Speech, Language and Communication Support for Children

Emma Lewell-Buck Excerpts

Wednesday 4th July 2018 Westminster Hall

[Mrs Emma Lewell-Buck (South Shields) (Lab)]

It is a pleasure to serve under your chairmanship, Ms Dorries. I thank the hon. Member for Taunton Deane (Rebecca Pow) for securing today’s debate, 10 years on from the Bercow report, on this important topic. I pay tribute to Mr Speaker, I CAN and the Royal College of Speech and Language Therapists for their groundbreaking work in this area, and to all hon. Members who have spoken today.

Many of us take communication for granted, but imagine being unable to express how you feel, what you think and what you need. My hon. Friend the Member for Birmingham, Edgbaston (Preet Kaur Gill) described that scenario eloquently. The effects can be debilitating and can last throughout childhood and adolescence and well into adulthood if someone is left unsupported. I know myself how frustrating that can be. Growing up with dyspraxia—being different and standing out—caused me to have chronic low self-esteem and to isolate myself from my peers. Of course, I did all right in the end —I ended up in this place—but that is because I got lucky and have had the benefit of being surrounded, then and now, by some phenomenal people. For the 1.4 million children who struggle with speech, language and communication needs, it is vital that the right support is there when they need it, but it is often lacking. Our children are being let down to the degree that, at present, six children in every classroom do not meet the expected levels of communication and language skills at age five.

Children with speech, language and communication difficulties can access speech therapy and support via a number of avenues, including their health visitor, GP or school, but the Government have presided over a decline of more than 2,000 health visitors in the past two years. Fewer GPs are in place than in 2015, and our schools are facing the first real-terms funding cuts in 20 years—more than £2 billion is being cut from their budgets. It is little wonder, then, that the “Bercow: Ten Years On” report highlighted that 73% of parents and carers found it difficult to get help with their child’s speech, language and communication needs, and 52% thought their family’s experience of speech, language and communication support was poor.

As my hon. Friend the Member for Stoke-on-Trent Central (Gareth Snell) said, the original Bercow report called for early intervention that prioritises speech, language and communication therapy in Sure Start children’s centres, 500 of which the Government have closed. The report called for the workforce to be strengthened, but senior and specialist language posts are being lost due to a restructuring of NHS speech and language therapy services. It called for the primary and secondary curriculum to emphasise speech and language communication. Instead, speaking and listening has been removed from the national curriculum, the judgment of communication has been removed from the Ofsted framework and there is no assessment of spoken language in the curriculum after the age of five. Some 49% of early years practitioners receive little or no initial training in typical speech, language and communication development.

The Communication Trust—a large consortium of speech and language and communications skills charities—saw demand for its services increase by 33% last year, but in March this year the Department for Education told us that its contract would be ending. The tender to replace it has no mention at all of speech, language and communication. The “Bercow: Ten Years On” report highlighted that only 15% of survey respondents said that speech and language therapy was available as required in their local area. It is little wonder that, last year, only 234,076 children with speech, language and communication needs actually received any support.

The pattern of Government neglect is more apparent when children have needs in addition to speech and language difficulties, or get support via education and healthcare plans. The hash the Government have made of those plans is well documented. They were supposed to encourage joined-up planning between healthcare professionals and schools, but in reality that is not happening. It is often said that health is missing from the plans. At least 65,000 children were not moved on to the new plans by the Government’s deadline of March this year. A damning report by the local government and social care ombudsman, which looked at a large sample of plans, found many flaws in their execution.

A report by the Royal College of Speech and Language Therapists noted that children without plans are being left completely without support. Just 40% of respondents said that they have the capacity to deliver services to children without a plan, and 43% said that speech and language therapy is not being commissioned for the crucial age group of nought to two, or for people aged 18 to 25 who are preparing for work or further education.

The Bercow report revealed that more than half of parents and carers had to wait longer than six months for their child to get the help they needed. Six months is a long time in a child’s developmental cycle. My six-year-old constituent, Penny Whyte, has a speech disorder and has been receiving blocks of speech therapy since the age of three, but she has to wait an average of nine months between blocks. She was also referred to intensive therapy, but has had to wait three years for a place. Imagine being Penny’s mam, Donna, who knows that her little girl is just as bright and capable—perhaps more so—than everyone else, but she is falling behind her peers. Her true potential is masked because the support she needs is being withheld by a fragmented system that cares more about marketisation and the profit that can be gleaned from health and education services than about their delivery.

The Government talk a good game when it comes to social mobility, but the reality is different. In areas of social disadvantage, 50% of children start school with delayed language and communication skills. Children eligible for free school meals are 2.3 times more likely than their peers to have language difficulties. Only 51% of those pupils achieve a good level of development at the end of their early years foundation stage, compared with 69% of their peers. Children with special educational needs or disability remain stubbornly over-represented in alternative provision and exclusion figures. Three quarters of pupils in pupil referral units have special educational needs. Last year alone, more than 4,000 were left without a school place. Some are subject to informal exclusions, and some are being home-schooled. The fact is that the Government have not bothered to keep track of those children, so we do not know where they are and what support, if any, they are getting.

I want to give a shout out, if you will permit me, Ms Dorries, to some of the non-verbal children I worked with in the past, who are now adults. They taught me the power of communication, which is so much more than words. It can be a smile, a sparkle in the eye, a nod of the head, a hand movement, a laugh or a cry. What they all had in common is that, once they had the right support and were able to use words, they were like different children. One boy I remember in particular transformed from being stoic and withdrawn into being a massive chatterbox—the life and soul of his classroom. That is the power of consistent and sustained speech and language therapy. That power is in the gift of the Minister and the Government.

The Prime Minister said months ago that she would respond formally to the report. She has not done so. The Minister said a few weeks ago in Education questions that he was looking closely at the recommendations. I have not asked the Minister any questions today, because I simply want him to respond to my comments, those of my hon. Friends, and the report’s findings and recommendations. The children struggling to get by, my constituent Penny Whyte and my younger self at least deserve that.

[The Parliamentary Under-Secretary of State for Education (Nadhim Zahawi)]

It is a pleasure to serve under your chairmanship, Ms Dorries.

The hon. Member for South Shields (Mrs Lewell-Buck) started well by asking us to imagine what it would feel like to be unable to communicate or explain one’s own feelings, and the hon. Member for Birmingham, Edgbaston (Preet Kaur Gill) said the same thing. I do not need to imagine that, because I was that child. I came to this country with my parents as immigrants in 1978 at the age of 11, and I could not speak English. I sat at the back of the class. Initially, my teachers thought I had learning difficulties, but within six months I had picked up the language. I guess I am the embodiment of what speech, language and communication skills can do for a young child immigrant in this country who cannot speak the language properly.

I feel, however, that the hon. Member for South Shields let herself down by politicising this debate—we have had a good debate today—and attempting to weaponise it, whereas the hon. Member for Stoke-on-Trent Central (Gareth Snell), and his colleague the hon. Member for Stoke-on-Trent North (Ruth Smeeth) in an intervention, spoke eloquently about the work being done by Stoke Speaks Out and in the opportunity area. I must say to both hon. Members that the opportunity areas are the best infrastructure I have seen, of any Government intervention, and have a real chance of working for those disadvantaged communities because they are bottom-up, with real, measurable targets and outcomes. My ambition is to ensure that we meet those targets over three years so that I can make the argument that we should keep supporting opportunity areas.

I congratulate my hon. Friend the Member for Taunton Deane (Rebecca Pow) on securing this important debate, and I am grateful for this opportunity to set out the Government’s position on supporting children and young people with special educational needs and disabilities, including those with speech, language and communication needs. I am determined to see children and young people with SLCN receive the support they need to achieve in school and in independent life.

I was pleased to be able to speak at the launch of “Bercow: Ten Years On”, and I am grateful for the work that the Royal College of Speech and Language Therapists, I CAN and, of course, Mr Speaker himself have done. It was a good coming together of all the specialists, and I put it on the record that the Government will respond formally to the report in due course. I have recently accepted an invitation from the all-party parliamentary group on speech and language difficulties to discuss how we can work together to best support children and young people with SLCN. I hope hon. Members here, and others, will join me in attending the seminar.

Our latest figures show that SLCN is the second commonest need for pupils with an educational health and care plan, with 14.3% of pupils having that need. It is also the second commonest need for those with special educational needs support, at 22%. I know that the “Bercow: Ten Years On” review reports that there is a poor understanding of SLCN and insufficient resourcing for the sector, and many colleagues have talked about that. Of course, that is neither my nor the Government’s expectation. I expect children and young people with SLCN to receive the support they need to help them fulfil their aspirations alongside their peers, and we are taking action to make that a reality.

A lot of progress has been made over the 10 years since the original Bercow review was carried out. The Government have introduced, through the Children and Families Act 2014, the biggest change to the system in a generation. The reforms are about improving the support that is available to all children and young people with SEND. We are doing that by joining up services for ages nought to 25 across education, health and social care, and by focusing on positive outcomes in education, employment, housing, health and community participation. The move to a more child-centred, multi-agency and participative education, health and care needs assessment is improving the support that is available to children and young people with SEND, including those with SLCN.

As of 31 March, over 236,000 children and young people had had their statement of SEN converted to an EHC plan, which equates to 98.4%. That is great news, but we know there is much more to do. The completion of the statutory transition period to the new system is a great achievement, but it is not the end point for the reforms. We are only part of the way to achieving our vision. The biggest issue we now have to address is changing the culture in local government, clinical commissioning groups and education settings.

[Mrs Lewell-Buck]

Will the Minister give way?

[Nadhim Zahawi]

I am short of time and I have a lot to say about this subject, so the hon. Lady will forgive me if I do not.

Supporting schools to respond to the needs of all their pupils is crucial to achieving our ultimate goal of culture change. We know that spoken language underpins the development of reading and writing, and that the quality and variety of language that pupils hear and speak is vital for developing their vocabulary, grammar, reading and writing. The national curriculum for English, which colleagues mentioned in their comments, reflects the importance of spoken language in pupils’ development across the whole curriculum. At primary level, children should be taught to ask relevant questions, to articulate and justify answers, arguments and opinions, to participate in collaborative conversation, to use spoken language to develop understanding and to speak audibly and fluently, with an increasing command of English. Teachers should ensure the continual development of pupils’ confidence and competence in spoken language and listening skills.

Having developed those resources and many others relating to other specific impairments, we are now taking a more strategic approach to better supporting the educational workforce and equipping them to deliver high-quality teaching across all types of SEN. We have recently contracted with the Whole School SEND Consortium to enable schools to identify and meet their SEND training needs, and I am delighted that the Communication Trust is part of that consortium.

Through that work, the Whole School SEND Consortium will create regional hubs across the country to bring together local SEND practitioners. The hubs will work to encourage schools to prioritise SEND within their continuous professional development and school improvement plans. The resources provide leaders, teachers and practitioners with access to information about evidence-based practice that can be effective for SEN support, including for those with SLCN.

In terms of joint work and joint commissioning at local authority level, the duty to commission services jointly is vital to the success of the SEND reforms. We recognise that unless education, health and social care partners work together, we will not see that holistic approach to a child’s progression or the positive outcomes that the system aims to achieve. Joint working is one of the best ways of managing pressures on local authority and NHS budgets. Looking for more efficient ways to work together, to share information and to avoid duplication will work in favour of professionals and families.

Some areas are demonstrating excellent joint working. Wiltshire is an example, with positive feedback on the effectiveness of its local joint commissioning arrangements. It was reported that senior officers across education, health and care worked together effectively, adopting a well-integrated and multi-agency approach to plan and deliver services to children and young people with SEND. We want to learn from those examples. The hon. Member for Stoke-on-Trent Central mentioned the evidence gathered through Stoke Speaks Out. It troubles me that that particular group of people have to keep reinventing and going back for different pots of money, rather than our looking at that evidence and beginning to scale it for the rest of the country.

[Nadhim Zahawi]

I hear the hon. Lady’s point; I know she is a great champion of the project, and I pledge to her that I will look at this evidence and see what more we can do to ensure that there are consistent outcomes.

The hon. Member for Stoke-on-Trent Central talked about early years education. It is fundamental that we identify SLCN as early as possible, as we know that can have a profound impact later in life. Children who struggle with language at age five are six times less likely to reach the expected level in English at age 11 than children who have good language skills at age five, and 11 times less likely to achieve the expected level in maths. By age three, disadvantaged children are, on average, already almost a full year and a half behind their more affluent peers in their early language development. That is also why, from a social mobility perspective, the case for addressing SLCN in the early years is so important.

In our social mobility action plan, “Unlocking Talent, Fulfilling Potential”, we announced our ambition to close the word gap in the early years between disadvantaged children and their peers.

[Mrs Lewell-Buck]

Will the Minister give way?

[Nadhim Zahawi]

I will make some progress and then, as I think we might be all right on time, I will give way.

We have announced a range of measures worth more than £100 million to address word gap, including £20 million for school-led professional development for early years practitioners to support early language development, and a £5 million “what works” fund in partnership with the Education Endowment Foundation. The evidence is clear that parents have a crucial role in this area. The “Study of Early Education and Development” report showed that, aside from maternal education, the home learning environment is the single biggest influence on a child’s vocabulary at age three. We will therefore invest £5 million to trial evidence-based home learning environment programmes in the north of England.

On 1 July, we launched a £6.5 million fund and invited voluntary and community sector organisations to bid for grants to run projects that help disadvantaged families and children with additional needs, and improve children’s early language and literacy skills. Local authorities sit at the centre of a wide range of services and workforces that make a big difference to SLCN. We will work with local authorities through a peer support and challenge programme to deliver better early language outcomes for disadvantaged children, learning from the best evidence so that we can scale it. We will also publish an early years dashboard showing local authorities’ performance in early years outcomes, with a focus on disadvantaged children and early language and literacy.

We recognise the important links between a child’s early health and development and their later education outcomes. That is why we have formed a partnership with Public Health England, which my hon. Friend the Member for Taunton Deane mentioned, and the Department of Health and Social Care to improve early language outcomes for disadvantaged children. In May, Public Health England launched a call for good local practice and pathway examples. At a workshop in London today, it will set out the key components of a model speech, language and communication needs pathway built on the best evidence and experience of implementation in practice. Those resources will provide health visitors with additional tools and training to identify and support children’s SLCN, and ensure that the right support is put in place early.

Let me turn to the mental health Green Paper. Mental health was another key feature of the “Bercow: Ten Years On” report, which highlighted the links between SLCN and mental health issues and made a number of recommendations about how the proposals in the Green Paper link with SLCN provision. The Government published the Green Paper, “Transforming Children and Young People’s Mental Health Provision”, on 4 December last year. The consultation closed on 2 March and we are currently considering responses. We will issue a formal response in due course.

The Green Paper creates clear expectations about the changes every area should seek in order to improve activity on prevention, partnership working between children and young people’s mental health services and schools, and access to specialist support. As part of that, we are incentivising every school and college to train a designated senior lead for mental health to co-ordinate a whole-school approach to mental health and wellbeing. We expect the designated senior lead to liaise with speech and language therapists to ensure that children with SLCN receive the help they need.

[Mrs Lewell-Buck]

I thank the Minister for eventually giving way. He said that I had let myself down by making this issue political. I respectfully say that he is letting me and other hon. Members down. I listed a litany of failures by this Government towards children with speech, language and communication needs, and not once—

[Ms Nadine Dorries (in the Chair)]

Order. Mrs Lewell-Buck, please make an intervention, not a speech.

[Mrs Lewell-Buck]

Sorry. Not once has the Minister responded with anything practical. All he says is, “In the future we will”. What about now? This is urgent.

[Ms Nadine Dorries (in the Chair)]

I call the Minister. Please remember to leave a minute for Ms Pow to wind up the debate.