Speech and Language Therapy

Caroline Johnson Excerpts

Monday 27th January 2025 Westminster Hall

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

It is a pleasure to serve under your chairmanship today, Mr Vickers. I congratulate the hon. Member for Lichfield (Dave Robertson) on his introduction to today’s debate. I also particularly congratulate Mikey Akers, who I understand introduced this petition, for the work that he has done in raising awareness of verbal apraxia—work that will no doubt help people right across the country. I know that he has been working with my hon. Friend the Member for Meriden and Solihull East (Saqib Bhatti) on this issue too, and no doubt that will also be helping people. I also welcome Chris Kamara to the Gallery. He is doing great work on raising awareness too. The more awareness we raise, the better it will be for everybody, and the easier it will be for people to be treated for the conditions they have.

As we have heard today, speech and language therapists have a wide range of skills for people of all ages. The issue is much bigger than speech itself. It also includes swallowing, from newborns with developmental delay to the elderly, who may be struggling to swallow after a stroke. It is about communication, feeding issues, and specific sound delays—a stammer. Speech and language therapists are involved in a huge amount of work.

I have seen in my own family the work that speech and language therapists do, with one child unable to say “s”, and having speech therapy to try and encourage her to do so—one of her younger siblings, having spent much time attending these appointments, consequently learned to say “s” about 18 months earlier than she was supposed to.

I also had a child with a stammer who was treated successfully. I learned from that that the whole family needs to be involved in treating the child, and I am grateful for the support that I got from the NHS speech and language therapists for my family. When I went along, particularly with the child with the stammer, I learned that the parent, and indeed the whole family, had to play games every day. I had to learn to play with my child without asking her any questions, which is a lot harder than it looks.

I learned about the importance of sleep and that early therapy is better. I remember the speech and language therapist likening the condition to a record getting stuck in a groove on a record player. If someone got stuck in a particular groove, the more times the disc went round the deeper it got and the harder it was to jump out, so it is important to ensure that speech and language therapy is instituted as early as possible to make it easier to treat the patient.

I want to ask the Minister about parent resources. If early is better, special guidance on aspects of treatment and management even before the patient sees a speech and language therapist would be helpful. I saw that Hereford and Worcestershire health and care NHS trust had some very good online resources for parents and what they can do to help their child with a speech or language condition.

The priority of reducing overall waiting times for community services was reflected in NHS England’s operational planning guidance for 2024-25. Local systems across England were asked to develop the comprehensive plan by June 2024 to reduce the overall waiting times for community services, including reducing waits over 52 weeks for children’s community services. The waiting lists have reduced from roughly 76,000 last July to 63,000 at the end of last year, which is still too long. Will the Government focus on trying to reduce the waiting lists still further? And does the Minister have a target in mind for next year to see how far he would consider it successful to have reduced those waiting lists?

What is also clear and has been reflected in many hon. Members’ speeches is that the demand for speech and language therapy has gone up. According to Department for Education data, in 2023-24 370,000 pupils had a speech, language and communication need in England—an increase of over 64%, from 225,000 in 2015-16. That is not related to an overall increase in the number of school-age children, so why is that the case?

One could perhaps consider that more people are aware of the conditions, thanks to active campaigns. That is a good thing because people are getting referred earlier and treated earlier. But it also would appear that the number of children affected by speech and language conditions has gone up. The Minister and his Government have talked a lot about prevention being better than cure, and I agree with that. So what work has he done to look at the causes of the rise in speech and language difficulties?

As I was researching causes, I came across the issue of screen time. What is the effect of screen time? It reduces imagination, peer-to-peer speaking and verbal problem solving. It is also a solitary rather than truly social activity. We know that children are spending more and more of their time online, particularly young children. Families are smaller. Does that mean that people have less time to interact with other children? We have an increase in the number of bilingual children. Although that in itself does not cause speech and language problems, it can cause temporary language mixing at younger ages, and in some cases slower vocabulary acquisition in early years. What is the Minister doing to find the cause of the rapid increase in the number of children with speech and language difficulties so that we can prevent them rather than waiting for them to occur and then treating them?

I also want to talk about the Nuffield Early Language Intervention, known as NELI, which was mentioned earlier. It is a teaching assistant-delivered programme that has been accessed by over 11,000 schools since the pandemic. It is known to improve the speech and language communication of the children who go through the programme by three months; the improvement is much greater for more disadvantaged children. Can the Minister commit to continuing to ensure that children have access to the NELI programme?

Pre-election, the Department of Health and Social Care worked with the Department for Education to ensure that young people with special educational needs and disabilities received the right support. The collaboration included working together to implement the SEND and alternative provision improvement plan, published on 2 March 2023. Those two Departments also worked together on SEND workforce planning and established a steering group to oversee the work, with a view to completing it by 2025. Will the Minister provide an update on the steering group’s work and what plans there are to commission research into supply and demand for speech and language therapy?

In 2023 the Department for Education launched the two-year early language and support for every child pathfinder project with NHS England to improve access to speech and language therapy. Funding for that is due to run out this year, so can the Minister confirm whether it will be renewed to allow the project to continue?

The Government are also due to refresh the NHS long-term workforce plan this year. Back in 2023, that plan set out an ambition to increase allied health professional training places by 25% by 2031-32. However, the Royal College of Speech and Language Therapists and others have highlighted that that is likely to cover only speech and language therapists in the NHS workforce, and the Minister also needs to address shortages in educational and criminal justice settings. Can he confirm what work he is doing with his colleagues across Government to ensure that is the case?

Many speeches today have been focused on the social speech and language needs of children, which is understandable, but in the Minister’s wrapping up, will he talk about what work he is doing to support adults with speech and language difficulties or swallowing needs? Finally, we understand from the newspapers that many aspects of care across the NHS are now to be deprioritised, and Ministers are to focus on one specific target. While I would not expect the Minister to comment on any leaks, can he confirm that speech and language therapy will not see a reduction in real-terms resources?