[Baroness Parminter]

My Lords—

[Lord Ramsbotham]

My Lords—

[Lord Strathclyde]

My Lords, we have not heard from a Liberal Democrat on this Question. We will hear from the noble Baroness, Lady Parminter, and then from the Cross Benches.

--- Later in debate ---

[Lord Ramsbotham]

My Lords, I declare an interest as the vice-chairman of the Institute for Food, Brain and Behaviour which is currently conducting work in a school in Dagenham replicating work that in young offender institutions reduced the offending rate by 40%. Will the Minister agree to invite the scientists from the Oxford Department of Physiology, Anatomy and Genetics who are conducting this work to talk to his officials about what lessons are learnt from this very important trial which has implications for behaviour as well as for nutrition?

[Lord Hill of Oareford]

My Lords, I am very grateful for the suggestion. Yes, of course.

UN Convention on the Rights of the Child

Lord Ramsbotham Excerpts

Thursday 22nd March 2012 Lords Chamber

[Lord Ramsbotham]

My Lords, can the Minister confirm whether the instructions from the Cabinet Office will also include impact assessments in the post-legislative study of the impact of Bills such as the Legal Aid, Sentencing and Punishment of Offenders Bill, which has been going through this House?

[Lord Hill of Oareford]

I will need to check to find out precisely what areas that guidance covers. When I have an answer, I will reply to the noble Lord and tell him what I am able to.

Citizenship Education

Lord Ramsbotham Excerpts

Tuesday 14th February 2012 Lords Chamber

[Lord Hill of Oareford]

I agree with the noble Baroness, Lady Massey, that there is an overlap between the two, particularly at primary level. On where we have got to with our review, I know that she is keen for us to get to the sticking point. However, because of our need to take into account the report from the expert panel, the timescale for responding has moved back a little and we need to dovetail the PSHE review with the overall national curriculum review. We will bring that forward in due course.

[Lord Ramsbotham]

My Lords, what steps are being taken to increase citizenship education in young offender institutions and other places where children are held in custody?

[Lord Hill of Oareford]

On the specific details of what is happening in institutions—I recognise the noble Lord’s concern about that, and I agree with him on the importance of this in prisons and young offenders institutions—if I may, I will follow this up with my colleagues to see if I can help him with some more specific information about those programmes.

Education Bill

Lord Ramsbotham Excerpts

Tuesday 18th October 2011 Lords Chamber

[Lord Peston]

My Lords, we are all indebted to the noble Lord, Lord Northbourne, for raising the subject today, as on many other days previously in my years here. He is indefatigable in his determination to remind us of the importance of young children and of the family in providing the relevant context.

I was going to say that we are all parents but looking at the grey hair around this House, I am obviously talking overwhelmingly to grandparents rather than parents. However, thinking back to when we were young parents, there would be no disagreement that our duty was overwhelmingly to our children. I am not opposed to parental education; quite the contrary—the more the better. I certainly did not have any but my wife and I had no doubt whatever that when we got married we would have children and that, of course, the children were our responsibility. We devoted our lives to them. They are now very grown up but occasionally the phone rings and one will ask, “Is mum there?”, meaning that he has a problem of the sort that he used to have when he was three years old.

There is nothing between us on what we are focusing on. The question is: what contribution we can make in the context of this Bill, which will become an Act of Parliament? I am not too happy at the negativism I have heard from one or two noble Lords on this.

I say to myself, “Why should we not put our aspirations in the Bill?”. Would it not be useful for your Lordships—people of experience and distinction—to send out the message that the noble Lord, Lord Northbourne, wishes us to send? I believe very strongly that the answer to that question is yes. I see nothing in our unwritten constitution that says aspirations must never be placed in an Act of Parliament. Indeed, I would go further: I feel those of us in this House would be failing in our duties if we did not insist that proper recognition was made of our aspirations. I am therefore in agreement with the noble Lord, Lord Northbourne, that this should be in the Bill.

I also think that, in terms of making policy, there is a genuine problem sometimes in not having all the relevant information we might need. This is not the last Bill that will ever be presented to your Lordships’ House on education, nor the last to be presented that will deal with the subject of children. It would be jolly good if we were able to speak with a full factual basis behind us. That is why I would particularly hope that the Minister would look at Amendment 3—also tabled by the noble Lord, Lord Northbourne—with the intention of giving us a database for future policy-making in due course.

I conclude as I began: it would be a very valuable thing for this House of older men and women to send out a message to the world that we really do think this is of central importance, and we aspire to do something about it.

[Lord Ramsbotham]

My Lords, like other noble Lords, I should like to pay tribute to my noble friend Lord Northbourne for his absolutely indefatigable championing of early years provision, which is the context of the amendment. I also agree with my noble friend Lady Howe about the importance of assessment, and echo the words of the noble Lord, Lord Eden, about communication. While I am commending, I also commend the Minister for the way that he has communicated with us all throughout this Bill, by writing to us, informing us and keeping us in the picture. That is very much appreciated.

I have to say to the Minister that, in saying what I am going to say, I end up with a question, which is a question born out of disappointment, from over a number of years, in failing to achieve what I know many noble Lords in this House want. In coming to this particular description, I was interested in the report and summary of evidence released in July by the All-Party Parliamentary Group for Education. I would like to quote certain passages from the all-party group’s reports, which I think are important, especially in connection with the amendment of the noble Lord, Lord Northbourne.

First, the all-party group states that all respondents to the inquiry,

“were of the opinion that early intervention is essential and that recommendations or statutory guidance should be provided to health authorities to prompt earlier intervention”.

I say that because I will conclude with health. Of all the different interventions, I have always felt that one of the most important is that of speech and language therapists, who enable children to communicate with their teachers when they start school. Without that, the pupils cannot engage. When we are talking about education, we are also discussing why people cannot engage. This point has been made over and over again, without success.

As has been said many times,

“It is vital that assessments and interventions are tailored to the specific needs of pupils”.

The point about such interventions is that they should identify specific needs, including difficulties and disabilities such as problems with hearing, sight and so on. This interests me because I have tried to get this introduced before, after I carried out an experiment in young offender institutions with children aged 15 and upwards. That experiment proved that, had those children had that intervention earlier, they might not have arrived at the institution—by and large, their journey until then had been one of failure, not least failure in education. I saw this represented and repeated by children on intensive supervision orders in Leeds, which proved exactly the same thing. The report by Mr John Bercow, as he then was, into the whole question of learning difficulties and how they were not being tackled, highlighted the same problem.

However, when I put up the suggestion that there should be speech and language therapists in every young offender institution to establish what was preventing people making progress, the whole issue ended up with money. The Ministry of Justice was unable to fund speech and language therapists because they came from the Department of Health. Similarly, when I put up exactly the same proposal in earlier education Bills, the same answer has come: it is the Department of Health's responsibility to provide these people.

Education Bill

Lord Ramsbotham Excerpts

Thursday 30th June 2011 Grand Committee

[Lord Quirk]

My Lords, I support Amendments 34 and 35. I do so having in mind particularly children who are speech defective and suffer from various communication needs where the continual and continuous support by speech therapists and others is vital. There is only a small window of opportunity, to coin a phrase, in which you can address speech pathological problems. All exclusions are a tragedy, but they are an especial tragedy for someone for whom a continuous supply of special education is required as, for example, in speech pathology.

The amendment of the noble Lord, Lord Rix, which was introduced by the noble Baroness, Lady Walmsley, talks about behavioural needs. I hope that it is understood that this goes very much further to the conditions underlying the behavioural needs in question.

[Lord Ramsbotham]

My Lords, I entirely endorse what my noble friend Lord Quirk just said about those with communication difficulties. Like a number of other failings in health and education, I have been alerted to a particular problem by the numbers suffering from it in custody, such as those with the communication difficulties that we have just been hearing about. Some 48 per cent of young offenders suffer from attention deficit hyperactivity disorder, commonly known as ADHD.

I have spoken already about the concentration in this Bill on who should be assessed and the lack of detail on what should be assessed. In the opening amendment, my noble friend Lord Northbourne talked about a child's healthy, social, emotional and cognitive readiness to enter school. The noble Baroness, Lady Perry, questioned the responsibility for preparation being passed to local government. I agreed with that in one particular respect—the word “consistency”. If you delegate responsibilities, they will inevitably be given different priorities, which leads to what are known as postcode lotteries. There must be no postcode lottery in ensuring that our children—all our children—are as ready as possible to enter school, which means that possible preventable problems have been identified and amelioration plans made.

I spoke to Amendment 1 to suggest that every child’s communication skills should be assessed, not just to identify learning disabilities and special educational needs, but also difficulties that do not qualify for either definition. The problem with ADHD is that it is another one that does not qualify for definition either as a learning disability, a disability or a special educational need. It is not mentioned in any of the other amendments in this group although it is hinted at in Amendment 42 about which the noble Lord, Lord Touhig, has just spoken.

ADHD is a common behavioural disorder affecting school-age children. But it is also a clinically distinct neurobiological condition that is caused by an imbalance of chemicals affecting specific parts of the brain responsible for behaviour. If you look at the figures, 3.62 per cent of all boys and 0.85 per cent of all girls aged between five and 15 suffer from ADHD, 90 per cent of whom will underachieve academically at school. Children with ADHD are more than 100 times at greater risk of being excluded than other children and up to two thirds of those who are diagnosed with ADHD will continue to experience symptoms into adulthood.

It is not always generally understood what these symptoms might be, and in looking for them the clearest I could find was in A Parent’s Guide to ADHD in Children published in 1997, which said that:

“Children with ADHD often act without thinking, can be hyperactive, and may have trouble focusing. ADHD can affect all aspects of a person's life, extending far beyond poor behaviour or problems at school. The symptoms can have a significant impact on family life, relationships with friends, school discipline and society as a whole.

In other words, it is not something to be taken lightly or wantonly.

Although the youth crime action plan in 2008 identified ADHD as one of the main risk factors in criminal offending during childhood, ADHD struggles for recognition within the current educational system. The term is not listed in the Special Educational Needs and Disability Act. It is not listed in the Disability Discrimination Act, the SEN Code of Practice, or the Disability Discrimination Act 1995 Code of Practice. It is not mentioned in the 2005 report on improving behaviour by the Practitioners’ Group on School Behaviour and Discipline led by Sir Alan Steer. It is mentioned only in the section entitled removal of pupils on medical grounds in the 2008 government guidance on exclusion, Improving Behaviour and Attendance: Guidance on Exclusion from Schools and Pupil Referral Units. The only mention under that is pretty bare. It does not include any direction regarding the next steps for school staff to adhere to in order to make correct, informed decisions on exclusion.

ADHD is not mentioned in Support and Aspiration: A New Approach to Special Educational Needs and Disability published in March this year, so does not qualify for education and health and care plans from birth to 25.

A specialist consultant using standard criteria and rating scales can diagnose ADHD in school-age children, but the majority of adolescent psychiatrists and paediatricians believe that it is currently underdiagnosed in the United Kingdom. Sadly, once it is diagnosed there is no quick fix. The condition is manageable with a combination of regimes that include behaviour management, cognitive therapies and medication.

According to NICE, ADHD is associated with significant financial and emotional cost to the healthcare system, education services, families, carers and society as a whole, quite apart from the basic financial cost of £4,000 a year to teach a child in mainstream and £15,000 a year in a pupil referral unit. Carrying on with this problem, two thirds of parents of children with ADHD who had been in contact with teachers found that the perceived competence by teachers in the management of ADHD was at best variable. A very large number of specialists feel that teachers are not aware of ADHD and do not therefore realise what the symptoms are or that people showing those symptoms should be referred to someone as quickly as possible. We come down to the fact that, at present, ADHD is usually identified only after the second exclusion for bad behaviour. The youngest excludee whom I came across in prison was a boy who had been excluded from his playgroup at the age of four and never allowed to attend any form of education thereafter. It was small wonder that I found him Young Offender Institution Dover—and that was down to ADHD.

What should we do? We have already brought out the fact that a large number of ministries are involved in taking action to ensure that every child is ready for school. I have already quoted a number of Ministers who are involved in different aspects of ADHD. I ask the Minister to agree to undertake not only to consider my amendment, which has a specific recommendation about action following a second exclusion and is what is happening now and should be enshrined—but to start thinking seriously about those who are at risk of exclusion as a result of ADHD by raising its profile on the political and healthcare agendas to ensure better futures for children with this condition.

If we were to go on to debate the subject, I would talk about the effects of nutrition, because it has such a huge effect on the brain and is such a powerful contributor to the condition and its treatment. However, this is not the time or the place for that. However, confident in the hope that the Minister will accept my plea and its logic, I am sure that all that can come out in the consideration that will, I hope, follow.

[Lord Storey]

My Lords, I agree with the noble Lord, Lord Quirk, that any exclusion is a tragedy for that pupil and for the school itself. That is not to say that there are not occasions when pupils have to be excluded. Children have a right to learn and teachers have a right to teach. We must always remember that. However, in my experience—and the noble Lord’s point is important here—children with learning difficulties, and with social, emotional and behavioural difficulties, are more likely to be excluded than any other group of children. If we can sort out those issues at school, and more importantly if we have the resources to do that, the likelihood of exclusion is considerably reduced.

I do not think that any pupil wants to be excluded from school. I repeat again that it is a tragedy for that pupil and that family. If we can identify issues early on and sort them out at school, and if we have the resources to do that, the problem of school exclusions becomes considerably reduced. However, when there are exclusions—I am looking at Amendment 43—it is important that the mechanisms of exclusion are properly conducted, that the families can make representations on the proposal to exclude, and that there is an opportunity for them to appeal against that exclusion. There are often certain circumstances, and my experience is that schools and head teachers do not want to exclude. It is the final avenue that they have to go down, and if any reasons come out on appeal, it is not an admission of failure by the school or its leadership. They are more than happy to understand those reasons and to reconsider the situation. Finally, we must make that process transparent. We must make the language we use and the way we carry out the process as simple, clear and concise as possible.