Speech Therapy Services (Children)

Annette Brooke Excerpts

Wednesday 3rd November 2010 Westminster Hall

[Annette Brooke (Mid Dorset and North Poole) (LD)]

It is a pleasure to serve under your chairmanship, Mr Streeter. I apologise that I will have to leave before the end of the debate; one of my constituents has organised a big rally in Old Palace yard for park home owners, and I should be standing alongside the banners that will, inevitably, be there.

I officially start by congratulating the hon. Member for Blackpool North and Cleveleys (Paul Maynard), who spoke elegantly and passionately. He brought the debate alive for us this morning. It is a timely debate because we are at a crossroads; we can look back over the excellent work that came out of the Bercow review, but we are at a point where we need to look forward, learn what we can from the past and take some steps forward. I appreciate the fact that the previous Government commissioned the Bercow report, committed resources—never enough, of course, but the resources were considerable—developed an action plan, appointed a communication champion and designated next year as the national year of speech, language and communication. Those were important steps forward.

As the hon. Gentleman and the hon. Member for North West Durham (Pat Glass) pointed out, there is a spectrum of needs, which is why the matter is complex to debate. At one end, there is high need, low incidence, which needs highly specialised skills and technology, some of which comes in very expensive packages, but what an enormous difference it can make to the quality of life of the child and whole family. I want to touch on the whole family throughout the debate because it is important. At the other end of the spectrum, there are issues that we know can be addressed through simple interventions, which I shall touch on.

It is highly significant that speech, language and communication needs feature in statements of special educational needs for 26.5% of mainstream educated children. How significant the problems are is absolutely staggering. Other Members have dwelt on the fact that if there is a communication problem, a behavioural problem often emerges. That is natural; for a three or four-year-old who cannot express themselves, with adults not responding in the way the child wishes, what else do they do? Inevitably, we will have behavioural problems; and that, of course, identifies the necessity of early intervention. Not intervening early means that problems escalate to widespread exclusions at secondary schools and the concerning percentage of young offenders who have speech and language difficulties. Obviously, we must emphasise that it is not a straight one to one causal relationship, but there is a significant link.

I was interested in the comments by Jean Gross because we are concerned about people thinking, “Oh, the child’s just lazy. There are lots of very clever people who didn’t start to speak until three or four. Do we need early intervention?” I passionately believe that we do. A mother came to me with a boy of four. He could not speak and his behaviour was getting out of control. I suggested that the mother went to the GP to ask for a specialist referral, and the GP came back at me and said, “How dare you tell me how to do my job?” I was rather pleased that I stirred that up. When we talk about training the whole work force in these needs, we need to include health workers, health visitors and GPs, as well as those in education.

I want to be brief, so I shall go over the key issues quickly. I recall that the Bercow report said that provision and joint working is patchy across the country. There were 16 pilots announced in 2009 to look at best practice in working together in health and education. I do not know if there has been a chance to evaluate them, but it is important to look at everything that has been initiated and evaluate it as soon as is timely. We have to learn from all of this, but it is difficult to come up with a national framework because the solutions have to be local.

I am concerned about health provision. We have speech therapists and we have teachers trained by specialist speech therapists, which is good but it must not be a substitute—it is an add-on. Too many authorities are using it as a substitute, but it is not. We must have sufficient qualified speech therapists. I cannot get a grip on what the shortage is. As the Minister is aware, I am always asking parliamentary questions about numbers of specialist workers, but I cannot home in on what the shortage is, and we must have a grasp of what the needs are. I can think of fantastic situations in which specialists trained up pre-school workers, for example, in children’s centres to work with children identified as having language delay. That is good for low-level speech and language problems, but we are not getting a grip on the exact size of the work force needed to address the issues, on how it is all pulled together and on where working together comes forth and provides an add-on. Simply saying, “All we’re doing is perfectly satisfactory,” when it is a substitute, is not good enough.

I emphasise the point the hon. Member for Blackpool North and Cleveleys made about the importance of an individual solution, particularly for a family. A mother who came to see me had six children including five-month-old twins, and one child in the middle had speech and language difficulties. A package was drawn up for her to give an amount of assistance a day. Of course involving parents and carers in the package is important, but, somewhere along the line, the family circumstances have to be taken on board.

Due to time, I shall end there. I endorse all the points made already, and I look to the Minister to focus on getting a grip on how all the services come together to give the best possible start to communication in a child’s life.