Auditory Verbal Therapy

James Frith Excerpts

Tuesday 21st January 2025 Westminster Hall

[Mr James Frith (Bury North) (Lab)]

It is pleasure to speak under your chairmanship, Mr Western. I congratulate my hon. Friend the Member for Washington and Gateshead South (Mrs Hodgson) on securing this important debate and on her contribution to ensuring that this profound therapy is better heard, better known and more available to choose for a great many in our society.

When there is so much to resolve, so much to fix and sort out, it feels like smaller causes struggle to be heard or seen. Our politics seems too busy to care about even more causes; it is all just too much. Alternatively, it can be said that the last Parliament did good things for the deaf community, so to expect new money for new causes is a stretch too far, naive even. We must believe in better. Each Parliament has the opportunity to help the underserved, and there are always issues that, with the right political heat and weight, can be transformed. Such issues have long been on the roll of Government successes, whatever the political weather. Think of the long-standing injustices, new medicines on the NHS, or social equalities we have addressed.

The missions of this Government delivered their enormous parliamentary majority and a mandate to renew, reform and transform. Auditory verbal therapy takes the Government’s vital missions for health, for children, for the smashing of barriers to opportunity, and for growth, and it brings them to life. This cause gives the missions cause to blossom. There may not be a better example of a cause that, for such a fraction of an investment, can be transformational.

I know what we are asking for will not be green-lit today, but I know what we need. Former Health Secretaries I have met have spoken of the “whiteboard moment”, when we get the issue on to the whiteboard. That is the goal. It is the moment when the Minister asks their civil service teams to make something possible—to draft a plan to take us from where we are to where we need to be. It is a pilot, a tester, a starter for 10, where the Government do not just take our word for it, but see for themselves.

Should there be concern among our deaf community, let me say that this is not about undermining the celebrated protected status of British Sign Language. We celebrate BSL as a language—a unique cultural identity—and the last Parliament’s recognition of BSL in law was a landmark achievement. The argument for auditory verbal therapy is an argument for choice—choice for the child, their family and their future—and ensuring that families have the knowledge and support to choose the best path for them. It is not about competing choices, but having access to all of them. The demand is that these families’ cause is heard, and the majority of the country agrees. In a recent YouGov poll, 85% of UK adults believed that auditory verbal therapy should be available to all children via publicly funded services such as the NHS.

The first years of a child’s life are critical. It is when their brains are most receptive to language and communication. For deaf children, early intervention is essential. Auditory verbal therapy enables deaf children to develop listening and spoken language skills and equips them to thrive alongside their hearing peers. With AVT, 97% of deaf children without additional needs achieve age-appropriate spoken language within two years. That is the transformation we seek. It is not a big ask, but it has giant implications for the impact that AVT can have if we can reach that whiteboard moment and have civil service teams working with experts to bring this therapy into NHS early years programmes. It is preventive healthcare at its best: cost-effective, compassionate and life-changing.

For someone who learns that their child is deaf, navigating this new world is disorientating and complex, and they will feel unsure. It is also the moment where we should ensure that parents learn that there is a therapy that could help their child to communicate on a par with their hearing peers. The option of AVT should be as freely considered as learning to sign, and traditional or developing means.

Withholding this therapy after people have learned of its existence cannot remain the position, yet learning of AVT only to be told that it is unavailable, unaffordable or simply not an option where someone lives is the reality for far too many families. With only 33 certified auditory verbal therapists across the UK, access to AVT is exclusive and rare. Most families will never hear of it. By removing the barriers, we can give parents and their children the opportunity to decide for themselves. That means training more therapists—supported by Government bursaries—to meet growing demand, building regional hubs, expanding telepractice services so that no family is left behind, and raising public awareness to ensure that families know that AVT is an option.

If the heart of the argument does not move us, the head can. This therapy means economic growth and a sound investment in families’ futures and ours. This cause is transformational for not just them but the economy. For £2 million annually—a fraction, or a rounding error, when it comes to the NHS budget—we could ensure that thousands of deaf children access AVT. According to independent economic analysis, this investment would unlock £11.7 billion in benefits over 50 years, and here is how. We would reduce education costs, as early intervention means less reliance on one-to-one support, saving £3.4 billion. We would increase employment, with confident, independent deaf adults contributing £1 billion to economy. And we would improve quality of life, with thriving, independent individuals generate £4 billion in societal benefits. Without early intervention, the costs are far greater. Delayed support leads to unfulfilled promise or potential, higher unemployment, mental health challenges and long-term reliance on public services.

The new Government have wasted no time identifying waste to be cut from their spending. The Cabinet Office has pledged to reduce the £7 billion per year spent on consultants. Official analysis found that total spending on consultancy in 2022-23 was £1.2 billion, with the Department of Health and Social Care among the highest spenders, at £281 million. I share this Government’s instincts: the money saved must now transform the lives of those accessing AVT. Does the Minister agree?

For just £2 million a year, we can train more specialists in order to remove the barriers to opportunity, expand access through the NHS and ensure that every family makes informed decisions. We are not asking for those decisions today, but for a commitment to start this journey and to draft a plan that takes us from this underserved system to one that provides choice and opportunity for every deaf child and their family. With parents given every option to choose for them, their children are given the best chance to thrive. When all deaf children thrive, our society is stronger, more inclusive and more prosperous. This underserved issue can benefit from the Government’s mission to transform. As the campaign says, “Hear Us Now.”

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[The Minister for Care (Stephen Kinnock)]

It is a great pleasure to serve under your chairship, Mr Western. I thank my hon. Friend the Member for Washington and Gateshead South (Mrs Hodgson) for securing this vitally important debate, and for her powerful and moving contribution to our discussion.

I would also like to break with protocol and welcome Sam to Parliament today. He is clearly a remarkable young man, and an inspiration to us all—thank you for being here, Sam. Like the shadow Minister, the hon. Member for Hinckley and Bosworth (Dr Evans), I thank hon. Members for their excellent contributions today. We have had a range of contributions, including from the shadow Minister, and from the hon. Members for North Shropshire (Helen Morgan) and for Strangford (Jim Shannon), and my hon. Friends the Members for Bury North (Mr Frith), for Bolton North East (Kirith Entwistle), for Derby South (Baggy Shanker) and for Bolton South and Walkden (Yasmin Qureshi). I think that may be all, but huge apologies if I have missed anybody. All their contributions were excellent and very well put.

My hon. Friend the Member for Washington and Gateshead South has done so much work to champion the interests of children with special educational needs and disabilities, including non-hearing children. I know that she also has an excellent partnership with Auditory Verbal UK, which I welcome to Parliament today. I would, of course, be happy to meet its representatives to follow up on all the points made in this debate.

This Government are committed to raising the healthiest generation of children ever. We will deliver on this ambition through the health and opportunity missions, and through the Government’s child poverty strategy. This is not about silos, with each Department delivering one part of a puzzle that does not fit together properly; this is about systemic, holistic change, and ensuring that we join up analysis, expertise and delivery across Government. Our mission-driven Government will drive long-lasting and sustainable change for children now and in the future. We will break down barriers to opportunity and ensure that every child has the best start in life. This includes all children and young people with special educational needs and disabilities, including non-hearing children.

We know that developing early communication skills is a key foundation for life, and there are serious knock-on consequences when that development is delayed. That is why we are committed to improving access to early interventions so that every child can find their voice. With the right support, children with hearing loss can develop effective communication skills, live fulfilling lives and enjoy the same opportunities as everyone else. The Government recognise the importance of the earliest days of an infant’s life. There is strong evidence that the 1,001 days from conception to the age of two set the foundations for our cognitive, emotional and physical development. That is why we are giving a £126 million boost for families to give every child the best start in life.

Thousands of families across England will be able to access family hubs, which will act as a one-stop shop for help with infant feeding advice, parenting classes and perinatal mental health support, among other things. Figures from the National Deaf Children’s Society show that there were more than 45,000 deaf children and young people in the UK in 2023. Between one and two babies in every 1,000 are born with permanent hearing loss in one or both ears. This number increases to about one in every 100 for babies who have spent more than 48 hours in intensive care. Early and effective support is crucial for these children and their families. Permanent hearing loss can significantly affect a baby’s development, so early and effective support is crucial for these children and their families.

It is vital that we intervene at birth. The NHS newborn hearing screening programme—the NHSP—aims to find babies who have hearing loss as early as possible so that the right support and advice can be offered right from the start. As we all know, language is linked to social, emotional and learning outcomes. From birth through to childhood, children and young people with hearing loss might need a range of therapies, such as speech, language and auditory verbal therapy. However, as we have heard today, those children are not always receiving the support that they need.

We recognise the important role of auditory verbal therapy as one of the therapies that can be useful for children with hearing loss. NHS audiology services, including the provision of therapies for children with hearing loss, are locally commissioned, and responsibility for meeting the needs of children with hearing loss lies with local NHS commissioners, because local systems are best placed to meet the needs of their own communities.

After 14 years of Tory neglect, incompetence and austerity, our NHS and care service are on their knees, but this Government are committed to properly funding the NHS, and we recently provided a £26 billion boost for health and social care in the autumn Budget. NHS England is responsible for determining allocations of financial resources. Each ICB will then commission the services they need for their local area, taking into account their annual budget, planning guidance and the wider needs of the population they cover. NHS England is supporting integrated care boards to make informed decisions about the provision of audiology services so they can provide consistent, high-quality and integrated care to non-hearing children.

In July 2016, NHS England published “Commissioning Services for People with Hearing Loss: A framework for clinical commissioning groups”. The framework supports NHS ICBs to make informed decisions to address inequalities in access and outcomes between hearing services.

[Mr Frith]

Does the Minister agree that, for all the good intentions of ICBs, our healthcare system is atomised, but that if they were to take instruction from guidance provided nationally, the pillar-to-post experience of a lot of families seeking auditory verbal therapy would end? Will he commit to updating the nine-year-old guidance to ICBs, or at least acknowledge that it needs updating, with a national pilot that proves the efficacy of AVT for families seeking that intervention?

[Stephen Kinnock]

My hon. Friend will know that one of the constant challenges in the system is getting the right balance between empowering those operating at the coalface—those who are close to the communities and know them best—to ensure they are delivering the best possible services, and ensuring consistency and coherence, both strategic and operational, across the entire system. It is safe to say that we are not always getting that balance right. One of the key objectives of the 10-year planning process that we are going through will be to address the so-called postcode lottery—variation between regions—across the whole range of health and care. Without that cross-cutting strategic look at the system, it will not be possible to get the balance right. I absolutely take the point, but one thing I will say is that we are crystal clear when we issue guidance to ICBs that they must take that guidance into account, and their performance is monitored on that basis.