Speech Therapy Services (Children)

Paul Maynard Excerpts

Wednesday 3rd November 2010 Westminster Hall

[Paul Maynard (Blackpool North and Cleveleys) (Con)]

Thank you for calling me to speak in this important debate, Mr Streeter. It is important because of the very large number of children in this country who require speech therapy to make the most of their lives. I am delighted that the Minister is able to join us today and apologise for dragging her away from the important work of putting together the Green Paper that we anticipate. I pay tribute to the personal interest she has shown in the matter not only since getting her job in government, but when she was in opposition.

I will not start by reciting the usual litany of depressing statistics associated with speech and language therapy as my opening gambit, which would be a little predictable. Instead, I will start by paying tribute to the work of some of the charities involved and to the previous Government. What we have today is the end result of a process. It started with a charity called I CAN, which ran the campaign, “Make Chatter Matter”, and spent three years building awareness among politicians, such as us, about the importance of speech and language communication. That led to the Bercow review, the better communication action plan—brought forward by the previous Government—the appointment of Jean Gross as communications champion and the designation of 2011 as the year of speech, language and communication.

We are part way along an important journey that was initiated by the previous Government and then taken up by the current Government. That is why it is really important to pay tribute to the fact that a Green Paper is now coming forward. Among all the organisational changes that we are planning in public services, I am delighted that the Government have found space in their schedule for a Green Paper on the important issue of special educational needs. It is a welcome opportunity to entrench greater choice for parents, earlier identification of the needs of those with speech and language difficulties, more tailored support and improved transition services, which I believe are so important.

Clearly, there is still work to be done. There is an organisation in the north-west called speechbubble.co.uk —why they have to add “.co.uk” to everything these days, I do not know—which works in my constituency and many others in the region to encourage better quality speech and language provision. In its survey of SEN co-ordinators, it found that more than half had never heard of the Bercow report and were not even aware of that ongoing process.

Members must forgive me, for I will now embark on a bit of a shopping list of issues that I think still need to be considered in the Green Paper. Given the time available and the number of Members who wish to speak, they will have to forgive me if it turns into something like an episode of “Supermarket Sweep”, rather than a shopping list. I will do my best not to lose coherence.

It is crucially important that I pay tribute to my own speech therapist, Mrs Williams, who saw me for four years, between the ages of five and nine, to help me learn to communicate better. It was only when I was preparing for the debate that I began to think about what she had taught me, as I never really thought about it at the time. She was not teaching me to make a noise or how to speak, but how to communicate and get my message across. There is often a misconception that speech and language therapy is about putting stuff into people’s minds so that they have something to say. There was plenty going on in my mind—far too much, actually—so my mouth could not keep up when I was trying to express it all. She taught me to slow down and not to panic, stammer or trip over myself. Although that is not always ideal within a parliamentary setting, when one might have a six-minute speech limit, it is still a useful lesson today. There is no need to rush. Just because one has things to say, one does not need to get them all out in 30 seconds.

[Mr Adrian Bailey (West Bromwich West) (Lab/Co-op)]

I congratulate the hon. Gentleman on securing the debate. Unfortunately, I will have to leave before the end to attend a meeting, which I apologise for. He rightly paid tribute to the work of his speech and language therapist. Does he agree with me that it is important that all levels of the Government work with the Royal College of Speech and Language when developing their policies in that area so as to maximise the potential benefit they can get from it?

[Paul Maynard]

I thank the hon. Gentleman for his intervention and agree entirely. Our speech and language therapists are a much underused resource, and as time moves on they will be in much more demand. A report shortly to be published by the International Longevity Centre will tell us how, with the growing incidence of Alzheimer’s and the difficulties that adults with communication problems will face, the pressure on speech and language therapists will increase far more.

[David Simpson (Upper Bann) (DUP)]

I, too, congratulate the hon. Gentleman on securing the debate, and I congratulate the work of speech therapists. One issue that we have found in Northern Ireland relates to recruitment; perhaps he will comment on it. We find that of the 15 or so young ladies—it is predominantly young women—who start the course in college, only four or five are left trying to finish the course at the end of the year. The therapists do fantastic work, but there is a concern about the provision, and I would be interested to hear his comments on that.

[Paul Maynard]

I thank the hon. Gentleman for an interesting contribution, which highlights a problem that covers so many areas of medical training: what comes in at the beginning does not always come out at the end. We have to support those who are making a commitment to public service.

It is worth noting that speech and language therapists play an immensely important role across a wide range of areas. In the youth justice system, for example, the offenders are children, although we often do not think of them as such. The work that speech and language therapists do within young offender institutions is vital in reducing reoffending rates and crucial for improving life chances. The Children’s Communication Coalition made an interesting comment in its June 2010 report:

“The true costs of not supporting children with speech, language and communication needs—above and beyond those that are measurable in direct financial terms—are very great indeed. The personal and familial costs of poor educational attainment, descent into criminality and long-term exclusion from the mainstream are hugely significant and potentially corrosive to society at large. Poor educational outcomes often lead to poorly paid jobs or unemployment. In turn, this can lead to a perpetuation of the poverty trap and a vicious cycle of health problems and health inequalities”.

In a sense, that could sum up the entire debate in 30 seconds, and I could just sit down. It covers everything we need to be concerned about.

[Nick Smith (Blaenau Gwent) (Lab)]

I congratulate the hon. Gentleman on securing the debate. Does he agree that communication competency needs to be a key performance indicator, along with literacy and numeracy, in our schools?

[Paul Maynard]

I agree entirely. The hon. Gentleman has anticipated my next point. Speech and language therapists are there not just to help children, but to help the entire children’s work force understand that communication needs to be the golden thread running through everything they do. They need to be equipped to train staff, teachers and others who work with children, as well as the children themselves. I ask the Minister to confirm that she will do all she can to ensure that we recruit more speech and language therapists to meet the unmet needs that are out there.

The better communication action plan made a specific commitment to universal screening as part of the healthy child programme. Many major bodies, including the Royal College of Speech and Language Therapists, which I suspect has managed to get many supporters to attend the debate, wants to see that occur at age two and five, in advance of the reading assessment. What steps will the Minister take to ensure that that aspect of the action plan is taken into account?

Another important aspect that is often overlooked is that when we discuss children’s speech therapy we often think of those aspects that are what I describe as being high incidence, but low need. In other words, many children face communication difficulties, such as language delay, but their support needs are actually quite low. There is a much smaller group, which has much more complex needs, but the incidence of that need is relatively low. That poses a particular problem in commissioning. I wonder what the Minister’s views are on how we balance those two competing aspects, because where there is low incidence but high need, it is often more of a health intervention, rather than an educational intervention, that is required.

[Jim Shannon (Strangford) (DUP)]

Just this last year, I witnessed what I can only describe as the transformation of a young boy from being unable to communicate to being able to talk quite clearly within a matter of months, so I have seen at first hand the work that can be done. One of our concerns, which is shared by many people who look after young boys and who try to train them, relates to the financial provision. In relation to the comprehensive spending review cuts that have been made and how they will affect provision, does the hon. Gentleman agree that the front-line service of speech therapy should be retained and that people should know that the moneys are there for young people?

[Paul Maynard]

I thank the hon. Gentleman for his intervention. I agree entirely. That is why we say continually that the most vulnerable are those that really should be protected, and front-line services will be protected.

Whenever we try to abolish quangos in particular, we can always find one saving grace in every quango that gives us a justification for keeping it. With Becta, which provides educational technical equipment, one of the saving graces was the work that it did in the augmentative and assistive communication sector—AAC for short, to save me a bit of time. Can the Minister confirm whether the funding that was originally to go through Becta to the AAC sector will still go to it to fund not just the specialist provision of AAC equipment, but the leadership roles in the sector? That is another part of the better communication action plan that I hope will be continued throughout the year of speech, learning and communication in 2011. Will she also commit to re-examining the issues of provision in the AAC sector? She may not be aware of the problems facing the ACE—Aiding Communication in Education—centre in Oxford, which faces closure as a result of some of the changes in that charity and the funding of the wider sector.

Will the Minister support the proposals from the communication champion, Jean Gross, for a new AAC commissioning model that reflects the differences between high incidence, low need, and low incidence, higher need, which are crucial to a proper appreciation of the sector’s needs?

I said that I did not want continually to go in for shocking statistics, but let me give just one, which is that 55% of children in the more deprived areas arrive at primary school with some form of language delay. That does not necessarily mean that there is anything going on; it just means that they are delayed in the formation of basic skills. That happens for a range of reasons, but often it can be something as simple as mum and dad not talking to them when they were babies.

Booktrust, a charity of which many hon. Members may be aware, does fantastic work in more deprived areas just by handing out bags of books to young mums to encourage them to read and by saying to young dads, “It’s a good thing to sit down with your young child and read them a story. Don’t just watch the football match. Read “Peppa Pig” or whatever children’s literature you happen to have to hand; it helps your children.”

Can the Minister confirm, in light of the CSR, that the very important funding that Booktrust receives from the Government, which allows it to access £4 of private funding for every £1 of Government funding, will continue in order to help us to deal with that language delay and gap in the most deprived areas? That is just one example of the philosophy of early intervention, which is gradually receiving unanimous, all-party support as a principle. What it means in policy terms often varies greatly, but the principle of early intervention is now accepted by all in the House, I hope. It allows us to escape the departmental silo thinking that has bedevilled public policy formation in this country for far too long.

How does the Minister think that the pupil premium, which both coalition parties advocated pre-election, will benefit children requiring speech and language therapy at the moment? In particular, does she agree on the importance of appropriate diagnosis and that improving the quality of diagnosis might lead to fewer children being diagnosed as having special educational needs? Does she recognise that one goal of speech, language and communication therapy must be to take pupils off the SEN register because their language delay has been dealt with, the gaps have been filled and they are now able to participate fully in society? I ask that because there is a particular problem with stigmatisation.

Even 30 years ago, when I had speech therapy, I was taken out of my primary school and transported down to the village health centre. I was regarded as different—special—because I had to be taken out. That was 30 years ago; one would like to think that things had moved on. Unfortunately, the stigma is still there. I urge the Minister to ensure that more and more services can be delivered in the school setting and do not require the pupil to be stigmatised, or made to look different or special.

Let me explain one way of doing what I have described. At Fleetwood high school, in the constituency of Lancaster and Fleetwood, which neighbours mine, children with special educational needs are dealt with under the same umbrella as those who come under the gifted and talented scheme. There is not such a difference between them as one might think, because very many people with special educational needs, and in particular speech and language needs, are also very gifted and talented young men and women. The two are very often the same group. I urge the Minister to consider how such an approach can reduce stigmatisation.

I warmly welcome the ambition of the forthcoming Green Paper to equip parents to have more choice in and more say over how their children are treated by the “system”. One of the grave frustrations of so many parents whom I meet in my advice surgeries—and, I am sure, those whom other hon. Members meet in their surgeries—is that when they take their children to the office of the relevant public organisation and sit down to have a discussion about their child’s needs, they immediately find that there is a form before the public servant in front of them and they are then forced somehow to adjust their child’s needs to fit the existing boxes on the form. If their child’s needs do not quite fit, there is a problem; they do not quite get the tailored support that they need.

Can the Minister make any suggestions about how we start to change the tick-box culture? I think that this is the most crucial question in public policy at the moment: how do we get away from a situation in which services are designed for people to fit into and move to a situation in which services are designed to fit around the needs of the individual? That is important.

[Alun Cairns (Vale of Glamorgan) (Con)]

I congratulate my hon. Friend on securing the debate and on the contribution that he is making. He refers to the Green Paper. Does he share my concern about the risk to the statementing procedures posed by the potential withdrawal of the rights that currently apply under those procedures? An example of the importance to the statementing procedures of speech and language therapy is that 10% of cases at the special educational needs tribunal arise as a result of deficiency in speech and language therapy provision in schools.

[Paul Maynard]

That is a very important statistic and I thank my hon. Friend for making his intervention. I hope that it will be borne in mind that we have to get the process of diagnosis right. There is no point in merely diagnosing children with special educational needs as a shortcut to fulfilling some target in a back office somewhere. The system must be designed around the needs of each individual child.

Finally—as I am sure everyone will be pleased to hear—and most importantly, my biggest concern about the Green Paper is the fact that so much of what we shall require will have to come from the Department of Health as well as the Department for Education. My big fear, based on observing 20 years of public policy in this country, is that getting Departments to talk to each other, to sing from the same hymn sheet and to work to the same agenda is perhaps the hardest task in government. It is not enough just to have the smiling, happy faces of two Cabinet Ministers at the bottom of the introduction page of a Government document. There needs to be an alignment of strategic priorities, close partnership working and agreement. Can the Minister confirm what joint working is occurring with the Department of Health and how the plans for NHS reform, academies and special educational needs will coalesce seamlessly? That is the real challenge.

I do not want to go back into the statistics, but so many children are struggling at school through no fault of their own but merely because their needs have either not been identified or not catered for adequately. Too many children are trapped. It is a form of social exclusion that they are not able to participate fully in society. I strongly welcome all that the Minister is doing in this field, and I urge her to continue her work. I look forward to seeing the Green Paper, as I am sure many other people in the sector do, and I look forward to hearing the Minister’s answers to my questions today.